Why cant i choose more than one specialty

[edialgo]

Ok hello everyone this is my first post and i have been wrestling with trying to figure out this question for quite some time now. I am a premed student that is trying to figure out what type of specialty i would like to pursue but as of right now im interested in doing Emergency medicine, Family med, and surgery and truthfully i really want to do all 3. Unfortunately when i ask if this is possible i am told immediately that i cant and im crazy for wanting to do it but no one seems to want to say why this isnt a possibility, would someone please answer this question for me it would be greatly appreciated.

Dont know if this is the right forum for this question....

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[Purplerainangel]

You definitely don't need to decide any time soon-- I'd wait till your rotations and getting to medical school before you make any hard decisions

 

[pennybridge]

why don't you just compromise and do ophtho?

 

[notaroche]

I'd advise you to get this issue resolved ASAP.

 

[Vano]

I don't see why not. You can graduate med.school then do all 3 residencies one after another. Let's see that would be: 3+3+5yrs and then maybe do another year or two to specialize in peds or vasc or cardio surgery and will have a grand total of 11-13yrs post med.school. Granted you get in right after college and finish school when u're 25-27 you'll start practicing by the time you're close to 40. But all this talk is nonsense because when you're done with your M3 you would only want to do one and "lifestyle" specialty at that. Why don't you just do OBGYN--some fam.med/prim.care stuff+some surgery+plenty of nightly emergencies

 

[SiR99]

its so obvious why you cant do all three. When you specialize you have to commit to it and go that route, its not like they teach surgeons the same things they teach family physicians. Like in undergraduate programs they don't teach chemistry majors the same things as they do physics majors.

Even if you were willing to put in all the extra time, I doubt any Med school would rather teach you a second and third specialty and let you take up space and time, when they can give other people the chance who don't even have a specialty.

 

[diosa428]

First of all, you really don't need to decide now, but it's good that you have different interests. You can, in fact, do some combined residencies, although they are usually EM/IM, EM/peds, or IM/peds, as far as I know. The reason that most people don't do combined residencies is that you really can only practice one specialty. You will get a job as a surgeon, an EM doc, or an FM doc. You will not hold multiple positions. Therefore, you really only need training in one area. Also, as already mentioned, you'd have to do residency in each of those specialties, which would take forever, and it's not worth it if you're ultimately only going to practice one of them.

 

[chable]

There is a residency program that combines emergency medicine and family practice but it's only available to D.O. students. There's roughly 5 programs with 19 spots each year. Two out of three not so bad, right?

But you need to relax and take things one step at a time. Get into a medical school first or else you can be a triple specialty janitor who can sweep, mop and dust.

 

[pennybridge]

i like to think of EM docs as family practice doctors with adhd so bad the amount of adderall needed to control it would kill an elephant.

can anyone imagine an emergency doctor in a family clinic?

someone comes in for their check up "what you again? the hell's wrong now?"

 

[lilnoelle]

There are funding issues for individuals who want to do more than one residency. I believe the government only pays hospitals for a certain amount of years of residency per individual.
There are residencies that are somewhat integrated. i.e I believe there is a EM/IM dual residency and theres IM/FM dual residencies, IM/Peds, FM/PSY, IM/PSY, PED/PSY, EM/IM/CC, and probably more.
Most people interested in more than one field do not do these double residencies because of time constraints and also because the dual residency means you don't get quite as much detail in each area.

Don't worry about not knowing your desired field. Most people decide that in med school. A lot decide in 3rd or even 4th year. If you decide now there is a good chance that you will change your mind in med school.

I, for instance, am interested in Surgery (all fields including competitive ones like ENT and Optho - all but general), Psych (probably adolescent maybe forensic), Anesthesiology, PM&R, and maybe Pathology (maybe forensic).
I'm hoping that I narrow it down this summer, but we'll see.

 

[chable]

can anyone imagine an emergency doctor in a family clinic?

someone comes in for their check up "what you again? the hell's wrong now?"

 

[lilnoelle]

Trauma surgery would bring together EM and Surgery.

 

[psipsina]

Agree with not having to decide now, I'm a first year in medschool and while certain things have piqued my interest I have by no means decided. You can't be all three because there isn't enough time in the day.

Hospitals and practices don't hire physcians that come in and work a day or two a week, so you cant be a surgeon on monday and tuesda, then do two ER shirts and then see some general patients. Most specialties require 60+ hours a week of work out of an attending.

Beyond the fact that no one would hire you, you wouldn't be a very good doctor in any of these things if you somehow were accepted to all three residencies (which I doubt would happen). Lets say you started with EM and did the shortest residency which is 3 years, but instead of putting your skills into practice you then did a 5 year surg residency, you would be so behind and out of practice that you wouldn't be a very good EM doc, but wait you still have to do your 3 year medicine residency, so when your done with that your even more behind in EM, youre now behind in surgery and your skills have gone to crap . . . It just doesn't make any sense . . . not to mention you would be making 40k/year working 80 hour workweeks for 11 years which makes no sense at all.

The reason for specialties is that no one person can do it all anymore. Each subject has so much depth and is constantly evolving and adding to its procedures that no one could keep up with it all. The generalists are the closest thing to a jack of all trades but whenever stuff gets weird they refer you out to a specialist because they can't really know it all.

 

[Green Pirate]

I'd advise you to get this issue resolved ASAP.

 

[mikeinsd]

its so obvious why you cant do all three. When you specialize you have to commit to it and go that route, its not like they teach surgeons the same things they teach family physicians. Like in undergraduate programs they don't teach chemistry majors the same things as they do physics majors.

Even if you were willing to put in all the extra time, I doubt any Med school would rather teach you a second and third specialty and let you take up space and time, when they can give other people the chance who don't even have a specialty.

calm down dude, the OP made it pretty clear that he/she knew it was a odd question...

and on the subject of things some people might think obvious - med schools dont train people in specialties, thats what residencies do

 

[edialgo]

lol wasnt really expecting a response this fast but much thanks

maybe i am going about this a little early but the dual specialty in EM/FM sounds kind of interesting. I wasnt really planning on doing all three specialties in subsequent order i was just curious if a hospital would train a resident in all 3 at the same time, but i guess that wouldnt make much sense now would it. Im just glad that you all answered questions that a lot of residents at the hospital im working at wouldnt answer.

 

[smq123]

Ok hello everyone this is my first post and i have been wrestling with trying to figure out this question for quite some time now. I am a premed student that is trying to figure out what type of specialty i would like to pursue but as of right now im interested in doing Emergency medicine, Family med, and surgery and truthfully i really want to do all 3. Unfortunately when i ask if this is possible i am told immediately that i cant and im crazy for wanting to do it but no one seems to want to say why this isnt a possibility, would someone please answer this question for me it would be greatly appreciated.

If you truly have your heart set on doing all three (and I also think you're kind of crazy, but that's okay), you could think about doing Family Med waaaayyy out in the boondocks - I mean, beyond rural. Someplace where YOU are the only trained medical professional for a hundred mile radius. You'll pretty much have to do Emergency Med, Family Med/pediatrics/internal med/geriatrics, minor Surgery, Obstetrics, and Gynecology, and anything else you can think of. And, if you play your cards right, the government (state or federal) will pay for your medical school tuition to let you do this.

 

[edialgo]

also i did a little research on family medicine and it said they were trained in a little surgery but it doesnt say in what way exactly, is it watered down general lol

 

[kdburton]

Ok hello everyone this is my first post and i have been wrestling with trying to figure out this question for quite some time now. I am a premed student that is trying to figure out what type of specialty i would like to pursue but as of right now im interested in doing Emergency medicine, Family med, and surgery and truthfully i really want to do all 3. Unfortunately when i ask if this is possible i am told immediately that i cant and im crazy for wanting to do it but no one seems to want to say why this isnt a possibility, would someone please answer this question for me it would be greatly appreciated.

Dont know if this is the right forum for this question....

As someone pointed out earlier there are some different combined residencies you can do in quite a bit less time than it would take to do them individually. I heard of some EM/IM physicians that primarily practiced internal medicine, but would moonlight in the ER on the weekends sometimes. Its definately possible to do that, but I don't think theres much overlap for a surgery specialty and EM/family med

 

[smq123]

also i did a little research on family medicine and it said they were trained in a little surgery but it doesnt say in what way exactly, is it watered down general lol

All family med residents have to rotate through general surgery as part of their training. They can probably do minor procedures (maybe mostly trauma-related injuries?) - I doubt that they get enough training to remove gall bladders or anything. It probably also depends on where that particular Family Med doctor did his/her training.

If you really like ER, primary care, and surgery - maybe think about OB/Gyn? They do a lot of routine, primary care-type stuff (Pap smears, etc), but they also are trained in surgery (it's a surgical sub-specialty) and are often called down to the ER for consultation.

 

[DrBowtie]

All family med residents have to rotate through general surgery as part of their training. They can probably do minor procedures (maybe mostly trauma-related injuries?) - I doubt that they get enough training to remove gall bladders or anything. It probably also depends on where that particular Family Med doctor did his/her training.

If you really like ER, primary care, and surgery - maybe think about OB/Gyn? They do a lot of routine, primary care-type stuff (Pap smears, etc), but they also are trained in surgery (it's a surgical sub-specialty) and are often called down to the ER for consultation.

I'd agree with the suggestion of OB-Gyn. They do a healthy mix of emergency, surgery, and primary care.

 

[lilnoelle]

I'd agree with the suggestion of OB-Gyn. They do a healthy mix of emergency, surgery, and primary care.

Hmmmm.... I thought I'd like OB/GYN until this module. I love babies and pregnancies but really would like to avoid any specialty where I have to look at a person's genitalia regularly. Seriously, especially after spending a little time in a clinic.

Anyway - I think surgical aspects of FM are pretty limited... stitches, resetting broken bones, maybe a few more things. I'm guessing a dentist does more surgery than a FM.

Ob/Gyn is a good field to combine all the things your interested in....

but I wouldn't worry about figuring it out right now.


I have had a general surgeon that practices in a relatively rural area that he is pretty much a primary doc. So work as a rural surgeon that occasionally works in the ER trauma surgery.

 

[MDee]

I'd say wait until rotations.

 

[jojocola]

Hrm, this topic is interesting. I think they could make this work, for two specialties.

 

[lsumedgirl]

i like to think of EM docs as family practice doctors with adhd so bad the amount of adderall needed to control it would kill an elephant.

can anyone imagine an emergency doctor in a family clinic?

someone comes in for their check up "what you again? the hell's wrong now?"

Good point, but I think there are exceptions to every rule. I know a couple of FP docs who moonlight in the ER, and are going back for their residencies in EM. I think it just takes a unique personality to succeed at both... can be done, but rare (probably?).

 

[DropkickMurphy]

i like to think of EM docs as family practice doctors with adhd so bad the amount of adderall needed to control it would kill an elephant.

can anyone imagine an emergency doctor in a family clinic?

someone comes in for their check up "what you again? the hell's wrong now?"

How much time have you actually spent around emergency departments? They tend to see their fair share of repeat customers ("frequent fliers") and the ADD assessment isn't correct necessarily because of the fact that they often have to juggle multiple cases at once, which is something that would give someone with a truly poor attention span fits.

 

[pennybridge]

How much time have you actually spent around emergency departments? They tend to see their fair share of repeat customers ("frequent fliers") and the ADD assessment isn't correct necessarily because of the fact that they often have to juggle multiple cases at once, which is something that would give someone with a truly poor attention span fits.

yeah I was going to go with the frequent flier joke or the "90% of er visits are primary care anyway" joke, but those are so depressing, so I went with the upbeat mass appeal specialty stereotype joke.

don't get your er tech panties in a bunch, they can't all be winners

 

[Tired]

Ok hello everyone this is my first post and i have been wrestling with trying to figure out this question for quite some time now. I am a premed student that is trying to figure out what type of specialty i would like to pursue but as of right now im interested in doing Emergency medicine, Family med, and surgery and truthfully i really want to do all 3. Unfortunately when i ask if this is possible i am told immediately that i cant and im crazy for wanting to do it but no one seems to want to say why this isnt a possibility, would someone please answer this question for me it would be greatly appreciated.

We can debate the practicality of becoming Board Certified in multiple disparate specialties. However, as a premed, you shouldn't ever suggest an interest in this.

The reason is simple: From a practical standpoint, it is extremely difficult to do both logistically and personally. The strain on your personal and financial life of pursuing one specialty is hard enough. Most will simply be unable to do more than one, especially when they are essentially unrelated (FM vs surgery). There is also the issue of residency funding, and long-term debt, which others have alluded to.

Most people in medicine talking to you will immediately assume that you have minimal experience with what physicians' lives are actually like. To suggest that you can easily double or triple the average physician workload and training makes you sound silly. If, after med school and a residency, you still are thinking about this, explore it then. In the meantime, saying these kinds of things before you even make it to medical school just makes you sound kind of dumb.

 

[edialgo]

Most people in medicine talking to you will immediately assume that you have minimal experience with what physicians' lives are actually like. To suggest that you can easily double or triple the average physician workload and training makes you sound silly. If, after med school and a residency, you still are thinking about this, explore it then. In the meantime, saying these kinds of things before you even make it to medical school just makes you sound kind of dumb

wow that was a little harsh i never suggested that i can easily do it nor that it was the only thing that i wanted to do, i just asked them if there was a way to do it, perhaps a speacialty that integrates a little of all 3. im not that foolish

 

[Tired]

wow that was a little harsh i never suggested that i can easily do it nor that it was the only thing that i wanted to do, i just asked them if there was a way to do it, perhaps a speacialty that integrates a little of all 3. im not that foolish

That wasn't harsh. You asked an honest question, and I gave you an honest answer.

In your initial post, you said you wanted to do all three specialties. I didn't interpret that as "combining elements of three specialties", rather than getting board certified in all three.

Even with this new interpretation of what you're talking about, I wouldn't recommend advertising your interests. Until you get a better idea of what it means to be a surgeon, or an FP, or an ER doc, saying you want to "integrate" these specialties is sort of like saying, "I want to be an investment banker, an astronaut, and on weekends drive for NASCAR." Impossible? No. Common, or likely to occur? Not so much.

 

[gary5]

You'll need to choose one someday, but now is too early. You'll know when you rotate. ER has some family and some surgery built in. If you want to do several different things, then you'll want an area that allows you to do several different things. It's so simple that it sounds silly to say it. Anyway, you'll find it. It's out there.