Remembering the path...

[Skeptic]

So as a fun little game (and as a third year medical pion struggling with figuring out exactly what I want to do with the rest of my life), I thought it would be nice if everyone who has finally decided or is in the process of deciding on rads put down what they were/are debating in between for career options.

Por ejemplo, my top three choices are rads, ob, and rads. Who's next?

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[CopperT]

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[elperro]

see next

 

[elperro]

I have been struggling with the choice between rads and path. I really like both specialties. I have had a rotation in rads and it seems like they are all very happy. I have been down to path many times, and their docs seem the same way. I guess it all comes down to what you like looking at better, since they have similar knowledge bases--pathology and anatomy with the difference being in histology vs. radiographs.
Such a hard choice, it is driving me crazy. The CP aspect of path drives me to rads since I hate the thought of laboratory and people management. But, the disease processes fascinate me.
As for Rads, I'm not sure I will like seeing the disease process macroscopically as much i.e. sarcoid nodules on a b & w x-ray vs. in color under the scope. Rads has cool technology, but I'm not very tech savy, I was never good at math and physics, while I did great in biology. Still, I can't shake the thought of radiology since I really enjoyed the rotation. Any help out there?

 

[MD Dreams]

Top two choices:

1. Interventional Radiology
2. Anesthesiology

But, havn't ruled out

3. Surgery

I change my mind about three times a day!

 

[Epithelioid]

So as a fun little game (and as a third year medical pion struggling with figuring out exactly what I want to do with the rest of my life), I thought it would be nice if everyone who has finally decided or is in the process of deciding on rads put down what they were/are debating in between for career options.

Por ejemplo, my top three choices are rads, ob, and rads. Who's next?

Rads vs. ENT . . . decided on Rads

 

[Skeptic]

I have been struggling with the choice between rads and path. I really like both specialties. I have had a rotation in rads and it seems like they are all very happy. I have been down to path many times, and their docs seem the same way. I guess it all comes down to what you like looking at better, since they have similar knowledge bases--pathology and anatomy with the difference being in histology vs. radiographs.
Such a hard choice, it is driving me crazy. The CP aspect of path drives me to rads since I hate the thought of laboratory and people management. But, the disease processes fascinate me.
As for Rads, I'm not sure I will like seeing the disease process macroscopically as much i.e. sarcoid nodules on a b & w x-ray vs. in color under the scope. Rads has cool technology, but I'm not very tech savy, I was never good at math and physics, while I did great in biology. Still, I can't shake the thought of radiology since I really enjoyed the rotation. Any help out there?

Well, I think I'll use this forum as my own personal vent for the current state of medicine. It sucks. Third year has been a painful look into the world that I have committed myself to. Four years ago I would have done anything and everything, but after busting my rear end for so long, I'm growing tired of no reward, no pleasure in life. People bust my balls for wanting to go into radiology because of so-called "patient contact." But having gone through medicine and ob, I think it's overrated. Patient contact isn't worth the hours of beaucratic b^llsh^t and paperwork just for 15 minutes of human to human interaction. I think the draw to rads and path is that these are some smart people who get the chance to enjoy life. They understand disease process, clinical presentation, and are often the diagnosticians. They may not completely understand every nuance of management, but I personally don't like algorithms since they seem to change with every issue of NEJM or JAMA. I've been trying to love OB and Rads equally, trying to see the big picture (no pun intended). But in the end, I think I have to be honest with myself and my expectations in life (girlfriend, friends, beer, basketball) and go with the flow. Any other thoughts?

 

[Gumshoe]

skeptic, it's uncanny how when I just read this last post I almost thought it was me writing it while I read it to myself. It's right on. I've had a flavor of the month for weeks now during 3rd year, saying, "Maybe I'll like this" and then after going through a few days, I can't see myself doing it. Got any more pearls for me? I'm an avg. student that goes to a great school, below avg. boards, hoping to do well on step 2 and match. In what? I dunno

GS

 

[Skeptic]

skeptic, it's uncanny how when I just read this last post I almost thought it was me writing it while I read it to myself. It's right on. I've had a flavor of the month for weeks now during 3rd year, saying, "Maybe I'll like this" and then after going through a few days, I can't see myself doing it. Got any more pearls for me? I'm an avg. student that goes to a great school, below avg. boards, hoping to do well on step 2 and match. In what? I dunno

GS

sup gumshoe. nice to meet you. advice? ha. i'm so lost right now that me giving advice would be like asking ray charles/stevie wonder to win the Indy 500 (sorry, i'm not a PC person). i think if there's any commonality to most of the people who end up going into rads/path/(enter other basement-born-careers-in-medicine here), it's that they realize how horrible the field of medicine has become. in the first two years, i loved learning pathology, mechanism of disease, and the "buzzwords" of diagnosis. it made me feel like i knew something. granted, medical school hasn't tickled a single brain cell or forced me into original thought (unlike my undergrad stuff), but it's what i wanted to do. but i never in my right mind thought that i would end up spending so much time, so much money, and neglecting my girlfriend and my friends and my alcoholic tendencies to learn how to recognize that someone's NPH/Regular insulin regimen wasn't quite optimal. Or that their metprolol dose needs to be fine tuned. Or that a pregnant girl who doesn't know crap about her body who presents with rule out labor is required to have a sterile spec exam even though everybody in the damn hospital knows she's not in labor. it's that stuff i hadn't anticipated. i hadn't anticipated sitting on the phone for hours on end dealing with home health and medical records and the radiology technician trying to get beaucratic stuff done so that i could move on to my next task of writing a daily progress note like a freaking secretary somewhere. in the end, i realize that to me, it's not worth it.

i'm jealous. jealous of those truly committed, truly great med students, interns, residents, and docs out there who are amazing enough to wade through all of this and still care for people; sincerely want to help everyone who comes into the hospital door. sadly, i'm not that person. and i think that in the end, the little advice i can offer to anyone is that you must be honest with yourself. you can't lie to yourself thinking that you'll love doing such and such when you know that deep down, your heart won't be in it. to me, family, friends, sex, fun, are all important. i enjoy medicine. i enjoy science. but they will never take over my life. i know with rads that i can have a good balance between what i enjoy in life and what's important to me. come find me in 10 years to see if any of it was worth it, or if i made the right choices. i sure hope i do.

PM me if you want to vent, or talk. i honestly think that we all go through some serious mental sh^t during 3rd year and there's never a good venue through which to discuss them, at least with each other. my friend has recently developed hypertension. i think a couple people had herpes flares, and for some, IBS came roaring through. i think i've got GERD.

In the words of a famous lunatic, "The horror. the horror!"

 

[elperro]

I have had many of the same feelings. It is so frustrating to have worked so hard in something, and feel terrible about the state of medicine today. In my situtation, it gets even worse when I consider that I like pathology, but recent medicare proposals aim to cut reimbursements drastically in pathology. Insurance will follow suit. The same is happening to Radiology. Medicare is cutting reimbursement on scans of contiguous body parts, the technical component fee etc. etc. I don't know the specifics of it, you'd have to google it. The same is happening in EVERY specialty. I don't need to make a million dollars a year, and I don't want to be greedy, but I will have 200,000 in debt when I'm done. I've also worked by butt off, and sacrificed a lot. Why do physician salaries keep going down, while inflation goes up? The salaries in other fields go up to match inflation. Medicine is going to krump, and there is no easy solution. So much of it is political. My conclusion is: go into whatever is intellectually stimulating for you, and has a decent lifestyle. Working long, hard hours, i.e. surgery, will not be rewarded monetarily anymore. Look at what GS salaries have become, and compare that to the work they do.

 

[Gumshoe]

You guys flat out tell it how it is. I hope it all goes well for you guys. Perro, keep it real.

Skeptic, I PMed you

Gumshoe

 

[Skeptic]

You guys flat out tell it how it is. I hope it all goes well for you guys. Perro, keep it real.

Skeptic, I PMed you

Gumshoe

Gumshoe, I hit you back.

The real test is to now harness all of our frustration and anger and turn it into a spectactular personal statement that will force the eyes of any and all PDs out there. If only I could write like Yeates, Faulkner, Hemingway, or even Stan Lee...

 

[Amxcvbcv]

Damn it, you upperclassmen are supposed to post inspiring messages to keep us 1st and 2nd years motivated.


</sarcasm>


Thanks for the posts.

 

[Skeptic]

our collective apologies. i think as a 1st or 2nd year, it's important to keep an open mind, as i've said earlier (i give advice like i'm the dali llama for goodness sake) you have to be honest with yourself. i think there a few different types of people in medicine, but for simplicities sake, i'll break it down to three: 1) those who are obsessed with the field; medicine is their life. 2) those who find a niche within the field and love it, but enjoy life and have a good balance. 3) us rads people who realize that medicine is not what we thought it to be, and are finding our own niche so as to find a means to living a successful, balanced life that doesn't revolve around medicine. you'll learn as a 3rd year that you'll have to fall in love with something, or base your decision on lifestyle. board scores, AOA, where you went for med school, etc, is all very trivial when compared to figuring out the rest of your life. i'm currently on medicine where an intern and one 3rd year med/peds resident quit the programs on the same day. i think we can all agree that we don't want to be those people. be honest with yourself, and i think that much can be said. pm me (us) for more questions Mr. Sooner.

 

[bosky]

My favorite of the month - today was the last day of my particular rotation so this afternoon the senior resident on our service stopped ignoring the medical students after 4 weeks and bothered to teach for 15 min. The two MS3's I was with complied by asking questions they knew the answers to already. Obviously it was an evaluation day for all involved. I just can't play this game.

About to match radiology (hopefully), but still not sure radiology is above this...

 

[Skeptic]

good luck bosky. we wish you the best.

i agree with you on the meds-brown-nosing business, but unfortunately, that is the nature of the beast. it's been that way since pre-med, and will continue to be so until something clicks in the heads of all those who regurgitate First Aid like they are actually intelligent people. i've never considered people who study 20 hours/day and regurgitate fact to be intelligent. try working in a lab or a setting with original thought and then we'll talk.

we can only hope rads is better, but i think the pimping and the one-up-manship will continue. rads people are pretty bright, and unfortunately, many of those people are the one we've despised all throughout our careers. oh well, such is life.

my favorite, besides the two perspective articles in NEJM last week describing the demise of the physical examination... the hospital i was at likes clinical diagnosis rounds, where the chief takes the students around for PE skills. one of the med students was taking care of a patient with lupus. the group goes into the room, and the chief starts describing all the findings of SLE; malar rash, etc, etc. the whole time, noone says anything, nor is the patient really addressed. the group walks out of the room. the med student then looks at his papers and apologetically explains that the lupus patient was actually in the other bed.

i'll allow you to draw your own conclusions. voltaire wasn't kidding when he said medicine is just docs amusing patient while allowing nature time to cure.