When did you decide what specialty?

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freedoctor17

freedoctor17

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For current med students/residents/docs. At what point did you decide which type of residency you wanted to match to? I've never really thought about anything other than primary care but with seeing all these threads on specialties I'm interested to hear about this.

Do a lot of people intending on primary care end up switching during med school? Or is that usually just people interested in a specific specialty?
 
Current MS4 who is currently going through the match. I came to a final decision during M3, but my field of choice changed drastically from what I expected.

Going into med school I was 95% sure I wanted to do ortho. After about a semester of realizing med school was way more work than I expected, realizing residency was even worse, and then realizing that ortho was one of the longest training periods, I changed my mind to either FM or PM&R (wanted to do sports med) and went into 3rd year feeling that way. Early on I had a pscyh rotation and absolutely fell in love with it. Did an elective later 3rd year to make sure it wasn't just the attending or hospital that I enjoyed so much and it just confirmed that I would pursue psych.

My advice looking back is to go in with an open mind with the expectation that you'll be trying to match into something extremely competitive like derm or neurosurg. That way if you end up changing your mind all your options will still be available.
 
Stagg737 said:
Current MS4 who is currently going through the match. I came to a final decision during M3, but my field of choice changed drastically from what I expected.

Going into med school I was 95% sure I wanted to do ortho. After about a semester of realizing med school was way more work than I expected, realizing residency was even worse, and then realizing that ortho was one of the longest training periods, I changed my mind to either FM or PM&R (wanted to do sports med) and went into 3rd year feeling that way. Early on I had a pscyh rotation and absolutely fell in love with it. Did an elective later 3rd year to make sure it wasn't just the attending or hospital that I enjoyed so much and it just confirmed that I would pursue psych.

My advice looking back is to go in with an open mind with the expectation that you'll be trying to match into something extremely competitive like derm or neurosurg. That way if you end up changing your mind all your options will still be available.
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Wow what a change! I've been thinking pediatrics recently just from my shadowing and volunteering but I also have a very narrow field of experiences so I won't be surprised if something else grabs my attention. I'm not really interested in any of the super competitive specialties, especially those with a training period of more than 3-4 years after med school. No neurosurgery for me lol.
 
freedoctor17 said:
At what point did you decide which type of residency you wanted to match to?
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I was dead set on Internal Medicine through college and into the MS-3 year, but then I did my Pediatric rotation and was attracted to that field. After some additional electives to test the waters, I stuck with Peds. No regrets.
 
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freedoctor17 said:
Wow what a change! I've been thinking pediatrics recently just from my shadowing and volunteering but I also have a very narrow field of experiences so I won't be surprised if something else grabs my attention. I'm not really interested in any of the super competitive specialties, especially those with a training period of more than 3-4 years after med school. No neurosurgery for me lol.
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You may feel that way now, but try and keep an open mind. Even if you don't want a really long residency, you may end up wanting to pursue something like derm or optho which are shorter but still highly competitive. Just keep in mind that you don't know what you don't know, and once you get more experience in various fields you may change your mind.
 
Going into med school I was thinking radiology or neurology because of my research background (neuroscience with an emphasis on fMRI) and undergrad degree (neuroscience). However, I kept an open mind and enjoyed aspects of every rotation. Never had a big "aha" moment but I did decide, sometime near the end of M3, that the day-to-day work of radiology was more relevant to my interests and minimized the frustrating things I disliked about other specialties. That's the theory, at least.
 
Stagg737 said:
You may feel that way now, but try and keep an open mind. Even if you don't want a really long residency, you may end up wanting to pursue something like derm or optho which are shorter but still highly competitive. Just keep in mind that you don't know what you don't know, and once you get more experience in various fields you may change your mind.
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I definitely will! I realize I don't even have enough experience to know what those other specialties do lol (I've only shadowed inpeds, radiology, and cardio and even then I'm sure shadowing doesn't give you a good enough idea to decide).
 
I initially thought cardiology, then fell in love with the OR early in MS3 year and thought I'd be a general surgeon. I eventually landed in anesthesiology toward the end of my MS3 year. Since I was an HPSP student, I was part of the military match in December of my MS4 year. In my blog, I wrote about the case that really helped me finalize my decision: Gas Words: The dance.
 
I knew before I even started med school that I was going into surgery. Which kind was a whole different story. I really became fascinated with general surgery and all that it allowed a practitioner to do. Once I started residency, it didn’t take long to become introduced to and enamored with vascular surgery and now that’s where I’m headed. As always, keep an open mind. Have fun. Cheers.
 
Mine was somewhat reverse engineered and chaotic.

Went in thinking Gen Surg, was my first rotation out of pre-clinical and was off my list quick. Anesthesia and PM&R stood out to me early on during rotations and then late-MS3 I did an ortho rotation and really enjoyed it. I did some sub-I early MS4 and as much as I enjoyed it and loved the OR I missed you know...medicine.

Ran with anesthesia and now being at tail end of intern year I know I made the right choice. For those who love the OR and Medicine in general (and hate rounds ) it’s a win-win.
 
Thought cardiothoracic surgery entering med school; those television medical shows can really glamorize the surgical specialties. Did vascular and renal transplant surgical rotations during MS3/MS4. Turned out I hated the long days and after my first operation found it boring being in the OR. Needed some mental challenges so decided on cardiology. It was my plan till a month before submitting fellowship applications. Was asked to do A/I - had always found immunology fascinating and looking at an easier lifestyle that this subspecialty offered convinced me.
 
Hey! I’m a current MS4 hoping to match into OB/GYN next week. I went through a lot of different stages/phases in imagining which specialty I wanted to enter. I started out (like many) wanting to end up as a cardiothoracic surgeon, and I totally agree that the glorification of surgery as a specialty in media was a big reason it appealed to me before I knew anything about what a life in surgery would actually be like. I also entertained emergency medicine as a specialty in my pre-clinical years, as I was an EMT back in the day.

For me, the clinical years were the turning point (specifically my 3rd year). I tried to envision myself working in each specialty as I rotated through to see what felt right. It’s easy to be interested in certain things early on before you actually see what living a life in that specialty would be like; I’m talking hours, pay, procedures vs. no procedures, etc., but also the intensity of “the hierarchy” as well as the personality and culture that comes with each specialty and whether I fit in with the types of people drawn to that area.

Eventually, it became clear that the area I was most passionate (read: invigorated me even after long, hard days) was women’s health. I enjoyed making informed decisions quickly without talking everything to death (sorry, medicine) and also being able to have the option to definitively/surgically manage my patients without necessarily sacrificing the ability to practice clinic-based primary care. The social justice and advocacy component of OB/GYN always called to me as well, and it feels very empowering and meaningful to (hopefully) be able to be a provider and a protector of women’s health care as an future physician.
 
Was a gradual journey until I found the exact right spot, then it was fast.

Started out thinking Peds Ortho or Peds ENT, with some sort of peds medical specialty (GI and cardiology were considerations) as a distant third option

Combination of not loving the OR (most of it), culture of surgery, and scoring at the mean for Step 1 put me squarely into peds.

Loved my IM clerkship and so was planning on applying to some Med-Peds programs along with straight Peds, with the thought that if I did Med-Peds I'd actually look to do a dual fellowship in adult and pediatric pulm or adult congenital if I went into cardiology...was thinking med peds enough that I did a medicine sub-I in July of M4

In August of M4 did an away rotation (mostly to hang out with one of my best friends, rather than for any sort of clinical experience), ended up in the PICU...and that was it. Combined everything I wanted and needed from a medical career in one place. Dropped any plans for med-peds, looked at residency programs specifically based on their critical care divisions and how many people went into PICU fellowships. As a resident, only wavered slightly in the 2 months before I started my first PICU month, just to hedge my bets in case I was disappointed and didn't love it as much as I had, but 48 hours in, I knew it was right. Now about to be 3 years out of fellowship and can't imagine doing anything else.
 
Thanks to the OP for starting this! I, too, am having a difficult time thinking through specialties (even though I matriculate this year and certainly don't have to decide, yet). Extensive shadowing with one doctor led me to love both longitudinal care and the OR, so I imagine I'll try to go for some specialty that has a combination of both, but I'm very open to changing my mind. I love reading how others considered different specialities - and how many changed their minds after seeing different aspects of care.
 
Just curious: were some of these switches made because of performance on STEP? Or more "I could if I want to but I realize I hate it" type of thing?
 
buckoh24 said:
Just curious: were some of these switches made because of performance on STEP? Or more "I could if I want to but I realize I hate it" type of thing?
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Personally, I had a step score and grades high enough to do whatever I wanted. I just realized that what I originally thought I wanted to do wasn't really me. Plus I had a rotation at the place I ended up doing residency at that was amazing and pretty much sold me on the whole EM thing. No regrets thus far.
 
I had some specific interests going into med school, but I was more than a little interested in emergency medicine, but it was at the end of my first shift of my first emergency rotation that I knew 100% that I wanted to be an emergency physician. Literally, the only time I’ve been more “in love” is with my wife.
 
buckoh24 said:
Just curious: were some of these switches made because of performance on STEP? Or more "I could if I want to but I realize I hate it" type of thing?
Click to expand...

It was a consideration in my decision making but I was already not loving the OR, was seeing how difficult the personalities in surgical fields could be, and not feeling like I was a good fit. Getting my score back basically was the absolute final nail in the coffin that was already being lowered into the ground.
 
I decided on radiology at the beginning of 4th year. Seriously, I think I considered close to every specialty during my third year. I was freaking out because it seemed like almost everyone knew what they were applying for already, had letters lined up, etc. Realized that I would likely be happy in any specialty I picked. Thought Radiology would fit me well given the breadth of knowledge needed of each specialty, all the “interesting” cases almost always get imaged in some manner, all the different procedures you can do, especially with IR, so I just went for it. Find out next Friday where I match!
 
Went into school and M3 year thinking IM ... did not enjoy my experience. Then thought neurology, psych, and then FM .. did peds rotation at the end of 3rd year and found I was actually enjoying going into work ... children can be absolutely hilarious and in my experience to date the majority of parents are super appreciate of what you do for their kiddos (got really sick of ungrateful patients on medicine just yelling at us all the time). Also, I feel like compared to medicine it's a lot more laid back overall.

Decision for peds was reaffirmed when I saw a ton of the staff dressing up on Halloween :pirate:
 
Oso said:
”did peds rotation at the end of 3rd year and found I was actually enjoying going into work”
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I did peds as my first MS3 rotation and as a fresh new clinical noob found the experience intimidating so peds was out as a career choice. Ironically it came back into my life since A/I covers all ages, being a combined ABIM and ABP specialty.
 
Catalystik said:
I was dead set on Internal Medicine through college and into the MS-3 year, but then I did my Pediatric rotation and was attracted to that field. After some additional electives to test the waters, I stuck with Peds. No regrets.
Click to expand...

In fairness inpatient peds is IM for kids.
 
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