Did you end up specializing in what you thought you would when you started med school?

[What's Up Doc]

I know that most people go into med school with a lot of confidence that they know what specialty they want to end up practicing. I've also seen a lot of statistics that show how many people regret their specialty choices, and this worries me. I've done quite a bit of volunteering in children's hospitals, and I'm very confident that I want to eventually subspecialize in peds (I won't pretend to know exactly what subspecialty). I'm concerned, however, that this may change at some point for reasons that I can't see right now, and that's actually a pretty terrifying concept. I'm wondering how many of you ended up specializing in what you thought you'd specialize in when entering med school, and how many of you were turned off to the specialty during rotations? I'd specifically like input from those who were interested in pediatrics before med school; did you stay interested in that specialty/subspecialty, or did the passion fade? Input from anyone is greatly appreciated though!

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[colbgw02]

Lowly pre med here.

I know that most people go into med school with a lot of confidence that they know what specialty they want to end up practicing. I've also seen a lot of statistics that show how many people regret their specialty choices, and this worries me. I've done quite a bit of volunteering in children's hospitals, and I'm very confident that I want to eventually subspecialize in peds (I won't pretend to know exactly what subspecialty). I'm concerned, however, that this may change at some point for reasons that I can't see right now, and that's actually a pretty terrifying concept. I'm wondering how many of you ended up specializing in what you thought you'd specialize in when entering med school, and how many of you were turned off to the specialty during rotations? I'd specifically like input from those who were interested in pediatrics before med school; did you stay interested in that specialty/subspecialty, or did the passion fade? Input from anyone is greatly appreciated though!

Really?

 

[mvenus929]

I started fairly confident that I wanted to do peds, and that's what I'm doing. I took a test early in first year to determine which specialties might be a good fit for me, and I scored like 92% peds, and the next closest specialty was at like 10%, so when I say fairly confident, I mean it. I thought for a little while about switching to Family, but realized I didn't like adult outpatient medicine. I also thought about switching to OBGYN, but didn't like the surgical aspect of it.

One of my preceptors told me that peds is a specialty you tend to stick with, because usually those interested in peds like it because the don't want to do adult medicine, or really really like kids and have worked with them extensively prior to med school. That said, I don't know why the idea of switching to another specialty frightens you. You may decide that you don't like the parental counseling part of it, or that you really like working with your hands and feel surgery is a better fit (there were multiple people in my class who were deciding between surgery and peds up until September of fourth year, when residency applications were due). There's nothing wrong with that, and it really is about playing to your strengths and where you see your career going. Be open minded to liking other specialties. If nothing else, understand that you can learn a lot from the other specialties, even if they only or primarily see adults.

Edited for typos. This is what I get for typing on my iPad.

 

[235009]

I started med school wanting to do EM and ended up choosing IM. You learn a lot about what a specialty is actually like once you get to med school instead of the glorified version on tv or on the sdn forums.

I can see how peds would be one specialty you stick with though.

 

[Narmerguy]

Moving to Pre-Allo.

 

[swamprat]

Starting med school I wanted to do EM.. changed my mind about 10x from surgery, cardiology, derm etc. Third year is really the year where you decide what you like and dont. Ended up going into EM, happy with my decision.

 

[Ismet]

Why would you be terrified that your interest might change? If you find a specialty you think you like more, I'd think that would be a good thing and not a bad thing...

I'm obviously 2 years behind @mvenus929 but at this point I'm kind of feeling the same way. I've been thinking peds this whole time, but just did a month of FM and REALLY loved it, did everything from a well check on a 5-day-old to a checkup on a 90-year-old. I have outpatient peds next week and inpatient peds next month so we'll see how it goes. The thing is to keep an open mind through med school, and 3rd year is really the time you figure everything out. You really don't know what a specialty is like until you are working in it, shadowing really doesn't do it. Probably the first distinction people make is surgery vs medicine, usually you have a pretty good idea if surgery might be right for you early on, but of course that can change too.

 

[Goro]

At the end of their 3rd year, most of my students only know what they DON'T want to do!

 

[TooMuchResearch]

Wanted EM. Went EM.

 

[DarknightX]

Started out thinking I might do Emergency Medicine. Thought there was absolutely no way I would go into Surgery (they woke up too early, too many hours, and everyone seemed mean), so I scheduled it as my last rotation of third year.

The only thing I liked about EM was trauma (I quickly realized that trauma surgeons actually got to do all the cool stuff), and I hated everything else about it. I absolutely loved surgery as a med student and now I can't imagine doing anything else. I would quit medicine if I couldn't be a surgeon.

Go into third year with an open mind is my advice.

 

[Optimus-Prime]

Started out thinking I might do Emergency Medicine. Thought there was absolutely no way I would go into Surgery (they woke up too early, too many hours, and everyone seemed mean), so I scheduled it as my last rotation of third year.

The only thing I liked about EM was trauma (I quickly realized that trauma surgeons actually got to do all the cool stuff), and I hated everything else about it. I absolutely loved surgery as a med student and now I can't imagine doing anything else. I would quit medicine if I couldn't be a surgeon.

Go into third year with an open mind is my advice.

Trauma/critical care fellowship?

 

[FutureOncologist]

Starting MS3 soon and I'm looking forward to IM, EM and GS rotations (a little hesitant on GS due to the horror stories I've read haha). As my name implies, I want to work with cancer. There is no Surgical Oncology technically, but I hope to maybe work close with oncologists if I do surgery.

 

[karayaa]

to the OP
http://www.studentdoctor.net/2014/07/what-i-wasnt-meant-to-do-in-medical-school/

 

[What's Up Doc]

to the OP
http://www.studentdoctor.net/2014/07/what-i-wasnt-meant-to-do-in-medical-school/

Haha that article is actually what made me want to start this thread! I just wanted to get a bigger sample size than one author. It's a great article though

 

[Catalystik]

I'm wondering how many of you ended up specializing in what you thought you'd specialize in when entering med school, and how many of you were turned off to the specialty during rotations?

I thought I wanted to go into IM, but changed my mind after third year clinical rotations and went into pediatrics. I've never regretted my decision.

 

[Cyberdyne 101]

Starting MS3 soon and I'm looking forward to IM, EM and GS rotations (a little hesitant on GS due to the horror stories I've read haha). As my name implies, I want to work with cancer. There is no Surgical Oncology technically, but I hope to maybe work close with oncologists if I do surgery.

But there are surgical oncology fellowships!
http://www.surgonc.org/training-education/surgical-oncology/program-list
And neurosurgeons by default seem to train in surgical oncology.

 

[karayaa]

But there are surgical oncology fellowships!
http://www.surgonc.org/training-education/surgical-oncology/program-list
And neurosurgeons by default seem to train in surgical oncology.

but it's not a real speciality bc it's not (yet) BC

 

[FutureOncologist]

But there are surgical oncology fellowships!
http://www.surgonc.org/training-education/surgical-oncology/program-list
And neurosurgeons by default seem to train in surgical oncology.

I wish it was real. It isn't recognized by the board of surgeons as a real specialty in surgery, despite that there are programs that train you in surgical oncology.

 

[Cyberdyne 101]

I wish it was real. It isn't recognized by the board of surgeons as a real specialty in surgery, despite that there are programs that train you in surgical oncology.

It seems real to me. There are surgeons that resect tumors. Although, I can't tell you anything about "official classifications."

 

[FutureOncologist]

It seems real to me. There are surgeons that resect tumors. Although, I can't tell you anything about "official classifications."

I'm also considering going through Neurology/Neurosurgery and do a fellowship in Neurooncology (it's a real thing). It all seems interesting to me.

 

[Cyberdyne 101]

I'm also considering going through Neurology/Neurosurgery and do a fellowship in Neurooncology (it's a real thing). It all seems interesting to me.

Yes, neuro-oncology is definitely real as well!
(We're discussing the paranormal fields in medicine).

 

[FutureOncologist]

Yes, neuro-oncology is definitely real as well!
(We're discussing the paranormal fields in medicine).

Only a few spots in the country (I think around 8-10) so if I decide to leave the Navy (offers a fellowship in Oncology, but not Surgical- or Neuro-Oncology) I will definitely train in it.

 

[RJGOP]

It seems real to me. There are surgeons that resect tumors. Although, I can't tell you anything about "official classifications."

http://www.mcw.edu/orthopaedicsurgery/subspecialties/musculoskeletaloncologycenter.htm
This website lists Musculoskelotal Oncology as a fellowship for orthopedics. I'm sure other specialties have oncologic fellowships as well.

 

[colbgw02]

If your criterion for a subspecialty to be "real" is certification, then there is a huge number of fields that aren't "real". In other words, that's a bad criterion.

 

[Salt Salt]

I want to know the same thing but for psychiatry rather than pediatrics!

 

[Euxox]

You learn a lot about what a specialty is actually like once you get to med school instead of the glorified version on tv or on the sdn forums.

TV glorifies EM. SDN glorifies derm!

 

[Gauss44]

At the end of their 3rd year, most of my students only know what they DON'T want to do!

So, what's the least popular?

 

[Ismet]

So, what's the least popular?

Technically the least popular specialties are the most competitive specialties that don't have a lot of openings and therefore there's a lot of self-selection. Also varies a lot by class and individual interests. Case in point: in 2014, 2 people from my school matched to psych. In 2013, 9 people matched to psych. In 2011, 19 people matched to peds. In 2010, 8 people matched to peds.

 

[Cyberdyne 101]

Only a few spots in the country (I think around 8-10) so if I decide to leave the Navy (offers a fellowship in Oncology, but not Surgical- or Neuro-Oncology) I will definitely train in it.

I just walked past this eerie building...

I swear it's haunted by surgical oncologists and possibly neuro-oncologists...
I definitely felt a presence...

 

[Cyberdyne 101]

http://www.mcw.edu/orthopaedicsurgery/subspecialties/musculoskeletaloncologycenter.htm
This website lists Musculoskelotal Oncology as a fellowship for orthopedics. I'm sure other specialties have oncologic fellowships as well.

MSK tumors are rare. I believe @ridethecliche sees them all the time though. (Most spine tumors are metastatic tumors).
Some ortho spine surgeons do surgical oncology.

 

[FutureOncologist]

MSK tumors are rare. I believe @ridethecliche sees them all the time though. (Most spine tumors are metastatic tumors).
Some ortho spine surgeons do surgical oncology.

This is why I hesitate to do Surg Onc. Many surgical specialties already train you to remove/biopsy the tumor. Path does the lab work and the Oncologist reads and assesses the findings. I could be wrong though.

 

[Goro]

I've worked in that building!

I just walked past this eerie building...
View attachment 184127
I swear it's haunted by surgical oncologists and possibly neuro-oncologists...
I definitely felt a presence...

 

[Cyberdyne 101]

This is why I hesitate to do Surg Onc. Many surgical specialties already train you to remove/biopsy the tumor. Path does the lab work and the Oncologist reads and assesses the findings. I could be wrong
though.

This might depend on the specific tumor, subspecialty, and/or region. In NYC for
example, many doctors are sub-specialists because there is a large enough caseload for them to have a more specific focus.

Also, only neurosurgeons are qualified to resect brain tumors (a specialty specific example). Not even a fellowship trained general surgeon can surgically treat such cancers.

@Winged Scapula is a surgical oncologist. Maybe she can enlighten us.

 

[Cyberdyne 101]

I've worked in that building!

So you've seen them... Or you're actually one of them... The black cat definitely has a supernatural aura...

 

[AMEHigh]

I was pretty open to do anything when I started, but thought I would like family and emergency the most. I had absolutely zero interest in ob/gyn or surgery.

I ended up loving both ob/gyn and surgery and am applying for ob/gyn this year. And through the process so far I've learned that I really don't like any other specialty enough to want to make it a career, so it's either ob/gyn or nothing for me. It's interesting what you find out you like and what your personality is better for once you're in the thick of things.

 

[What's Up Doc]

I was pretty open to do anything when I started, but thought I would like family and emergency the most. I had absolutely zero interest in ob/gyn or surgery.

I ended up loving both ob/gyn and surgery and am applying for ob/gyn this year. And through the process so far I've learned that I really don't like any other specialty enough to want to make it a career, so it's either ob/gyn or nothing for me. It's interesting what you find out you like and what your personality is better for once you're in the thick of things.

Why did you think you absolutely wouldn't end up doing surgery before med school?

 

[Captain Toad]

So, what's the least popular?

I personally would say that it is Nuclear Medicine.

Both because no one knows what it is and pure nuc has a terrible job market, from what I understand.

 

[ridethecliche]

MSK tumors are rare. I believe @ridethecliche sees them all the time though. (Most spine tumors are metastatic tumors).
Some ortho spine surgeons do surgical oncology.

Shameless self promotion.

A first author abstract i submitted to the musculoskeletal tumor society conference just got accepted for a podium presentation. So much excite!

And yeah, my center is a hub for some gnarly spine cases both for primary and metastatic tumors. I love the research, but I'm not sure I could ever do the practice. It's really really really freaking stressful. I love watching those cases but I run out of nails to bite off 10 minutes into ever procedure. There's just so much going on with neuromonitoring, achieving landmarks navigation, ensuring lack of cord disruption...

One of the fellows once joked that he almost hoped that the first patient he had in his solo practice was paraplegic since he could only make the patient feel better. I think that about sums up how incredibly stressful the profession is.

And here's the point where I will stress that I am a lowly research coordinator who lucked out and works at an amazing center. My opinions are founded in my limited research experience and from being a fly on the wall way too often.

 

[What's Up Doc]

 

[MEN2C]

Wanted to do EM. Doing Peds.

 

[Cyberdyne 101]

I apologize for the semi-off topic posts
Anyway, I think you should be excited about exploring other specialties in med school.

 

[themockjock]

Came in wanting to do surgery - wasn't sure what kind. Wavered for a while, spent some time with anesthesia and critical care. Hated every second I was on the wrong side of the curtain and/or taking care of unit patients that weren't "mine" from the OR. Vacillated through several surgical subspecialties - Trauma/SCC (super strong and sexy at my institution), ENT, Plastics, etc. Finally spent some time on the cardiac service, fell in love. Applying I-6, GS 4+3 and regular GS.

So still in a surgical subspecialty. Didn't really think much about CT surg as a pre-med or first year, even after I shadowed some CT surgeons. It was only after I started scrubbing and taking care of cardiac patients that I realized "yep, this is what I want to do with my life." I was also happy for the opportunity to try other things (like anesthesia, etc) and realize just how unhappy I would be doing them, especially knowing that the grass won't be greener on the other side of the curtain when I'm doing up to 10 years of training post med school.

 

[alpinism]

Started out thinking I might do Emergency Medicine. Thought there was absolutely no way I would go into Surgery (they woke up too early, too many hours, and everyone seemed mean), so I scheduled it as my last rotation of third year.

The only thing I liked about EM was trauma (I quickly realized that trauma surgeons actually got to do all the cool stuff), and I hated everything else about it. I absolutely loved surgery as a med student and now I can't imagine doing anything else. I would quit medicine if I couldn't be a surgeon.

Go into third year with an open mind is my advice.

Lol I was the exact opposite of this.

Came into med school sick of the BS involved with EMS and wanting to do Surgery (General or Orthopedics)...
...now I can't see myself doing anything else but EM.

The only thing I liked about surgery was trauma. After rotating through general surgery I realized that most trauma was blunt and non-operative plus most of the cool stuff went to the sub specialists (neuro/ent/ophtho/plastics). Besides that I generally disliked everything about surgery: limited variety of procedures, baby sitting post-op patients, rounding, clinic, early mornings, horrible hours, and malignant personalities. Never really got excited about being in the OR either. Mostly I was just bored. Ortho is still pretty cool but for multiple reasons I'd much rather do EM.

For me, I love dealing with crashing patients and doing resuscitations. I also like variety and treating everything from broken bones to sepsis to heart attacks. In addition, I like being the first person to see a patient without any background information or testing. EM has a ton of problems and is mostly primary care nowadays, but I'd much rather spend 25% of the time doing something I love rather than being bored all the time.

 

[alpinism]

So, what's the least popular?

probably neurosurgery.

 

[neusu]

probably neurosurgery.

I wouldn't say least popular, perhaps least explored. Most schools do not give medical students a great opportunity to investigate neurosurgery and students who have an interest in neurosurgery have to do a fair amount of leg-work to find out if it is for them.

I came to medical school interested in neurosurgery, but wanted to rule out the other options. Ended up in neurosurgery.

 

[FutureOncologist]

I wouldn't say least popular, perhaps least explored. Most schools do not give medical students a great opportunity to investigate neurosurgery and students who have an interest in neurosurgery have to do a fair amount of leg-work to find out if it is for them.

I came to medical school interested in neurosurgery, but wanted to rule out the other options. Ended up in neurosurgery.

Do you ever feel daunted or discouraged by seeing people with such debilitating conditions caused by life-altering accidents? Like seeing teens become mentally/physically handicapped because of just 1 accident?

 

[Cyberdyne 101]

I wouldn't say least popular, perhaps least explored. Most schools do not give medical students a great opportunity to investigate neurosurgery and students who have an interest in neurosurgery have to do a fair amount of leg-work to find out if it is for them.

I came to medical school interested in neurosurgery, but wanted to rule out the other options. Ended up in neurosurgery.

Would you say that at least a sizable percentage of ppl who match into neurosurgery had interest in the field prior to med school (or at least as an MS-1)?

 

[neusu]

Do you ever feel daunted or discouraged by seeing people with such debilitating conditions caused by life-altering accidents? Like seeing teens become mentally/physically handicapped because of just 1 accident?

Surprisingly, no. Yes, it is heart-wrenching to see young, healthy people in the prime of their lives suffer from injury or disease. Often, in these scenarios, our position is to stabilize their injury so it does not become worse, so merely saving their life is a positive occurrence. Also, our field in general is involved in all spectrum of research from injury/disease prevention to new and innovative treatments to repair and return function. Likewise, we are also developing prosthetics or interfaces wherein injured people can maintain independent function, despite their injury.

For me, in any case, what can be discouraging is putting my full effort in to provide care for an individual with an injury of their own fault, having an excellent outcome, and having the individual return to my care for the a similar injury. The stereotypical example would be an alcoholic TBI injury from fall/assault/DWI who comes in half-dead and is saved. Spends a while in the hospital. Returns to the world only to come back from another alcohol related injury.

 

[neusu]

Would you say that at least a sizable percentage of ppl who match into neurosurgery had interest in the field prior to med school (or at least as an MS-1)?

For the most part, yes. For those who know early in medical school that they want to do neurosurgery, they investigate the possibility early and confirm it is what they would like to do and take advantage of opportunities to increase their competitiveness through research and involvement in the field. There is also a sizable percentage of people who do not decide until later in medical school, but as a whole, the field tends to have early adapters.

 

[Cyberdyne 101]

Surprisingly, no. Yes, it is heart-wrenching to see young, healthy people in the prime of their lives suffer from injury or disease. Often, in these scenarios, our position is to stabilize their injury so it does not become worse, so merely saving their life is a positive occurrence. Also, our field in general is involved in all spectrum of research from injury/disease prevention to new and innovative treatments to repair and return function. Likewise, we are also developing prosthetics or interfaces wherein injured people can maintain independent function, despite their injury.

For me, in any case, what can be discouraging is putting my full effort in to provide care for an individual with an injury of their own fault, having an excellent outcome, and having the individual return to my care for the a similar injury. The stereotypical example would be an alcoholic TBI injury from fall/assault/DWI who comes in half-dead and is saved. Spends a while in the hospital. Returns to the world only to come back from another alcohol related injury.

What you mentioned in the first paragraph is very encouraging for those of us that have interest in this field. Thank you!

And I can only begin to imagine the frustration you feel with the type of patient you described in the 2nd paragraph. If only you could implant a microchip in their brain (after the 1st injury) to inhibit future reckless behavior.