When did you know you wanted to specialize?

[DennisReynolds]

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What's up SDN.

4th year on the interview trail for IM right now. I ended up choosing IM simply due to process of elimination and was impressed with the numerous avenues you can go after getting licensed in IM... especially when it comes to fellowship.

My question for you folks is WHEN did you know you wanted to specialize or pursue fellowship? If you didn't choose to specialize, are you happy doing general IM?

Appreciate the input!

 

[InvestingDoc]

Well, I started out die-hard wanted to be a vascular surgeon when I entered medical school ( I had no exposure to medicine other than PCP and vascular surgery).

M3 said F that surgery and the hours and fell in love with cardiology and wanted to do interventional cards around M3 early M4.

After intern year fell in love with general medicine and decided not to specialize.

I was a hospitalist for almost 3 years then transitioned to primary care.


I think of specialties much like falling in love. It happens at different speeds and at different ages for us all and that's okay. Don't worry about it and enjoy the ride brother

 

[bronx43]

Like many other male internal medicine residents, I was gungho cardiology until end of second year, when I couldn't see myself getting called at night for afib or abnormal ECGs, let alone have to drive in for STEMIs. Did hospital medicine for about a month then decided to do fellowship in rheumatology. There are certain struggles with this field for me, but the hours are unbeatable and the job prospects are solid.

 

[aafisahar]

knew ever since M1's cardiovascular block that I wanted to be a cardiologist and now I'm in cardiology fellowship.

 

[Eyeronic]

When did you know you wanted to specialize?

PGY-1, July 1st at approximately 5:45am.

 

[DennisReynolds]

I appreciate all of the replies so far.

I've been feeling some type of actual "void" because for the first time in my life... I don't have any actual "PLANS" for my life. I went into 3rd year and went into each rotation with eyes wide open to see what kind of doctor/attending I wanted to be.

Surgery - Hated the hours, hated the life the attendings lived, multiple divorces, hated the OR personnel and their crappy ass attitude every single day. Hated scrubbing in and out. Gallbladders, gallbladders, and more gallbladders. WTF.

Peds - Hated the parents. Hated explaining to people with 5th grade education why they should stop watching YouTube documentaries and that vaccines were not a ploy for government mind control. Also... kids are nasty and hated doing physical exams on them cause they couldn't sit still.

Ob-Gyn - Same as surgery with even worse OR staff. Ob Nurses are some of the most vile, evil, rude, terrible people in a hospital. Sorry. Not sorry. Also, this sole rotation made me believe that EVERYBODY should pass a written exam in order to have children because some of the homes these kids are being brought into and the unstable relationships they are being used as a reason to be brought into the world are absolutely heart-wrenching. Loved the women's health aspect and made me appreciate women and their body a lot more and made me appreciate the privilege that men have.

Psych - I didn't feel like an actual doctor. Yes, you can make bank... but at what cost? Being yelled at, threatened daily, almost sucker punched by schizophrenics and manic-depressive folks and having to hold people in the inpatient unit on 5150 and rewording my HPI just so it can fit what medicare and the government will bill for? Seriously? Put them back on their meds and medicate the snot out of them and then once homeboy leaves the unit, he'll be back in a few weeks/months doing the same stuff.

It came down to FM vs. IM for me at this point and here we are.

I am blessed to have really minimal loans at this point in my life but also want to be able to make sure I take the right step in the right direction with my degree and my life.

Kinda wish I just looked into more fields... did fall in love with neurology a week before applications were due and after my application was submitted.

I guess a fellowship in OPP, with a cash-based practice on the side like some of our faculty do isn't too far-fetched while working for one of the new DO schools opening up in the pipeline to cash in on the demand.

Or go into the administrative side after residency.

The options are endless.

All jokes aside, I'ma just take it day by day. Appreciate you letting me vent and the opinions thus far.

Keep 'em coming!!!

 

[1Cor1557]

What's up SDN

My question for you folks is WHEN did you know you wanted to specialize or pursue fellowship? If you didn't choose to specialize, are you happy doing general IM?

Appreciate the input!

My 1st inpatient ward month.

 

[JustPass]

Never

 

[jdh71]

4th year of Med school taking care of 20 year old with a nasty post flu MRSA pneumonia in the county hospital ICU.

 

[chessknt]

Based on my medical school class somewhere around preschool.

 

[CatFactorial]

Junior year in college I wanted to do stem transplantation. Will complete my heme/onc training and stem cell fellowship in about 2 years.

 

[CatFactorial]

I appreciate all of the replies so far.

I've been feeling some type of actual "void" because for the first time in my life... I don't have any actual "PLANS" for my life. I went into 3rd year and went into each rotation with eyes wide open to see what kind of doctor/attending I wanted to be.

Surgery - Hated the hours, hated the life the attendings lived, multiple divorces, hated the OR personnel and their crappy ass attitude every single day. Hated scrubbing in and out. Gallbladders, gallbladders, and more gallbladders. WTF.

Peds - Hated the parents. Hated explaining to people with 5th grade education why they should stop watching YouTube documentaries and that vaccines were not a ploy for government mind control. Also... kids are nasty and hated doing physical exams on them cause they couldn't sit still.

Ob-Gyn - Same as surgery with even worse OR staff. Ob Nurses are some of the most vile, evil, rude, terrible people in a hospital. Sorry. Not sorry. Also, this sole rotation made me believe that EVERYBODY should pass a written exam in order to have children because some of the homes these kids are being brought into and the unstable relationships they are being used as a reason to be brought into the world are absolutely heart-wrenching. Loved the women's health aspect and made me appreciate women and their body a lot more and made me appreciate the privilege that men have.

Psych - I didn't feel like an actual doctor. Yes, you can make bank... but at what cost? Being yelled at, threatened daily, almost sucker punched by schizophrenics and manic-depressive folks and having to hold people in the inpatient unit on 5150 and rewording my HPI just so it can fit what medicare and the government will bill for? Seriously? Put them back on their meds and medicate the snot out of them and then once homeboy leaves the unit, he'll be back in a few weeks/months doing the same stuff.

It came down to FM vs. IM for me at this point and here we are.

I am blessed to have really minimal loans at this point in my life but also want to be able to make sure I take the right step in the right direction with my degree and my life.

Kinda wish I just looked into more fields... did fall in love with neurology a week before applications were due and after my application was submitted.

I guess a fellowship in OPP, with a cash-based practice on the side like some of our faculty do isn't too far-fetched while working for one of the new DO schools opening up in the pipeline to cash in on the demand.

Or go into the administrative side after residency.

The options are endless.

All jokes aside, I'ma just take it day by day. Appreciate you letting me vent and the opinions thus far.

Keep 'em coming!!!

I don’t mean to judge, do you think a process of elimination has led to the void you describe? Rather than eliminate based on what one doesn’t like pursue something you want to do?

That the patients are often super sick before during and after transplant is exhausting. Patients are mostly cool to work with but there are definitely punks you have to deal with. My program like many is staffed by too many mid levels who are managing among the most complicated patients in the hospital. As an ABIM certified internist, it is more than grating to be ignored by them as they simply go to the attendings who are so far removed from
Bread and butter internal medicine that They now practice voodoo medicine.

But stem cell transplant is a remarkable therapy and nothing else has captured my attention