your top specialty choice regardless of grade

Discussion in 'General Residency Issues' started by mandownunder, Dec 26, 2002.

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  1. General Surgery

    23 vote(s)
  2. Surgical Subspecialties

    90 vote(s)
  3. Internal Medicine

    32 vote(s)
  4. Pediatrics

    15 vote(s)
  5. Family Practice

    21 vote(s)
  6. OB/GYN

    10 vote(s)
  7. Psychiatry

    16 vote(s)
  8. Anesthesia

    29 vote(s)
  9. Pathology

    26 vote(s)
  10. Radiology

    45 vote(s)
  11. Ophtho

    31 vote(s)
  12. Emergency Medicine

    57 vote(s)
  13. Rad Onc

    16 vote(s)
  14. Derm

    20 vote(s)
  15. PM&R

    22 vote(s)
  1. mandownunder

    mandownunder Member 7+ Year Member

    Dec 16, 2002
    What would be your top choice if you can get into any specialty and where would you go and why?
    You can post how competitive you think you are: first, second, third or fourth quartile.

    1. Anesthesiology
    2. Family Practice
    3. Pediatrics
    4. Surgery and subspecialties
    5. OBGyn
    6. Opthal/Derm
    7. Radiology/ Rad Onc
    8. Internal Medicine
    9. Psychiatry
    10. PM&R/Pathology
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  3. neilc

    neilc 1K Member 7+ Year Member

    Jun 1, 2001
    sunny CA
    my top three:
    1. general surg cause i want to operate! this is why i am in med school
    2. ob/gyn; lots of surg, if i can't do GS i think this is a good compromise.
    3. FP rural...could do some ob, and it would be cool to be like the old time gp, and take care of everything

    after more exposure to everything, we shall see if the list changes! it would be cool to see some folks rankings now, and what they were before they got to the wards...i am interested in how many of us changed our minds and the reasons that lead to it.
  4. DuneHog

    DuneHog Senior Member 7+ Year Member

    Feb 6, 2002
    I'm applying for otolaryngology (surgical subspecialty). I think it's the best specialty for me, and one of the best specialties out there. The breadth of otolaryngology is amazing. I also enjoy the challenge of the complex anatomy and the highly technical nature of many of the operations. You also have the opportunity to see a wide variety of patient and problems. I am in the process of constructing my rank list. One of the great things about this specialty is that you will get fantastic training at just about every program in the country. It's really just a matter of finding what particular aspects of a program are important to you (ie academic vs clinical, geography, teaching and hospital environment). I'm top quartile, as are most otolaryngology applicants.
  5. southerndoc

    southerndoc life is good Moderator Emeritus Lifetime Donor 10+ Year Member

    Jun 6, 2002
    44% of the people are interested in general surgery? Cool!

    Let's see what it is when everyone on SDN gets a chance to vote (this goes for you trolls out there that never post! Like PR, if you are reading this!)
  6. ApacheIndian

    ApacheIndian philomath 10+ Year Member

    Apr 3, 2002
    For me it'd be Diagnostic Radiology without a doubt. Best specialty on earth IMHO :).

    Why did you put Rads & Rad Onc together? I don't think they're at all similar...
  7. mandownunder

    mandownunder Member 7+ Year Member

    Dec 16, 2002
    Hi Cuts,
    I only had 10 options. Couldn't squeeze in PM&R either.
  8. Gas

    Gas Member 10+ Year Member

    Nov 11, 2002
    I am a 4th year med student going for anesthesiology, but that is not up there. I like anesthesiology because:

    1. Pharmacology and Physiology - I liked these basic science subjects more so than anatomy and I would love to apply this knowledge to real patients.

    2. Medicine - I like internal medicine in theory, but not practice. Too much paperwork, noncompliant patients, and low sense of accomplishment. On my medicine rotation, I felt like nobody was doing anything for the patient, but with anesthesiology, I am completely in charge of the patient from a medical point of view. If something goes wrong, I fix it (or at least try). If I give a drug, I have instant feedback. In addition, anesthesiologists need to have knowledge of a broad spectrum of pathologic conditions.

    3. Patient relationship - Sounds weird, but I like the brief and intense relationship. I may not get to follow-up with the patient every 3-6 mos. like other docs, but that 3-6 hours I spend with the patient in the OR is exhilarating, even if nothing happens. Just the thought that I am the pilot of the plane is exciting enough for me.

    4. Lifestyle - Anesthesiologists work longer hours than radiologists or dermatologists, but not as long as surgeons. For me, it's a compromise. I can live with these hours since I love it.

    Honestly, I could go on and on. There are some downsides to anesthesiology, such as the moody surgeons, constant stress, expectation of perfection, cyclical job market, etc. But I love what they do, so I want to do it. Plain and simple.

    By the way, I am in the top quartile of my class, but I am still weary of this year's match due to the increased competition. There are a ton of qualified candidates out there, so we'll have to see what happens.
  9. southerndoc

    southerndoc life is good Moderator Emeritus Lifetime Donor 10+ Year Member

    Jun 6, 2002
    Did I completely miss something, or has the list been expanded since I voted this am?

    I know this isn't a scientific study, but if the list has been expanded after many have already voted, wouldn't this affect the results?

    Tell me I'm not imagining things here... :confused:
  10. Jim Picotte

    Jim Picotte Senior Member 7+ Year Member

    What's that saying everyone uses....oh yeah Radiology or Bust.
  11. superstar

    superstar Junior Member 7+ Year Member

    Nov 13, 2002
    "Just the thought that I am the pilot of the plane is exciting enough for me."

    You didn't think a gen surg residency candidate would let this slip, did you?

    Gas, there are many benefits to being an anaesthesiologist but being "the pilot of the plane" in the OR would not be one of them.

    For the rest of your career your unofficial title (once you finish training) will be "chief towel boy/girl in command" to the attending surgeon.

    Gas, you can't have everything- money, hours and self-respect- but 2 out of 3 ain't bad.

    See ya in the OR, towel boy.
  12. southerndoc

    southerndoc life is good Moderator Emeritus Lifetime Donor 10+ Year Member

    Jun 6, 2002
    :laugh: :laugh: :laugh:

    That was good! Real good! :clap:

    :laugh: :laugh: :laugh:
  13. Tenesma

    Tenesma Senior Member 10+ Year Member

    Jun 11, 2002
    superstar... when you become a surgical resident you will quickly realize that you may be the captain of the ship, but the anesthetist is still pilot of the plane - and it is just a matter of cooperation to make things work out.... in the sick trauma patient for example, the surgeon fixes the problem while the anesthetist keeps the patient alive so that the problem can be fixed... without each other the patient wouldn't survive... so why don't you spend some time being a real doctor before you call somebody towel boy...

    by the way i am at MGH, and it is obvious why you didn't get a GS interview at MGH - you wouldn't have fit in with the team approach to patient care. I am friendly with the program chair (Dr. Ferguson) and i know he wouldn't appreciate your thought process...
  14. badassy

    badassy Senior Member 7+ Year Member

    Sep 17, 2002
    Top 3.
    1. Psychiatry
    2. Emergency Medicine
    3. Pathology
  15. Is there a field as good or better? I think not.
  16. superstar

    superstar Junior Member 7+ Year Member

    Nov 13, 2002

    I didn't get an interview at MGH because I didn't honor my third year rotations (most likely).

    Another reason I wouldn't have fit in at MGH: I have a sense of humor and you guys (well, especially you Tenesma) don't.

    Also, I would never personally attack someone or someone's credentials- it just is not nice.

    Your sick trauma patient scenario is not the typical one.

    For the record, I love anaesthesiologists (truly love)- my future son is sitting in the womb of one!

    I just wanted to remind the future gas doctor that he had a colleague in the room- a colleague that trained long and hard to get where he got.

    Of course, the contributions of an experienced anethesiologists are unique and can make the difference between life and death. Of course.

    These inter-specialty rivalries are fun!
    My next post will belittle the entire field of internal medicine.
    Loosen up Tenesma! Is your jock strap on to tight?

    No hard feelings! (excluding Tenesma)
  17. Tenesma

    Tenesma Senior Member 10+ Year Member

    Jun 11, 2002

    your attempt at humor is weak and immature... i hope that you grow up during your surgical residency.

    my comments are not related to inter-specialty rivalry. In my opinion rivalry between specialties is a waste of intellect... we all end up practicing medicine in one form or another, and usually for the benefit of the patient.

    i also never attacked your credentials... because to be quite honest, they don't matter as much as bedside manner and inter-colleague relationships.

    for the record my jock strap is just tight enough... and i agree, no hard feelings
  18. mandownunder

    mandownunder Member 7+ Year Member

    Dec 16, 2002
    I didn't expand the number options. The moderator did and it is better. Sorry to those who voted earlier.
    Didn't realize EM is that popular - no wonder it is so competitive!
  19. Gas

    Gas Member 10+ Year Member

    Nov 11, 2002
    In reply to superstar, I'm glad you have a sense of humor, but don't let that ever compromise patient care. I am the pilot, you are the technician. I am buying you time to do surgery, similar to how a pilot keeps the plane in the air long enough so that the engine can propel the plane to the destination. Both need to work together. If the engine fails, and the pilot can't save the plane, it crashes. Understand?

    In other words, I keep an eye on the plane so that if some problem occurs, such as the engine failing (or the surgeon cutting an artery), I am qualified to fix it. So the way I see it is that you are just an engine, and I am the real brain behind the operation - your watchdog.

    I wish more surgeons had a sense of humor, I mentioned that as one of the disadvantages of being an anesthesiologist. But you can't blame surgeons - they see their loved one like once/week, no wonder they are always in a bad mood!

    BTW, this analogy has gone far enough.
  20. Ctrhu

    Ctrhu Member 7+ Year Member

    Nov 9, 2002
    Gas & Superstar,
    The Blood Brain Barrier - which sides are you guys on?
  21. superstar

    superstar Junior Member 7+ Year Member

    Nov 13, 2002

    Please check out the DSM-IV criteria for delusional disorder. I believe you would qualify for the grandiose subtype. Of course, I can't rule out a substance-induced psychotic disorder or a psychotic disorder due to a general medical condition. I was never much into generating a differential, but this is fun.
  22. Gas

    Gas Member 10+ Year Member

    Nov 11, 2002
    Superstar, now you are just trash-talking. I'm surprised you were able to generate even that much of a differential before deciding to perform a lobotomy.

    Oooooooooh, did I make the mighty surgeon cry? Bash the anesthesiologist some more, very professional way to vent your frustrations of entering a career where you will have no life. If you need further help, enroll in an anger management class. But make sure you enroll in the midnight session since that is about the time you will be done with evening rounds every day during residency.
  23. DuneHog

    DuneHog Senior Member 7+ Year Member

    Feb 6, 2002
    I just wanted to point out that not all of surgery has a bad lifestyle. Some surgical subspecialties, especially Oto-HNS and Urology, allow for plenty of free time. This is probably one of the reasons why surgical subspecialty is the most popular option on this poll.

    As for your pilot analogy, I actually think that it's a pretty good one. The problem is that most of the time the anesthesiologist is like a commercial airline pilot who just sits back and doesn't do to much for most of the flight. Personally, I would get board. Where this analogy breaks down is in the patient/public perception. While most of the public would agree that the pilot is the one "in charge" of the airplane, most patients give very little thought to the anesthesia part of an operation, and I think that most patients also feel that the surgeon is the one "running the show."

    Tenesma: You are obviously a bitter troll. I hope you develop a better sense of humor or you are in for a lifetime of anger and frustration. I think that we all know that the anesthesiologists and surgeons generally get along very well and always work together to provide the best patient care. A little jest on a message board certainly doesn't indicate that anyone lacks professionalism or the ability to get along well with their colleages.
  24. Tenesma

    Tenesma Senior Member 10+ Year Member

    Jun 11, 2002
    a bitter troll? gimme a break... and i have a great sense of humor, i just didn't like superstars initial posting and i didn't find it funny... sorry...

    otherwise i absolutely agree with your posting... the general public is clueless about the role of the anesthesiologist in the OR, and the perception of the surgeon running the show is rampant... I actually have no problem with that perception, because in the long run it is the surgeon managing that patient anyway. It amuses me sometimes when patients ask me if i'll actually be in the OR with them while they are asleep - they firmly believe that i am there to put them to sleep, and then just saunter off to neverland...

    as far as surgical lifestyle - most of them don't suck that bad... Uro/ENT/breast have a relatively cush lifestyle compared to the GenSurg/CT/Neurosurg folks.... I actually put up with neurosurgeries temper tantrum, because besides serving as good comical relief they really need to vent sometimes - they work like dogs at my program.
  25. Gas

    Gas Member 10+ Year Member

    Nov 11, 2002
    About surgery's lifestyle, my jokes were in reference to GS. No mystery that the surgical subs appeal to people because of lifestyle, hence the competition.

    I agree that one downside about anesthesiology is that public perception you guys mentioned and the fact that everyone takes them for granted. It's just the nature of the game - brief patient relationship.

    Thanks for the entertainment!
  26. southerndoc

    southerndoc life is good Moderator Emeritus Lifetime Donor 10+ Year Member

    Jun 6, 2002
    In all seriousness, this is exactly how I've seen it done at two hospitals... the anesthesiologist literally goes from OR to OR watching the nurse anesthetist intubate. He/she comes in about every 15-30 minutes to make sure everything is ok. The nurse anesthetist is there the whole time.

    As far as a general surgeon's lifestyle... keep in mind that people value "lifestyles" differently. One person may find medicine just a job and value being able to go on vacations and such. Another person may think medicine is their vacation. This is by choice, not by lack of an outside life. They may not have an outside life because they do not want it.

    Most surgeons are in private practice, and as such, they can set their own schedules. They don't have to keep doing so many cases per week, seeing patients until 8 pm, etc.
  27. 1 vida

    1 vida New Member

    Nov 6, 2002
    ABC's of anesthesiology




    'nuff said
    (quoted from an anesthesiologist "pilot")

  28. OldManDave

    OldManDave Fossil Bouncer Emeritus Moderator Emeritus 10+ Year Member

    Feb 26, 1999
    Lafayette, IN
    1 - anesthesiology
    2 - surgery, probably CT or Trauma
    3 - ER
  29. JPNSU

    JPNSU Member 7+ Year Member

    Dec 19, 2002
    south Florida
    Here is my top 3

    1. Ophthalmology
    2. Otolaryngology
    3. Radiology

    Jason Park MS-IV

    OldManDave, how are you making out in anesthesiology?
  30. blackcat

    blackcat Senior Member 7+ Year Member

    Nov 25, 2002
    ABC's of EM

    A - Airway

    B- Breathing

    C- Circulation

    D- Discharge/Disposition:laugh:
  31. GenMed

    GenMed Member 7+ Year Member

    Dec 12, 2002
    you left out neuro from the poll
  32. Behcet

    Behcet Member 7+ Year Member

    Dec 29, 2002
    i never did an anesthesia rotation, but i did get to spend a month on a community plastic surgery rotation (that was a fun month!)...and it seemed like at least at that hospital, the private anesthesiologists didn't do anything, the CRNAs did all the work. it was a lot different from the university hospital where i did the rest of my stuff. at the private hospital, the anesthesiologists just watched the CRNAs intubate and then left to go watch tv in the lounge. the CRNA stayed in the OR and kept in touch by walkie-talkie with the anesthesiologist (who usually never came in the room again). i used to hang out in the surgeon's lounge a lot, and i can say, i never heard a kind word said about an anesthesiologist (altho many surgeons had many things to say about them...). like i said, it may only be that one hospital, but i got the idea that in private practice, far from being the pilot of the plane, the anesthesiologists were more like the guy who loads the baggage on...
  33. mandownunder

    mandownunder Member 7+ Year Member

    Dec 16, 2002
    Sorry about the Neuro omission. It wouldn't fit under an Internal Medicne Subspecialties listing either (Cardio, GI, Pulm, Hemonc, Nephro, Rheum, ID...).
    Did you vote as IM instead?
  34. gbv

    gbv Member 10+ Year Member

    Jun 4, 2002
    interesting thread here!

    I just had a question for some of you getting closer to graduation. What do you do if you are interested in two vastly different specialties (to be specific psychiatry and Opth)? Do you have to decide early on if you might want to do something competitive, so that you can get a start on research (I was thinking that for some competitive residencies it might be best to try to get some type of research as soon as one can manage), or would it look bad to do a bunch of research that was say, Opthal. related, only to decide later that you really want to do psych--would that look kind of weird to Psych residency committees? I hope my question makes some sort of sense, and I hope this isn't too out of place :) Thanks a lot!
  35. pimmar

    pimmar Member 10+ Year Member

    May 5, 2001
    1.Plastics or Ortho
    4. Derm
    5. Endocrinology, hematology, or rheumatology
  36. Imhotep

    Imhotep Attending 7+ Year Member

    Aug 6, 2002
    ABC's of medicine





  37. EidolonSix

    EidolonSix Member 7+ Year Member

    Nov 10, 2001 don't diagnose anything, you don't treat anything....and your patients have forgotten your name before the procedure even has begun. Well at least there is golf.
  38. Gator05

    Gator05 Resident 7+ Year Member

    Oct 17, 2001
    Gotta comment on the anesthesiology issue...

    Like in any other specialty, there are good practitioners, and ones not to be admired so much.

    And in private practice, my experience has been that the anesthesiologists and surgeons try to help each other as much as possible; otherwise, each runs the risk of having their life made a living hell.

    Anesthesia may be "boring" in some cases; some people might prefer this pace, or take pride in perfecting the induction/emergence for already healthy patients in lower-risk procedures.

    Then there are the pediatric liver transplants, the multiple-valve replacements, AAA's on 90 year old ladies, burn patients, 50+ or even 100+ liter infusions, septic patients, pediatric hearts, traumas, and your plain old sick-as-stink patients you merely hope survives the next 5 minutes. Don't forget the critical care aspect; challenges abound in this realm, for days and weeks and months on end...

    Want more respect from patients? A good OB anesthesiologist is a hero to any woman (or couple) craving some pain relief. Same could be said for pain management...

    The variety of opportunities anesthesia affords is quite appealing. How one uses those opportunities defines them as a practitioner.
  39. Quack

    Quack Junior Member 7+ Year Member

    You know, I keep seeing these posts and hearing comments from people in (or heading into) one specialty pissing on other specialties. Personally, I'm really glad that people graduating from med school have VARIED interests -- there are some many fields that I'm very glad that others are heading into to take care of specific populations and/or problems that don't appeal to me. For example, I'm glad that others want to do derm -- skin stuff grosses me out. While I'm sure that others are equally glad that I'm going into general surgery and not them. Do I think that my field is better than all others? Certainly not. It's simply a better fit for my interests (or so I hope).

    Given the privilege to work with GOOD physicians in other fields is key. I've been in on cases where the anesthesiologists (all 5 or 6 that were called in) are the main reasons our patient is up and walking today. Or any primary care physician who understands when to call for a consult and when to wait (not every patient who has a belly ache needs a surgeon).

    And while I enjoy giving friends in other fields a friendly ribbing every now and then, the point is that it's friendly and two directional, not acromonious.

    So will you all please start learning to play well with others?

    And for the original question: what specialty?
    1. gen surg
    2. leaving clinical med for one of those $150k+ 40h/wk jobs I got offered in the pharm industry
  40. DermRes

    DermRes Member 7+ Year Member

    Jan 3, 2003
    I am surprised that so few people are interested in derm!

    It is really a good field. It is very challenging and is a great field for people who are artistically inclined with good motor skills.
  41. EidolonSix

    EidolonSix Member 7+ Year Member

    Nov 10, 2001
    I apologize for my witless and scathing comment and humbly beg forgiveness from all of those future and current anaesthesiologists who practice their art selflessly and without temptation of dollar signs and the monday, tuesday, wednesday, thursday and friday afternoons on the golf course or at the yacht club.
  42. Apollyon

    Apollyon Screw the GST Lifetime Donor 10+ Year Member

    Nov 24, 2002
    Because so few people are in derm.
  43. felson

    felson Member 7+ Year Member

    Jan 4, 2003
  44. felson

    felson Member 7+ Year Member

    Jan 4, 2003
    BUMP again:clap: :laugh:
  45. felson

    felson Member 7+ Year Member

    Jan 4, 2003
    BUMPY:laugh: :clap: :laugh:
  46. BenHoganFan

    BenHoganFan Member 7+ Year Member

    Dec 19, 2002
    Even though I was selected for Diagnostic Radiology here are my choices:

    1. Radiology
    2. Ophthalmology
    3. Anesthesiology

    4. Internal Medicine - NOT!
    4. Family Practice - NOT!
    4. Pediatrics - NOT!
    4. Psychiatry - NOT!
  47. rotty1021

    rotty1021 Member 7+ Year Member

    Oct 19, 2002
    Psych, Derm, and Optho all the way. I find these specialties to be fun and rewarding. They can't be beat.
  48. felson

    felson Member 7+ Year Member

    Jan 4, 2003
  49. patelakshar

    patelakshar Member 7+ Year Member

    Nov 11, 2002

    Why the tension between gas and surgs? Is it really like this in the 'real world'?...maybe i should reconsider my specialty...well here they are:


    (in no particular order):
  50. hedging

    hedging Junior Member 7+ Year Member

    Jan 8, 2003
  51. save10

    save10 Doctors do it better 7+ Year Member

    Nov 13, 2002
    wow FP isnt in last place. I love an underdog.

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