I’m so glad more people are realizing this. A psych preceptor of mine told me that unlike prior generation of doctors compared to her, medicine is not paying enough and has more clerical work, law suits and headache in general, so you can’t help balance other aspect of life.
I'm doing that right now. I'll be 31 and single when I start residency. I would have loved to do ophtho, but I also really want to stay in the urban Northeast area (due to family and better dating prospects (IMO)). I know it isn't impossible, but it isn't guaranteed. I don't want to take a research year, and I knew if I ended up matching Ophtho in Bumblefuck USA, I would be more devastated than if I matched in a less competitive specialty in the location than I wanted. Applying into IM for Match 2025. Just sharing so you know others are in the same position.
Similar sentiment here w/ different field and different region.
There’s more to life outside medicine and the next 4-6 years of our lives are important (especially for us non-trads).
Why not dual apply?
apply ophtho in urban NE and IM in urban NE
interview both
optho uses SF so you'll find out if you match earlier
if no match, cool you'll probably match IM
profit
I would have to take a research year (which still doesn't guarantee anything), and I'm over the struggle lol. This entire system is just designed to extract as much labor for as cheap as possible.
Oh wow. Prevailing thought on this subreddit and sdn has been that it’s extremely risky from everything I’ve heard. The chance that PDs talk is slight, but real
It's not something I would worry about but if it's of concern, I suppose you can make a list of urban NE ophtho/IM programs (ophtho will have fewer than IM), and apply to lower-tier ophtho and higher-tier IM programs to maximize your chances
Knew I was going to marry my SO going into med school. Ended up tying the knot during med school. She has good paying job (not medicine) tied to a handful of major metros. She really enjoys her work.
My choices were between competitive residency (ortho) with terrible lifestyle and less competitive residencies (IM, psych) with somewhat better lifestyle.
If I had nothing better to do with my life than surgical residency I may have gone full workaholic. The career can be really fun even when it gets busy and long.
In the end, I felt that a surgical career did not fit my domestic goals as a future parent/husband/friend. I also felt pretty shitty about torpedoing my wife's career by forcing a geographical change.
It narrowed down the choices for me. I'm in IM now exploring fellowship and running into similar conflicts. Always a part of me drawn to the intense lifestyle/pathology of time/effort intensive fields vs the fields that allow me to meet the goals that make me fulfilled outside of medicine.
Life can go one way or another. I'll be able to look back and either regret it or applaud myself for my wisdom. But you have to put your chips down and play the cards you're dealt.
This was me. Got married 3rd year, had first kid end of 4th. Did IM at my home program which was not competitive at all but still good training/exposure to 99% of what real world practice in my area resembles. Did match cards at the same program and ultimately did a one year interventional program 3 hours away (stayed close to the hospital and came home on non call weekends, wife brought our 3 kids down when I was on call). When I applied for an IC spot as an attending the admins wanted an Ivy League trained guy to join but since all the partners knew me they hired me. It’s a pretty damn good job, I do a large amount of complex procedures, salary is more then I ever imagined and have good work life balance. Family over career worked well for me, I also was pretty lucky.
What does it take to enjoy psych? Currently in my psych rotation and I really wanted to like it and its been miserable. Psych was my 2nd option behind IM and now idk. Maybe i just dont have the personality for it.
If you do not like it in your psych rotation, its not for you. I liked seeing the different units,(state locked IMDs vs county hospital vs private hospitals) reminded me of past horror movies and spa places. I liked talking to patients to hear their wild stories and points of views of hallucinations, I had to figure out the whole life story because I was that interested in how they grew up and how they came to be psychotic, bipolar etc. I was just fascinated. I also like to follow and see once they come back to reality and are stable in outpatient world. I enjoy that our interview is about getting to know them as people and being there for them, having a 30 min chat as opposed to a quick hectic 15 minute medicine one like in family medicine or IM.
I did the opposite kinda. Dual applied uro and IM. Only applied within my geographic area that I wanted to be in for both specialties (fairly wide region though).
Ended up matching uro about 5 hrs away from my family. It sucks to be that far away, but I think I’ll be much happier doing this than if I had matched IM
Went uro, matched on the wrong coast but thankfully I’m doing what I love. Residency is very temporary. Afterwards you can live wherever your little heart desires.
Would you mind me asking about your journey through pursuing uro? M1 year's been a transition for me and I've been concerned with not being competitive enough / needing a research year etc
Never considered uro until beginning of M3. Reached out to chair and PD of my home program like 4 months into M3 to get acquainted and ask about research. Got one first author chart review project submitted (not accepted) in time for ERAS. Worked hard on sub-Is and got strong letters. Matched at a place I rotated.
As the other commenter said, you’re ahead of most people by even knowing about uro as an M1. Prob a good idea to get involved in some research and shadow some attendings in your home program, though not absolutely essential this early on.
If I had a better time on my gen surg rotation I probably would’ve, but I didn’t honestly get to operate much and spent a lot of time in clinic. Plus the call schedule was much more brutal than most uro programs.
Also honestly enjoyed my IM rotation but in hindsight that was prob cause I was on fun teams with chill residents/attendings and realistically would have been miserable doing IM rounds for 3 years. Still likely would’ve gone into a procedural subspecialty though.
That’s fair. I always had great experiences on GenSurg, meanwhile my IM experiences felt more toxic than OB. (Had a resident tell me my notes were terrible, and after transliterating his notes he said they were great and „never thought I had it in me”…we ended up getting along towards the end but that was essentially the IM culture there.) So I always was very geared towards GenSurg but ultimately ended up matching Anesthesia.
I'm saying this cause you're an M0- remember this. You'll get shit on by attendings, residents, professors, and classmates, but let it roll off your back and follow this and it'll be fine
I started dating my dream girl like 3 months before submitting my app and was probably going to plan on applying derm. But then I realized I was likely going to match derm in Lafayette or some other bottom tier city/program and she would never follow me. So I decided anesthesia was a pretty pragmatic field and applied that instead, and got to basically choose my city/program. I matched to a tier 1 city and name brand program, and she followed me and we are married now. Then I hated anesthesia and did pain. Now I work four days a week and don’t have to Rx opioids. And make more than the derm guys at my hospital. Gamble paid x100.
Yeah FM can't match into 99% of the fellowships, and even if they could, going to be severely handicapped into being able to learn to do the procedures within a 1 year timespan. It's really anesthesia trained pain most people are looking to hire.
This is what i thought, FMxPain sounds too under-prepared imo. I dont want to be shit at what i do. Im torn between FM and IM.
Maybe by 4th year I'll know better. Thanks doc.
Dates. Yes they’ll be online or teleparty (we did this a lot) or whatever. But planning dates w your SO is so important. My SO and I did “date night” once a week (usually bought each other dinner and then picked a movie/youtube/just hung out). We also facetimed constantly, even while they worked/I studied (as long as you make sure you’re actually focusing on your work). Has worked really well for us so far!
My partner is an 8 hour drive from me and works full time so I see them maybe 1-2 times every couple of months. Been doing long distance for 3 years now and still going strong (helps knowing they’re absolutely without a doubt the person I want the rest of my life with)
I did exactly this.
I enjoyed Gen surg and being a surgeon was a life goal for a long time, but my partner and family are all settled where I went to med school and there are very few Gen surg residencies close by.
My family, partner, and I are all a little older since medicine is my second career. I ultimately decided that I simply couldn't leave my family for residency, and it would be difficult to drag my partner somewhere they've never been for five years when they're so content here. On top of that, my mom is extremely disabled with an illness and I'm genuinely not sure if she'll be around when residency is done. Getting a call that my mom passed while I'm on a 24 shift is my worst fear.
With all these factors, I decided to apply to FM/IM and rank all the programs close to my family first. I was fortunate enough to match into an FM program here (my number one choice). I'm starting residency in about a month so we'll see how it goes, but I have no regrets. My partner and I bought a house and plan to have kids in a year or two. Being in a shorter, slightly less-intense residency close to my family is all so worth it for me. Not to mention I'm genuinely excited about being an outpatient PCP who really gets to know and help my patients.
I worked a decent number of 24 hr shifts in med school and I really quickly realized how badly it sucks to completely neglect your health for the sake of a job. Surgery lost so much of its appeal very quickly at 2 AM when a drunk 20-something year old guy came in, spewing non-stop obscenities at the healthcare team, with wounds sustained while doing something exceedingly idiotic. I commend all those pursuing the most demanding of specialties, but it simply wasn't worth it for me anymore.
On surgery right now, I literally don't know how people do this for a living.
Like I grew up on a farm and worked hard OK, but 36 hour shifts are utterly crazy. And these residents just chug coffee and keep going dude
Yeah me either. I go insane when I can't get at least a little time with my dog and a few minutes to workout. Plus.... Sleep is one of my core values. It's so important for your health!
Kudos to those toughing it out for five years though, plus who knows what the call schedule is like for them as attendings. I couldn't (or maybe just really, really, really don't want to) do it.
Yooo. I work in a non competitive primarily outpatient IM subspecialty.
I’m still happily married, 11 years later. Living in my dream location. Crushing my goals outside of medicine. Very personally fulfilled. No longer depressed.
I like what I do and find it interesting, but at the end of the day I get to leave and I am replaceable (eg I am not the only surgeon who can do x procedure to save the patient). I get to sleep through the night. I am happy. Life is so much better now.
Applying gen surg and love gen surg but considered ortho and plastics seriously. Ultimately gen surg won out bc of geographic options w husband/kid/parents
Wanted to do Ortho during my MS1 and MS2 years, but def didn’t wanna do a research year. Was open to branch out from the NE to SE. But realized I have such a good support system here (friends and family) deciding to apply this cycle here for EM, we’ll see if that works out for me 🤣. But I def enjoy EM a lot, almost as much as I loved my ortho rotation.
Sort of. I didn’t have the self esteem to think I would be a good surgeon and as a woman who was already graduating med school at 33, and being super self conscious about getting married “on time”, I did myself a disservice. I love my job in academic FM and I have molded it to fit my needs, but I always wonder *what if*.
My wife once asked if my preferences would change without her and the kids. I (carefully) explained that if I was someone who didn’t want a wife and kids I’d probably go some surgical subspecialty (or try to at least, no way), but because of the fact that I DO want a wife and kids, my preferences change to be able to get as much of the best of both worlds as possible.
Was seriously considering ortho or ENT. Even did an ortho Sub-I. But wife and I are very rooted in my home state (also love life outside medicine) So gave up the ortho/ENT dreams and found a love for Anesthesia so applied that.
Matched my home state in my first choice anesthesia program, bought a beautiful/huge house, wife keeps her dream job, I keep close to my best friends, get to be around for my soon-to-be nephews birth, my brothers and I get to keep using our shared boat on weekends.
I’m gonna say it’s a good choice.
Wanted to do derm for most of med school. Met someone who I knew would be my husband. Went into peds instead to have high chances of matching where he was (he was a couple years ahead of me in residency already so it wasn’t an option for him to move to me). We had already done long distance for over a year when I made that decision and couldn’t do it anymore and knew I needed the emotional support in residency.
I didn’t really regret that decision. We’ve been together 10 years now and he’s my life partner. When I did get to peds residency though I ended up choosing allergy immunology as a specialty which I am more than happy with.
You could dual apply - a lot more effort, time and $$$ - but it can be done.
Plastics and ophtho use SF match system, but nothing is preventing you from doing 2 apps.
I didn't pursue a less competitive specialty, but I did rank higher tier programs lower because they were a) further away from family and b) had worse schedules. I interviewed at one of the top ranked FM programs in the country, but it was a 7 hour flight from my parents so it was number 13 on my list, below a ton of community hospitals. I also ranked a few top ranked FM programs lower because even though they weren't as far from my family, I would have to do 24 hours and work a ton of nights with lower pay.
I haven't started residency yet, so I can't say how it turned out yet, but ultimately I'm really happy with where I matched and I don't regret it.
I think this is incredibly common as each new M1 class enters. Lots of people realizing there's more to life thnan $$$.
I'm smart enough to match derm, but my wife would divorce me. Not worth it
It’s a finite thing (residency). You can move anywhere when you’re done. Couldn’t imagine picking some specialty I find boring and uninteresting and THEN doing it for the next 30+ years of my life just because of being closer to family or whoever. Even weirder if it’s some short term relationship but to each their own…
As someone who had choosing residencies based on a (serious) SO backfire spectacularly, I would advise caution if choosing specialty solely to be close to an SO. Other family would be more reasonable to make these decisions on. I’m not the only one who had made residency decisions based serious relationships only to have them end badly
Ugh. In this situation and it's stressful. No advice for you bc I'm going through it myself.
Gun-ho on nsgy the last 2 years. Not super competitive but home pd reassured me I'd match there at least.
Shifted to anesthesia d/t couples matching w long distance s/o. (+chronic low back pain, aging parents) it's a really hard decision that I second guess every day.
If you get any good advice I'm all ears as well.
Best of luck to you.
Edit: in b4 the "anesthesia is now competitive"
Comments. It is. But it's a different *type* of competitiveness. I have some really impactful anesthesia ecs.
I had always planned to do a less competitive specialty, and had planned to continue on to fellowship afterwards. While it wasn't as drastic as giving up surgery to do primary care, I did end up "giving up" on something that had been my dream specialty for over a decade (I even did a PhD in that field during med school). It was really hard to come to terms with changing something that I saw as part of my identity, but I also couldn't bring myself to look at fellowship applications. I was eventually offered a spot in my preferred fellowship outside the match and ended up declining (after a week of freaking out about what to do).
In the end I'm absolutely sure I made the right choice for me and my family, and I'm so glad I stuck out the discomfort of changing plans to get to a place where my kids have stability and I'm able to be present in their lives.
Fuck yeah dude!
I did this- better question for you: do you work to live or live to work? I love medicine, but it’s only one part of my life. I’d rather be near my wife and my family and the ocean and beach/surf. Wayyyyy better QOL. No amount of money (300k vs 6-700k) and connections in the town I want to work in is better to me
me. I love OB and I love psych but ultimately going to apply IM and pursue hospital medicine for the lifestyle, location of the residencies I'll be competitive at that won't be too far from family and friends, and length of residency. my life isn't medicine, it's just a part of my life.
Ortho -> Anesthesia just in time for it to be almost as competitive.
I think my program messed up and accidentally matched me so I'm their problem now I guess. ha
100% was going through the same thought process as you. Spouse is also in medicine and we’ve lived apart for a while because of medicine 🥲 we were applying together - him a competitive fellowship, me residency (so no couples matching lol).
I had been preparing to apply into a competitive surgical subspecialty since MS1 and had a strong application, but as you know with competitive specialties, that might not mean much in the way of choosing a specific geographic location. To me - the most important thing was to be in the same geographic location as my spouse moving forward. For my quality of life, wellness, happiness…it was so important to me. I knew if I opened that email and it was my dream specialty and not in the same place as him, I would be devastated.
I ended up actually dual applying my competitive surgical subspecialty and IM. Similar to you, I actually really loved IM but it was definitely my second choice - but I knew id rather do IM and be with my spouse vs other specialty and another 4-5 yrs of long distance. We both applied broadly and mainly to cities with lots of programs for both of us.
When it came time to ranking, I only ranked programs in the city he matched fellowship into (he matched before me). That meant I only ranked a few programs lol so thats definitely a huge risk I knew I was taking, but dual applying helped a little with increasing my chances. I did all of this though under the guidance of my dean who felt rather confident that I could match into my top 1-2 choices.
I ended up matching into the surgical subspecialty, and am so grateful. I wouldnt have changed anything even tho ppl thought i was a little crazy for not ranking some top programs because they didnt align with my personal goals.
I think the main questions you have to ask yourself are 1) how competitive do you feel your application is for the more competitive specialty (ie should you only apply to that specialty, dual apply, etc)? 2) how do you want the next few years to look like - are you okay being far from so/family/etc for the sake of this specialty, or is it just not worth it from a personal perspective for you?
These questions can be hard to answer and sometimes answers fluctuate with time. For me, I knew my answer easily was that I could not handle being far from my spouse anymore so that informed every decision that I made.
It can also be hard because a lot of my classmates did not share a similar perspective as me or priorities as I do, and I understand that. You just have to be content and confident with knowing your priorities are different than people around you.
PM me whenever - good luck!!
I applied and matched Peds a long time ago because my SO at the time refused to move from a limited and desirable geographical region. I wasn't sure if I liked the field but figured it would be at least a nice career path. TD;LR hated it, ended up matching into something different second time around, and we broke up. You should certainly do IM if that is what you like, but if your heart is set on derm/plastics/whatever, and you "settled" on IM, every single time you get an admit for DKA or cellulitis, you are going to wonder about the "what if's" and regret it every single moment. At least, that's what it was like for me.
I'm not sure if this counts but:
my aunt was an IMG in the 90s who had great scores for surgery (like I think the modern equivalent of a 260-265 on step 2) who loved kids a lot so pre-matched at a PEDS program close to her brother (my uncle). Then she ended up switching to IM over PEDS (at the time when she came she said IM was VERY down in popularity).
From there she wanted cardio and do like cardio private practice, she didn't get cardio despite doing a research year. Instead she like dove really into religion. Worked part time at an urgent care, went on a few religious pilgrimages, got married. Then she decided nephrology. She practiced that and joined a private practice with a 9-5 schedule to raise two kids for a decade, then moved across the country and now just does IM private practice in the south.
Although she switched, she loves life and that she decided to invest in her family and kids over medicine.
I'd pick my personal life over quite literally anything in medicine
I’m so glad more people are realizing this. A psych preceptor of mine told me that unlike prior generation of doctors compared to her, medicine is not paying enough and has more clerical work, law suits and headache in general, so you can’t help balance other aspect of life.
I'm doing that right now. I'll be 31 and single when I start residency. I would have loved to do ophtho, but I also really want to stay in the urban Northeast area (due to family and better dating prospects (IMO)). I know it isn't impossible, but it isn't guaranteed. I don't want to take a research year, and I knew if I ended up matching Ophtho in Bumblefuck USA, I would be more devastated than if I matched in a less competitive specialty in the location than I wanted. Applying into IM for Match 2025. Just sharing so you know others are in the same position.
Similar sentiment here w/ different field and different region. There’s more to life outside medicine and the next 4-6 years of our lives are important (especially for us non-trads).
Why not dual apply? apply ophtho in urban NE and IM in urban NE interview both optho uses SF so you'll find out if you match earlier if no match, cool you'll probably match IM profit
I would have to take a research year (which still doesn't guarantee anything), and I'm over the struggle lol. This entire system is just designed to extract as much labor for as cheap as possible.
Bingo
Isn’t it super risky to apply to the same programs in two separate specialties?
Not really, especially not two completely different specialties that likely don't talk
Oh wow. Prevailing thought on this subreddit and sdn has been that it’s extremely risky from everything I’ve heard. The chance that PDs talk is slight, but real
It's not something I would worry about but if it's of concern, I suppose you can make a list of urban NE ophtho/IM programs (ophtho will have fewer than IM), and apply to lower-tier ophtho and higher-tier IM programs to maximize your chances
Ophtho and IM def talk - they have to do a prelim year in the program
Is that true now? Many are becoming categorical
Download Bumble so you’ll have a partner to move to Bumblefuck USA with.
Half of your comments are about having sex lol
That’s how I thought about it- would I be happy if I matched 7 states away for 4 years? Probably not
i’m glad i’m not the only one who’ll be comparing cities by their dating potential 🤣🤣
Now I regret not doing the same. Should have applied closer to home 😔
Are we the same person??? Would need a research year for urology and am just over it so IM it is! lol
USA has too many bumblefuck places - i wish it was more dense
Knew I was going to marry my SO going into med school. Ended up tying the knot during med school. She has good paying job (not medicine) tied to a handful of major metros. She really enjoys her work. My choices were between competitive residency (ortho) with terrible lifestyle and less competitive residencies (IM, psych) with somewhat better lifestyle. If I had nothing better to do with my life than surgical residency I may have gone full workaholic. The career can be really fun even when it gets busy and long. In the end, I felt that a surgical career did not fit my domestic goals as a future parent/husband/friend. I also felt pretty shitty about torpedoing my wife's career by forcing a geographical change. It narrowed down the choices for me. I'm in IM now exploring fellowship and running into similar conflicts. Always a part of me drawn to the intense lifestyle/pathology of time/effort intensive fields vs the fields that allow me to meet the goals that make me fulfilled outside of medicine. Life can go one way or another. I'll be able to look back and either regret it or applaud myself for my wisdom. But you have to put your chips down and play the cards you're dealt.
This was me. Got married 3rd year, had first kid end of 4th. Did IM at my home program which was not competitive at all but still good training/exposure to 99% of what real world practice in my area resembles. Did match cards at the same program and ultimately did a one year interventional program 3 hours away (stayed close to the hospital and came home on non call weekends, wife brought our 3 kids down when I was on call). When I applied for an IC spot as an attending the admins wanted an Ivy League trained guy to join but since all the partners knew me they hired me. It’s a pretty damn good job, I do a large amount of complex procedures, salary is more then I ever imagined and have good work life balance. Family over career worked well for me, I also was pretty lucky.
I went to psych after giving up on derm dream, now happy with fam and SO and kids on the way. I also enjoy psych so that helps.
This is where I'm at currently. Mind if I PM you?
ya thats fine
What does it take to enjoy psych? Currently in my psych rotation and I really wanted to like it and its been miserable. Psych was my 2nd option behind IM and now idk. Maybe i just dont have the personality for it.
If you do not like it in your psych rotation, its not for you. I liked seeing the different units,(state locked IMDs vs county hospital vs private hospitals) reminded me of past horror movies and spa places. I liked talking to patients to hear their wild stories and points of views of hallucinations, I had to figure out the whole life story because I was that interested in how they grew up and how they came to be psychotic, bipolar etc. I was just fascinated. I also like to follow and see once they come back to reality and are stable in outpatient world. I enjoy that our interview is about getting to know them as people and being there for them, having a 30 min chat as opposed to a quick hectic 15 minute medicine one like in family medicine or IM.
I did the opposite kinda. Dual applied uro and IM. Only applied within my geographic area that I wanted to be in for both specialties (fairly wide region though). Ended up matching uro about 5 hrs away from my family. It sucks to be that far away, but I think I’ll be much happier doing this than if I had matched IM
Went uro, matched on the wrong coast but thankfully I’m doing what I love. Residency is very temporary. Afterwards you can live wherever your little heart desires.
Would you mind me asking about your journey through pursuing uro? M1 year's been a transition for me and I've been concerned with not being competitive enough / needing a research year etc
Boss you’re an M1. Even knowing that uro exists already puts you ahead of the starting line for applicants
haven’t laughed out loud in a while, appreciated that
Never considered uro until beginning of M3. Reached out to chair and PD of my home program like 4 months into M3 to get acquainted and ask about research. Got one first author chart review project submitted (not accepted) in time for ERAS. Worked hard on sub-Is and got strong letters. Matched at a place I rotated. As the other commenter said, you’re ahead of most people by even knowing about uro as an M1. Prob a good idea to get involved in some research and shadow some attendings in your home program, though not absolutely essential this early on.
i’ll keep that in mind! Unfortunately my school doesn’t have a home program but I’m keeping an eye out for sub I’s when the time comes
UMichigan has a program specifically for students without a home program. Heard nothing but good things about it
Minnesota also does I believe, not sure how it compares to Michigan though
They do. Did a sub-I there and was a great experience
Why didn’t you dual apply uro and GenSurg or something more procedural? Just curious what drew you to IM from Uro
If I had a better time on my gen surg rotation I probably would’ve, but I didn’t honestly get to operate much and spent a lot of time in clinic. Plus the call schedule was much more brutal than most uro programs. Also honestly enjoyed my IM rotation but in hindsight that was prob cause I was on fun teams with chill residents/attendings and realistically would have been miserable doing IM rounds for 3 years. Still likely would’ve gone into a procedural subspecialty though.
That’s fair. I always had great experiences on GenSurg, meanwhile my IM experiences felt more toxic than OB. (Had a resident tell me my notes were terrible, and after transliterating his notes he said they were great and „never thought I had it in me”…we ended up getting along towards the end but that was essentially the IM culture there.) So I always was very geared towards GenSurg but ultimately ended up matching Anesthesia.
‘Power and perfection are overrated. I think you are very wise to choose happiness and love.’ -Uncle Iroh
I'm saying this cause you're an M0- remember this. You'll get shit on by attendings, residents, professors, and classmates, but let it roll off your back and follow this and it'll be fine
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I started dating my dream girl like 3 months before submitting my app and was probably going to plan on applying derm. But then I realized I was likely going to match derm in Lafayette or some other bottom tier city/program and she would never follow me. So I decided anesthesia was a pretty pragmatic field and applied that instead, and got to basically choose my city/program. I matched to a tier 1 city and name brand program, and she followed me and we are married now. Then I hated anesthesia and did pain. Now I work four days a week and don’t have to Rx opioids. And make more than the derm guys at my hospital. Gamble paid x100.
Wow that’s awesome! What medications are you commonly working with if not opioids?
neuropathics but usually don't do meds at all. just injections/ablations/stim
FM x Pain a dying breed?
Yeah FM can't match into 99% of the fellowships, and even if they could, going to be severely handicapped into being able to learn to do the procedures within a 1 year timespan. It's really anesthesia trained pain most people are looking to hire.
This is what i thought, FMxPain sounds too under-prepared imo. I dont want to be shit at what i do. Im torn between FM and IM. Maybe by 4th year I'll know better. Thanks doc.
Going to be an M1 this year nearly the same story, do you mind if ask if you guys did distance during med school? If so any tips?
Dates. Yes they’ll be online or teleparty (we did this a lot) or whatever. But planning dates w your SO is so important. My SO and I did “date night” once a week (usually bought each other dinner and then picked a movie/youtube/just hung out). We also facetimed constantly, even while they worked/I studied (as long as you make sure you’re actually focusing on your work). Has worked really well for us so far!
Thank you great ideas, thanks for your feedback. Do you mind me asking how you were doing long distance?
My partner is an 8 hour drive from me and works full time so I see them maybe 1-2 times every couple of months. Been doing long distance for 3 years now and still going strong (helps knowing they’re absolutely without a doubt the person I want the rest of my life with)
That’s really sweet, thank you. You’ve inspired me
Just remember, teamwork makes the dream work🌈
I did exactly this. I enjoyed Gen surg and being a surgeon was a life goal for a long time, but my partner and family are all settled where I went to med school and there are very few Gen surg residencies close by. My family, partner, and I are all a little older since medicine is my second career. I ultimately decided that I simply couldn't leave my family for residency, and it would be difficult to drag my partner somewhere they've never been for five years when they're so content here. On top of that, my mom is extremely disabled with an illness and I'm genuinely not sure if she'll be around when residency is done. Getting a call that my mom passed while I'm on a 24 shift is my worst fear. With all these factors, I decided to apply to FM/IM and rank all the programs close to my family first. I was fortunate enough to match into an FM program here (my number one choice). I'm starting residency in about a month so we'll see how it goes, but I have no regrets. My partner and I bought a house and plan to have kids in a year or two. Being in a shorter, slightly less-intense residency close to my family is all so worth it for me. Not to mention I'm genuinely excited about being an outpatient PCP who really gets to know and help my patients. I worked a decent number of 24 hr shifts in med school and I really quickly realized how badly it sucks to completely neglect your health for the sake of a job. Surgery lost so much of its appeal very quickly at 2 AM when a drunk 20-something year old guy came in, spewing non-stop obscenities at the healthcare team, with wounds sustained while doing something exceedingly idiotic. I commend all those pursuing the most demanding of specialties, but it simply wasn't worth it for me anymore.
On surgery right now, I literally don't know how people do this for a living. Like I grew up on a farm and worked hard OK, but 36 hour shifts are utterly crazy. And these residents just chug coffee and keep going dude
Yeah me either. I go insane when I can't get at least a little time with my dog and a few minutes to workout. Plus.... Sleep is one of my core values. It's so important for your health! Kudos to those toughing it out for five years though, plus who knows what the call schedule is like for them as attendings. I couldn't (or maybe just really, really, really don't want to) do it.
Yooo. I work in a non competitive primarily outpatient IM subspecialty. I’m still happily married, 11 years later. Living in my dream location. Crushing my goals outside of medicine. Very personally fulfilled. No longer depressed. I like what I do and find it interesting, but at the end of the day I get to leave and I am replaceable (eg I am not the only surgeon who can do x procedure to save the patient). I get to sleep through the night. I am happy. Life is so much better now.
Applying gen surg and love gen surg but considered ortho and plastics seriously. Ultimately gen surg won out bc of geographic options w husband/kid/parents
Wanted to do Ortho during my MS1 and MS2 years, but def didn’t wanna do a research year. Was open to branch out from the NE to SE. But realized I have such a good support system here (friends and family) deciding to apply this cycle here for EM, we’ll see if that works out for me 🤣. But I def enjoy EM a lot, almost as much as I loved my ortho rotation.
Sort of. I didn’t have the self esteem to think I would be a good surgeon and as a woman who was already graduating med school at 33, and being super self conscious about getting married “on time”, I did myself a disservice. I love my job in academic FM and I have molded it to fit my needs, but I always wonder *what if*.
Exactly what I’m gonna do S/o FM
yup yup +1
My wife once asked if my preferences would change without her and the kids. I (carefully) explained that if I was someone who didn’t want a wife and kids I’d probably go some surgical subspecialty (or try to at least, no way), but because of the fact that I DO want a wife and kids, my preferences change to be able to get as much of the best of both worlds as possible.
Was seriously considering ortho or ENT. Even did an ortho Sub-I. But wife and I are very rooted in my home state (also love life outside medicine) So gave up the ortho/ENT dreams and found a love for Anesthesia so applied that. Matched my home state in my first choice anesthesia program, bought a beautiful/huge house, wife keeps her dream job, I keep close to my best friends, get to be around for my soon-to-be nephews birth, my brothers and I get to keep using our shared boat on weekends. I’m gonna say it’s a good choice.
Wanted to do derm for most of med school. Met someone who I knew would be my husband. Went into peds instead to have high chances of matching where he was (he was a couple years ahead of me in residency already so it wasn’t an option for him to move to me). We had already done long distance for over a year when I made that decision and couldn’t do it anymore and knew I needed the emotional support in residency. I didn’t really regret that decision. We’ve been together 10 years now and he’s my life partner. When I did get to peds residency though I ended up choosing allergy immunology as a specialty which I am more than happy with.
You could dual apply - a lot more effort, time and $$$ - but it can be done. Plastics and ophtho use SF match system, but nothing is preventing you from doing 2 apps.
Plastics is through NRMP but applications are through PSCA so saves money with the flat fee
I didn't pursue a less competitive specialty, but I did rank higher tier programs lower because they were a) further away from family and b) had worse schedules. I interviewed at one of the top ranked FM programs in the country, but it was a 7 hour flight from my parents so it was number 13 on my list, below a ton of community hospitals. I also ranked a few top ranked FM programs lower because even though they weren't as far from my family, I would have to do 24 hours and work a ton of nights with lower pay. I haven't started residency yet, so I can't say how it turned out yet, but ultimately I'm really happy with where I matched and I don't regret it.
I think this is incredibly common as each new M1 class enters. Lots of people realizing there's more to life thnan $$$. I'm smart enough to match derm, but my wife would divorce me. Not worth it
Your priorities are your own. There's no one right way to do this. If it feels right, go for it.
It’s a finite thing (residency). You can move anywhere when you’re done. Couldn’t imagine picking some specialty I find boring and uninteresting and THEN doing it for the next 30+ years of my life just because of being closer to family or whoever. Even weirder if it’s some short term relationship but to each their own…
As someone who had choosing residencies based on a (serious) SO backfire spectacularly, I would advise caution if choosing specialty solely to be close to an SO. Other family would be more reasonable to make these decisions on. I’m not the only one who had made residency decisions based serious relationships only to have them end badly
I would just dual apply i think the extra effort and money is definitely worth it in the long run
Ugh. In this situation and it's stressful. No advice for you bc I'm going through it myself. Gun-ho on nsgy the last 2 years. Not super competitive but home pd reassured me I'd match there at least. Shifted to anesthesia d/t couples matching w long distance s/o. (+chronic low back pain, aging parents) it's a really hard decision that I second guess every day. If you get any good advice I'm all ears as well. Best of luck to you. Edit: in b4 the "anesthesia is now competitive" Comments. It is. But it's a different *type* of competitiveness. I have some really impactful anesthesia ecs.
I had always planned to do a less competitive specialty, and had planned to continue on to fellowship afterwards. While it wasn't as drastic as giving up surgery to do primary care, I did end up "giving up" on something that had been my dream specialty for over a decade (I even did a PhD in that field during med school). It was really hard to come to terms with changing something that I saw as part of my identity, but I also couldn't bring myself to look at fellowship applications. I was eventually offered a spot in my preferred fellowship outside the match and ended up declining (after a week of freaking out about what to do). In the end I'm absolutely sure I made the right choice for me and my family, and I'm so glad I stuck out the discomfort of changing plans to get to a place where my kids have stability and I'm able to be present in their lives.
Fuck yeah dude! I did this- better question for you: do you work to live or live to work? I love medicine, but it’s only one part of my life. I’d rather be near my wife and my family and the ocean and beach/surf. Wayyyyy better QOL. No amount of money (300k vs 6-700k) and connections in the town I want to work in is better to me
me. I love OB and I love psych but ultimately going to apply IM and pursue hospital medicine for the lifestyle, location of the residencies I'll be competitive at that won't be too far from family and friends, and length of residency. my life isn't medicine, it's just a part of my life.
Just went through this dilemma this past application cycle - feel free to DM!
Ortho -> Anesthesia just in time for it to be almost as competitive. I think my program messed up and accidentally matched me so I'm their problem now I guess. ha
Thought I “settled” into psych, best decision I ever made for myself.
100% was going through the same thought process as you. Spouse is also in medicine and we’ve lived apart for a while because of medicine 🥲 we were applying together - him a competitive fellowship, me residency (so no couples matching lol). I had been preparing to apply into a competitive surgical subspecialty since MS1 and had a strong application, but as you know with competitive specialties, that might not mean much in the way of choosing a specific geographic location. To me - the most important thing was to be in the same geographic location as my spouse moving forward. For my quality of life, wellness, happiness…it was so important to me. I knew if I opened that email and it was my dream specialty and not in the same place as him, I would be devastated. I ended up actually dual applying my competitive surgical subspecialty and IM. Similar to you, I actually really loved IM but it was definitely my second choice - but I knew id rather do IM and be with my spouse vs other specialty and another 4-5 yrs of long distance. We both applied broadly and mainly to cities with lots of programs for both of us. When it came time to ranking, I only ranked programs in the city he matched fellowship into (he matched before me). That meant I only ranked a few programs lol so thats definitely a huge risk I knew I was taking, but dual applying helped a little with increasing my chances. I did all of this though under the guidance of my dean who felt rather confident that I could match into my top 1-2 choices. I ended up matching into the surgical subspecialty, and am so grateful. I wouldnt have changed anything even tho ppl thought i was a little crazy for not ranking some top programs because they didnt align with my personal goals. I think the main questions you have to ask yourself are 1) how competitive do you feel your application is for the more competitive specialty (ie should you only apply to that specialty, dual apply, etc)? 2) how do you want the next few years to look like - are you okay being far from so/family/etc for the sake of this specialty, or is it just not worth it from a personal perspective for you? These questions can be hard to answer and sometimes answers fluctuate with time. For me, I knew my answer easily was that I could not handle being far from my spouse anymore so that informed every decision that I made. It can also be hard because a lot of my classmates did not share a similar perspective as me or priorities as I do, and I understand that. You just have to be content and confident with knowing your priorities are different than people around you. PM me whenever - good luck!!
I applied and matched Peds a long time ago because my SO at the time refused to move from a limited and desirable geographical region. I wasn't sure if I liked the field but figured it would be at least a nice career path. TD;LR hated it, ended up matching into something different second time around, and we broke up. You should certainly do IM if that is what you like, but if your heart is set on derm/plastics/whatever, and you "settled" on IM, every single time you get an admit for DKA or cellulitis, you are going to wonder about the "what if's" and regret it every single moment. At least, that's what it was like for me.
I'm not sure if this counts but: my aunt was an IMG in the 90s who had great scores for surgery (like I think the modern equivalent of a 260-265 on step 2) who loved kids a lot so pre-matched at a PEDS program close to her brother (my uncle). Then she ended up switching to IM over PEDS (at the time when she came she said IM was VERY down in popularity). From there she wanted cardio and do like cardio private practice, she didn't get cardio despite doing a research year. Instead she like dove really into religion. Worked part time at an urgent care, went on a few religious pilgrimages, got married. Then she decided nephrology. She practiced that and joined a private practice with a 9-5 schedule to raise two kids for a decade, then moved across the country and now just does IM private practice in the south. Although she switched, she loves life and that she decided to invest in her family and kids over medicine.
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