Ensuring you get into a specialty?

[V781]

I'm not interested in Internal Medicine or Family Medicine at all. If I end up in either at the end of Medical School years, I would likely regret having taken the MD path at all. I would rather specialize as a PA than become a PCP.

Students in Medical School will be difficult to compete with - only the best get in. How realistic is a plan to be matched into a specialty? I'm assuming those that do get matched are doing research, presentations, shadowing and leading elective groups all while maintaining some of the highest grades in the class?

Specialties I'd consider are all very competitive:
Cardiology
Neurology
Radiology
Anesthesiology
Obstetrics
Neonatology (subspecialty of pediatrics)

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[Inspired Chaos]

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[etp123]

I don't think it's really possible to give a fair assessment on your chances of getting into a specialty before you're even admitted. The journey begins once you're actually a med student and your performance from there on. Everyone has the same chances to match into a specialty at the beginning of their med student journeys. I'm not really sure what you mean by realistic because realistically speaking people do get matched to those specialties... are you willing and determined enough to put in the same amount of work or more to be just as competitive as they are?

Others can't really give an assessment because they don't know how hard you will work for it compared to your peers. Some other things may sort of matter like age, your med school, and whatnot... but best I think anyone can say is focus on getting into med school right now, and once you're in then worry about these questions. Maybe you might even change your mind once you're a med student.

 

[V781]

I don't think it's really possible to give a fair assessment on your chances of getting into a specialty before you're even admitted. The journey begins once you're actually a med student and your performance from there on. Everyone has the same chances to match into a specialty at the beginning of their med student journeys. I'm not really sure what you mean by realistic because realistically speaking people do get matched to those specialties... are you willing and determined enough to put in the same amount of work or more to be just as competitive as they are?

Others can't really give an assessment because they don't know how hard you will work for it compared to your peers. Some other things may sort of matter like age, your med school, and whatnot... but best I think anyone can say is focus on getting into med school right now, and once you're in then worry about these questions. Maybe you might even change your mind once you're a med student.

Well, realistic as far as chances, percentages, statistics...

I just wouldn't want to be stuck in Primary Care so I feel I have to consider the chances of that now...I'm also looking at the PA route.

If I made it in directly after undergrad, I'd be finished with Med School at 32-33.

 

[etp123]

Well, percentages are easy enough to look up and judge for yourself. You can look also at schools within your target range and see what percent of their students end up in what specialty. But again theres several factors we don't know to which may or may not indicate you as a good candidate for getting into those specialties.

Best I can say is weigh your choices carefully and if IM or FM is really not a good option for you, and you think you'd be OK with PA, maybe that would be a wiser choice.

 

[Bru]

I'm not interested in Internal Medicine or Family Medicine at all. If I end up in either at the end of Medical School years, I would likely regret having taken the MD path at all. I would rather specialize as a PA than become a PCP.

Students in Medical School will be difficult to compete with - only the best get in. How realistic is a plan to be matched into a specialty? I'm assuming those that do get matched are doing research, presentations, shadowing and leading elective groups all while maintaining some of the highest grades in the class?

Specialties I'd consider are all very competitive:
Cardiology
Neurology
Radiology
Anesthesiology
Obstetrics
Neonatology (subspecialty of pediatrics)

This may seem a bit harsh but your perception is not particularly accurate. Cards and Neonatology are competitive (although you need to do an IM residency before doing cards generally speaking). The rest aren't too bad particularly if you aren't picky about geography.

Unfortunately, there are no guarantees in this process and these things are not certain. You just need to do it if you want to get a sense of things and do the best you can at med school.

 

[backside_attack]

You say no IM, yet claim you want to do cardiology.... why don't you learn more about how this actually works instead of asking about your chances?

Please go the PA route so I can be your boss one day. You're too lazy to look up the routes to specialties and matching statistics, so you definitely shouldn't go to medical school.

Don't s**t on primary care. Especially since they're the ones sending you referrals if you're a specialist.

 

[bears1992]

I'm guessing by Internal Medicine you meant PCP or hospitalist. PAs are very limited in fields outside of primary care and emergency medicine and while PAs are getting more independence around the country, most of that lies in primary care. It's quite possible that the role of PA and NP will shift solely to primary care leaving the more specialized areas of medicine for physicians. I think you have a much better shot of getting into a specialty with MD than you would with PA. These threads are full of PAs asking about becoming an MD rather than MDs wanting to become PAs.

 

[V781]

You say no IM, yet claim you want to do cardiology.... why don't you learn more about how this actually works instead of asking about your chances?

Please go the PA route so I can be your boss one day. You're too lazy to look up the routes to specialties and matching statistics, so you definitely shouldn't go to medical school.

Don't s**t on primary care. Especially since they're the ones sending you referrals if you're a specialist.

How in the world is this "s**tting" on primary care?? You're overly sensitive. I'm not interested in the position. Period. You're really applying your imagination here. Of course PCP send referrals...

I listed Cardiology as a specialty I'd consider (among several others). The end goal is what I am considering, not the path there (residency is the path there). Obviously, the path toward a specialty includes spending time in all parts of the hospital. I want to specialize in a particular system. How are you so confused???

You sound as though you have control issues. I sincerely hope there aren't any PAs working beneath you.

 

[bears1992]

How in the world is this "s**tting" on primary care?? You're overly sensitive. I'm not interested in the position. Period. You're really applying your imagination here. Of course PCP send referrals...

I listed Cardiology as a specialty I'd consider (among several others). The end goal is what I am considering, not the path there (residency is the path there). Obviously, the path toward a specialty includes spending time in all parts of the hospital. I want to specialize in a particular system. How are you so confused???

You sound as though you have control issues. I sincerely hope there aren't any PAs working beneath you.

You will make a very caring doctor.

 

[Mad Jack]

I'm not interested in Internal Medicine or Family Medicine at all. If I end up in either at the end of Medical School years, I would likely regret having taken the MD path at all. I would rather specialize as a PA than become a PCP.

Students in Medical School will be difficult to compete with - only the best get in. How realistic is a plan to be matched into a specialty? I'm assuming those that do get matched are doing research, presentations, shadowing and leading elective groups all while maintaining some of the highest grades in the class?

Specialties I'd consider are all very competitive:
Cardiology
Neurology
Radiology
Anesthesiology
Obstetrics
Neonatology (subspecialty of pediatrics)

Neuro, OB, and anesthesia are pretty chill.

There's a lot you can do in FM that is more specialty-like, btw.

 

[DrMidlife]

It shouldn't take until post #12 for links to official myth-crushing data to be posted, folks.

nrmp.org

Specifically: NMRP data and reports, for residency.

And then you can define "competitive" to suit your own needs. OB had a 100% match this year, meaning OB was more competitive than derm this year. The most dramatic increase in match rates is in DOs, before and after the AGCME/AOA merger.

The formula for matching well is almost identical to the formula for getting into med school. Scores, grades, letters, relevant experience, likability. By following the formula you maximize your odds; you never get a guarantee by following the formula.

BTW, primary care is a specialty, requiring a 3+ year residency and board certification. The only way to be a practicing non-specialist is to stop after intern year (at which point you can get a license and prescribe, and work in a doc-in-a-box or on a reservation or in a prison).

The things that suck about primary care, that make people not want to do primary care, are also present in specialties. Unless you are able to position yourself to not need insurance reimbursement (which makes you a businessperson more than a clinical provider, pros & cons with that), you will be subject to chronic disease, opioid management, hospital administration, patients with borderline personality disorder, requirements to see a ridiculously high number of patients per day, that particular hamster-like feeling of constantly fighting your EMR to allow you to do your job without actually getting anywhere, etc.

tl;dr: don't go to med school if you can't accept the bad parts of practicing medicine in the US. specialties won't save you.

 

[V781]

You will make a very caring doctor.

I'm hoping this isn't sarcasm. The poster's response was rude and unnecessary.

I have nothing against primary care physicians.

 

[V781]

It shouldn't take until post #12 for links to official myth-crushing data to be posted, folks.

nrmp.org

Specifically: NMRP data and reports, for residency.

And then you can define "competitive" to suit your own needs. OB had a 100% match this year, meaning OB was more competitive than derm this year. The most dramatic increase in match rates is in DOs, before and after the AGCME/AOA merger.

The formula for matching well is almost identical to the formula for getting into med school. Scores, grades, letters, relevant experience, likability. By following the formula you maximize your odds; you never get a guarantee by following the formula.

BTW, primary care is a specialty, requiring a 3+ year residency and board certification. The only way to be a practicing non-specialist is to stop after intern year (at which point you can get a license and prescribe, and work in a doc-in-a-box or on a reservation or in a prison).

The things that suck about primary care, that make people not want to do primary care, are also present in specialties. Unless you are able to position yourself to not need insurance reimbursement (which makes you a businessperson more than a clinical provider, pros & cons with that), you will be subject to chronic disease, opioid management, hospital administration, patients with borderline personality disorder, requirements to see a ridiculously high number of patients per day, that particular hamster-like feeling of constantly fighting your EMR to allow you to do your job without actually getting anywhere, etc.

tl;dr: don't go to med school if you can't accept the bad parts of practicing medicine in the US. specialties won't save you.

I want to become a master of one particular area of the field that I am interested in and I want to deal with cases that are primarily related to that area. I want to care for more than just the average patient with a cold or a headache. PCP is the first visit, and an important one, but they have to send away all their interesting cases -unable to witness or help with further treatment. I'd love to be the one examining an x-ray or an EKG... or delivering a baby.

It is not for the reasons that you listed. I'm aware that all doctors deal with difficult patients and a difficult administration.

 

[xffan624]

I'm not interested in Internal Medicine or Family Medicine at all. If I end up in either at the end of Medical School years, I would likely regret having taken the MD path at all. I would rather specialize as a PA than become a PCP.

Students in Medical School will be difficult to compete with - only the best get in. How realistic is a plan to be matched into a specialty? I'm assuming those that do get matched are doing research, presentations, shadowing and leading elective groups all while maintaining some of the highest grades in the class?

Specialties I'd consider are all very competitive:
Cardiology
Neurology
Radiology
Anesthesiology
Obstetrics
Neonatology (subspecialty of pediatrics)

Cardiology is a subspecialty of internal medicine. Ob/Gyn is a specialty that is often considered primary care. If you''d rather be a PA than a primary care doctor than you clearly don't know much about those fields. So you're more likely looking for the prestige aspect of it. In that case, you will be miserable in medical school and better staying away. Medical school is for folks who want to be doctors, not compete in p1ssing contests.

How in the world is this "s**tting" on primary care?? You're overly sensitive. I'm not interested in the position. Period. You're really applying your imagination here. Of course PCP send referrals...

I listed Cardiology as a specialty I'd consider (among several others). The end goal is what I am considering, not the path there (residency is the path there). Obviously, the path toward a specialty includes spending time in all parts of the hospital. I want to specialize in a particular system. How are you so confused???

You sound as though you have control issues. I sincerely hope there aren't any PAs working beneath you.

I'm hoping this isn't sarcasm. The poster's response was rude and unnecessary.

I have nothing against primary care physicians.

I'm sorry, but basically stating that you'd rather be a PA than consider being a primary care doctor is pretty insulting to primary care doctors.

And btw, many people (and the federal government IIRC) consider ob/gyn to be a primary care doctor. Many young women only see a an ob/gyn for their medical care.

 

[bears1992]

Just go to med school OP. If you aren't fixated on a single specialty and you don't bomb your boards, you should be able to find something outside of becoming a primary care physician or a hospitalist. PA is not for anyone who wants to "become a master of one particular area". It's sort of the opposite of PA.

 

[DrMidlife]

I have no problem with anybody doing any specialty. Go for it.

That said, nontrads really need to be aggressive in rooting out BS reasons for wanting to be a doctor, wanting to not go DO, wanting to be a subspecialist etc. Idealist delusions and convenient generalizations are adorable over in pre-allo. Those of us over 30, over 40, over 50 who are taking ridiculous risks to get into a ridiculously demanding career had by god better not be kidding ourselves. Had by god better keep working to understand what we're getting ourselves into. Can't go home and let our parents take care of us if we flame out, can we now.

But I've written before about how it's not all that likely we'll know what we're getting into, not in any useful way. If you know what a tesseract is, that's pretty much what you turn into, when you go from premed to med school, again to residency, again to practice. You can't know what you're getting into. A square unaware of the cube.

Watch out for the Third Year Spatula. Assume you'll have your mind flipped like a pancake. You'll be cruising along knowing for sure you don't want to do peds...and then. Sure you don't want to do inpatient. Sure you want to be a surgeon. Sure as hell you don't want to do psych. Your ambitions are, most likely, at the mercy of the physicians who tolerate you in your third year. Who show you what you get to do. Who show you what you DON'T ever want to have to do again. Hope and pray you meet your people in time to pick a specialty in which you get to work with your people. (Strongly recommended: get as much time as you can with non-academic providers. Don't just learn within med ed.)

So. I was a nontrad premed who would not have done med school if I'd known I'd end up in primary care. I still get a jones for the specialty I really wanted.

But goddamn I get to do a whole lot of medicine.

Things I did in FM residency the last month of intern year and the first month of R2: delivered 25 or so babies and managed mother/baby postpartum to discharge to clinic, did my own EKGs in clinic and read them my own damn self (I'll order out that echo though, let's not kid around), sewed up maybe 7 or 8 lacs including a really hard ziggy eyebrow on a 7 year old, did a couple paracenteses, managed transplant referral for a patient with a congenital disease now 40 and miserable she can't have kids, read my own damn xrays because the overnight tele-reads are crap, diagnosed postpartum pre-eclampsia in a lady with a headache too persistent to be from an epidural oh hey look at that proteinuria in that UA y'all didn't think I should order, got a package of homemade caramels from an 87 year old clinic patient (really, really tasty), got slightly less sucky at Spanish, made security do their job and deal with my patient who smokes meth in his hospital bathroom between dialyses, caught an absent red reflex in a newborn, fought admin on behalf of a nurse who got in trouble for my my own stupid mistake, raised hell within the system over a rhabdo patient who didn't get any fluids for 13+ hours, discussed acute inpatient care overnight with about a dozen specialists who didn't have to drive into the hospital because I'm reasonably competent at the basics, did inpatient management for a nephrostomy-whoops-duodenal perf-whoops-still a duodenal perf-whoops-oh hey can you manage the transfer to tertiary now. Didn't intubate anybody recently. Still haven't done a damn cortisone injection. I start my ICU rotation next month. Doing a month of trauma/CC soon. This is what's called "full spectrum" FM. Yada yada.

So what. I have to decide what work I want after residency. Do I want to stick with inpatient, for which my program's recent graduates are getting $350k offers in small but nice hospitals? Do I want to focus on obstetrics and do an extra year to get my c-section count up so I can operate without a supervising grownup in the OR? Do I want to think about the inpatient peds offer I got from a town I might actually like living in? Do I want to take an in-residency stipend (good god I could use it) from a decent health system in return for a couple years' commitment to 4 days of clinic and Q9 call? Do I want to keep doing full spectrum and maybe do clinic+L&D+ED+management in the boonies? Dunno yet.

Hope this helps somebody.

 

[V781]

Cardiology is a subspecialty of internal medicine. Ob/Gyn is a specialty that is often considered primary care. If you''d rather be a PA than a primary care doctor than you clearly don't know much about those fields. So you're more likely looking for the prestige aspect of it. In that case, you will be miserable in medical school and better staying away. Medical school is for folks who want to be doctors, not compete in p1ssing contests.



I'm sorry, but basically stating that you'd rather be a PA than consider being a primary care doctor is pretty insulting to primary care doctors.

And btw, many people (and the federal government IIRC) consider ob/gyn to be a primary care doctor. Many young women only see a an ob/gyn for their medical care.

In particular, I was considering Cardiology or Cardiothoracic surgery as a PA. The PA position has its advantages, so I can't possibly see how it'd be an insult to consider it over the other. PAs do not, however, have much room for growth beyond the first few years and many feel that they are not challenging themselves enough. Knowing myself, I am sure I would feel this way at some point and would always feel that I am capable of more...I am truly in love with Physiology.

Ob/gyn is a specialty that requires further education about a particular system in the body. I care about the words in bold. I want to work with and observe the organs associated with a particular specialty.

Many other students want to specialize. In what words would you prefer they use to express their reasoning for the pursuit? If I were to say that I did not want to become a gastroenterologist, would everyone feel just as offended?

"Many young women only see an ob/gyn for their medical care." Why would that upset me? I'm not afraid of patients.

 

[Goro]

I have no problem with anybody doing any specialty. Go for it.

That said, nontrads really need to be aggressive in rooting out BS reasons for wanting to be a doctor, wanting to not go DO, wanting to be a subspecialist etc. Idealist delusions and convenient generalizations are adorable over in pre-allo. Those of us over 30, over 40, over 50 who are taking ridiculous risks to get into a ridiculously demanding career had by god better not be kidding ourselves. Had by god better keep working to understand what we're getting ourselves into. Can't go home and let our parents take care of us if we flame out, can we now.

But I've written before about how it's not all that likely we'll know what we're getting into, not in any useful way. If you know what a tesseract is, that's pretty much what you turn into, when you go from premed to med school, again to residency, again to practice. You can't know what you're getting into. A square unaware of the cube.

Watch out for the Third Year Spatula. Assume you'll have your mind flipped like a pancake. You'll be cruising along knowing for sure you don't want to do peds...and then. Sure you don't want to do inpatient. Sure you want to be a surgeon. Sure as hell you don't want to do psych. Your ambitions are, most likely, at the mercy of the physicians who tolerate you in your third year. Who show you what you get to do. Who show you what you DON'T ever want to have to do again. Hope and pray you meet your people in time to pick a specialty in which you get to work with your people. (Strongly recommended: get as much time as you can with non-academic providers. Don't just learn within med ed.)

So. I was a nontrad premed who would not have done med school if I'd known I'd end up in primary care. I still get a jones for the specialty I really wanted.

But goddamn I get to do a whole lot of medicine.

Things I did in FM residency the last month of intern year and the first month of R2: delivered 25 or so babies and managed mother/baby postpartum to discharge to clinic, did my own EKGs in clinic and read them my own damn self (I'll order out that echo though, let's not kid around), sewed up maybe 7 or 8 lacs including a really hard ziggy eyebrow on a 7 year old, did a couple paracenteses, managed transplant referral for a patient with a congenital disease now 40 and miserable she can't have kids, read my own damn xrays because the overnight tele-reads are crap, diagnosed postpartum pre-eclampsia in a lady with a headache too persistent to be from an epidural oh hey look at that proteinuria in that UA y'all didn't think I should order, got a package of homemade caramels from an 87 year old clinic patient (really, really tasty), got slightly less sucky at Spanish, made security do their job and deal with my patient who smokes meth in his hospital bathroom between dialyses, caught an absent red reflex in a newborn, fought admin on behalf of a nurse who got in trouble for my my own stupid mistake, raised hell within the system over a rhabdo patient who didn't get any fluids for 13+ hours, discussed acute inpatient care overnight with about a dozen specialists who didn't have to drive into the hospital because I'm reasonably competent at the basics, did inpatient management for a nephrostomy-whoops-duodenal perf-whoops-still a duodenal perf-whoops-oh hey can you manage the transfer to tertiary now. Didn't intubate anybody recently. Still haven't done a damn cortisone injection. I start my ICU rotation next month. Doing a month of trauma/CC soon. This is what's called "full spectrum" FM. Yada yada.

So what. I have to decide what work I want after residency. Do I want to stick with inpatient, for which my program's recent graduates are getting $350k offers in small but nice hospitals? Do I want to focus on obstetrics and do an extra year to get my c-section count up so I can operate without a supervising grownup in the OR? Do I want to think about the inpatient peds offer I got from a town I might actually like living in? Do I want to take an in-residency stipend (good god I could use it) from a decent health system in return for a couple years' commitment to 4 days of clinic and Q9 call? Do I want to keep doing full spectrum and maybe do clinic+L&D+ED+management in the boonies? Dunno yet.

Hope this helps somebody.

I so love this woman!

 

[Goro]

It shouldn't take until post #12 for links to official myth-crushing data to be posted, folks.

nrmp.org

Specifically: NMRP data and reports, for residency.

And then you can define "competitive" to suit your own needs. OB had a 100% match this year, meaning OB was more competitive than derm this year. The most dramatic increase in match rates is in DOs, before and after the AGCME/AOA merger.

The formula for matching well is almost identical to the formula for getting into med school. Scores, grades, letters, relevant experience, likability. By following the formula you maximize your odds; you never get a guarantee by following the formula.

BTW, primary care is a specialty, requiring a 3+ year residency and board certification. The only way to be a practicing non-specialist is to stop after intern year (at which point you can get a license and prescribe, and work in a doc-in-a-box or on a reservation or in a prison).

The things that suck about primary care, that make people not want to do primary care, are also present in specialties. Unless you are able to position yourself to not need insurance reimbursement (which makes you a businessperson more than a clinical provider, pros & cons with that), you will be subject to chronic disease, opioid management, hospital administration, patients with borderline personality disorder, requirements to see a ridiculously high number of patients per day, that particular hamster-like feeling of constantly fighting your EMR to allow you to do your job without actually getting anywhere, etc.

tl;dr: don't go to med school if you can't accept the bad parts of practicing medicine in the US. specialties won't save you.

To follow up my wise colleague's post, Primary Care is not the 7th Circle of Hell most pre-meds make it out to be.