When to decide on a specialty?

[Amxcvbcv]

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Forgive me if this should go in a different forum. Since I'm still pre-allopathic I felt it should go here.


When did you or do you think you'll decide on a specialty? I ask because I don't think I've gone about it the right way, if there is such a thing. Now I realize I am free to change it as I see fit, so play along a bit with your thoughts and discussion.

Here's my situation:

When I originally decided I wanted to be a doctor I didn't even know there were specialties. I didn't particularly care, either. I was young, naive, and full of dreams... Or something like that. 😛

Random person/family member: "What do you want to do with your life?"

Me (pre-college/early college days): "I want to be a doctor!"

Random person/family member: "That's great! Good luck!"

As I've gone further down the road to medical school people start getting more specific. The question showed up in conversations with practically everyone and particularly with the interview committees I had the pleasure of visiting last year, both pre-med and at my chosen medical school.

Concerned other person: "You want to be a doctor? What kind?"

Me: "Well, I haven't given it a lot of thought, but I'm interested in radiology in particular as well as family practice and internal medicine."

Concerned other person: "That's good..." (And in the case of interviewers this is when they'd start writing)

So, it turns out one of the reasons I got rejected last year is that I expressed an interest in radiology yet I had no substantive experience shadowing radiologists.

So I reiterate my question:

When did you decide or when to you think you'll decide? Pre medical school? 1st year? 4th year? As you fill out the ERAS? I cannot say with any kind of certainty what kind of doctor I will end up being, so I felt kind of betrayed that a trivial decision at that point in my life caused me such difficulty. I've decided that I like radiology the most, but I haven't spent one day in a medical school class nor on clinical rotations? How could that "decision" carry any kind of weight?

Let me know what you think - I hope my post is cogent.

 

[drguy22]

i think thats whats all the 3rd and 4th year clinical rotations are for...you get a taste of everything and then in the end you get to choose wat u want i guess....anyone correct me if im wrong...its kinda like buying a car....you dont go "oooo.... i like..... buy buy buy" u gotta test drive it first.

 

[stinkycheese]

As much as any pre-med thinks they know exactly what they want to do, they will change their minds more times than they can count (even if just transiently) before putting down that rank list during fourth year. Some people even rank more than one specialty. You're not supposed to know now. However, I do think its dick of a school to hold the radiology thing against you since it's just an interest and you're not committed to it yet. Maybe they used that as one factor in why you didnt get in, but hopefully it didnt play too much of a role.

 

[Amxcvbcv]

However, I do think its dick of a school to hold the radiology thing against you since it's just an interest and you're not committed to it yet. Maybe they used that as one factor in why you didnt get in, but hopefully it didnt play too much of a role.

I know there was more to it than that, but in all fairness they did mention it in the re-applicant's workshop I attended last Spring.

 

[UseUrHeadFred]

Great question. I'll give you my anecdotal opinion.

First thing to realize: This is an unfair situation. People who know what they want to do early on - and follow up on it - have an enormous advantage.

A lot of medical students decide within the first couple months of fourth year. That only gives you time for two or three electives, if you have none during M1 or M2. That means during your third year you need to decide if you want OR or not and then narrow it down further in your so-called "spare time" during third year.

The problem is, a lot of the really competitive specialties strongly favor those who have done more than one rotation and have done some research during medical school. So a student who decides on Radiology or Dermatology in first year can do research before even getting to third year and already have an enormous advantage.
It's not a hopeless disadvantage, but a considerable one.

The final complication is that some specialties match early - for example, Opthalmology. This gives you even less time to decide.

The moral of the story is: If you have a lot of interests, you must use your own initiative during your limited free-time in school to narrow it down.

 

[summerlovin]

I've heard that you should do lots of research before entering medical school because once you're there, you don't have the time to research or may have a bad rotation in something you could have been interested if the circumstances were different.

I'm a premed and am just trying to learn as much as I can about each specialty now, while keeping an open mind.

 

[UseUrHeadFred]

The problem with that situation is that the ERAS application for residency is similar to the AMCAS.

AMCAS doesn't want to know about high school.
ERAS doesn't want to know about undergrad.

(Someone correct me if I'm wrong.)

 

[Amxcvbcv]

Bumping this one to the top...

Anyone have anything else to add?

 

[pez head]

about eras: it's WAY WAY WAY easier than amcas. easy-schmeasy. much less bs. as far as college stuff, my dean advised me to put every job i've ever had down, including those in highschool and college. the people who look at your cv want to make sure you're not a homocidal maniac. having lots of jobs looks good, as long as you weren't fired or whatever. and for college - in my personal statement, i talked about stuff i did in college and how it relates to my chosen specialty.

for the love of all that is holy, don't start worrying about that eras crap until you have to. in fact, some people in my class have just recently submitted the thing and they're still getting interviews! (that varies with specialty, of course!) i didn't know squat about it until sept. of my sr. year when i had to start filling it in.

and all that admissions hoo ha about shadowing people pre med - i'm sure it's lovely if you did it and it will help, but seriously, that's kinda what medschool is for. any clinical experience, volunteering helps, i never candy-striped or did research, but i went to emt school at nite during college - i never WORKED as an emt, but just by going thru the training, that says commitment.

they might be asking you if you've followed a radiologist to try and assess your over all level of commitment to going into medicine. it's ok to not know what you want to do as long as you convey that you are ready to make a committment and that you're not going to flake out and quit (once you're in, they'll be getting $$$ x 4 years - security)

and you will continue to be plagued by people asking you "what do you want to do?" saying you don't know works, or just tell them something - whatever strikes you at the moment. you're not expected to know! all thru my 3rd year people on rotations would ask - but by that time i was so used to saying "i don't know" that it didn't matter anymore. there are people in my class who still don't know so are applying to a medicine transition year, some internal med programs, some radiology, some derm... (you can write as many different personal statements as you like and assign them as you see fit)

it's all gonna be ok. there's just so much you can do, and a lot of it involves waiting. so loosen your collective sphincters 🙂

(that's what i would have like to have been told)

ok, that's my soapbox - and it's all my opinion, based on what i've been thru, your experiences may be totally different, so take with a grain of salt. i'm very experienced at being wrong.

 

[fotolilith]

Yeah, every one of my interviewers asked me that question...and a lot of them did not even ask why I wanted to be a doc!

If you have an idea about what you want, back it up with specifics in your interview...when I mentioned my 2 main interests, I cited volunteer experience in a certain underserved population as one reason, and lessons I'd learned from shadowing a specialist in the other field.

If you cannot give them concrete reasons or examples of WHY you are interested (ie, give them an image of you serving in that field), then it might be best to tell them you have not made up your mind and are excited about exploring your possibilities while in school.

I ask docs/ MSx when they decide, and they say that your clinical years given you a lot of experience, but it also helps to go into preceptorships or shadow docs after you start your 2nd year (you probably don't want to over commit yourself your first year).

Another thing - in my last interview (to my top choice school) I told my interviewer I wanted to go there b/c I wanted to stay in the state and network (which is true). He suggested that I should do a LOT of research (shadow, look up info, talk to docs) to figure out what field I'd like to enter after med school, because during med school I could use my time (ie, first summer) to do research/ shadow/ network in order to get rec letters from people in my field of interest - which always helps when you're trying to get a job/ residency some place. So, knowing what you like early on can help you get your goals faster (but you should research your interests, not just have a vague idea).

Good luck!

 

[lattimer13]

you're too late to decide now...you had to decide when you started kindergarten.

seriously, wait until latter years of med school to decide on a specialty.

 

[fielight]

who knows why a school might reject you for expressing an interest in radiology... but my guess is that you didn't elaborate enough. it's perfectly fine to just have "an interest" without any real experience (med schools know that shadowing/hospital experience is very different from a real, life-long career, and it would be ridiculous for anyone to decide on a specialty based on an exposure so brief). but if you had said something along the lines of your being a very visual person, you love looking at and identifying patterns, maybe throw in something about the fascination with radiological technology (which is quite fascinating, really), and that all of the above make you feel like radiology is something that you would "definitely consider" pursuing, then you would probably have fared better in the interview.

as for the specific specialty, it's really not possible to make a decision before med school. the fact is, even long before you start rotations, certain classes/experiences in year 1 & 2 will change your perspective, and sometimes drastically; med school has a strange way of doing that to people. and as pez head noted, there are M4's that apply for residency and still are unsure if they picked the right specialities... it's a very complicated decision that involves multiple factors (many that are impossible for a pre-med even to conceive).

 

[Pir8DeacDoc]

very good advice throughout this thread. Just to reiterate what has already been said, fields aren't always the way you think. Plus there is a huge difference in shadowing someone and actually doing the stuff yourself. Example: Classmate of mine has wanted to do OB since before med school. She does the rotation and hates it. Now she is really finding her niche in psych. Best advice is to do well during the first two years and on Step I... A lot of weight is placed in step I in some of the competitive fields. There is time during third and fourth year to do some field specific research if you really want to.

As far as the interest in radiology thing. It would depend what school you were interviewing at when you said this. I know that my school was specifically chartered to meet the primary care needs of the residents of eastern NC. Therefore you almost definitely won't get in if you say you want to be an orthopod. Also, if you tell them you want to do something and have no relevant shadowing, then how the heck do you know you like it?!?

Good luck to you guys. Take it slow and easy and don't sweat things so much right now. Plenty of stress awaits you in the next few years.