Tag Archives: internal medicine

Picking Your Field of Medicine

13 Mar

This question seems to follow extended learners around for much longer than necessary. Everyone wants to know – when you’re finally done with all of this school, what are you going to be? This question follows you endlessly around from your childhood, up through undergrad. Then in medical school, the question is, so you’re going to be a doctor but what kind of doctor? Will you be a surgeon, a family doc, a dermatologist? You may think it’s all over after that but even in residency, you will be asked, are you going to specialize? What type of practice do you want? It’s never ending.

During medical school the most difficult question to answer is what field will you choose as your field of practice. One must think about this deeply and often because the residency application season starts before you’ve even had a month to spend immersed in your field of choice for some. It’s a decision that you want to have no restrictions on. Sometimes your decisions as a first or second year medical student may affect your decisions while applying, perhaps you didn’t get the grades/scores/experiences you could have – try to avoid this and keep all doors open! For instance, I believed with all my heart that I would go into emergency medicine. I was set to be on national leadership, I had attended national conferences, I had arranged big events at my school regarding emergency medicine… It wasn’t until I walked away from my ob/gyn rotation, the 3rd rotation of my 3rd year of medical school that my whole world shifted. All I wanted was to be back on ob/gyn, I couldn’t get enough of ob/gyn topics.  I really had to consider if I had set myself up to achieve this new goal of joining the ranks as an ob/gyn. At that point I knew I was a decent candidate for emergency medicine but had no idea if I would get into ob/gyn. I was blindsided by this revelation.

One way to pick a specialty is to take a quiz, The University of Virginia’s Medical School Aptitude Test.  I can’t say how much I’d rely on a quiz to tell me where I should be but perhaps it could highlight some potentials to check out.  I’m sure many of you have seen the cartoon with the flow chart of how to pick your field of practice. It hits home because we as scientists really resonate with quick and easy flow sheets. It’s too bad that there’s so much more to it than what’s on the cartoon.  Here’s a sample cartoon from another great blog, A Cartoon Guide to Becoming a Doctor:

So what did I do? I sought out a lot of advice from my peers, my advisors and also the residents I worked with most closely to see how to determine if Ob/Gyn was really for me. I received a lot of advice that I felt was really helpful:

  1. I truly believe the biggest thing I learned through picking a field of medicine is to keep an open mind from day 1 until you’re matched.  I think this will give you the highest chance of being satisfied with your choice.  One of my favorite quotes that I experienced to ring true during medical school was this; “If you hold on tight to what you think is your thing, you might find you’re missing all the rest.” -DJM.
  2. Go sit in a break room/call room/nurses station of the specialty/field you’re wondering about and soak in the general feel of the doctors/residents/midlevel providers.  Could you stand hanging out with the type of people that attracts your field of choice?  Can you stand the jokes, can you watch the TV station that is on (e.g. Fox news 24-7)?  A lot of the chit chat that goes on is the typical chit chat that you’d be taking part in for a majority of your time because even in residency you’re surrounded by these people all day. Are they “your people” or would you rather go down the hall to some other call room… perhaps one more lively? or perhaps more quiet? Would you go out to the bar/dinner with these people?  I’ve worked on almost every floor of the hospital and now rotated all throughout the hospital and it’s very easy to see once you spend some time with many of the various types of physicians that certain fields attract certain personality types.  You’ve got to find where you fit.
  3. Go to your Family medicine rotation, hopefully in an office that is fully functional, your stereotypical family medicine office (one that sees old/young, rich/poor, sick/well) and go through the schedule for the day and pick out which patients you most want to see.  Is there a trend?  What about which patient’s you absolutely would not want to see.. the ones you’d rather go hide in the bathroom for their visit – is there a trend with those ones?  You may find that there’s no way in hell that you want to see any more peds for the rest of your life, that helps narrow it down, right? Perhaps you truly do want to see everyone still, well FM/ER may be for you.
  4. What rotation do you have no problem with getting up early and being on time for?  Do you stay late for a certain rotation?  Do you have no problem coming in on the weekend?   You may  have none like this but if you happen to have one – Pay attention, this one might be for you!
  5. Is there a rotation that you go home and want to read more on the topics you discussed/encountered that day?  If there’s a trend, this field may be the one for you because you’ll have to do a lot of reading and studying in residency and it may as well be on a topic that you like to read about.
  6. What type of stories do you tell your friends/family?  Are there certain experiences that have made your day or broke your heart?  Personally, I don’t mind internal medicine but my heart is broken every day on that service which tells me there’s no way I could do that for the rest of my life.  I also remember a friend stopping me while I was telling him a story about delivering a baby that I was ecstatic about and him telling me to remember that moment – I think he knew Ob/Gyn was for me at that moment in time.

I particularly like this post on KevinMD “4 Bad Reasons Why Medical Students Choose a Specialty.”  If you’re choosing a specialty based on money and/or lifestyle I can’t say that you are terribly wrong for this, however I hope these are not the only reasons you choose this career.  As I mentioned earlier, you have to love what you’re doing/studying/reading/teaching because there’s no escaping it while in residency and there’s no point in being miserable if there’s something else you’d enjoy more.

Good luck! four leaf clover

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