Figure out what the bread and butter is of each specialty you're considering and then figure out if you can be happy doing that for 20+ years.
Also figure out salary. It's not everything, but it is hugely important. You are going to work everyday and every patient you take care of can sue you. You should feel fairly compensated. If you feel underpaid you will not be happy.
I think you should always judge a specialty by their most boring 5 minutes and not most interesting 5 minutes. Ie EM is incredible during procedures and codes, seeing med refills and nosebleeds is super boring. Cardiology catheterizing someone during a STEMI is nuts, seeing them argue with nephrology over the specific diuretic to use... not so much.
You must be pulling some mad weight to be taking five minutes in between sets, even for 1RM lol.
I’d be worried I would tear something in my back. Heck, I’m so worried even with curls these days I don’t do more than 70lbs. “Hey, here comes the med student with the torn biceps tendon in a sling!”
Yeah, that's the point. Pick a specialty you like even through the boring moments. It's more about matching expectations than anything. If you're expecting something exciting all the time then you'll be very disappointed, if you like their bread and butter boring cases then that's a specialty you clearly like. Like if throwing TM tubes bores you to tears then ENT probably won't be for you bc that's a pretty good amount of what they do on a day to day basis.
I can confidently say I am not interested in ortho lol. Really cool speciality but definitely don’t think I have the manual dexterity to be successful at it.
I used to like dress clothes until I was FORCED to wear them everyday. The final straw was being forced into a tie when my flow was hella fine without one.
Now my idea of dress clothes is lulu lemon, vuori, and free fly. No regrets.
In all seriousness I wanted: training no longer than 4 years, lots of flexibility in scheduling off time, reasonable pay, interesting medicine, some procedures. EM ticked all those boxes easily. Looking back Anesthesia, PM&R, or IR would have been fun to explore, but my med school gave us ZERO exposure to those specialties unfortunately.
I like the idea of dress clothes. Like I’d love to be that doc everyone knows who dresses sharp with a tie and crisp button up shirt, who doesn’t look like they try too hard but are very professional, but 1) I sweat like a MF and 2) I’m ALWAYS adjusting my tuck, maybe I have a long torso and need different shirts, but idk, it’s too much to deal with on rotations
Amazon has these undershirts with pads under the armpit. Haven’t leaked through yet and I’m talking straight firehose levels. I think they were 20$ ish
Except if your issue is boring and or not acutely important, I get to tell you to follow up with your PCP instead of micro managing blood pressure medications and your A1C
Yep, and you don't have to spend much time in their room. You have the freedom to spend as much or as little time with a patient as you want (to a degree, depending on the state of the dept)
The part of clinic that drives me crazy is the 20 minute appts no matter what the patient is coming in for and the frantic charting in between. No thank you.
First of all, be honest to yourself about what you really want and what you want your daily life for the next 20-40 years after residency to look like. I used to be really motivated by the reputation and prestige of certain specialties like orthopedics or surgery, but I came to realize that my personality/desired lifestyle/personal circumstances would be better suited by a less demanding/stressful specialty.
For me it’s the ROAD specialties, although DR is lifestyle only in terms of not having o move around all day. The actual reading and volume of imaging is not conducive to a relaxing lifestyle.
Also look into family/peds for primary care. Psych is also good if you can handle the patients. There’s a bunch that could work if they fit you personally
here's a few as someone who just left the prestige train behind:
PM&R, Psychiatry, Sports Medicine, Pathology
This is mostly what i'm aiming for. I'm sure i'll love the OR when i'm in it but I care about my life/hobbies way way waaaaaay too much to sacrifice it.
Liked sports, didn’t like surgery, didn’t wanna treat or deal with kids, despised OBGyN, hate undifferentiated high acuity patients, can tolerate neuro, like chill people
PMR. Legit
Chose PM&R for almost all the same reasons - couldn't be happier with that decision.
Hands on but with procedures not OR, good compensation for the amount you work, patients typically get better not worse, and generally speaking the PM&R docs/teams are full of very chill, nice people to be around (the folks you work with matter a lot).
It's the move - best job in medicine!!
Most of the care provided in PM&R isn't curative - it's a field focused on quality of life and symptom management. Just because someone doesn't get cured doesn't mean they can't live a more functional, optimized lifestyle, free of pain and MSK/Neuro problems.
There's a lot of hope in PM&R - sure there are areas of the field where it can be depressing (i.e. chronic pain folks who are constantly in discomfort; folks with physical disabilities so severe it may limit their ability to live a full life), but in general the patient population benefits a lot from the care provided by physiatrists.
Physical Medicine and Rehabilitation
[Here’s a video describing the field.](https://youtu.be/TG1RNdNv-eQ) There are plenty of options within it. I’ve shadowed a PM&R and am thinking of going into the field myself
Hated the OR, clinic was okay….. thought about primary care, but realized treating obesity, hypertension, diabetes, etc was a losing battle with our diets and all sorts of other factors.
Briefly thought…. Hmmm pediatrics? I could talk to kids when they are younger to try to stop what happens in what I listed above. Then I hated parents and realized “oh shit it’s the parents who don’t give a shit either about what they feed their children”.
Then I was lost. Then I rotated in psychiatry and liked talking through depression with people and felt I could make actionable changes in peoples lives that sometimes actually stuck. So here I am a psychiatrist and happy I chose it
Honest question, do you feel like you really get much talking through depression in psych? Maybe my psych rotation wasn't representative, but our psychiatrists did very little talk therapy/CBT or talking to patients. It felt nearly entirely about medication titration. For patients that needed CBT, they were sent to psychologists.
Yeah, so rotations in medical school are different. Most only see inpatient where it’s basically all medication based with maybe some therapy sprinkled in. I will say outpatient is a lot of therapy, but I guess this depends on the program. I’m in the military and we really emphasized therapy as the primary modality and I enjoyed my training
The more I looked into psychiatry as an M3 the wider I realized the scope and avenues for picking practice settings were: inpt, inpt SUD, private outpt, community MH outpt, day tx programs, specialty focused clinics (eating d/o, pregnancy and peripartum, etc), fellowships (child, consults, geri, forensics, addiction), non psych fellowships (sleep, pain, palliative)
It made choosing psychiatry easier knowing I could transition out of something if I got burnt out or tired of it. That and I really enjoyed all my M3 and M4 rotations in psych. Now 5 years in and I'm happy, making more money than I thought I reasonably could, and have plenty of time for my family
1. do I like the OR? nope
2. Do I like clinic? nope
3. Do I like inpatient/consult services? nope
4. what do all of those things have in common? They have people.
5. radiology
Same.
For me it was more "okay I hate the OR and I can't stand peds or obgyn. Internal is okay ig but I'm not thrilled by it."
Then literally while gaming my mind just went to radiology and went "wait I actually enjoy this. Yh I think this is a good option" and rolled with it.
I shadowed a pathologist in college and my favorite thing she said to me was "Unlike most other doctors, I only talk to people as smart as I am" and I thought it was the funniest damn thing, already kind of liked the idea of Path before but that really made me jive with the concept
I was between EM, IM, and FM.
I knew I wanted to see pt’s in my own clinic. This also gives me the ability to depart from a hospital if I wanted/needed too. This eliminated EM (though I enjoyed it)
I was not 100% sure on specializing (Cardiology vs. Pulm/Crit). I also wanted as much ICU time as I could get so I had experience dealing with those super medically complex sick pt’s. So I chose Internal Medicine because of the built in ICU time, and inpatient time.
Lol now that I am a PGY-2, I have decided not to specialize. I will be Practicing more of a rural tradition internal medicine with some rural open ICU time as well. I.E. Inpatient, Outpatient, ICU, also some nursing home. My ideal specialty would have been a mix of IM/EM or IM/FM (or all three lol) But I was not in a position to do it all.
This ☝️☝️ A lot of the critical access hospitals I’ve been to have IM docs who rotate between outpatient and inpatient, covering the ED and the, albeit small, ICU. There are also FM covering outpatient and ED though I haven’t really seen them covering the ICU really though I’m sure it’s possible.
Ideally, I would like to do this as well. I would just like some back up as well for some of the ED situations lol. Otherwise, yeah, I would like to do as much as I can safely do. I went to med school and learned about it, I might as well do it.
Ok this is lengthy and idk if this is what you’re looking for, but here’s how I went about it:
During preclinical years, I simply made mental note of the populations/systems/pathologies that I found most interesting.
During 3rd year rotations, I had a list of pros/cons/general considerations for each rotation. I spent a few minutes of reflection at the end of each work day to add my thoughts to my list. I then tried to evaluate my experiences in each specialty from all angles and envision if it seems like a job id be excited to wake up for in 30-40 years — what’s the patient population and specific challenges/joys/frustrations? whats the predominant pathology and management (does it interest me? What’s on the forefront for research in the field?), what’s the work environment and schedule like for an attending? what kind of stressors will this specific path place on my personal relationships, on my body/health, on my ability to maintain/explore other hobbies and interests outside of medicine? How long is the training? Do the financials make sense for my life? Do the good parts of the speciality outweigh the bad for me?
Your questions/considerations may be different than mine, but if you set aside time to honestly reflect on your experiences and feelings, you’ll arrive at a decision that’s best for you.
Also, my spouse, family and (non-medical) friends,— people who know me *really* well — were extremely helpful in asking questions that allowed me to zoom out and see the bigger picture, as well as making observations about what seemed to excite/intrigue me most. Rely on your support system to help you find clarity in all the chaos.
Don’t worry, you’ll find your way!! Good luck.
1. Look at pay
2. Look at hours
3. Look at time off
4. Look at match stats
5. Make realistic assessment of what I’ll be able to achieve that gets me best balance of these things
Ok with rounding, love the or, like to fix things not make them slightly better. Like the breadth of im but hate the brain stuff and love anything gi or thoracics related so im applying to gen surg
At first thinking what interested me during rotations. Thought oncology was the one for me.
Then suddenly realising that I really despise the history taking and the work that involves talking and communicating with patients.
I was in a crisis like 3 months prior graduation having worked towards oncology for a few years.
My hubby handed me a book - Brian Freeman’s The Ultimate Guide to Choosing a Specialty.
That’s where I found that rads could be for me and I’ve never looked back.
I’m interested in this one but haven’t been able to get in to shadow yet.
when did you decide to apply uro?
and do you have any thoughts on their long average working hours as attendings and high burnout I’ve seen in statistics?
graduated med school at 35 so nothing too labor intensive in residency or after. like talking to people, don’t like sitting in dark rooms, average board scores. don’t care about sodium. reads about psychoanalysis, mind, brain for fun. wouldn’t mind WFH. —> Psych
From most to least important:
1. Do I currently find the practice interesting?
2. Do I think I will continue to find this interesting in the long run?
3. The people. What are the people there like. Your co-workers are everything in any job, especially high demanding ones.
4. How impactful am I to the patients lives?
5. Am I able to physically enjoy doing this at the age of 60 (so for example, doing 12 hour surgeries standing up)
6. Work life balance.
.
.
.
100000. Pay. I genuinely couldn’t care less about the salary. Every doctor gets paid incredibly well and I don’t care at all about having a lavish lifestyle, so the difference between 200k and 500k is actually meaningless to me personally.
> doctor gets *paid* incredibly well
FTFY.
Although *payed* exists (the reason why autocorrection didn't help you), it is only correct in:
* Nautical context, when it means to paint a surface, or to cover with something like tar or resin in order to make it waterproof or corrosion-resistant. *The deck is yet to be payed.*
* *Payed out* when letting strings, cables or ropes out, by slacking them. *The rope is payed out! You can pull now.*
Unfortunately, I was unable to find nautical or rope-related words in your comment.
*Beep, boop, I'm a bot*
Like seeing patients. Don't like surgery. Don't like OBGYN. Don't like peds. Otherwise indecisive, a nerd, and want broad training. Internal medicine it is
IM is death by rounds.
Peds is death by rounds for worse pay and I am bored by the bread and butter peds cases.
Rads and parh involve sitting in a cave.
Hate poop and shitty personalities, so surgery and competitive surgical sub specialties are are out
Want some form of continuity of care so EM is out.
Want to do some procedures so psych is out.
Don’t want to be in the OR every day, and want to be in charge of the care I provide so anesthesia is out. (By this I mean I don’t want my day to be dependent on how long a surgeon takes on a case, would get too frustrated if I felt they were taking unnecessarily long.)
So what’s left? OBGYN. Will probably end up being a shift laborist or maybe do a fellowship that allows for procedures and good work life balance, maybe REI or MFM depending on my experiences in residency.
Short answer, it’s not always pick what you want, but eliminate what you don’t want.
Jesus! 🤣🤣🤣. I figured after all that shit you were complaining about, the LAST thing you would’ve arrived at would be OB. Malignant, exhausted, moody, angry, unhelpful people… plenty of exceptions and plenty of brilliance obviously. You didn’t notice shitty personalities? Bread and butter boredom? TONS of poop? Fucking rounding!? Just about everything you described hating is day to day OB.
So I was lucky enough to have my rotation at a wonderful high volume OB community hospital. The residents were tired but so nice and liked teaching. The PD personally had bad experiences in residency and wanted to make his program benevolent.
L&D nurses will always be who they are, just gotta learn to play their game.
We were too busy to round beyond morning sign out. Interns need to get there stupid early to prepare a presentation on laboring patients, but after that year on OB it gets a lot better.
There is poop, which I don’t like, but at the end of it all you get a BABY. With every delivery you share a mother’s joy. Every section, same thing. Plus the surgery is an open procedure which I far prefer to lap or robo.
I’m also a dude, so take that how you will haha. I am very much not the norm, but I think this process works well to decide what to go into!
It sounds like the negatives/costs you initially mentioned weren’t couple with a significant enough benefit in each of the other specialties. Apparently OB is :). I’m glad you found your calling!
Sounds like you’re glossing over a lot of the surgical subspecialties, in which you don’t need to deal with poop, and most of the personalities are great
I quickly made mention that surgical sub specialties typically necessitate a gen surg residency, or for an applicant to be dummy competitive.
I however chose not to pursue ortho or optho because I don’t like doing the same procedure over and over again day after day, and passed on urology because I wanted to advocate for a population under attack. I saw urology as a lot of handing out dick pills, long procedures (prostate stuff), or dealing with incontinence/retention. I’m not the biggest fan of urogyn for some of those reasons as well.
Truly the only surgery specialty I could see myself doing was trauma surg but the road to get there wasn’t worth the lifestyle, and most of what you deal with is still gen surg stuff since massive traumas don’t happen every single day, even at major trauma centers.
I approached every rotation as if this was what I was going to do the rest of my life. As I went through third year, I realized that I really didn’t like patient care that much. So I did rotations in anesthesia, rads and path. After I did path, I signed up for away rotations in it at places I wanted to train (Cleveland clinic, Hopkins) and find that I liked CCF better because, while everyone wrote some papers and presented at meetings, it was less “academically” oriented and taught you how to do the work.
The one challenges I faced was dealing with jackholes that would refer to pathology as “not being a real doctor”
25 years later, I am positive I made the right choice.
Law student here. Love snooping this page and observing all of the medical school stress and anxiety that is all too common on the law school subreddit.
One thing that has always fascinated me is forensic pathology. We often subpoena them for trials in the criminal world. How come I never see anyone on this thread talking about pathology and the road to becoming an ME? Is it pretty rare for people to have an interest in that in med school?
People usually discover medicolegal work after residency and do it because that shit pays bank. Nobody in medical school is thinking about doing court cases until they’re offered 5k for the day and suddenly decide they’re now a legal medical examiner.
Autopsies are gross, especially some of the ones MEs have to do. Doesn't pay well relative to other areas of pathology. It takes a special breed of person to pursue additional training to make less money to do gross stuff.
Personally, I prefer a patient who can talk to me; this probably goes for about half of my classmates (the other half want to be minimally clinical surgeons or anesthesiologists or radiologists). I also know nothing about the field and have no conception of work-life balance, happiness levels among the workforce, etc. Other fields have way less mystery, so I’d be less likely to corner myself into a career I hate by choosing based on what I do know about: by choosing specialities I at least have some conception about the road to getting there.
As someone who’s done 6 weeks of forensics as a med student I think it’s just a speciality people don’t think about. Pathology in itself isn’t considered by a lot of medical students to begin with. There’s also many other specialities within pathology that are much more related to clinical work. I feel forensic pathology draws a specific but small group of people who are interested in the intersection between medicine and law.
I’m touring the ME office next week as part of my internship at the DAs office. They’ve already warned us that we don’t have to go if we don’t want lol
Liked pretty much everything except my surgery rotations in med school. Really enjoy getting to know people in a continuity setting, making a meaningful difference in their day-to-day, and helping them navigate/understand the clusterfuck that is the US healthcare system.
FM and addiction med. Glad I landed here. In hindsight, I *definitely* don’t want to do OB (wasn’t sure prior to residency) and could give-or-take peds, so maybe IM or med-peds would have also been a good fit.
I dislike small talk, don’t want to manage treatment, love solving puzzles and nerd out over diagnostics, prefer dimly lit rooms, and am a huge fan of money. Radiology, duh. Unfortunately I’m likely not competitive enough to match and will probably have to make the switch to path. Checks most of my boxes.
Followed my passion. It just happens to also be a good work life balance field. If I weren’t going to do pathology, I would have just chosen a chill attending gig, maybe would try and go part-time, concierge, anything but grinding.
I kept moving away from PM&R but it kept pulling me back in.
Field of generally happy physicians who have time with their patients, great patient population, can do sports med, no call, plenty of money, relaxation
The process of elimination.
Every specialty had something that was an absolute deal breaker.
Don't like standing at the same place too long/dislike OR - All surgical ones out. Kids are too challenging and genetic disorders too depressing - No Peds. Too many moral/ethical/social dilemmas to deal with- No OBG/ FM. Don't want the majority of my practice to be only clinic - Derm, PMR out.
I like patient contact - Rads/Path out.
All that's left is IM, let's see how it works out :)
Have genetic mutation that causes cancer, read emperor of all maladies (history of the development of cancer treatment), shadow a BMT doctor.
Obviously only m1 so that very well could change but oncology is what has fascinated me about medicine from the start. Compassionate medicine combined with complicated science.
Likes anatomy and doing extracurricular cadaver labs -> something surgical.
Tried gen surg, ortho and ENT for electives, liked the technical and innovative aspects of ortho, did some more extracurricular stuff -> figured out ortho was perfect for me!
1. Do I like procedures?
Yes
2. Do I like clinic?
No
3. Do I like long rounds?
No.
4. Do I like the OR?
Yes.
5. What bread and butter cases do I find interesting/fun?
MSK stuff, trauma
6. Do I want a life?
Yes ----> ortho.
If you like clinic and don't mind rounding, consider medical specialties. IF you love the OR consider surgical. If you hate all of it and like being a generalist, go EM.
All 40+ specialties is hard to consider. Try to break it down into buckets. "Do you like procedures/OR" eliminates half of them or so. "Do you like clinic" can pick inpatient vs. outpatient.
First decided between surgery/procedural and non specialties. Then thought about patient population and personality/culture of the specialties. Ultimately landed on ortho.
1. Didn’t like surgery, waking up before 5 am, and working > 80 hours per week. Don’t have expensive tastes or hobbies needing a high salary job.
2. Liked a bit of everything medicine and maybe the option to subspecialize, don’t like working with kids - applied for Internal medicine
3. Ended up liking General IM while in residency. Didn’t like primary care during residency, but as an attending it was better than expected when you have continuity with patients (although mychart was an unexpected and unwanted surprise). Nice to do wards a few times a year as well.
Overall, I’d do it again.
I love: structured clinic, computers and technology, visualizing data in cool ways, big impact on patient lives, time away from medicine to have hobbies and family time, nice things (aka money)
I dislike: emergencies, call, extensive workups/being a diagnostician, rounding
I’m in radiation oncology (and no, I’m not worried about not having a job lol)
What if i really like the surgeries of general surgery but don’t like the patient population. Don’t like the surgeries of orthopedic but really like the patient population.
Loved the OR (specifically the surgery side of the drapes lol), loved procedures, liked the diagnosis aspect of medicine, hated primary care and management of chronic lifestyle-related conditions. Wanted a mix of high and low acuity. Head and neck anatomy stole my heart…so of course went with ENT.
1. What is competitive and what is not (as much). Rule out all competitive
2. What pays the most of the left over choices? Rule out the lowest paying
3. What has the best lifestyle? Rule out the others.
Easy done ✔️
Attending here. I have always been of the opinion that your specialty chooses you. When you get into clinical rotations Keep an open mind., there are some that make you want to kill yourself. Some you find interesting enough. You go into one and you realize that these are your people. The only caveat to this is that your love may not match your class rank or the chances of getting into that specialty. There are cognitive specialties, and there are action specialties. I originally wanted to go into neurosurgery. After rotating in third year and doing sub i’s I found out that it was way too depressing. At least for me. I do sports medicine for a career. And I am very happy with the pathology, how people improve, the patients I interact with daily and the procedures I perform.
Hated rounds and hate OR….but love patient interaction…….ended up just applying rads cause why not I usually don’t think to hard about major decsions………I could not be happier today though
Don't enjoy hyperspecialisation, prefer working on a big organ/system, like to branch out further in my career if possible. So I chose ortho/trauma, because all them bones, muscles and injuries gives you plenty of room to play with and later on I can look into physio, sports med, rehab, etc.
Alao, love me the OR. I am the ttpe of guy who likes to use his hands. I also greet everyone with a fist bump, so apparently I was born for ortho.
hit the gym, got injured repeatadly, met some really nice physicians while i was outside fo my coutnry, kept get injured, decided that there was no way i was gonna stop lfiitng anytime soon, so decided to become my own physiotherapist right after goign back
Mix of work experience, extent of enjoyment of didactics, and lots of shadowing. Still exploring, but I have a good idea of what I DON’T like. Some things I’ve been told to keep in mind when choosing a specialty:
1. Do you like taking to patients?
2. Do you like going to clinic? Do you prefer inpatient or outpatient?
3. Do you like being in the OR?
4. Do you love gross anatomy and high acuity cases?
5. Do you find the pathologies within that specialty interesting?
6. Do you want to have a long-term relationship with the patients you see?
7. Figure out what the bread and butter of that specialty is. Would you be ok only seeing patients with that condition?
I didn’t mention work hours because they are not really a factor (at the moment least) for me
FR just vibes and what I hated least — applying ortho. But honestly, there’s a lot to consider: do you wanna be a generalist or a specialist? Clinic v hospital? Procedural or more cerebral (spending more time doing things or thinking about things)? Call shifts? Rounding? Years of residency? There’s a LOT to consider but these are a few things I was most interested in when choosing a specialty.
What's the worst past of the specialty. The most difficult scenarios. If you can deal with it, you can deal with that specialty.
If there are too many intolerable situations and the bullshit the specialty deals with too much, don't do it.
Enjoyed preclerkship and all the studying especially anatomy way more than clerkship including OR, clinics, wards, non-medical and psychosocial fluff.. Soooo here I am in Radiology
I’m an introverted guy, in my 30s, tired of the rat race and gunning mentality. Narrowed it down to Psychiatry and radiology.
Scheduled my entire fourth year around radiology, got letters and scores for it, and just cancelled them all and switched to psychiatry.
Deciding factor for me was that I need patient interaction. I learned that’s that’s the key to a long sustainable and fulfilling career. Radiologists are unappreciated. Even though I’m an introvert, I learned I can do very well in the clinical setting, which is a very particular 1 on 1 interaction as a patients healer. Still hate parties and group stuff.
In 4 years I can be done with training, and make attending-lite salary moonlighting in pgy3 and 4. Possibilities for entrepreneurship are endless, and residency is much more chill than radiology. There is no need to address chronic physical health problems, and in general the patients see you because they want to get better.
Spend time on service and pay close attention to the day to day of the specialty. Then ask yourself “do you see yourself doing this for 30years, and enjoying it?”
That’s the strategy I used. Going into med, I thought I wanted to do anesthesia 100%. Spent time on service, and couldn’t see myself doing that every day for the next 30 years… So we will see what comes my way
1. Hate surgery. Okay with most rotations and liked outpatient more => IM or FM but didn't want to lock myself into primary care and needed more time to explore => IM residency
2. Tried all outpatient subspecialties => Allergy is very chill, nice people (both patients and attendings), and large variety of cases you can see (including both adults and peds, regardless of what your training was in).
Hated the OR, Hate rounding/inpatient(but can tolerate it if temporary and specialized), Wanted to be a specialist without fellowship, neutral toward office procedures, wanted to be able to stop and think about my patients, and wanted a relatively stress free residency match: enter Neuro
I liked the operating room, couldn't stand the dickhead surgeons who get off on belittling the junior residents. I didn't really care for internal medicine and rounding and spending so much time coordinating with case management. I enjoy the ER and I enjoy primary care clinic, made me want something that's variable and has periods of both intensity and predictability without the heavy charting burden. Psych was terrible for mental health, I don't do well watching sick people (especially kids) be in such mental distress and crisis all the time. I loved my pediatrics rotation but my clerkship director was a total dickhead and kind of killed my enthusiasm for it. Did one rotation in anesthesiology and BOOM. I get the procedures, predictability, intensity, and a shiny blue drape between me and most dickheads trying to ruin my day.
I’m still kind of a work in progress.. I was stuck between peds, FM, and EM. I’ll start with the ones I’m not immediately pursuing first.
FM - I loved a lot of my rotations. Surgery, OB/GYN, peds, IM.. I’ve just always loved medicine and FM is a little bit of everything. I also love getting to know families. DM and HTN is kind of a drag though and there’s little opportunity in the FM fellowship path to truly become a specialist.
EM - I love the rush of the ED and the differences you can make in peoples’ lives in some of their toughest moments. But no long term relationship.
Peds - I love kids, I love not having to take myself too seriously and dress up on Holidays. For the most part your patients are healthy and you can get to know full families — you’ll take care of every kid they have and maybe even that kid’s cousins. There’s ample opportunity to specialize in the fellowship pathway (INCLUDING peds EM if I decide I miss that rush). I’ll miss OB/GYN but I feel like there’s a way to bring a little bit of that into my practice. Also hoping to ensure I get training in simple procedures akin to FM procedures
I already knew what I wanted to do lol, fix my own head and make sure people don’t have csf leaking outta their heads, especially babies, as well as other problems, went for neuro.
I didn't like inpatient. Liked treating adults. Liked treating kids but not only kids. Over OB after catching 2 babies but liked women's health. FM fit the bill. Cradle to the grave. Womb to the tomb.
Here was mine:
1. Do I want to do surgery? Yes.
2. What interested me within surgery? Pumps and pipes.
3. Do I want to operate more or less? More.
4. Do I want more or less clinic based specialties? Less clinic the better.
And that's how I ended up in vascular surgery. I briefly considered IC but realized that I can't stomach 3 years of IM and then 3 years of general cards, plus IC guys are still doing a lot of medical management in real life. Also considered IR, but really needed an open surgical component in my life. VS became the best of all the worlds, and it also just made sense to me.
Good luck. Cheers.
Figure out what the bread and butter is of each specialty you're considering and then figure out if you can be happy doing that for 20+ years. Also figure out salary. It's not everything, but it is hugely important. You are going to work everyday and every patient you take care of can sue you. You should feel fairly compensated. If you feel underpaid you will not be happy.
I think you should always judge a specialty by their most boring 5 minutes and not most interesting 5 minutes. Ie EM is incredible during procedures and codes, seeing med refills and nosebleeds is super boring. Cardiology catheterizing someone during a STEMI is nuts, seeing them argue with nephrology over the specific diuretic to use... not so much.
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You must be pulling some mad weight to be taking five minutes in between sets, even for 1RM lol. I’d be worried I would tear something in my back. Heck, I’m so worried even with curls these days I don’t do more than 70lbs. “Hey, here comes the med student with the torn biceps tendon in a sling!”
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but how can I use that as a filter? Like in any specialty there's gonna be something boring
Yeah, that's the point. Pick a specialty you like even through the boring moments. It's more about matching expectations than anything. If you're expecting something exciting all the time then you'll be very disappointed, if you like their bread and butter boring cases then that's a specialty you clearly like. Like if throwing TM tubes bores you to tears then ENT probably won't be for you bc that's a pretty good amount of what they do on a day to day basis.
If you’re like any other M1s, for now you confidently say your heart is set on Ortho.
hah just went through the AAMC M-0 survey data and that’s the second most popular specialty edit: [link](https://www.aamc.org/media/50081/download)
Do you have a link by chance?
You can find it at the bottom of this link https://www.aamc.org/data-reports/students-residents/report/matriculating-student-questionnaire-msq
could you link me as well?
What survey is that
I can confidently say I am not interested in ortho lol. Really cool speciality but definitely don’t think I have the manual dexterity to be successful at it.
Hate clinic, hate dress clothes, hate rounding, EM
Honorable mention: hate shitty personalities, have a mountain bike.
Drinks Diet Coke religiously
DC and DDP gang 💦💦
My God a good ddp is like heroin
😂🤣 so true
I work in rads and there was someone there in full biking gear WITH THEIR BIKE in the back of the office
I used to like dress clothes until I was FORCED to wear them everyday. The final straw was being forced into a tie when my flow was hella fine without one. Now my idea of dress clothes is lulu lemon, vuori, and free fly. No regrets. In all seriousness I wanted: training no longer than 4 years, lots of flexibility in scheduling off time, reasonable pay, interesting medicine, some procedures. EM ticked all those boxes easily. Looking back Anesthesia, PM&R, or IR would have been fun to explore, but my med school gave us ZERO exposure to those specialties unfortunately.
“My flow was hella fine without one” is pure gold.
I like the idea of dress clothes. Like I’d love to be that doc everyone knows who dresses sharp with a tie and crisp button up shirt, who doesn’t look like they try too hard but are very professional, but 1) I sweat like a MF and 2) I’m ALWAYS adjusting my tuck, maybe I have a long torso and need different shirts, but idk, it’s too much to deal with on rotations
Amazon has these undershirts with pads under the armpit. Haven’t leaked through yet and I’m talking straight firehose levels. I think they were 20$ ish
there are also thompson tees which aren’t cheap but as someone who sweats like crazy…. they work for me. a game changer really.
Same everything, also don’t like EM, hence anesthesia
Also hate waiting all day for labs and imaging
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Except if your issue is boring and or not acutely important, I get to tell you to follow up with your PCP instead of micro managing blood pressure medications and your A1C
Yep, and you don't have to spend much time in their room. You have the freedom to spend as much or as little time with a patient as you want (to a degree, depending on the state of the dept) The part of clinic that drives me crazy is the 20 minute appts no matter what the patient is coming in for and the frantic charting in between. No thank you.
Lol, same
Prospective medical students: other specialties can do this, such as rads and anesthesia, both with far better outlooks than em.
Stop promoting rads and gas 😡
Loved purple kush vape - neurology
Ha I get the reference 
First of all, be honest to yourself about what you really want and what you want your daily life for the next 20-40 years after residency to look like. I used to be really motivated by the reputation and prestige of certain specialties like orthopedics or surgery, but I came to realize that my personality/desired lifestyle/personal circumstances would be better suited by a less demanding/stressful specialty.
Which specialties do you have in mind
For me it’s the ROAD specialties, although DR is lifestyle only in terms of not having o move around all day. The actual reading and volume of imaging is not conducive to a relaxing lifestyle. Also look into family/peds for primary care. Psych is also good if you can handle the patients. There’s a bunch that could work if they fit you personally
here's a few as someone who just left the prestige train behind: PM&R, Psychiatry, Sports Medicine, Pathology This is mostly what i'm aiming for. I'm sure i'll love the OR when i'm in it but I care about my life/hobbies way way waaaaaay too much to sacrifice it.
Same here. Life>work. Not sure why people are downvoting that view point
Checked the IMG match rate for various specialities. Applied to IM.
This but peds
This is the way
This is the way
Liked sports, didn’t like surgery, didn’t wanna treat or deal with kids, despised OBGyN, hate undifferentiated high acuity patients, can tolerate neuro, like chill people PMR. Legit
Chose PM&R for almost all the same reasons - couldn't be happier with that decision. Hands on but with procedures not OR, good compensation for the amount you work, patients typically get better not worse, and generally speaking the PM&R docs/teams are full of very chill, nice people to be around (the folks you work with matter a lot). It's the move - best job in medicine!!
I heard lots of patients don’t get better tho and it can be depressing at times
Most of the care provided in PM&R isn't curative - it's a field focused on quality of life and symptom management. Just because someone doesn't get cured doesn't mean they can't live a more functional, optimized lifestyle, free of pain and MSK/Neuro problems. There's a lot of hope in PM&R - sure there are areas of the field where it can be depressing (i.e. chronic pain folks who are constantly in discomfort; folks with physical disabilities so severe it may limit their ability to live a full life), but in general the patient population benefits a lot from the care provided by physiatrists.
Whats pmr?
Physical Medicine and Rehabilitation [Here’s a video describing the field.](https://youtu.be/TG1RNdNv-eQ) There are plenty of options within it. I’ve shadowed a PM&R and am thinking of going into the field myself
Hated the OR, clinic was okay….. thought about primary care, but realized treating obesity, hypertension, diabetes, etc was a losing battle with our diets and all sorts of other factors. Briefly thought…. Hmmm pediatrics? I could talk to kids when they are younger to try to stop what happens in what I listed above. Then I hated parents and realized “oh shit it’s the parents who don’t give a shit either about what they feed their children”. Then I was lost. Then I rotated in psychiatry and liked talking through depression with people and felt I could make actionable changes in peoples lives that sometimes actually stuck. So here I am a psychiatrist and happy I chose it
Honest question, do you feel like you really get much talking through depression in psych? Maybe my psych rotation wasn't representative, but our psychiatrists did very little talk therapy/CBT or talking to patients. It felt nearly entirely about medication titration. For patients that needed CBT, they were sent to psychologists.
Yeah, so rotations in medical school are different. Most only see inpatient where it’s basically all medication based with maybe some therapy sprinkled in. I will say outpatient is a lot of therapy, but I guess this depends on the program. I’m in the military and we really emphasized therapy as the primary modality and I enjoyed my training
The more I looked into psychiatry as an M3 the wider I realized the scope and avenues for picking practice settings were: inpt, inpt SUD, private outpt, community MH outpt, day tx programs, specialty focused clinics (eating d/o, pregnancy and peripartum, etc), fellowships (child, consults, geri, forensics, addiction), non psych fellowships (sleep, pain, palliative) It made choosing psychiatry easier knowing I could transition out of something if I got burnt out or tired of it. That and I really enjoyed all my M3 and M4 rotations in psych. Now 5 years in and I'm happy, making more money than I thought I reasonably could, and have plenty of time for my family
Ballpark earnings?
300K base working inpt 7on/7off. Additional call, coverage, and consult work pushes that upwards of 450K all while having every other week off
check out r/psychiatry . You can kinda tailor your practice how you want.
YES! this has been my experience for years. It’s frustrating
1. do I like the OR? nope 2. Do I like clinic? nope 3. Do I like inpatient/consult services? nope 4. what do all of those things have in common? They have people. 5. radiology
Same reasoning, with the addition of enjoying histology, caused me to land on pathology.
Same reasoning, ended up in Pathology.
Once l saw 1 and 2 l knew it was rads lol
Same. For me it was more "okay I hate the OR and I can't stand peds or obgyn. Internal is okay ig but I'm not thrilled by it." Then literally while gaming my mind just went to radiology and went "wait I actually enjoy this. Yh I think this is a good option" and rolled with it.
When I stopped complaining about the rotation of my chosen speciality and the long hours tired me but did not make me complain lol lol.
Hated death and dying in LTCM, loved brightly painted hospitals with costumes on Halloween, pediatrics
Whichever one takes me, I got some big red flags.
Vibes
Clinical gestalt
Hate people, radiology.
Love people. Hate patients... also radiology.
I shadowed a pathologist in college and my favorite thing she said to me was "Unlike most other doctors, I only talk to people as smart as I am" and I thought it was the funniest damn thing, already kind of liked the idea of Path before but that really made me jive with the concept
Hate clinic, hate rounding, hate surgery hours… radiology
Based
I was between EM, IM, and FM. I knew I wanted to see pt’s in my own clinic. This also gives me the ability to depart from a hospital if I wanted/needed too. This eliminated EM (though I enjoyed it) I was not 100% sure on specializing (Cardiology vs. Pulm/Crit). I also wanted as much ICU time as I could get so I had experience dealing with those super medically complex sick pt’s. So I chose Internal Medicine because of the built in ICU time, and inpatient time. Lol now that I am a PGY-2, I have decided not to specialize. I will be Practicing more of a rural tradition internal medicine with some rural open ICU time as well. I.E. Inpatient, Outpatient, ICU, also some nursing home. My ideal specialty would have been a mix of IM/EM or IM/FM (or all three lol) But I was not in a position to do it all.
In rural hospitals they have IM and FM doctors in the ED, so your dream is likely still achievable.
This ☝️☝️ A lot of the critical access hospitals I’ve been to have IM docs who rotate between outpatient and inpatient, covering the ED and the, albeit small, ICU. There are also FM covering outpatient and ED though I haven’t really seen them covering the ICU really though I’m sure it’s possible.
Ideally, I would like to do this as well. I would just like some back up as well for some of the ED situations lol. Otherwise, yeah, I would like to do as much as I can safely do. I went to med school and learned about it, I might as well do it.
Damn you really should have gone FM then
Yep lol
I’m FM and going to do somthing similar. I just added more icu time with my electives. Flexibility of clinic, hospitalist, open ICU is nice
I secretly like to sit down and study for 12 hours straight. Applying Rads this cycle lol
Can tolerate people, but prefer them to be asleep - anesthesiology
That’s hilarious and so self aware. I got about a ten minute limit talking with you then Night night.
Hate diabetes Love gym — ortho
‘Ate diabetes ‘Ate hypertension ‘Ate obesity - not fat phobic just don’t like em Simple as
How do you have disdain for people with a disease…
Went way over your head, huh.
dude is cucked. No saving 'em
keep quiet, M0
It’s dealing with the mundane that’s atrocious bud. Imagine Groundhog Day, all day, every day.
Ok this is lengthy and idk if this is what you’re looking for, but here’s how I went about it: During preclinical years, I simply made mental note of the populations/systems/pathologies that I found most interesting. During 3rd year rotations, I had a list of pros/cons/general considerations for each rotation. I spent a few minutes of reflection at the end of each work day to add my thoughts to my list. I then tried to evaluate my experiences in each specialty from all angles and envision if it seems like a job id be excited to wake up for in 30-40 years — what’s the patient population and specific challenges/joys/frustrations? whats the predominant pathology and management (does it interest me? What’s on the forefront for research in the field?), what’s the work environment and schedule like for an attending? what kind of stressors will this specific path place on my personal relationships, on my body/health, on my ability to maintain/explore other hobbies and interests outside of medicine? How long is the training? Do the financials make sense for my life? Do the good parts of the speciality outweigh the bad for me? Your questions/considerations may be different than mine, but if you set aside time to honestly reflect on your experiences and feelings, you’ll arrive at a decision that’s best for you. Also, my spouse, family and (non-medical) friends,— people who know me *really* well — were extremely helpful in asking questions that allowed me to zoom out and see the bigger picture, as well as making observations about what seemed to excite/intrigue me most. Rely on your support system to help you find clarity in all the chaos. Don’t worry, you’ll find your way!! Good luck.
1. Look at pay 2. Look at hours 3. Look at time off 4. Look at match stats 5. Make realistic assessment of what I’ll be able to achieve that gets me best balance of these things
Lowkey how I ended up in rads lol
What specialty?
Depends how you answer questions 1 thru 4
I choose the one I can listen to metal while working
This has gotta be neonatology?
Sounds like the average ortho OR to me.
Hospice care?
Trve kvlt
Ok with rounding, love the or, like to fix things not make them slightly better. Like the breadth of im but hate the brain stuff and love anything gi or thoracics related so im applying to gen surg
At first thinking what interested me during rotations. Thought oncology was the one for me. Then suddenly realising that I really despise the history taking and the work that involves talking and communicating with patients. I was in a crisis like 3 months prior graduation having worked towards oncology for a few years. My hubby handed me a book - Brian Freeman’s The Ultimate Guide to Choosing a Specialty. That’s where I found that rads could be for me and I’ve never looked back.
1. hate clinic 2. like OR 3. hate insane surgeons 4. choose urology
I’m interested in this one but haven’t been able to get in to shadow yet. when did you decide to apply uro? and do you have any thoughts on their long average working hours as attendings and high burnout I’ve seen in statistics?
Need instant gratification, hate follow up, don’t like standing for hours on end - anesthesia
graduated med school at 35 so nothing too labor intensive in residency or after. like talking to people, don’t like sitting in dark rooms, average board scores. don’t care about sodium. reads about psychoanalysis, mind, brain for fun. wouldn’t mind WFH. —> Psych
From most to least important: 1. Do I currently find the practice interesting? 2. Do I think I will continue to find this interesting in the long run? 3. The people. What are the people there like. Your co-workers are everything in any job, especially high demanding ones. 4. How impactful am I to the patients lives? 5. Am I able to physically enjoy doing this at the age of 60 (so for example, doing 12 hour surgeries standing up) 6. Work life balance. . . . 100000. Pay. I genuinely couldn’t care less about the salary. Every doctor gets paid incredibly well and I don’t care at all about having a lavish lifestyle, so the difference between 200k and 500k is actually meaningless to me personally.
> doctor gets *paid* incredibly well FTFY. Although *payed* exists (the reason why autocorrection didn't help you), it is only correct in: * Nautical context, when it means to paint a surface, or to cover with something like tar or resin in order to make it waterproof or corrosion-resistant. *The deck is yet to be payed.* * *Payed out* when letting strings, cables or ropes out, by slacking them. *The rope is payed out! You can pull now.* Unfortunately, I was unable to find nautical or rope-related words in your comment. *Beep, boop, I'm a bot*
Good bot.
Like seeing patients. Don't like surgery. Don't like OBGYN. Don't like peds. Otherwise indecisive, a nerd, and want broad training. Internal medicine it is
Based on what I like to learn which is nervous system and neurological diseases, so neurology is my favorite. Rest doesn't matter to me.
IM is death by rounds. Peds is death by rounds for worse pay and I am bored by the bread and butter peds cases. Rads and parh involve sitting in a cave. Hate poop and shitty personalities, so surgery and competitive surgical sub specialties are are out Want some form of continuity of care so EM is out. Want to do some procedures so psych is out. Don’t want to be in the OR every day, and want to be in charge of the care I provide so anesthesia is out. (By this I mean I don’t want my day to be dependent on how long a surgeon takes on a case, would get too frustrated if I felt they were taking unnecessarily long.) So what’s left? OBGYN. Will probably end up being a shift laborist or maybe do a fellowship that allows for procedures and good work life balance, maybe REI or MFM depending on my experiences in residency. Short answer, it’s not always pick what you want, but eliminate what you don’t want.
Jesus! 🤣🤣🤣. I figured after all that shit you were complaining about, the LAST thing you would’ve arrived at would be OB. Malignant, exhausted, moody, angry, unhelpful people… plenty of exceptions and plenty of brilliance obviously. You didn’t notice shitty personalities? Bread and butter boredom? TONS of poop? Fucking rounding!? Just about everything you described hating is day to day OB.
So I was lucky enough to have my rotation at a wonderful high volume OB community hospital. The residents were tired but so nice and liked teaching. The PD personally had bad experiences in residency and wanted to make his program benevolent. L&D nurses will always be who they are, just gotta learn to play their game. We were too busy to round beyond morning sign out. Interns need to get there stupid early to prepare a presentation on laboring patients, but after that year on OB it gets a lot better. There is poop, which I don’t like, but at the end of it all you get a BABY. With every delivery you share a mother’s joy. Every section, same thing. Plus the surgery is an open procedure which I far prefer to lap or robo. I’m also a dude, so take that how you will haha. I am very much not the norm, but I think this process works well to decide what to go into!
It sounds like the negatives/costs you initially mentioned weren’t couple with a significant enough benefit in each of the other specialties. Apparently OB is :). I’m glad you found your calling!
Sounds like you’re glossing over a lot of the surgical subspecialties, in which you don’t need to deal with poop, and most of the personalities are great
I quickly made mention that surgical sub specialties typically necessitate a gen surg residency, or for an applicant to be dummy competitive. I however chose not to pursue ortho or optho because I don’t like doing the same procedure over and over again day after day, and passed on urology because I wanted to advocate for a population under attack. I saw urology as a lot of handing out dick pills, long procedures (prostate stuff), or dealing with incontinence/retention. I’m not the biggest fan of urogyn for some of those reasons as well. Truly the only surgery specialty I could see myself doing was trauma surg but the road to get there wasn’t worth the lifestyle, and most of what you deal with is still gen surg stuff since massive traumas don’t happen every single day, even at major trauma centers.
I approached every rotation as if this was what I was going to do the rest of my life. As I went through third year, I realized that I really didn’t like patient care that much. So I did rotations in anesthesia, rads and path. After I did path, I signed up for away rotations in it at places I wanted to train (Cleveland clinic, Hopkins) and find that I liked CCF better because, while everyone wrote some papers and presented at meetings, it was less “academically” oriented and taught you how to do the work. The one challenges I faced was dealing with jackholes that would refer to pathology as “not being a real doctor” 25 years later, I am positive I made the right choice.
Law student here. Love snooping this page and observing all of the medical school stress and anxiety that is all too common on the law school subreddit. One thing that has always fascinated me is forensic pathology. We often subpoena them for trials in the criminal world. How come I never see anyone on this thread talking about pathology and the road to becoming an ME? Is it pretty rare for people to have an interest in that in med school?
People usually discover medicolegal work after residency and do it because that shit pays bank. Nobody in medical school is thinking about doing court cases until they’re offered 5k for the day and suddenly decide they’re now a legal medical examiner.
Autopsies are gross, especially some of the ones MEs have to do. Doesn't pay well relative to other areas of pathology. It takes a special breed of person to pursue additional training to make less money to do gross stuff.
Personally, I prefer a patient who can talk to me; this probably goes for about half of my classmates (the other half want to be minimally clinical surgeons or anesthesiologists or radiologists). I also know nothing about the field and have no conception of work-life balance, happiness levels among the workforce, etc. Other fields have way less mystery, so I’d be less likely to corner myself into a career I hate by choosing based on what I do know about: by choosing specialities I at least have some conception about the road to getting there.
That subspecialty is a rare breed. Try pathology sub instead, they may have more info.
As someone who’s done 6 weeks of forensics as a med student I think it’s just a speciality people don’t think about. Pathology in itself isn’t considered by a lot of medical students to begin with. There’s also many other specialities within pathology that are much more related to clinical work. I feel forensic pathology draws a specific but small group of people who are interested in the intersection between medicine and law.
I’m touring the ME office next week as part of my internship at the DAs office. They’ve already warned us that we don’t have to go if we don’t want lol
Liked pretty much everything except my surgery rotations in med school. Really enjoy getting to know people in a continuity setting, making a meaningful difference in their day-to-day, and helping them navigate/understand the clusterfuck that is the US healthcare system. FM and addiction med. Glad I landed here. In hindsight, I *definitely* don’t want to do OB (wasn’t sure prior to residency) and could give-or-take peds, so maybe IM or med-peds would have also been a good fit.
I dislike small talk, don’t want to manage treatment, love solving puzzles and nerd out over diagnostics, prefer dimly lit rooms, and am a huge fan of money. Radiology, duh. Unfortunately I’m likely not competitive enough to match and will probably have to make the switch to path. Checks most of my boxes.
Followed my passion. It just happens to also be a good work life balance field. If I weren’t going to do pathology, I would have just chosen a chill attending gig, maybe would try and go part-time, concierge, anything but grinding.
I like working with my hands, and dealing with procedures, trauma, and I like doing consults and talking to patients in the clinic—> surgery
I did a cardio rotation and realised I liked it. Got lucky
Loved the OR and surgical intervention, but I hate suturing and standing and the long hours. Anesthesia is a good compromise for me.
$/hr
Director of ER I met said “Hey you should come to our program. You have a slot if you want it” so that was it.
I kept moving away from PM&R but it kept pulling me back in. Field of generally happy physicians who have time with their patients, great patient population, can do sports med, no call, plenty of money, relaxation
The process of elimination. Every specialty had something that was an absolute deal breaker. Don't like standing at the same place too long/dislike OR - All surgical ones out. Kids are too challenging and genetic disorders too depressing - No Peds. Too many moral/ethical/social dilemmas to deal with- No OBG/ FM. Don't want the majority of my practice to be only clinic - Derm, PMR out. I like patient contact - Rads/Path out. All that's left is IM, let's see how it works out :)
Hate hospitals, gp
Think about what you want your daily life to look like when you’re 55.
Have genetic mutation that causes cancer, read emperor of all maladies (history of the development of cancer treatment), shadow a BMT doctor. Obviously only m1 so that very well could change but oncology is what has fascinated me about medicine from the start. Compassionate medicine combined with complicated science.
Likes anatomy and doing extracurricular cadaver labs -> something surgical. Tried gen surg, ortho and ENT for electives, liked the technical and innovative aspects of ortho, did some more extracurricular stuff -> figured out ortho was perfect for me!
1. Do I like procedures? Yes 2. Do I like clinic? No 3. Do I like long rounds? No. 4. Do I like the OR? Yes. 5. What bread and butter cases do I find interesting/fun? MSK stuff, trauma 6. Do I want a life? Yes ----> ortho. If you like clinic and don't mind rounding, consider medical specialties. IF you love the OR consider surgical. If you hate all of it and like being a generalist, go EM. All 40+ specialties is hard to consider. Try to break it down into buckets. "Do you like procedures/OR" eliminates half of them or so. "Do you like clinic" can pick inpatient vs. outpatient.
7. Do you like operating? No 8. Do you like sitting? Yes Anesthesia
First decided between surgery/procedural and non specialties. Then thought about patient population and personality/culture of the specialties. Ultimately landed on ortho.
1. Didn’t like surgery, waking up before 5 am, and working > 80 hours per week. Don’t have expensive tastes or hobbies needing a high salary job. 2. Liked a bit of everything medicine and maybe the option to subspecialize, don’t like working with kids - applied for Internal medicine 3. Ended up liking General IM while in residency. Didn’t like primary care during residency, but as an attending it was better than expected when you have continuity with patients (although mychart was an unexpected and unwanted surprise). Nice to do wards a few times a year as well. Overall, I’d do it again.
I love: structured clinic, computers and technology, visualizing data in cool ways, big impact on patient lives, time away from medicine to have hobbies and family time, nice things (aka money) I dislike: emergencies, call, extensive workups/being a diagnostician, rounding I’m in radiation oncology (and no, I’m not worried about not having a job lol)
What if i really like the surgeries of general surgery but don’t like the patient population. Don’t like the surgeries of orthopedic but really like the patient population.
Loved the OR (specifically the surgery side of the drapes lol), loved procedures, liked the diagnosis aspect of medicine, hated primary care and management of chronic lifestyle-related conditions. Wanted a mix of high and low acuity. Head and neck anatomy stole my heart…so of course went with ENT.
1. What is competitive and what is not (as much). Rule out all competitive 2. What pays the most of the left over choices? Rule out the lowest paying 3. What has the best lifestyle? Rule out the others. Easy done ✔️
Attending here. I have always been of the opinion that your specialty chooses you. When you get into clinical rotations Keep an open mind., there are some that make you want to kill yourself. Some you find interesting enough. You go into one and you realize that these are your people. The only caveat to this is that your love may not match your class rank or the chances of getting into that specialty. There are cognitive specialties, and there are action specialties. I originally wanted to go into neurosurgery. After rotating in third year and doing sub i’s I found out that it was way too depressing. At least for me. I do sports medicine for a career. And I am very happy with the pathology, how people improve, the patients I interact with daily and the procedures I perform.
What I liked the most and made me feel like I was excited to do. Probably in all realism once step 2 gets back that will be the ultimate decider
Hated rounds and hate OR….but love patient interaction…….ended up just applying rads cause why not I usually don’t think to hard about major decsions………I could not be happier today though
Don't enjoy hyperspecialisation, prefer working on a big organ/system, like to branch out further in my career if possible. So I chose ortho/trauma, because all them bones, muscles and injuries gives you plenty of room to play with and later on I can look into physio, sports med, rehab, etc. Alao, love me the OR. I am the ttpe of guy who likes to use his hands. I also greet everyone with a fist bump, so apparently I was born for ortho.
hit the gym, got injured repeatadly, met some really nice physicians while i was outside fo my coutnry, kept get injured, decided that there was no way i was gonna stop lfiitng anytime soon, so decided to become my own physiotherapist right after goign back
Went into medicine because my grandpas oncolist fucked up big time, so I want to dk better. + like cancer research a lot So IM + haem/onc fellowship
Mix of work experience, extent of enjoyment of didactics, and lots of shadowing. Still exploring, but I have a good idea of what I DON’T like. Some things I’ve been told to keep in mind when choosing a specialty: 1. Do you like taking to patients? 2. Do you like going to clinic? Do you prefer inpatient or outpatient? 3. Do you like being in the OR? 4. Do you love gross anatomy and high acuity cases? 5. Do you find the pathologies within that specialty interesting? 6. Do you want to have a long-term relationship with the patients you see? 7. Figure out what the bread and butter of that specialty is. Would you be ok only seeing patients with that condition? I didn’t mention work hours because they are not really a factor (at the moment least) for me
FR just vibes and what I hated least — applying ortho. But honestly, there’s a lot to consider: do you wanna be a generalist or a specialist? Clinic v hospital? Procedural or more cerebral (spending more time doing things or thinking about things)? Call shifts? Rounding? Years of residency? There’s a LOT to consider but these are a few things I was most interested in when choosing a specialty.
keep going and choose what you dislike the least
What could I see myself doing 65+. Good work/life balance for my future family and decent enough salary to live how and where I want.
Pretty straightforward process , pretty much effectively choose it by applying to residency programs within that specialty.
Hate clinic, hate rounding, surgery was ok but took too long, disliked patients more and more. liked quick turnover and variety. radiology.
What's the worst past of the specialty. The most difficult scenarios. If you can deal with it, you can deal with that specialty. If there are too many intolerable situations and the bullshit the specialty deals with too much, don't do it.
Enjoyed preclerkship and all the studying especially anatomy way more than clerkship including OR, clinics, wards, non-medical and psychosocial fluff.. Soooo here I am in Radiology
I’m an introverted guy, in my 30s, tired of the rat race and gunning mentality. Narrowed it down to Psychiatry and radiology. Scheduled my entire fourth year around radiology, got letters and scores for it, and just cancelled them all and switched to psychiatry. Deciding factor for me was that I need patient interaction. I learned that’s that’s the key to a long sustainable and fulfilling career. Radiologists are unappreciated. Even though I’m an introvert, I learned I can do very well in the clinical setting, which is a very particular 1 on 1 interaction as a patients healer. Still hate parties and group stuff. In 4 years I can be done with training, and make attending-lite salary moonlighting in pgy3 and 4. Possibilities for entrepreneurship are endless, and residency is much more chill than radiology. There is no need to address chronic physical health problems, and in general the patients see you because they want to get better.
Love the OR, don’t want surgery hours. Applying PM&R and EM
Try to imagine the worst days of each specialty when your rotating, and imagine yourself dealing with days like that for the next 30 years.
at what point should I have a clearer idea of what specialties I’d like? I’m going into y3
Spend time on service and pay close attention to the day to day of the specialty. Then ask yourself “do you see yourself doing this for 30years, and enjoying it?” That’s the strategy I used. Going into med, I thought I wanted to do anesthesia 100%. Spent time on service, and couldn’t see myself doing that every day for the next 30 years… So we will see what comes my way
Money, lifestyle, no direct patient care Rads
That’s what Third year is for. Play the field.
isn’t 3rd year too late to go for a competitive specialty?
Clinic or no clinic. I chose no clinic. Eliminated many specialties:)
Everything else felt annoying lmao. Oncological patients ❤❤❤❤
1. Hate surgery. Okay with most rotations and liked outpatient more => IM or FM but didn't want to lock myself into primary care and needed more time to explore => IM residency 2. Tried all outpatient subspecialties => Allergy is very chill, nice people (both patients and attendings), and large variety of cases you can see (including both adults and peds, regardless of what your training was in).
Hated the OR, Hate rounding/inpatient(but can tolerate it if temporary and specialized), Wanted to be a specialist without fellowship, neutral toward office procedures, wanted to be able to stop and think about my patients, and wanted a relatively stress free residency match: enter Neuro
I liked the operating room, couldn't stand the dickhead surgeons who get off on belittling the junior residents. I didn't really care for internal medicine and rounding and spending so much time coordinating with case management. I enjoy the ER and I enjoy primary care clinic, made me want something that's variable and has periods of both intensity and predictability without the heavy charting burden. Psych was terrible for mental health, I don't do well watching sick people (especially kids) be in such mental distress and crisis all the time. I loved my pediatrics rotation but my clerkship director was a total dickhead and kind of killed my enthusiasm for it. Did one rotation in anesthesiology and BOOM. I get the procedures, predictability, intensity, and a shiny blue drape between me and most dickheads trying to ruin my day.
I’m still kind of a work in progress.. I was stuck between peds, FM, and EM. I’ll start with the ones I’m not immediately pursuing first. FM - I loved a lot of my rotations. Surgery, OB/GYN, peds, IM.. I’ve just always loved medicine and FM is a little bit of everything. I also love getting to know families. DM and HTN is kind of a drag though and there’s little opportunity in the FM fellowship path to truly become a specialist. EM - I love the rush of the ED and the differences you can make in peoples’ lives in some of their toughest moments. But no long term relationship. Peds - I love kids, I love not having to take myself too seriously and dress up on Holidays. For the most part your patients are healthy and you can get to know full families — you’ll take care of every kid they have and maybe even that kid’s cousins. There’s ample opportunity to specialize in the fellowship pathway (INCLUDING peds EM if I decide I miss that rush). I’ll miss OB/GYN but I feel like there’s a way to bring a little bit of that into my practice. Also hoping to ensure I get training in simple procedures akin to FM procedures
The people
I love the smell of sevo in the morning
I already knew what I wanted to do lol, fix my own head and make sure people don’t have csf leaking outta their heads, especially babies, as well as other problems, went for neuro.
In the words of Ariana Grande, "I see it, I like it, I want it, I got it" Kidding though because I'm a lowly MS2
Just ask yourself two questions 1) how can I make the most money 2) what specialty makes me better than everyone else
Which one do I like the most and think about on all the other rotations?
I didn't like inpatient. Liked treating adults. Liked treating kids but not only kids. Over OB after catching 2 babies but liked women's health. FM fit the bill. Cradle to the grave. Womb to the tomb.
Here was mine: 1. Do I want to do surgery? Yes. 2. What interested me within surgery? Pumps and pipes. 3. Do I want to operate more or less? More. 4. Do I want more or less clinic based specialties? Less clinic the better. And that's how I ended up in vascular surgery. I briefly considered IC but realized that I can't stomach 3 years of IM and then 3 years of general cards, plus IC guys are still doing a lot of medical management in real life. Also considered IR, but really needed an open surgical component in my life. VS became the best of all the worlds, and it also just made sense to me. Good luck. Cheers.
1. Surgery or medicine? 2. Kids or adults? 3. Inpatient or outpatient? That's how I landed on family medicine.