When do people decide specialty?

[Dr. Death]

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Just wondering because I feel like if you want to go into some specialties like Derm, Ortho, etc. you have to start day 1 of med school getting research experience. In third year you need to be scheduling electives/ auditions. I feel like I'm already behind because I don't know what I want to go into. Thank you for your responses. Also if I have misunderstood anything about this process feel free to correct me.

 

[NotASerialKiller]

You're not behind, everyone I've spoken to in med school or beyond has said that everyone changes their minds. I think there's a point relatively early on when you have to decide surgical vs non-surgical, but apart from that you certainly don't have to declare your specialty on the first day of med school.

 

[mimelim]

Just wondering because I feel like if you want to go into some specialties like Derm, Ortho, etc. you have to start day 1 of med school getting research experience. In third year you need to be scheduling electives/ auditions. I feel like I'm already behind because I don't know what I want to go into. Thank you for your responses. Also if I have misunderstood anything about this process feel free to correct me.

#1 I don't know how one can have a "feeling" about what is required to get into competitive residencies given the wealth of data out there about what people do to get into those specialties.
#2 Even if research is important, of the 13 Derm applicants who had zero research, 9 of them matched. Of those with one research project (36 applicants), 25 matched. I am in a research heavy field. The concept that you MUST do research in order to get into a particular specialty is folly.
#3 Scheduling aways is easy and not exactly time consuming.

If I had to guess...
25% 'know' what they are going into and change their mind anyways
10% 'know' what they are going into and end up going into that specialty
40% have a vague idea of what they are interested in and figure things out before MS3
15% have no idea what they are interested in and figure things out by mid MS3
10% have no idea what they are interested in and figure things out by the end of MS3 or beginning of MS4

Trying to pick a specialty before you actually see what they do day in day out is silly. Few students have extensive exposure prior to MS2/MS3, thus, for the majority of students, 'picking' a specialty before MS2/3 is a waste of time.

 

[md-2020]

@mimelim what about the people who "know" what they are going into but eventually have to realize that their scores aren't up to par? I'd imagine those are quite a hefty portion of the pie....

 

[caffeinemia]

#1 I don't know how one can have a "feeling" about what is required to get into competitive residencies given the wealth of data out there about what people do to get into those specialties.
#2 Even if research is important, of the 13 Derm applicants who had zero research, 9 of them matched. Of those with one research project (36 applicants), 25 matched. I am in a research heavy field. The concept that you MUST do research in order to get into a particular specialty is folly.
#3 Scheduling aways is easy and not exactly time consuming.

If I had to guess...
25% 'know' what they are going into and change their mind anyways
10% 'know' what they are going into and end up going into that specialty
40% have a vague idea of what they are interested in and figure things out before MS3
15% have no idea what they are interested in and figure things out by mid MS3
10% have no idea what they are interested in and figure things out by the end of MS3 or beginning of MS4

Trying to pick a specialty before you actually see what they do day in day out is silly. Few students have extensive exposure prior to MS2/MS3, thus, for the majority of students, 'picking' a specialty before MS2/3 is a waste of time.

You forgot the significant number that decide after intern or pgy 2 or 3 year of surgery that surgery isn't for them. Repeat ad nauseum with other specialities.

 

[Dr.Sticks]

You figure it on on YouTube! I decided I'm gonna be a sex doc!

 

[allantois]

When you get your USMLE score.

Unless, of course, you are going DO.. 🙄

 

[mimelim]

@mimelim what about the people who "know" what they are going into but eventually have to realize that their scores aren't up to par? I'd imagine those are quite a hefty portion of the pie....

The real answer is that nobody really knows how many people are like that. Maybe there are a fair few that didn't let anyone know they wanted to do Derm, but 'changed their mind' after they got their board scores and just don't want others to know. But, I don't think that there are that many people like that. Board scores in my limited experience don't come as a surprise to most people. I don't really know many people who's plans changed after they got their score back. They may change what programs they target, but not what specialty.