Don’t forget radiology. It rocks.
Good luck with the match
My former physician, who was nearing retirement age, once jokingly told me that if he had it to do over again he would have become a dermatologist: “Your patients don’t die, and they never get well,” he said. 
Melanoma is a bitch though and one of the deadliest kinds of cancer. Dermatologists have to tell many patients that the mole on their shoulder will mean that the patient won’t live to see their kids graduate high school.
Yeah, I knew someone would bring that up. Perhaps in his mind he would refer those patients to cancer specialists, or perhaps he was simply exercising literary license for the sake of a joke. Who knows? Still, it’s a humorous insight into what a physician might view as the being the perfect type of practice.
I’m in year 3 of about 8 years of an MD/PhD program. From the clinical experience I have had so far I have come to realize the following things must be taken into account when I eventually choose a specialty:
-I like working with sick people
-I like doing procedures, but do not want to do surgery
-Primary care is not for me
With that in mind, my current list of specialties that I am interested in is as follows:
1)Pulmonary/Critical Care medicine–a subspecialty of internal medicine, a rotation I enjoyed. I am interested by the pulmonary physiology and pathology, and it is also one of the 3 pathways to certification in critical care. If I did this, I would probably want to practice mostly in the ICU and not so much in pulmonary clinic
2)Emergency Medicine–good variety, lots of procedures, shift work is a plus
3)Anesthesiology–I like the physiology and pharmacology aspects, lifestyle is a plus, and it is another one of the recognized pathways to critical care certification (surgery is the third)
I’m an Emergency Physician. I’m in my first year of practice out of residency and I don’t think there is another specialty I would enjoy as much. I am young enough to handle the night shifts, weekends, holidays and I don’t mind so much the indigent and generally belligerent types.
If I had to choose another career, I would likely choose something procedurally oriented such as interventional radiology, pathology, or a surgical subspecialty. I have a special loathing in my heart for clinic work and rounding though, so most everything is out.
I see several people here (mostly those in medical school already) are considering Emergency Medicine. I think that’s great, it’s a fun but tough field. There are also several threads about lay-peoples’ experiences in the ED lately. I had considered a ‘Ask the ER doc’ thread, but didn’t know if there would be any interest. Anyone think I should or want me to start one?
Oh, for those of you who aren’t sure where you fall, I offer this algorithm
Absolutely! Be prepared for a lot of “Is [procedure/medicine/machine/love interest] like it is on TV?”, though!
Not necessarily.
My PhD is technically in pathology, though I call myself an immunolgist. Most of the pathologists I know are either PhDs, or if they are more clinically than research oriented, DVMs.
Excuse my ignorance, I wasn’t aware there were pathologists from a PhD background.
How time flies! I still remember when you and DoctorJ were med students!
[sub]I’m old! I’m old!![/sub]
Me, I feel like a cardiologist manqué. It’s the only medical specialty that really interests me. It’s nice – you don’t have to saw people apart, and you actually get to use the stethoscope.
Radiology here involves 6 years of hospital medicine before you get to sit in a room in the dark. Not for me.
I have only met 1 radiologist who I would describe as “nice”, the rest seem to fall somewhere on the autism spectrum or to have major anger management issues.
I like the microbiologists (although most of their stories make me a little OCD-ish), and I know one senior pathologist who is a wonderful jazz musician in his spare time.
The radiologists, as a bunch, have never really made me want to get to know them personally.
Sorry to hear that. Here (in Canada) you do four years of med school, one year of internship, then sit in the dark for four years learning radiology. After that you can subspecialize for a year or so if you want, but its optional. 6 years of hospital medicine? like, after the MD and before radiology? wow. No wonder they have anger management issues. Maybe you should come to Canada, where the radiologists are human.
No heat here, just an attempt at witty apologia, with a bit of sarcasm. The horse’s ass was intended to be me, for my flippant post. the thread’s all very theoretical, right? I don’t intend to be any sort of physician.
Yeah, Attack from the 3rd dimension I know. The idea is they have to know what they’re diagnosing before they can just diagnose it from an X-ray, but they are all bitter and twisted by the experience.
We don’t have Internists here, just GPs and the hospital specialty of General Medicine…which, as I have said, is a soul-destroying hell hole of blighted dreams. If we had Internists here I might consider it.
Really, I just love gynae so much… There is a lot more “art” to it than most of the other specialties, the treatment is very individualised and laparoscopic surgery is cool. I found myself so much less stressed working in that rotation, even though the work itself was much more high-risk.
I’ve decided I’m a bit odd.
“The man in bed 3 has chest pain” or “The woman in bed 2 has low urine output post-op” are phrases that fill me with dread, yet, somehow “Crash section- we need to get this baby out” makes me flip into super calm, confident and efficient mode.
I’m also a pathologist, and I love the field. If someone put a gun to my head and told me I had to switch to another specialty, though, I’d probably choose either Internal Medicine (possibly subspecializing in Oncology) or Anesthesiology.
That’s interesting; my experience has been the exact opposite. I’ve never known anyone who’s left pathology, but during my training, two of my fellow residents were switching careers from other medical fields. One was a board-certified OB/GYN, the other a Pulmonologist.
Interesting. There was a medical examiner (forensic pathologist) in New Orleans who was an accomplished jazz trumpet player, reportedly good enough to sit in with Al Hirt. He was informally known as “Dr. Jazz”.
By the way, the medical specialty I most associate with nasty and/or weird people is, for some reason, urology. Maybe it has to do with performing all those rectal exams and transurethral prostate resections (a damp and rather unpleasant procedure). Just about every urologist I’ve known has a social/bedside manner somewhere between curt and hostile.
Well, Kurt’s an asshole, so that’s a pretty broad range, there.
I guess I might as well check in. At this point, I really wouldn’t do many specialties aside from my own (Internal Medicine). As I tell my third year students, a lot of the decision depends on pacing. If you are a slow, methodical, reflective person, then you are not suited for surgery or ER medicine. If you get bored going over the same information many times, you shouldn’t be in medicine.
If had to choose a different specialty, my choices would be:
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Dermatology-I would have gone into it but it was just too competetive and the moles all tend to look suspicious after awhile. However, it pays well, you don’t work nights or weekends, and it is fairly low stress.
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Radiation Oncology-again, good pay and good hours with very little risk of doing too much damage since pretty much everything is done by protocol.
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Hospitalist-I love diagnosis and managing multiple medical problems, but don’t like the lack of follow-up.
Specialties I’d hate:
Surgery (any type)-hate hate hate standing up for hours on end. It makes my feet and back hurt.
Ob/Gyn-Everybody loves delivering babies and I do pretty much all the outpatient stuff in my office, but the hours are terrible. I hear that with so many planned deliveries, it’s not as bad, but I just don’t think I could deal with gyn infections all day.
ER-completely not for me. I like to take one complex problem and work through it thoroughly. In ER, you have to be doing twelve things at once, and basically looking for a quick fix for each problem.
Psychiatry-I asked two psychiatrists why they went into it and got the following replies:
“You know how when you see a person in pain, you want to stop the pain? When I see somebody with psychological pain, I want to help them”
and
“Beats working”
I fell asleep during my psych rotation. Not for me.
Unfortunately, there is really only one specialty who fits somebody who is a control freak, who likes diagnosis more than procedures, and likes to spend time balancing diuretics so that the kidney gets enough fluid while the lungs don’t get too much. Besides, I don’t have to suck up to any specialists for referrals, and I can do as much or as little management as I want. I can treat specialists as technicians to do my procedures for me, then manage patients on my own. I’m usually the only one who knows all of the medications my patients are on, and any changes have to go through me. On the other hand, the hours are bad, the pay terrible, and I get no respect. However, my patients trust me to be on their side, and there are some benefits (she writes as she contemplates which of the many plates of Christmas cookies patients have brought to attack first).
The pay is terrible? Really? My internist seems to be doing just fine. Are you in Canada or something?