[Residency] 4th year struggling to pick a specialty

[stemsoflife]

Hello! I'm new here and searching for some advice

I'm a 4th-year medical student and I cannot for the life of me pick a specialty!

My top priorities:

1. Working with both adults and kids
2. Procedures and medicine
3. Work-life balance and family time
4. Mostly inpatient work - some clinic is fine but do not want to spend the majority of my time in clinic (this is primarily the reason i'm not interested in family medicine)
5. Job opportunities - my fiancé and I are looking to be in a specific city to be close to our families
6. Done with residency and fellowship within 6 years

Background: Came into medical school only wanted to do OB. Still love the obstetric part of it but did not at all love the OR or the gynecology part of it so figured it didn't make sense to do a specialty where I only liked half of it. After this, I realized I enjoyed working with both adults and kids a lot so considered med peds. I like the idea of this field but from the digging that I've done it really seems like most people end up choosing to work with either adults or kids unless they do a combined fellowship or outpatient work. Combined fellowships just seem too long for me to handle and they seem to be specific in location. Thought EM for a while because I liked the fast pace and the ability to work with a variety of patients but could not for the life of me get the hang of the weird hours (i'm a very routine person) and wasn't sure about the lack of continuity of care. I didn't mind it for the 1 month I was on the rotation, but can see how it would be something missing for me later on. From EM, I realized my love of procedures so looked into anesthesia or interventional radiology. Peri-operative care just doesn't really interest me very much. I think interventional radiology would be really cool but I don't know too much about it yet or if, with all my particularities above, it's just a little too competitive or i've started looking into it too late.

Any advice is appreciated!! I really need to decide on something soon and every way I turn there is something that makes me shy away from the specialty. I know a common thing that people say is to look at the lows of the specialty and if you can deal with the lows adequately, that's the one you should pick. I understand this but at the end of the day, I just haven't found something that I can see myself doing for the rest of my life without missing an aspect of another specialty.

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[Hotshy]

I am biased but have you considered IM -> Pulmonary/Critical care? It would be adults only, but I think it checks the rest of your boxes. There's a lot of variety to the specialty. It's a good mix of outpatient pulmonary, inpatient consultation, and critical care. There is a great deal of medicine and physiology involved particularly when working in critical care. You get to do procedures in the critical care setting and sometimes in the office (such as a thoracentesis). You can finish residency and fellowship in six years. I think it's a great specialty if you're looking for to do both medicine and procedures with a variety of practice settings.

 

[Cath Up]

Hopefully someone with experience in some corner of medicine can come to the rescue and say "hey! You can have most of these priorities met in x specialty". But... your criteria are extremely specific. Maybe Ophtho, though I think that's a lot of outpatient. I think mostly everything else is there though. It's also very competitive.

As a rising 4th year I can commiserate with the reality that we will permanently say goodbye to a lot of aspects of certain specialties we enjoy. It sucks. It's what I've been coming to terms with for like 6 months.

 

[PugsAndHugs]

ENT
EM

 

[differentiating]

For what it's worth, I had an attending in med school who was med-peds trained and was a hospitalist at both our adult and children's hospital, and she split her clinical time between those two.

 

[TelemarketingEnigma]

1. Working with both adults and kids
2. Procedures and medicine
3. Work-life balance and family time
4. Mostly inpatient work - some clinic is fine but do not want to spend the majority of my time in clinic (this is primarily the reason i'm not interested in family medicine)
5. Job opportunities - my fiancé and I are looking to be in a specific city to be close to our families
6. Done with residency and fellowship within 6 years

Have you thought about med-peds? some of your priorities sound similar to mine (adults + kids, heavy inpatient work) and that's what I'll be applying. The tough part may be your 6 year time frame, since its a 4 year residency and fellowship lengths are often ~3 years. You'd definitely get medicine with potential opportunities for procedures depending on if you pick a subspecialty (you'd have all the adult and child subspecialties open to you, plus combined programs).

 

[DOFOSHO]

Radiology fits all 6 of those items.

 

[calivianya]

I would do another round of soul-searching on FM with the way you talk. FM is anything you want it to be, except for mostly inpatient. I have had clinical experiences with a FM doc who runs a nearly pure infectious disease practice, mostly HIV, and caters to the local gay population. It was always funny seeing the one random old lady - a true FM patient - in a sea of buff attractive dudes in the waiting room.

Rotated with another FM doc who is probably half derm. She runs an aesthetics center out of her office and has certain days of the month just for aesthetics procedures - Botox, fillers, lasers. She also has lots of derm the rest of the time - lots of kid interaction especially with the Accutane management and the billing on that seems to be really easy money - get ’em in once a month or so to assess progress and check med side effects, and all of them are crazily happy with her for making them more confident. Get ‘em in for the laser treatments once the Accutane is done to help with the scars.

If there is something you really want to do, it doesn’t seem to be off limits in FM if you’re willing to take some extra courses in it and get certified. Especially if you’re willing to stray outside of the city you want to stay near and set up a more rural practice, so you catch the patients who want XYZ specialist care that you’re interested in but don’t want to have to travel to the big city to get it. Places like that often have significant inpatient care in FM, too.

 

[mrbreakfast]

Unfortunately, you're probably going to have to sacrifice at least one of your priorities, and it's going to be one of #1, #4, or #5 - and very likely will be #1, as the main problem with your priorities is that few hospitals are going to be comfortable with a hospitalist treating both adults and kids.

Working with both adults and kids + inpatient only (sacrificing job opportunities) = med-peds or ED, working in a place that will let you see both because of staffing issues - this is probably going to be a small, rural community hospital, as even a number of smaller hospitals have pediatric ED docs, for example.

Working with both adults and kids + job opportunities (sacrificing mostly inpatient) = again, med-peds or FM, and again working in a more rural area, but the catch is you'd be almost exclusively outpatient.

Inpatient only + job opportunities (sacrificing working with both adults and kids) = everything else you've said screams IM hospitalist to me. It's almost perfect for you.


If you want to keep all three of those, and excluding things that it's too late to apply to (i.e. every surgical subspecialty, IR), the best specialty I can think of would be neurology as a neuro-hospitalist in a smaller hospital. You can see both adults and kids, as you'll likely be the only neurologist in house, and job opportunities abound. The downsides would be few procedures, potentially call, and that you won't be a true expert on a number of pediatric neurological pathologies; also, if you work in a bigger hospital (or bigger city) you probably won't be seeing many kids (as someone more specialized will).

 

[Chelsea FC]

If you value work-life balance and family time. Pick the easiest specialty you are competitive for and dont look back!

 

[Redpancreas]

Your priorities are making things more complicated than they need to be. Effectively any field that comes close to fitting your priorities becomes a hard no for one reason or the other. I don’t think you’re looking at this right.

Throw out these abstract priorities like having to do mainly inpatient because I don’t think medical school (3 month rotations) gives you the perspective to rule out outpatient. I also don’t think working with both adults+kids or procedures should be deal-breakers either unless you really want to work with kids. Start at the beginning. Medicine or Surgery. The answer for you seems to be Medicine. Next, consider how much of your life you want to spend with your job. Finally, decide if you want to be a specialist or a generalist. I think these three questions give you a sense of which field you’ll be able to tolerate and thrive in which really means the most for your life and your patients.

A good thing is that you’ve ruled out EM for a pretty valid reason (tolerance of shift changes). Note that while PCCM is more versatile from a job market standpoint, it carries many of the same cons that turned you off for EM. Honestly, the desire to do inpatient but not liking shift work is kind of a contradiction, especially moving forward. In my opinion, I think based on what you’ve written you’re the best fit for FM or Med-Peds but am thinking you don’t think FM is a respectable option and have this weird anti-clinic hang up, but then you don’t think Med-Peds is practical because it’s one more year than family?! You can’t have it both ways. Ultimately you need to pick which priorities matter the most and I suggest prioritizing the medicine vs. surgery schism, time/stress you’re willing to tolerate long term at work, and then whether or not you’d find a generalist role fulfilling or a specialist role more satisfying.

I would like to warn you against trying to find an “elegant solution” to all your priorities. Instead, go back to the drawing board and make 1-2 tough decisions upstream in your decisions tree and then maybe you’ll realize something like, hey, you know what I really think I’d love and do really well in Peds (example). Yeah I’ll miss adults but it is what it is.

Sorry to sound paternal. If you feel this was unproductive feel free to disregard. It’s just that in my experience with life, attempting to prioritize multiple abstract things like this simultaneously ends up making people unhappy. Try to keep it simple. And then be decisive when you choose.

That’s how I made my decision. At the end of the day the career is like a marriage. Instead of finding the perfect etc. etc. woman who checks all your fancy boxes, it’s more important to find someone who supports your goals, helps you raise your kids, and someone you can tolerate for the next 30-40 yrs.

 

[brownman23]

It seems like you’re leaning towards IM (and/or one of its subspecialties) from your list of priorities.

Have you given anesthesia any thought?

 

[VA Hopeful Dr]

ENT
EM

ENT to my understanding has a good bit of clinic. @operaman ?

For what it's worth, I had an attending in med school who was med-peds trained and was a hospitalist at both our adult and children's hospital, and she split her clinical time between those two.

That would be my suggestion, as long as the location they want to end up in has a children's hospital for peds inpatient.

Radiology fits all 6 of those items.

That depends on how much patient contact the OP wants. If that's not important, I agree with you. If the OP wants lots of patient interaction, this might not be the way to go.

 

[NicMouse64]

Was going to say anesthesia as well. Could do a pediatric fellowship or ICU fellowship or both. You can still do OB and I'm sure future partners would love you if you took all the OB call.....From what I've seen it has a good mix of procedures and medicine. Job market is currently not bad. Also you can do mommy tracks and have good work life balance from those I've talked to, you just will make less money.

 

[VA Hopeful Dr]

Was going to say anesthesia as well. Could do a pediatric fellowship or ICU fellowship or both. You can still do OB and I'm sure future partners would love you if you took all the OB call.....From what I've seen it has a good mix of procedures and medicine. Job market is currently not bad. Also you can do mommy tracks and have good work life balance from those I've talked to, you just will make less money.

... Peri-operative care just doesn't really interest me very much.

 

[Matthew9Thirtyfive]

ENT to my understanding has a good bit of clinic. @operaman ?

Did ENT as one of my surgical electives. Not much inpatient. Mostly clinic and OR.

 

[libertyyne]

The answer is always Radiology.

 

[Rekt]

Family medicine. It's really the only thing that comes close to what you're looking for.

 

[operaman]

ENT to my understanding has a good bit of clinic. @operaman ?

That would be my suggestion, as long as the location they want to end up in has a children's hospital for peds inpatient.

That depends on how much patient contact the OP wants. If that's not important, I agree with you. If the OP wants lots of patient interaction, this might not be the way to go.

Yeah ENT definitely has a lot of clinic. The exception would be something like head and neck cancer at an academic hospital. For those, there are many attendings that only do 1-1.5 clinic days per week and then the rest in the OR. This is primarily because many of their cases eat up an entire day and nearly all patients are referred with a diagnosis or darn close to it.

For most it’s probably 3 clinic days per week and 1-1.5 operative days. There can be some give and take depending on the practice, but that’s a good rule of thumb.

Our clinics tend to be very procedure heavy though. Flex snd rigid laryngoscopy, nasal endoscopy, debridements, awake laser procedures, biopsies, FNA, awake vocal fold injections, awake endoscopic sinus surgery, cosmetic and functional botox, cosmetic office procedures, ear microscopy, ear tube placement, tympanic injections… those clinics can be very hands on and very busy.

 

[Gastrapathy]

Priority #1 takes all the pediatric and medical subspecialties except allergy off the table. Med/Peds is two extra years of training to have the same scope of practice as FP. You’re basically left with the surgical subs and even there, fellowship trained peds specialists see a lot of the kids. Really need to reflect on that priority because it leaves you pretty limited and doesn’t reflect the realities of practice after training.

 

[Bobblehead]

Realistically if you don't know what you want to do yet pick something that kicks the decision down the road. Internal medicine would allow you to pick something later as your choices solidify and there's niche things like going straight from the IM residency to a 1 year sleep fellowship which technically allows you to treat both adults and children as part of your sleep practice. From a practice pattern standpoint I'm not sure I would recommend sleep as your only fellowship training post-IM residency.

 

[Redpancreas]

Priority #1 takes all the pediatric and medical subspecialties except allergy off the table. Med/Peds is two extra years of training to have the same scope of practice as FP. You’re basically left with the surgical subs and even there, fellowship trained peds specialists see a lot of the kids. Really need to reflect on that priority because it leaves you pretty limited and doesn’t reflect the realities of practice after training.

This exactly OP.

 

[stemsoflife]

For what it's worth, I had an attending in med school who was med-peds trained and was a hospitalist at both our adult and children's hospital, and she split her clinical time between those two.

This would be great! However, the new Peds Hospitalist fellowship requirement has made me shy away from this idea to be honest. An extra 2 years of fellowship when I can do a shorter time in a different residency or just an extra year to be in critical care seems a little pointless. But I appreciate this thought and it's good to know that option is there!

 

[stemsoflife]

Your priorities are making things more complicated than they need to be. Effectively any field that comes close to fitting your priorities becomes a hard no for one reason or the other. I don’t think you’re looking at this right.

Throw out these abstract priorities like doing inpatient because I don’t think medical school (3 month rotations) gives you the perspective rule out things like that. I also don’t think working with adults+kids or procedures should be deal-breakers either. Start at the beginning. Medicine or Surgery. The answer for you seems to be medicine. Next, consider how much of your life you want with your job. Finally, decide if you want to be a specialist or a generalist. I think these three questions give you a sense of which field you’ll be able to tolerate and thrive in which really means the most for your life and your patients.

A good thing is that you’ve ruled out anesthesia and EM both which allow heavy procedural inpatient opportunities. PCCM carries many of the same cons that turned you off for EM. In my opinion, I think you’d enjoy FM or Med-Peds but you don’t think FM is a respectable option and don’t think Med-Peds is practical. Ultimately you need to pick which priorities matter the most and I suggest prioritizing the medicine vs. surgery schism, time/stress you’re willing to tolerate long term at work, and then whether or not you’d find a generalist role fulfilling or a specialist role more so.

I would like to warn you against trying to find an “elegant solution” to all your priorities (which partly you can’t do because you’ve limited yourself to PGY-6) and instead go back to the drawing board and make 1-2 tough decisions and then maybe you’ll realize something like, hey, you know what I really think I’d love and do really well in Peds (example).

Sorry to sound paternal. If you feel this was unproductive feel free to disregard as I’m not offended as I wasn’t trying to put anyone down. It’s just that in my experience with life, attempting to prioritize multiple abstract things like this simultaneously ends up making people unhappy. Try to keep it simple. And then be decisive when you choose.

Hi there! Any and all advice is appreciated!

I definitely have realized that my priorities are restrictive, but they are things that are important to me and worth considering. I don't particularly think the medicine vs. surgery algorithm has been helpful for me personally, but I do agree that revisiting my priorities and picking the 2-3 that are non-negotiable for me will help me at least narrow it down. Thank you for the advice!

 

[stemsoflife]

Priority #1 takes all the pediatric and medical subspecialties except allergy off the table. Med/Peds is two extra years of training to have the same scope of practice as FP. You’re basically left with the surgical subs and even there, fellowship trained peds specialists see a lot of the kids. Really need to reflect on that priority because it leaves you pretty limited and doesn’t reflect the realities of practice after training.

I hate that you are right, but I appreciate this advice! Realistically for me, other than the lifestyle type priorities above this is the only practice-related priority that I think is the most important for me. I can't see myself being happy treating one population or the other! That being said, will definitely reconsider and re-prioritize. Thank you!

 

[stemsoflife]

It seems like you’re leaning towards IM (and/or one of its subspecialties) from your list of priorities.

Have you given anesthesia any thought?

Seems I need to revisit anesthesia and look at the variety of medicine you can do with this specialty. Thanks for this thought!

 

[Chelsea FC]

All 6 of those things cant matter the same to you. Pick 3 and know that chances are you will settle to a speciality that ticks 2 of the 3 boxes. I had a long list of wants like you did but knew deep down that Life outside of work is the most important thing for me. Then that made my decision easier.

 

[stemsoflife]

All 6 of those things cant matter the same to you. Pick 3 and know that chances are you will settle to a speciality that ticks 2 of the 3 boxes. I had a long list of wants like you did but knew deep down that Life outside of work is the most important thing for me. Then that made my decision easier.

What did you end up choosing and why?

 

[Chelsea FC]

What did you end up choosing and why?

PM&R because I didnt hate the work compared to other parts of medicine, like small procedures hated alot of FM stuff and above all I wanted to spend time with the Fam. would have done derm if i had the grades

 

[brownman23]

Hi there! Any and all advice is appreciated!

I definitely have realized that my priorities are restrictive, but they are things that are important to me and worth considering. I don't particularly think the medicine vs. surgery algorithm has been helpful for me personally, but I do agree that revisiting my priorities and picking the 2-3 that are non-negotiable for me will help me at least narrow it down. Thank you for the advice!

It should be pretty easy to figure out if you want surgery or not. Surgical residency just takes so much of your life that if you can see yourself being happy in a non-OR setting...surgery and its subspecialties can be crossed off.

 

[neriticzone]

ENT clinic can be pretty procedure heavy

 

[TelemarketingEnigma]

Med/Peds is two extra years of training to have the same scope of practice as FP.

Med/Peds is 4 years, so only one extra year over FM. The main reason i suggest it for OP (besides personal bias) is inpatient preference + heavier peds training. FM would be a better choice if OP wants obstetrics training though

 

[LunaOri]

How about neurology? It can be a good mix of inpatient/outpatient, and a variety of ages, especially if you start from a med-peds residency.

 

[VA Hopeful Dr]

How about neurology? It can be a good mix of inpatient/outpatient, and a variety of ages, especially if you start from a med-peds residency.

Adult neurology is its own specialty

 

[Redpancreas]

It should be pretty easy to figure out if you want surgery or not. Surgical residency just takes so much of your life that if you can see yourself being happy in a non-OR setting...surgery and its subspecialties can be crossed off.

All 6 of those things cant matter the same to you. Pick 3 and know that chances are you will settle to a speciality that ticks 2 of the 3 boxes. I had a long list of wants like you did but knew deep down that Life outside of work is the most important thing for me. Then that made my decision easier.

So
1. Medicine or Surgery?
2. How much of your life is in medicine?

it seems to boil down to that…

The immediately apparent workload of a surgeon is part of why I suggest OP first figure out if they want to do surgery or not but, outside of the time commitment, cutting open the body and immediately repairing something is an aspect of medicine that is so non-negotiable for some people. On the flip side; others may just not feel they’re up to doing such a thing so to me it’s generally the best first step instead of asking things like whether I would prefer inpatient or outpatient. OP should be asking questions that will be affecting him or her for 30-40 years.

 

[Redpancreas]

How about neurology? It can be a good mix of inpatient/outpatient, and a variety of ages, especially if you start from a med-peds residency.

Neurology is it’s own advanced field in the match and doesn’t go through medicine despite a prelim year. There’s no Med/Peds training equivalent there although there may be some diseases where adult or child Neuro can pick up a patient in their adolescence.

In terms of training though, you either do Child Neuro as a ?5 year residency or Adult Neuro as a 4 year residency. This is my understanding at least. Please correct me if I’m wrong.

 

[longhaul3]

PM&R satisfies your whole wishlist as far as I know. We work closely with a lot of PM&R docs and I'm pretty sure it fits the bill.

 

[Matthew9Thirtyfive]

Run far from EM.

 

[Dantes]

Psych maybe? With a child fellowship you could potentially still work with adults, and do a mix of inpatient/outpatient. No procedures unless you like ECT/TMS.

 

[OraclePL]

Med peds
4 year residency meets your criteria. Sets you up great for inpatient hospitalist work

 

[stemsoflife]

Run far from EM.

Why do you say that?

 

[Matthew9Thirtyfive]

Why do you say that?

Venture over to the EM forum and do some reading.

 

[WheezyBaby]

Priority #1 takes all the pediatric and medical subspecialties except allergy off the table. Med/Peds is two extra years of training to have the same scope of practice as FP. You’re basically left with the surgical subs and even there, fellowship trained peds specialists see a lot of the kids. Really need to reflect on that priority because it leaves you pretty limited and doesn’t reflect the realities of practice after training.

Med/Peds is only 1 additional year. Technically speaking, the scope of practice is less than family medicine because we don't practice obstetrics, and we definitely do less office-based procedures (or I should say, my experience at least is dramatically less training in residency to do office-based procedures - I'm sure someone interested could pursue this independently). Functionally speaking, we're going to have quite a bit more expertise in inpatient adult medicine, and dramatically more so in all of pediatric medicine. With regard to continued ability to see both adults and kids, there's obviously primary care and combined hospitalist. Within subspecialties, A&I and hospice and palliative medicine can lead to single fellowship / dual practice. I also personally know individuals who are completing or have completed combined fellowships in ID, rheumatology, critical care, endo, and nephro. Outside of specifically double boarding, there's also value in the field for a variety of specialties where you're "only practicing one", eg congenital heart disease (outpatient and CVICU), heme for AYA liquid malignancies. A little less tangible, but I also think there are aspects to training in peds that benefit someone practicing in medicine and vice versa.

With that being said, I wouldn't necessarily advocate this path for the OP. PM&R could actually be a solid fit.

 

[Matthew9Thirtyfive]

To follow up on the meds/peds thing, my friend’s brother is a meds/peds doc, and he splits his time between adult hospitalist and peds hospitalist. So he does exclusively inpatient adult and kids.

 

[mrbreakfast]

Neurology is it’s own advanced field in the match and doesn’t go through medicine despite a prelim year. There’s no Med/Peds training equivalent there although there may be some diseases where adult or child Neuro can pick up a patient in their adolescence.

In terms of training though, you either do Child Neuro as a ?5 year residency or Adult Neuro as a 4 year residency. This is my understanding at least. Please correct me if I’m wrong.

Neurology (and child neurology) are different from many other specialties in that graduates are expected to be able to provide basic subspecialty care to both age groups - adult neurology residents spend a minimum of 3-4 months doing pediatric rotations and child neurology residents can do 8+ months of adult neurology rotations. If you wanted to see both age groups as a practicing neurologist, the best way would be doing child neurology followed by a fellowship (e.g. neuroimmunology) and then seeing a split clinic.

If you want to see both age groups in an inpatient setting, you're essentially looking at practicing in an area where there simply aren't any child neurologists, which generally means not a large metro area.

 

[Redpancreas]

Neurology (and child neurology) are different from many other specialties in that graduates are expected to be able to provide basic subspecialty care to both age groups - adult neurology residents spend a minimum of 3-4 months doing pediatric rotations and child neurology residents can do 8+ months of adult neurology rotations. If you wanted to see both age groups as a practicing neurologist, the best way would be doing child neurology followed by a fellowship (e.g. neuroimmunology) and then seeing a split clinic.

If you want to see both age groups in an inpatient setting, you're essentially looking at practicing in an area where there simply aren't any child neurologists, which generally means not a large metro area.

I did not know this and agree if that's the case Neurology goes way farther than IM to ensure that both types of residents get training with the younger/older demographic. That being said, it seems like there is still an effective split between Child Neuro and Neuro (Adult IMO bc 4 mo. =/ competency) and one spending 4-8 months in residency in my mind is just the tip of the iceberg and the bolded part of your quote indicates the pediatric neuro and neuro (adult IMO) are effectively split. FM and IM PCPs are doing colonoscopies in areas that are not large metros. If I had a 12 yo I wanted assessed for a neurological disease, I would see a child neurologist, specifically. Additionally I'd imagine an attending's practice/competence is mostly their experience as an attending and not 4-8 months in residency. Sorry if I thread on some toes with that opinion and interested in hearing counterarguments.

 

[Katann]

I would have another look at FM. My residency program has a lot of inpatient experience (but also clinic) during residency and a lot of graduates go on to do mostly inpatient after they finish residency. I think you could probably find a lot of FM residencies that would be respectful of your career goals and (even though you would still have to complete the required clinic hours for their curriculum) they would assist you in meeting your ultimate inpatient goals once your 3 years are up.

 

[The Med-Peds Dude]

I'm probably a little biased, but I'll advocate for med-peds as well. The information you've received about people choosing adults/vs peds, eventually, isn't true for most of us, and there are a number of Med-Peds docs who do hospital medicine. The pediatric hospitalist thing makes this a less attractive option, but honestly, remains to be seen how widely hospitalist fellowship is adopted ("too little hospital medicine" said no pediatric resident, ever).

I also am compelled to discourage strict geographic limitations, as this may not be feasible; you shouldn't feel good about ranking, for example, 3 programs in one city and expect to match.

My 2 cents.

 

[underbite_frenchies]

Have you thought about IM—> hospitalist

1,3,4,5,6 seem to fit.

hematology/onco might also be a good fit but oncology isn’t for everyone. Would likely also limit your peds + adults


If you don’t love the OR then procedures might get dry fast. I hail from the OR, but the vibe isn’t for everyone. Otherwise anesthesia in big group with a mix of inpatient and outpatient setting could be a good fit.
Best of luck

 

[khichadi]

Venture over to the EM forum and do some reading.

How do I find EM (or specific specialty) forum? Do you have link?
Thanks.