Which specialty in medicine provides the most opportunity to do logical, deductive puzzle-solving?

[deleted363248]

Disclaimer: This will be a slightly long, verbose post, so apologies beforehand. I am a pre-med who hasn't started med school yet(I will in August), so I might be jumping the gun here, but I'd really to get some solid input/opinions about medical specialties so I can make an informed decision in the future when the time actually comes to choose. I'd appreciate if people could read the entire thing so they'll understand where I'm coming from. I'd further appreciate it if people could keep their personal judgments about me to themselves. Irrelevant comments will be ignored.

Here goes. And it's really quite a simple question. Out of all the specialties in the profession of medicine, which is the one, in you guys' estimation, that contains the MOST amount of cerebral puzzle-solving, intellectual stimulation, and "detective" work?

I realize I haven't started medical school yet(I will this August) so my question might seem childish and premature, but I sincerely believe, even at this early juncture, that the DIAGNOSIS of disease will end up being the primary thing I care about in my daily career. Treatments? Doing procedures? Relieving symptoms? Comforting and getting to know patients and their loved ones?---sure, these things would be nice in *small* doses, but they're not what really would get my blood pumping in this profession. I want to solve those cool "zebra" cases. I want to cross out symptoms on a whiteboard. I want to get challenging cases that stump other doctors. Hahah, as *unbelievably* cheesy as this sounds, I basically want a specialty that would let me be like Dr. Gregory House, minus all his other insane outlandish (but hilarious) shenanigans of course---I can't practice medicine from jail, lol.

In case it wasn't already apparent, treating, taking care of, and fraternizing with patients and their families are not high on my totem pole of interests. Constant patient contact, from what I've gleaned by talking to the residents and doctors I know, seems to be one the *most* overhyped, overrated, and mentally exhausting aspects of medicine, and I'm not surprised. I think for me, patients are essentially puzzles that need solving. I want to use my powers of deduction, observation, and logical reasoning to arrive at a valid diagnosis. I want to go home feeling intellectually sated and stimulated. Above all, I do NOT want to do repetitive cookbook procedures and treatments, however profitable they might be. I want to be able to THINK. ANALYZE. DEDUCE. PUZZLE-SOLVE.

Now, I consider myself an adult, and I'm not naive. I am well aware there is NO magic specialty in medicine which has challenging medical mysteries and fascinating zebra cases every single day----that is pure Hollywood fantasy and I know that. I am quite aware that all medical specialists have to deal with a large amount of boring, routine, bread-and-butter cases daily. That's just reality. And I'm fine with that, I don't need to be stimulated every single day. So my question is, in which specialty would I STATISTICALLY see stumping cases the most often? THAT'S the one I would like to go into.

And it goes without saying that sure, money is important. After such a looooooong, arduous, grueling, and expensive education and training, of course I want to have a nice comfortable life. BUT, $$$ are a good deal less important to me than having intellectual stimulation. I would GLADLY go into a somewhat lower-paying but highly cerebral and puzzle-oriented specialty with a huge f****ng smile on my face! WTF is the point of having wads and gobs of cash if you don't truly enjoy what you do?

Sorry for the rambling diatribe folks. Now, having read all my above criteria, which specialty do you think would be the overall best fit for me? Am I justified in my thinking, or being totally naive about what medicine really is? Please, honest differential diagnosis people! 😀

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[Kkshake]

Rheumatology

 

[Frogger27]

Rads

 

[deleted363248]

Rheumatology

Thanks for your answer. Could you elaborate on what makes Rheumatology a cerebral, puzzle-solving specialty a little more?

 

[Endoxifen]

Oncology would be great, depending on how much research you want.

 

[Lucca]

Are you in medical school? You dont have to have a specialty interest narrowed down this early. Wait until M3/4.


I don't understand. If you are already contemptuous of patient care before being involved in it in any capacity, why not just major in CS or become an engineer, or become a researcher where your entire job can be about solving analytical problems?

If you want to dispassionately solve problems, live comfortably, and have nothing to do with meaningful human interactions then that is a way better career path. Hell even something like management consulting.

 

[piii]

IR

 

[deleted363248]

Are you in medical school? You dont have to have a specialty interest narrowed down this early. Wait until M3/4.

No Lucca, I'm not in medical school yet. I don't have a specialty interest narrowed down either, I know it's too early for that. But, based on my personality and mindset, I think I have a general idea of the KIND of work that would interest me the most. Hence my original post.

Also, stop putting words in my mouth----I'm not contemptuous of patient care/doing procedures/treatments in the slightest. I know these things are a vital aspect of medicine. I even said I would like those things in small doses, but they are not my *primary* interest.

 

[AnatomyGrey12]

Diagnostic Medicine

 

[Funny_Current]

DR mostly, and then IR


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[deleted363248]

IR

Isn't Interventional Radiology mostly procedures?

 

[Levo]

Rheumatology

Rheumatology sounds horrible for the OP. You get the diagnosis right on the first visit, then you have years to decades of follow-up visits for medication adjustment and symptom management with that patient. That's true for just about every clinical specialty I can think of. The OP should really look to specialties with no patient contact like radiology and pathology.

 

[deleted363248]

Radiology seems to be winning here!

 

[deleted363248]

Diagnostic Medicine

Heh heh, I see what you did there.

 

[Gurby]

I think for me, patients are essentially puzzles that need solving. I want to use my powers of deduction, observation, and logical reasoning to arrive at a valid diagnosis. I want to go home feeling intellectually sated and stimulated. Above all, I do NOT want to do repetitive cookbook procedures and treatments, however profitable they might be. I want to be able to THINK. ANALYZE. DEDUCE. PUZZLE-SOLVE.

Now, I consider myself an adult, and I'm not naive. I am well aware there is NO magic specialty in medicine which has challenging medical mysteries and fascinating zebra cases every single day----that is pure Hollywood fantasy and I know that. I am quite aware that all medical specialists have to deal with a large amount of boring, routine, bread-and-butter cases daily. That's just reality. So my question is, in which specialty would I STATISTICALLY see stumping cases the most often? THAT'S the one I would like to go into.

I wonder if you will still be this enthusiastic after talking about options with a patient+family with a problem you can't figure out and that eventually kills them. Does that ever happen on House?

 

[Lucca]

I guess DR would be the option for you, but tbh sounds like you would be better off in another profession.

 

[deleted363248]

I guess DR would be the option for you, but tbh sounds like you would be better off in another profession.

Why? Why is being absolutely fascinated by the human body and having a keen interest in both basic and advanced science a wrong reason to enter medicine? Besides, you are completely ignoring the part where I said that I WOULD like patient contact and procedures, but in small doses.

 

[piii]

Isn't Interventional Radiology mostly procedures?

I didn't fully read your post so if you don't want procedures then that's cool. Yes IR is procedures but procedures are a different way to use logic and deduction to solve a problem. The reason I said IR is because it is combining the dectectice work of using DR and advanced instruments to solve many physiological problems in a non invasive way. The IR guys get called often before any surgeons, and are constantly innovating.

 

[deleted363248]

I didn't fully read your post so if you don't want procedures then that's cool. Yes IR is procedures but procedures are a different way to use logic and deduction to solve a problem. The reason I said IR is because it is combining the dectectice work of using DR and advanced instruments to solve many physiological problems in a non invasive way. The IR guys get called often before any surgeons, and are constantly innovating.

That......actually sounds very interesting and something that would be right up my alley, piii. I will give it some serious consideration and do more research of my own. As an IR, would a substantial chunk of my day still be spent doing regular diagnostic radiology with the rest being spent doing procedures to break up the "dark room" monotony?

 

[Lucca]

Why? Why is being absolutely fascinated by the human body and having a keen interest in both basic and advanced science a wrong reason to enter medicine? Besides, you are completely ignoring the part where I said that I WOULD like patient contact and procedures, but in small doses.

Contempt and disregard for the core activity of a profession -- treating patients (not to mention as seeing them only as 'puzzles' which is bound to cause you a lot of disappointment).

Maybe you would be a good fit for rads or path. I'm no expert, but I think going into this profession with the idea in mind that there are only 1-2 things you would be happy doing in it is a bad idea. But I'm not here to make your decisions for you, I'm just saying there are a lot of other careers that fit all of your criteria while being less competitive, grueling, and service-oriented. What are you going to do during intern year before you enter rads? Be miserable all of the time and get through it? Be one of the people on Allo that does nothing but complain about medical school and handwring about getting into a specific specialty because they couldnt see themselves being happy in any other? I guess a lot of people do that but idk why anyone would do that *by choice*, anticipating that misery.

 

[deleted363248]

Also, what about Neurology?

 

[deleted363248]

Contempt and disregard for the core activity of a profession -- treating patients (not to mention as seeing them only as 'puzzles' which is bound to cause you a lot of disappointment).

Maybe you would be a good fit for rads or path. I'm no expert, but I think going into this profession with the idea in mind that there are only 1-2 things you would be happy doing in it is a bad idea. But I'm not here to make your decisions for you, I'm just saying there are a lot of other careers that fit all of your criteria while being less competitive, grueling, and service-oriented. What are you going to do during intern year before you enter rads? Be miserable all of the time and get through it? Be one of the people on Allo that does nothing but complain about medical school and handwring about getting into a specific specialty because they couldnt see themselves being happy in any other? I guess a lot of people do that but idk why anyone would do that *by choice*, anticipating that misery.

Look, I do appreciate your input Lucca.......even though I disagree that wanting to take care of and comfort sick people should always be the primary motivation to enter medicine-----using your rationale, there are lots of other FAR less grueling and expensive careers where you can do that too.

But yes, I will definitely look into DR/IR and Pathology some more now.

 

[redsox93]

I would add emergency medicine. They make diagnoses on every patient they see if that's what you're interested in

 

[Gurby]

Also, what about Neurology?

I'm surprised nobody mentioned this. Seems to fit the bill pretty well:

 

[deleted781806]

I'll jump on-board and say that Radiology seems like the best fit for what you are describing, but I'm having some serious problems thinking that this motivation is going to get you very far in medicine. Treating patients only like "puzzles" that need to be solved instead of real, living, breathing human-beings who need to be cared for, as well as their families, is going to put a lot of drain on you and your relationships in the profession.

Bottom-line, you are going to have to bold-face lie about your motivations to admissions committees if you hope to gain entrance into a medical school, especially with the trend towards emphasizing service to others in clinical and non-clinical environments. Patient care is the backbone of the profession, there is a reason "diagnostic medicine" is not a real field. *Edit*: I would think of taking some of Lucca's advice and look into more research-based professions, which seem to be a much better fit for your motivations.

 

[tessellations]

I'll jump on-board and say that Radiology seems like the best fit for what you are describing, but I'm having some serious problems thinking that this motivation is going to get you very far in medicine. Treating patients only like "puzzles" that need to be solved instead of real, living, breathing human-beings who need to be cared for, as well as their families, is going to put a lot of drain on you and your relationships in the profession.

Bottom-line, you are going to have to bold-face lie about your motivations to admissions committees if you hope to gain entrance into a medical school, especially with the trend towards emphasizing service to others in clinical and non-clinical environments. Patient care is the backbone of the profession, there is a reason "diagnostic medicine" is not a real field. *Edit*: I would think of taking some of Lucca's advice and look into more research-based professions, which seem to be a much better fit for your motivations.

OP already said they were going to be entering med school in August, so it looks like they got by at least one admissions committee.

 

[libertyyne]

I didn't fully read your post so if you don't want procedures then that's cool. Yes IR is procedures but procedures are a different way to use logic and deduction to solve a problem. The reason I said IR is because it is combining the dectectice work of using DR and advanced instruments to solve many physiological problems in a non invasive way. The IR guys get called often before any surgeons, and are constantly innovating.

There is talk in the IR community that many of their bread and butter cases will be poached by other specialties and the field itself may not exist in 2 decades. I spoke to an IR Doc a few months back in detail regarding this, maybe it was just this one person who was pessimistic. Also DR, AI may reduce the need for the number of DR docs we have, so tread carefully. Plus you need to do 1+4+Fellowship to land a job so might as well do IR and you are still certified to read.

 

[deleted363248]

I'm surprised nobody mentioned this. Seems to fit the bill pretty well:

LMFAO, that is gooooollllld!

 

[deleted781806]

OP already said they were going to be entering med school in August, so it looks like they got by at least one admissions committee.

I must have missed the parenthetical when I read through the original post, so my apologies. Just redirect my comments towards professional relationships and how a motivation to only solve cases rather than cure human beings is misguided and will likely lead to dissatisfaction and burn-out within medicine. OP is going to have to go through years of patient contact and service based practice before they have a chance at removing themselves from it, I really don't understand the motivation at all.

*EDIT*: Saying "I want to solve those cool "zebra" cases." and "Treating, taking care of, and fraternizing with patients and their families are not high on my totem pole of interests" is just baffling to me. As others have pointed out, this enthusiasm is really going to wear thin when your "zebras" actually *do* stump you and there is nothing you can do for them or their families, or are you going to be so far removed that this won't bother you?

 

[mimelim]

Lots of commentary from people that have not spent much time practicing medicine in this thread. No offense meant to any of the above posters, but none of the above listed specialties are even remotely close to what the OP is asking for. Mainly because there isn't anything like that in medicine.

Based on your initial post, I'd recommend considering other fields outside of medicine. While I appreciate that you may have already been accepted to medical school, you don't know what you are getting into and frankly come across as incredibly naive about the practice of medicine. Your post reads like your understanding/impressions of medicine are based on TV shows. I certainly ended up in medical school just as naive (which I have detailed elsewhere on this forum), but I am also very adaptable and as it turns out a very good 'fit' for the clinical practice of medicine. Only you know yourself and whether or not you will get pigeon-holed into something when you realize that medicine is not House, MD.

 

[deleted363248]

Patient care is the backbone of the profession, there is a reason "diagnostic medicine" is not a real field. *Edit*: I would think of taking some of Lucca's advice and look into more research-based professions, which seem to be a much better fit for your motivations.

Doesn't Diagnostic Radiology + whatever Rads fellowship you choose, seem to be the very CLOSEST thing to Diagnostic Medicine? So how can you say it's not a real field?

Besides, and this is something which a lot of folks are missing------I don't want a 100% cerebral, solitary, intellectual freak specialty. I'm a little more well-adjusted than that, mmkay? It would certainly be nice to see some patients and do a few procedures throughout the day to break up the cerebral dark-room or lab-room routine of Rads or Path. Which is why IR or NIR is sounding very, very appealing at the moment! 🙂

 

[libertyyne]

I must have missed the parenthetical when I read through the original post, so my apologies. Just redirect my comments towards professional relationships and how a motivation to only solve cases rather than cure human beings is misguided and will likely lead to dissatisfaction and burn-out within medicine. OP is going to have to go through years of patient contact and service based practice before they have a chance at removing themselves from it, I really don't understand the motivation at all.

I would say that this line of thinking is very idealistic. Once you come out the other side you realize that a large portion of docs in service specialties just view their work as , gasp, a job. Plus the world still needs DR, IR , Path, and other low longitudinal patient contact doctors. the burnout studies I have seen have been correlated with income and hours worked.

 

[Goro]

All branches of Medicine have you do this. Did you not learn anything from shadowing????

Disclaimer: This will be a slightly long, verbose post, so apologies beforehand. However, I really need some solid advice about choosing a specialty, and I'd appreciate if people could read the entire thing so they'll understand where I'm coming from. I'd further appreciate it if people could keep their personal judgments about me to themselves. Irrelevant comments will be ignored.

Here goes. And it's really quite a simple question. Out of all the specialties in the profession of medicine, which is the one, in you guys' estimation, that contains the MOST amount of cerebral puzzle-solving, intellectual stimulation, and "detective" work?

I realize I haven't started medical school yet(I will this August) so my question might seem childish and premature, but I sincerely believe, even at this early juncture, that the DIAGNOSIS of disease will end up being the primary thing I care about in my daily career. Treatments? Doing procedures? Relieving symptoms? Comforting and getting to know patients and their loved ones?---sure, these things would be nice in *small* doses, but they're not what really would get my blood pumping in this profession. I want to solve those cool "zebra" cases. I want to cross out symptoms on a whiteboard. I want to get challenging cases that stump other doctors. Hahah, as *unbelievably* cheesy as this sounds, I basically want a specialty that would let me be like Dr. Gregory House, minus all his other insane outlandish (but hilarious) shenanigans of course---I can't practice medicine from jail, lol.

In case it wasn't already apparent, treating, taking care of, and fraternizing with patients and their families are not high on my totem pole of interests. Constant patient contact, from what I've gleaned by talking to the residents and doctors I know, seems to be one the *most* overhyped, overrated, and mentally exhausting aspects of medicine, and I'm not surprised. I think for me, patients are essentially puzzles that need solving. I want to use my powers of deduction, observation, and logical reasoning to arrive at a valid diagnosis. I want to go home feeling intellectually sated and stimulated. Above all, I do NOT want to do repetitive cookbook procedures and treatments, however profitable they might be. I want to be able to THINK. ANALYZE. DEDUCE. PUZZLE-SOLVE.

Now, I consider myself an adult, and I'm not naive. I am well aware there is NO magic specialty in medicine which has challenging medical mysteries and fascinating zebra cases every single day----that is pure Hollywood fantasy and I know that. I am quite aware that all medical specialists have to deal with a large amount of boring, routine, bread-and-butter cases daily. That's just reality. So my question is, in which specialty would I STATISTICALLY see stumping cases the most often? THAT'S the one I would like to go into.

And it goes without saying that sure, money is important. After such a looooooong, arduous, grueling, and expensive education and training, of course I want to have a nice comfortable life. BUT, $$$ are a good deal less important to me than having intellectual stimulation. I would GLADLY go into a somewhat lower-paying but highly cerebral and puzzle-oriented specialty with a huge f****ng smile on my face! WTF is the point of having wads and gobs of cash if you don't truly enjoy what you do?

Sorry for the rambling diatribe folks. Now, having read all my above criteria, which specialty do you think would be the overall best fit for me? Am I justified in my thinking, or being totally naive about what medicine really is? Please, honest differential diagnosis people! 😀

 

[deleted363248]

Lots of commentary from people that have not spent much time practicing medicine in this thread. No offense meant to any of the above posters, but none of the above listed specialties are even remotely close to what the OP is asking for. Mainly because there isn't anything like that in medicine.

Based on your initial post, I'd recommend considering other fields outside of medicine. While I appreciate that you may have already been accepted to medical school, you don't know what you are getting into and frankly come across as incredibly naive about the practice of medicine. Your post reads like your understanding/impressions of medicine are based on TV shows. I certainly ended up in medical school just as naive (which I have detailed elsewhere on this forum), but I am also very adaptable and as it turns out a very good 'fit' for the clinical practice of medicine. Only you know yourself and whether or not you will get pigeon-holed into something when you realize that medicine is not House, MD.

I appreciate your input. Yes, it's true I have a long way to go, and sure maybe I am probably a bit naive atm, and I may end up with a completely different mindset and line of thinking about the best specialty for me when I'm actually done with med school. We shall see, I'm very excited regardless!

 

[deleted781806]

It would certainly be nice to see a few patients and do a couple procedures throughout the day to break up the cerebral dark-room or lab-room routine of Rads or Path. Which is why IR or NIR is sounding very, very appealing at the moment! 🙂

I would say that this line of thinking is very idealistic. Once you come out the other side you realize that a large portion of docs in service specialties just view their work as , gasp, a job. Plus the world still needs DR, IR , Path, and other low longitudinal patient contact doctors. the burnout studies I have seen have been correlated with income and hours worked.

Sure, the burnout comment was a little reckless on my part, I admit that, and the world does always need more Radiologists and Pathologists. But the way in which OP phrased their post seemed to come from a very unrealistic ideal of what medicine can be like for them. I'll just direct up to mimelim. There really isn't a specialty that matches well with OP's motivations, and I think that the next handful of years are going to be rough for them until they are able to get away to the solitary bench-top or dark room.

 

[TXMED_1695]

But on Dr. House, he solves all kinds of mysterys! He's the Sherlock Holmes of medicine.

 

[deleted363248]

But on Dr. House, he solves all kinds of mysterys! He's the Sherlock Holmes of medicine.

Lol, god I almost wish I hadn't even mentioned House in my OP. I just did it to emphasize a point. I am fully aware Dr. Greg House is a nutjob (a very entertaining one), and that the show, while cleverly and slickly written, is/was about 99.994759199819% unrealistic. Let's all get off the House MD thing, lmao.

 

[NotYou20]

Lots of commentary from people that have not spent much time practicing medicine in this thread. No offense meant to any of the above posters, but none of the above listed specialties are even remotely close to what the OP is asking for. Mainly because there isn't anything like that in medicine.

Based on your initial post, I'd recommend considering other fields outside of medicine. While I appreciate that you may have already been accepted to medical school, you don't know what you are getting into and frankly come across as incredibly naive about the practice of medicine. Your post reads like your understanding/impressions of medicine are based on TV shows. I certainly ended up in medical school just as naive (which I have detailed elsewhere on this forum), but I am also very adaptable and as it turns out a very good 'fit' for the clinical practice of medicine. Only you know yourself and whether or not you will get pigeon-holed into something when you realize that medicine is not House, MD.

Yeah. OP, if, after laying out what you want your career to look like, you get a response like this from a doc you should seriously consider what he's saying. Getting accepted doesn't mean you have to go to med school. Some serious soul searching and looking at other careers now could put you on a path that's much better for you. And maybe you do that and still decide on medicine. That's cool, but it's worth the effort to do it now rather than when you're in med school.

 

[Lucca]

But on Dr. House, he solves all kinds of mysterys! He's the Sherlock Holmes of medicine.

interestingly enough, Sherlock Holmes' character was based off of a surgeon AC Doyle knew IRL and Edgar Allan Poe's detective stories.

So Sherlock Holmes....is kind of like the Sherlock Holmes of medicine

 

[mimelim]

Doesn't Diagnostic Radiology + whatever Rads fellowship you choose, seem to be the very CLOSEST thing to Diagnostic Medicine? So how can you say it's not a real field?

Besides, and this is something which a lot of folks are missing------I don't want a 100% cerebral, solitary, intellectual freak specialty. I'm a little more well-adjusted than that, mmkay? It would certainly be nice to see a few patients and do a couple procedures throughout the day to break up the cerebral dark-room or lab-room routine of Rads or Path. Which is why IR or NIR is sounding very, very appealing at the moment! 🙂

IR/NIR are not even remotely close to "Diagnostic Medicine" ie what House does. I just spent a month in NIR a few months back. There are obviously practice variations between institutions and between practices, but given how far away it is from what you are talking about, no it is not what you are 'looking for'. For starters, a good part of IR is being a technician (and some practices it is ONLY about being a technician). The patient shows up with the diagnosis in hand, imaging to show where the issue is and IR is being asked to solve the issue. Sure, sometimes they do diagnostic procedures, but does injecting contrast, seeing what lights up 'diagnostic nirvana'? I don't think so. I don't want to minimize how much work that they do or how hard it is to do what they do. There is a ton of thought that goes into how to perform these procedures and the challenges that they solve are hard. But, they are far removed from TV show medicine.

Pathology/DR? If anything they are the most protocol/patterned specialties...

 

[mimelim]

Lol, god I almost wish I hadn't even mentioned House in my OP. I just did it to emphasize a point. I am fully aware Dr. Greg House is a nutjob (a very entertaining one), and that the show, while cleverly and slickly written, is/was about 99.994759199819% unrealistic. Let's all get off the House MD thing, lmao.

I didn't even notice the House part in your OP to be honest. Your post screams it without the explicit mention. The issue is not that you want to be House, which everyone recognizes is a fictional character that couldn't survive in the real world. The issue is that that is the driving influence toward medicine, which at baseline is worrisome.

 

[deleted363248]

I didn't even notice the House part in your OP to be honest. Your post screams it without the explicit mention. The issue is not that you want to be House, which everyone recognizes is a fictional character that couldn't survive in the real world. The issue is that that is the driving influence toward medicine, which at baseline is worrisome.

So from what I gather, mimelim, when you yourself take stock of all the different specialties you can choose in medicine, NOT ONE medical specialty jumps out at you as being somewhat more intellectually stimulating, cerebral, and logical/puzzle-oriented above all the others? Not even one? You think they all basically become boring, routine, and protocol-driven after a couple years, and that the "DEEP satisfaction" you get from relieving/treating a certain symptom for the n-millionth time is really the only thing that gets doctors through the day after a while? Am I reading you right?

 

[TXMED_1695]

After fours years of UG, the people referencing Dr. House and Grey's anatomy, during my freshman year, those talking about Diagnostic medicine and Ortho being their inspiration for medicine - those people are long gone. In love with the idea of being a doctor, but that first Organic Chemistry exam reigns in reality fast. I just thought it was funny you mentioned House.

Lol, god I almost wish I hadn't even mentioned House in my OP. I just did it to emphasize a point. I am fully aware Dr. Greg House is a nutjob (a very entertaining one), and that the show, while cleverly and slickly written, is/was about 99.994759199819% unrealistic. Let's all get off the House MD thing, lmao.

 

[NotASerialKiller]

I wonder if you will still be this enthusiastic after talking about options with a patient+family with a problem you can't figure out and that eventually kills them. Does that ever happen on House?

Yeah but then he figures out what it was after they die for his own satisfaction, sometimes with an impromptu autopsy. My god he's fantastic...

 

[mimelim]

So from what I gather, mimelim, when you yourself take stock of all the different specialties you can choose in medicine, NOT ONE medical specialty jumps out at you as being somewhat more intellectually stimulating, cerebral, and logical/puzzle-oriented above all the others? Not even one? You think they all basically become boring, routine, and protocol-driven after a couple years, and that the "DEEP satisfaction" you get from relieving/treating a certain symptom for the n-millionth time is really the only that gets doctors through the day after a while? Am I reading you right?

Was about to start a nice long answer to this, but anesthesia just poked their head in and I have to scrub. Promise I'll be back a little bit later 😉

 

[Brill4]

Disclaimer: This will be a slightly long, verbose post, so apologies beforehand. However, I really need some solid advice about choosing a specialty, and I'd appreciate if people could read the entire thing so they'll understand where I'm coming from. I'd further appreciate it if people could keep their personal judgments about me to themselves. Irrelevant comments will be ignored.

Here goes. And it's really quite a simple question. Out of all the specialties in the profession of medicine, which is the one, in you guys' estimation, that contains the MOST amount of cerebral puzzle-solving, intellectual stimulation, and "detective" work?

I realize I haven't started medical school yet(I will this August) so my question might seem childish and premature, but I sincerely believe, even at this early juncture, that the DIAGNOSIS of disease will end up being the primary thing I care about in my daily career. Treatments? Doing procedures? Relieving symptoms? Comforting and getting to know patients and their loved ones?---sure, these things would be nice in *small* doses, but they're not what really would get my blood pumping in this profession. I want to solve those cool "zebra" cases. I want to cross out symptoms on a whiteboard. I want to get challenging cases that stump other doctors. Hahah, as *unbelievably* cheesy as this sounds, I basically want a specialty that would let me be like Dr. Gregory House, minus all his other insane outlandish (but hilarious) shenanigans of course---I can't practice medicine from jail, lol.

In case it wasn't already apparent, treating, taking care of, and fraternizing with patients and their families are not high on my totem pole of interests. Constant patient contact, from what I've gleaned by talking to the residents and doctors I know, seems to be one the *most* overhyped, overrated, and mentally exhausting aspects of medicine, and I'm not surprised. I think for me, patients are essentially puzzles that need solving. I want to use my powers of deduction, observation, and logical reasoning to arrive at a valid diagnosis. I want to go home feeling intellectually sated and stimulated. Above all, I do NOT want to do repetitive cookbook procedures and treatments, however profitable they might be. I want to be able to THINK. ANALYZE. DEDUCE. PUZZLE-SOLVE.

Now, I consider myself an adult, and I'm not naive. I am well aware there is NO magic specialty in medicine which has challenging medical mysteries and fascinating zebra cases every single day----that is pure Hollywood fantasy and I know that. I am quite aware that all medical specialists have to deal with a large amount of boring, routine, bread-and-butter cases daily. That's just reality. So my question is, in which specialty would I STATISTICALLY see stumping cases the most often? THAT'S the one I would like to go into.

And it goes without saying that sure, money is important. After such a looooooong, arduous, grueling, and expensive education and training, of course I want to have a nice comfortable life. BUT, $$$ are a good deal less important to me than having intellectual stimulation. I would GLADLY go into a somewhat lower-paying but highly cerebral and puzzle-oriented specialty with a huge f****ng smile on my face! WTF is the point of having wads and gobs of cash if you don't truly enjoy what you do?

Sorry for the rambling diatribe folks. Now, having read all my above criteria, which specialty do you think would be the overall best fit for me? Am I justified in my thinking, or being totally naive about what medicine really is? Please, honest differential diagnosis people! 😀

It might help if you don't base your decision of a medical career off of the workings of a "doctor" in a TV show. Because it looks like you wrote this post after binge watching 3 seasons of house in a day.

Healthcare consulting sounds like the right field for you. I think you will be sorely disappointed in real medicine.

 

[Stagg737]

I would add emergency medicine. They make diagnoses on every patient they see if that's what you're interested in

Not really, they're more of an advanced triage team for most cases. They may do some diagnosis, but they don't usually get the final say (unless they're not admitting them) and on the major cases they just stabilize the patient and send them off to the specialists. They also don't follow-up with patients, so if you're really curious about what a patient's outcome or diagnosis was, you've got to track down whoever you referred them to on your own time. It's a lot less actual diagnosis than most pre-meds think it is.

So from what I gather, mimelim, when you yourself take stock of all the different specialties you can choose in medicine, NOT ONE medical specialty jumps out at you as being somewhat more intellectually stimulating, cerebral, and logical/puzzle-oriented above all the others? Not even one? You think they all basically become boring, routine, and protocol-driven after a couple years, and that the "DEEP satisfaction" you get from relieving/treating a certain symptom for the n-millionth time is really the only thing that gets doctors through the day after a while? Am I reading you right?

That actually sounds about right. You'll get a zebra or some crazy case every once in a while, but it becomes a lot of the same thing over and over again. Sure, some are more intellectually stimulating, but there are other careers that involved A LOT more actual problem solving than medicine. The big gratification most of us get is not from "solving the puzzle", it's from knowing that we're actually making a difference in a patient's life, even if it is something we've done a million times before.

 

[deleted363248]

Well........all things considered, while I STILL think medicine still seems to be the best (if not perfect) OVERALL fit for me (especially when you factor in the decent compensation and job security RELATIVE to other careers-----yes, I believe these factors are also important to ALL people who choose medicine, and I think we all know that on some level), you guys have all given me a lot to think about. Thanks.

 

[TXMED_1695]

Logical, puzzle-oriented? Get doctors through the day? Boring? You realize you're talking about patients well-being and lifes, right? The Dr. House act isn't cute in the real world. Intellectually stimulating... Less TV, more shadowing.

So from what I gather, mimelim, when you yourself take stock of all the different specialties you can choose in medicine, NOT ONE medical specialty jumps out at you as being somewhat more intellectually stimulating, cerebral, and logical/puzzle-oriented above all the others? Not even one? You think they all basically become boring, routine, and protocol-driven after a couple years, and that the "DEEP satisfaction" you get from relieving/treating a certain symptom for the n-millionth time is really the only thing that gets doctors through the day after a while? Am I reading you right?

 

[deleted363248]

Logical, puzzle-oriented? Get doctors through the day? Boring? You realize you're talking about patients well-being and lifes, right? The Dr. House act isn't cute in the real world. Intellectually stimulating... Less TV, more shadowing.

Aaaaaaaaaactually TXMED, from what I've gathered from talking to the doctors that I know, building up the profession of medicine in your mind as some "noble higher calling" as opposed to a stable, secure, relatively interesting, and well-compensated job is WAY more naive than anything I could post about House (which was in jest for chrissakes).