What specialty should I pursue? please advise a lost 3rd year!

[never-too-late]

HELP! I'm looking for advice. I'm in my 3rd rotation of 3rd year and suddenly I'm so confused about what direction to go for residency. Getting ready to start this year, Psych was at the top of my list. Actually really Family med/Psych or the triple board for pediatric/adolescent psych was what I wanted to do. What I really dreaded and was 100% sure I did not want to do is surgery and was pretty sure I didn't want to do IM except maybe I was interested in endocrinology. Now I'm 2/3 done with my surgical rotation after doing IM and Psych and I'm just totally lost because:
1) I absolutely hated psych and there's no way you could pay me enough money to participate in that horribly broken system.
2) Surgery is the MOST FUN! Especially ortho, I think I could replace knees all day long. And I assisted on a craniotomy: whoa! talk about life changing (patient and mine)! Not a huge fan of gen surgery, but everything else I've seen has been cool.
3) I actually really liked IM. Not sure I'd want to be a hospitalist, but I don't think I'd hate it either.

So now my head is spinning because I need to re-evaluate my residency plans. Here are my strengths (for my application):

• Non-trad student who spent my previous life as a writer, so probably can knock out a couple of good essays
• never failed anything, never had to retest, remediate etc
• I actually did really well in neuroanatomy and thought about a neurology direction briefly after taking it
• Volunteered over 100 hours for pandemic relief, including pre-vaccine caring for covid positive patients, supposedly my dean's letter is going to have a special clause about that
• Research masters degree including publications
• I'm a pretty decent interviewee: I didn't get rejected from any school where I was interviewed

Here are my weaknesses:

• So far no honors (well I don't know any of my rotation grades yet)
• I'm a pretty mediocre standardized test taker. I mean good enough to pass COMLEX level 1, and get over a 500 on the MCAT, but not good enough to have gained MD admission. I haven't taken Step 1, but I'm probably going to take it in December or January.
• I lack confidence in many places, especially in the OR when faced with an aggressively opinionated surgeon. I'm a little worried surgical residency would make mince meat out of me. I despise being "pimped" and I usually can't come up with the answer just because it makes me so nervous

Here's what matters to me:

• I don't want the worst life style
• I need to be able to pay back my loans or get them forgiven...and I'm in my 40's
• I think I would have the most satisfaction when I get to know what happened to my patients (so not a hospitalist, probably not EM)
• I really love patient interactions, even really hard ones, even if the patient is dying, even if they're in the hospital with alcoholic pancreatitis and not willing to change

I was talking to an orthopedist this week who does the first pass screening on residency applications and he was telling me that he thought, if I could get the Step score necessary, I would easily gain admission to an Ortho residency because 1) I'm non-trad, 2) I'm a woman and 3) I have a lot of interesting life experience. I was kind of shocked by that. Now that surgical specialties could make my short list (if I could survive residency), I'm just not sure what to do.

What specialty would you advise me to consider and why?

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[Starbuxian]

IM. It is pertty difficult to get into ortho being a DO and also given your feelings toward gen surg which has a lot in common with ortho.

 

[AlbinoHawk DO]

I would put my efforts into going to a primary care track IM program then be open to Rheumatology, Endocrinology, Infectious Diseases and Nephrology as a subspecialty. This way you ensure you can be at the top for clinic medicine with continuity of care and perhaps follow your own clinic patients while hospitalized, but you also have the option of doing some specialties that really lend themselves to heavy clinic (rheum or endo) or mix inpatient/outpatient (ID/Nephro) without having to give up your life to pursue them

 

[DarkHorizon]

What was the comlex I score? Any ortho research? You’re pretty late to Ortho game. Ortho gunners at your school likely getting ready from day 1. But if you have a 600 plus score and a project or two, you can go all in. Schedule 4-6 audition rotation at historically osteopathic programs. Work your absolute hardest and you might get a spot. It will not be easy by any means however.

Also, once you get a spot, be ready to work hard. Very Long hours, especially as a junior resident. That can be rough in your 40s, depending on your personal life.

 

[VA Hopeful Dr]

IM with possibility of fellowship.

 

[never-too-late]

What was the comlex I score? Any ortho research? You’re pretty late to Ortho game. Ortho gunners at your school likely getting ready from day 1. But if you have a 600 plus score and a project or two, you can go all in. Schedule 4-6 audition rotation at historically osteopathic programs. Work your absolute hardest and you might get a spot. It will not be easy by any means however.

Also, once you get a spot, be ready to work hard. Very Long hours, especially as a junior resident. That can be rough in your 40s, depending on your personal life.

my score was "pass" as the only score possibilities when I took COMLEX 1 were "pass" or "fail". We no longer get a numeric score so I have no idea where in the passing range I fell. My research is not in Ortho. This doctor (again doing first pass screening for applications to a high ranking ortho residency) said the research did not need to be ortho and in fact meaningful research in anything was all that mattered. but I'm also not totally sold on ortho either, just realizing I like surgery as long as it's not removing gallbladders all day long.

 

[lockstitch]

If I'm reading this right, it seems like you had this crisis of what to pursue because of a comment that you could get into a very good ortho programme if you tried, being non-trad and female and whatnot. While that may be true--and maybe this will turn out to be the moment you set out on a path to your true calling--it could also be completely irrelevant if you just decide that ortho is just not for you. It doesn't seem likely that you'll get the lifestyle you want, based on most programs, and it just doesn't sound like you're particularly interested in the work either, for now. Ortho might not be removing gallbladders all day long, but it would probably also become routine eventually.

I wonder if part of what's throwing you off is that someone said, "Oh, without trying too much harder, you could actually make it into something other people are gunning hard for". That is a nice thing to hear in a funny way! But just because you could, doesn't mean you really would want to. See how you feel in a few weeks.

 

[Goro]

IM with possibility of fellowship.

This is the exact advice I would give any of my advisees if they were asking me the OP's question!

 

[annoyedpsychiatrist]

Horribly broken system of psychiatry, that is a pretty big generalization. The system has a lot of issues but you can still be a psychiatrist and help a lot of people. There multiple directions you can go with psychiatry, all of which usually help people.

 

[Pmrelax]

Consider PM&R!

Good lifestyle, lots of patient interaction. Our bread and butter patient is each specialty services “can you believe what happened to xyz patient” we help those people. We get to know them and the challenges these patients face. We are applied neurologist helping with Botox for spasticity, bracing, wheelchairs. You can do joint injections and manage all ortho things up until surgery. Including ultrasound injections. Or you can round in an inpatient service and help those with a tbi, stroke, or sci injury get back home. You can make more money and do pain medicine injecting peoples backs while helping with back pain. It’s a great field that’s Ill defined, and most people don’t know what we do. But that’s a benefit if you don’t like someone else defining what your capable of.

 

[never-too-late]

If I'm reading this right, it seems like you had this crisis of what to pursue because of a comment that you could get into a very good ortho programme if you tried, being non-trad and female and whatnot. While that may be true--and maybe this will turn out to be the moment you set out on a path to your true calling--it could also be completely irrelevant if you just decide that ortho is just not for you. It doesn't seem likely that you'll get the lifestyle you want, based on most programs, and it just doesn't sound like you're particularly interested in the work either, for now. Ortho might not be removing gallbladders all day long, but it would probably also become routine eventually.

I wonder if part of what's throwing you off is that someone said, "Oh, without trying too much harder, you could actually make it into something other people are gunning hard for". That is a nice thing to hear in a funny way! But just because you could, doesn't mean you really would want to. See how you feel in a few weeks.

no: I'm having the crisis because: 1) I thought I wanted to do psychiatry and geared my entire first 2 years in that direction and it turns out I hate it. and 2) I assumed I would despise surgery so much that I would dread each day in the OR and possibly lose my lunch or pass out on multiple occasions and it turns out I really enjoy being in the OR.

The thing with Ortho is it's my favorite of the surgical specialties I've experienced, but I had totally written it off because I assumed I wouldn't be competitive, and that remains true. I did want to get a broader perspective than the 1 doctor who I assist 2-3 times per week who also happens to be attached to an ortho residency, which is why I brought that up. But I'm not gunning for Ortho, just trying to get a better picture of whether or not it's an option or if I should think about it.

 

[never-too-late]

Consider PM&R!

Good lifestyle, lots of patient interaction. Our bread and butter patient is each specialty services “can you believe what happened to xyz patient” we help those people. We get to know them and the challenges these patients face. We are applied neurologist helping with Botox for spasticity, bracing, wheelchairs. You can do joint injections and manage all ortho things up until surgery. Including ultrasound injections. Or you can round in an inpatient service and help those with a tbi, stroke, or sci injury get back home. You can make more money and do pain medicine injecting peoples backs while helping with back pain. It’s a great field that’s Ill defined, and most people don’t know what we do. But that’s a benefit if you don’t like someone else defining what your capable of.

I'll look at it: thanks for the suggestion

 

[never-too-late]

The system has a lot of issues but you can still be a psychiatrist and help a lot of people. There multiple directions you can go with psychiatry, all of which usually help people.

Agreed: but I realized it wasn't for me, and that realization didn't come lightly, I've spend the past 3 months working through this and coming to terms with it. Glad you're making a difference out there, the need is certainly great!

 

[voxveritatisetlucis]

Many physicians (not physician advisors or department heads) will say that anybody has a chance at anything because generally it’s the polite thing to do. I’m not saying you don’t have a chance but you would almost certainly need a productive research year

 

[lockstitch]

no: I'm having the crisis because: 1) I thought I wanted to do psychiatry and geared my entire first 2 years in that direction and it turns out I hate it. and 2) I assumed I would despise surgery so much that I would dread each day in the OR and possibly lose my lunch or pass out on multiple occasions and it turns out I really enjoy being in the OR.

The thing with Ortho is it's my favorite of the surgical specialties I've experienced, but I had totally written it off because I assumed I wouldn't be competitive, and that remains true. I did want to get a broader perspective than the 1 doctor who I assist 2-3 times per week who also happens to be attached to an ortho residency, which is why I brought that up. But I'm not gunning for Ortho, just trying to get a better picture of whether or not it's an option or if I should think about it.

Sorry I misunderstood! Looks like you're getting a better grasp on things too, so all the best.

 

[Angus Avagadro]

Gas or rads. Do you like anatomy or physiology? Gas has more options. Pain, cardiac, CCM, neuro, ob, etc.. Rads if you like anatomy. Well reimbursed for loan payback.

 

[BobbyKoch]

Agreed: but I realized it wasn't for me, and that realization didn't come lightly, I've spend the past 3 months working through this and coming to terms with it. Glad you're making a difference out there, the need is certainly great!

That’s fine, maybe psych isn’t for you. But to base that decision on weeks worth of a DO school psych rotation…I would hope other readers would not do the same.

 

[DO2015CA]

That’s fine, maybe psych isn’t for you. But to base that decision on weeks worth of a DO school psych rotation…I would hope other readers would not do the same.

One week regardless of any school. My psych rotation was 100% inpatient at my DO school with very sick patients.

 

[Shahzadriel]

Gas or rads. Do you like anatomy or physiology? Gas has more options. Pain, cardiac, CCM, neuro, ob, etc.. Rads if you like anatomy. Well reimbursed for loan payback.

Kind of tangential question here, I hope it's not rude to inquire within this thread... I'm pretty interested in exploring Anes/CCM as a potential specialty. How uphill is the battle for DOs going Anes? I've gotten an acceptance from RVUCOM-CO and I have an MD interview scheduled. If I'm thinking of going anesthesiology should I always prioritize MD acceptances or would I find it roughly equal coming from a program like RVU?

Thank you for any insight!

 

[DO2015CA]

Kind of tangential question here, I hope it's not rude to inquire within this thread... I'm pretty interested in exploring Anes/CCM as a potential specialty. How uphill is the battle for DOs going Anes? I've gotten an acceptance from RVUCOM-CO and I have an MD interview scheduled. If I'm thinking of going anesthesiology should I always prioritize MD acceptances or would I find it roughly equal coming from a program like RVU?

Thank you for any insight!

You should always prioritize MD but as of now anesthesia is doable as a DO. No one knows what the future holds with all this school expansion

 

[FootballAndSkiing]

Kind of tangential question here, I hope it's not rude to inquire within this thread... I'm pretty interested in exploring Anes/CCM as a potential specialty. How uphill is the battle for DOs going Anes? I've gotten an acceptance from RVUCOM-CO and I have an MD interview scheduled. If I'm thinking of going anesthesiology should I always prioritize MD acceptances or would I find it roughly equal coming from a program like RVU?

Thank you for any insight!

RVU had 14 anesthesiology matches last year, so definitely possible

 

[Ho0v-man]

Kind of tangential question here, I hope it's not rude to inquire within this thread... I'm pretty interested in exploring Anes/CCM as a potential specialty. How uphill is the battle for DOs going Anes? I've gotten an acceptance from RVUCOM-CO and I have an MD interview scheduled. If I'm thinking of going anesthesiology should I always prioritize MD acceptances or would I find it roughly equal coming from a program like RVU?

Thank you for any insight!

No matter the specialty, always pick usmd

 

[Postictal Raiden]

I second PMR. It has enough Neuro and Neuro anatomy to satisfy the itch, it’s very procedural (but mostly low risk procedures), lifestyle is great, money is above average, and it is not terribly competitive.

 

[MDMechEngr]

Kind of tangential question here, I hope it's not rude to inquire within this thread... I'm pretty interested in exploring Anes/CCM as a potential specialty. How uphill is the battle for DOs going Anes? I've gotten an acceptance from RVUCOM-CO and I have an MD interview scheduled. If I'm thinking of going anesthesiology should I always prioritize MD acceptances or would I find it roughly equal coming from a program like RVU?

Thank you for any insight!

See Step 2 scores for anesthesiology Match. It will not be equal coming from RVU. Good luck on your interview and I hope you get the A.