What to do???????
We've picked out our 'tracks' for clincals and i'm sad that almost all of my friends or even just people that i like are in the opposite track as me. which means i won't hardly see them again. :( i'm stuck in the track with more hard core gunners (in quantity and quality- we actually counted).
I'm trying to figure out WTF it is I want to do for the rest of my life. Because I honestly don't have a freaking clue. I like everything. I can see myself hating everything. So i figure i might as well just free write for a bit on the pros and cons of the different options so i have something of a reference to look at.
General surg
um, fuck no. i came into med school sure i wanted to do something surgery, but then i took a laparoscopy elective and i realized there is no way in hell i want to work with these kinds of personalities. i mean come on people, didn't we all learn to share in the 3rd grade?
it used to be that surgeons were universally top-dog smart but now unless you're the exception or in a subspecialty you're more than likely just an overworked grump who likes to work with your hands. I refuse to suffer and be stepped on through 5 years of residency only to be left with the most boring body parts to operate on.
Internal Medicine
the more i think about it the more this makes more and more sense. I started to seriously consider IM after taking our renal class which I love love loved (not coincidentally our professor was awesome). I love physiology and almost every other specialty except maybe path or EM just seems like a collossal waste of 2 years of grueling preclinical education. I can't stand the thought of having all of this bullshit I memorize on a daily basis going to waste. One of the biggest reasons I went into medicine was so that I'd be able to take care of my family if any health problems ever came up and this is probably the most useful specialty for that sort of thing.
You get to use your brain (it's kind of like on House) and you also get to talk to people. The other day we spent a couple of hours talking to and physicalling an uneducated but totally sweetheart old lady. I actually stopped and told myself, if all i did all day was talk to and help out sweet and grateful old ladies I could totally be happy. We'll see how I feel after a year of dealing with druggies and such. But my family's had enough experience with grumpy/jerk docs and I'd like to prove that I can be different.
Cons: prestige, $, general healthcare industry bs, having to compete for fellowships
Emergency Medicine
Less pay but less work. <40 hour weeks sounds damn damn good. Skiing on weekends. Shiftwork. And I have to admit I'm big on the hero factor. I'd like to think that if the situation arose I'd be the best person to deal with an emergency, whether it's someone having a heart attack or sticking a pen through someone's throat. You know a lot about everything. And did I mention 36 hour work weeks?
Cons: disrespected by other physicians, working with homeless, druggies, thugs and the like.
Pathology
I think they're all creepy bastards. Cruel bridge trolls who make us memorize microscopic minutiae that we will never ever see or need to know about. If I had it my way 75% of pathology for med students would be limited to conceptual cartoon drawings. Actually most of our pathologists are super nice but the whole field still creeps me out.
Opthamology
Supposedly very happy and the jesus factor is definitely there. I totally dig the idea of restoring ppl's sight... that's the kind of thing people name their kids after you for. But goddamn what a waste of med school. We've had maybe 10-20 hours total of eye/eye-related lectures in 2 years. Renal, gi, resp, etc... all down the toilet. I'm also deathly afraid of fucking up someone's eyes. Not to mention it's super competitive.
Anesthesiology
I feel like a bitch to even mention this, but I won't lie and say I'm not seriously thinking about it. You get to sit there and read... books, comics, porn whatever. Imagine that!... reading... for pleasure! on the job. sure it occasionally is stressful or whatever, but comeon how smart is the average anesthesiologist. i'm sure i could learn to deal. They have like a 100% match rate for people with passing board scores. Sure you aren't the brains of the operation and you don't get any respect but you get to go home at the reasonable hour while the surgeon keeps toiling. I just don't get why it isn't more competitive. GREAT money, great hours, great lifestyle, all shiftwork. Seems too good to be true. I could open up a pain clinic with some other greedy bastards and rake in 1 million/year. I wish they made all anesthesiologists take huge paycuts so I wouldn't have to consider this.
Orthopedics
Seems kind of cool. Also seems like a lot of work. Very competitive. Need more data.
Urology
Another one of the big 4 ultracompetitive surg subspecialities (ent, ortho, urology, optho). Seems pretty damn cool. Except for the whole working with penises part. I flinch (and cry) everytime a big 8-foot chancred penis is projected onscreen during reproductive lectures. Not for me.
Obgyn
Fear of densitization. When I see a vagina, I want to want to have sex with it.
Neurology
Neuroanatomy was probably my favorite class this year, but i really can't see myself dealing with crazies and people going into freaking seizures right in front of me. I dug the whole mental gymnastics with lesion diagnosis but in the end how much can you really help those people. It's like, hey guess what dude, I just deduced you have korsakoff's psychosis! You won't even remember this conversation. booyah.
For me the biggest perk would be getting mistaken by laypeople as a neurosurgeon. Maybe if someone promised me a future million/year position in their sleep clinic...
Neurosurg
Seems like the coolest job ever. But why put myself through that kind of fatigue? THe whole "it's not brain surgery" joke will probably get old after 10 years or so. Which is about how long training lasts.
Dermatology
I've been thinking about this lately. Why? Because we're getting derm lectures this week and 3/4 have been pretty darn hot looking (med school goggles notwithstanding). Nothing sexier than a girl in high heels who can run circles around you intellectually. The only problem here is that derm lectures are boring as fuck and the whole field seems superficial and lacking in substance. Pimple poppers, indeed. Outside of your melanomas and what not, you treat everything (with marginal success) with steroids, creams, antibiotics, vitamin A and constant prayer. Then there's the whole issue of me not being smart enough... damn!
ENT
I guess if I had to pick right now this would probably be it. You get medicine and surgery. You work with people and cool toys. And if you believe the party line, it's supposedly hard not to like an otolaryngologist. They're all happy and hold hands and what not apparently. Not bitter and resentful like general surgeons. You get to operate on the coolest body parts outside of the 2 CNS specialties, and compared to neurosurgery, the lifestyle is "Every Night Tennis". Downside here is the competitiveness and my fear of being the village idiot. I also have no idea if I will even like surgery. There's also way too much material to learn in the head and neck.
Radiology
Seriously, seriously seriously tempthing the shit out of me. My friend's sister is a PGY2. Supposedly year 1 residency was 7-5. Year II 8-5. IN FREAKING RESIDENCY. If I sell out, i might as well sell out all the way and do something like this and make more money vs anesthesiology. With my software background I'm pretty good thinking in 3d and always got the highest or one of the highest scores on the anatomy slide exams. The hours are supposedly good, the pay is ridiculous, and I could probably do some computer science hobby stuff on the side. Sure there's no patient interaction... but I can get probably get good people satisfaction when I give them rides in my M3 and pay for their dinners and such. Helping people? I can roll up on a bum and afford to give him a benjamin.
Peds / Family Medicine
I'm in a lot of debt. End of story. Pride factor comes into play here too.
...
I probably missed a couple and forgot some big points but I have to go to bed soon and fix my retarded sleep schedule. So far it looks like:
ENT
Internal Medicine
Emergency Medince
Radiology
with maybes for
Ortho
Anesthesiology
I'm trying to figure out WTF it is I want to do for the rest of my life. Because I honestly don't have a freaking clue. I like everything. I can see myself hating everything. So i figure i might as well just free write for a bit on the pros and cons of the different options so i have something of a reference to look at.
General surg
um, fuck no. i came into med school sure i wanted to do something surgery, but then i took a laparoscopy elective and i realized there is no way in hell i want to work with these kinds of personalities. i mean come on people, didn't we all learn to share in the 3rd grade?
it used to be that surgeons were universally top-dog smart but now unless you're the exception or in a subspecialty you're more than likely just an overworked grump who likes to work with your hands. I refuse to suffer and be stepped on through 5 years of residency only to be left with the most boring body parts to operate on.
Internal Medicine
the more i think about it the more this makes more and more sense. I started to seriously consider IM after taking our renal class which I love love loved (not coincidentally our professor was awesome). I love physiology and almost every other specialty except maybe path or EM just seems like a collossal waste of 2 years of grueling preclinical education. I can't stand the thought of having all of this bullshit I memorize on a daily basis going to waste. One of the biggest reasons I went into medicine was so that I'd be able to take care of my family if any health problems ever came up and this is probably the most useful specialty for that sort of thing.
You get to use your brain (it's kind of like on House) and you also get to talk to people. The other day we spent a couple of hours talking to and physicalling an uneducated but totally sweetheart old lady. I actually stopped and told myself, if all i did all day was talk to and help out sweet and grateful old ladies I could totally be happy. We'll see how I feel after a year of dealing with druggies and such. But my family's had enough experience with grumpy/jerk docs and I'd like to prove that I can be different.
Cons: prestige, $, general healthcare industry bs, having to compete for fellowships
Emergency Medicine
Less pay but less work. <40 hour weeks sounds damn damn good. Skiing on weekends. Shiftwork. And I have to admit I'm big on the hero factor. I'd like to think that if the situation arose I'd be the best person to deal with an emergency, whether it's someone having a heart attack or sticking a pen through someone's throat. You know a lot about everything. And did I mention 36 hour work weeks?
Cons: disrespected by other physicians, working with homeless, druggies, thugs and the like.
Pathology
I think they're all creepy bastards. Cruel bridge trolls who make us memorize microscopic minutiae that we will never ever see or need to know about. If I had it my way 75% of pathology for med students would be limited to conceptual cartoon drawings. Actually most of our pathologists are super nice but the whole field still creeps me out.
Opthamology
Supposedly very happy and the jesus factor is definitely there. I totally dig the idea of restoring ppl's sight... that's the kind of thing people name their kids after you for. But goddamn what a waste of med school. We've had maybe 10-20 hours total of eye/eye-related lectures in 2 years. Renal, gi, resp, etc... all down the toilet. I'm also deathly afraid of fucking up someone's eyes. Not to mention it's super competitive.
Anesthesiology
I feel like a bitch to even mention this, but I won't lie and say I'm not seriously thinking about it. You get to sit there and read... books, comics, porn whatever. Imagine that!... reading... for pleasure! on the job. sure it occasionally is stressful or whatever, but comeon how smart is the average anesthesiologist. i'm sure i could learn to deal. They have like a 100% match rate for people with passing board scores. Sure you aren't the brains of the operation and you don't get any respect but you get to go home at the reasonable hour while the surgeon keeps toiling. I just don't get why it isn't more competitive. GREAT money, great hours, great lifestyle, all shiftwork. Seems too good to be true. I could open up a pain clinic with some other greedy bastards and rake in 1 million/year. I wish they made all anesthesiologists take huge paycuts so I wouldn't have to consider this.
Orthopedics
Seems kind of cool. Also seems like a lot of work. Very competitive. Need more data.
Urology
Another one of the big 4 ultracompetitive surg subspecialities (ent, ortho, urology, optho). Seems pretty damn cool. Except for the whole working with penises part. I flinch (and cry) everytime a big 8-foot chancred penis is projected onscreen during reproductive lectures. Not for me.
Obgyn
Fear of densitization. When I see a vagina, I want to want to have sex with it.
Neurology
Neuroanatomy was probably my favorite class this year, but i really can't see myself dealing with crazies and people going into freaking seizures right in front of me. I dug the whole mental gymnastics with lesion diagnosis but in the end how much can you really help those people. It's like, hey guess what dude, I just deduced you have korsakoff's psychosis! You won't even remember this conversation. booyah.
For me the biggest perk would be getting mistaken by laypeople as a neurosurgeon. Maybe if someone promised me a future million/year position in their sleep clinic...
Neurosurg
Seems like the coolest job ever. But why put myself through that kind of fatigue? THe whole "it's not brain surgery" joke will probably get old after 10 years or so. Which is about how long training lasts.
Dermatology
I've been thinking about this lately. Why? Because we're getting derm lectures this week and 3/4 have been pretty darn hot looking (med school goggles notwithstanding). Nothing sexier than a girl in high heels who can run circles around you intellectually. The only problem here is that derm lectures are boring as fuck and the whole field seems superficial and lacking in substance. Pimple poppers, indeed. Outside of your melanomas and what not, you treat everything (with marginal success) with steroids, creams, antibiotics, vitamin A and constant prayer. Then there's the whole issue of me not being smart enough... damn!
ENT
I guess if I had to pick right now this would probably be it. You get medicine and surgery. You work with people and cool toys. And if you believe the party line, it's supposedly hard not to like an otolaryngologist. They're all happy and hold hands and what not apparently. Not bitter and resentful like general surgeons. You get to operate on the coolest body parts outside of the 2 CNS specialties, and compared to neurosurgery, the lifestyle is "Every Night Tennis". Downside here is the competitiveness and my fear of being the village idiot. I also have no idea if I will even like surgery. There's also way too much material to learn in the head and neck.
Radiology
Seriously, seriously seriously tempthing the shit out of me. My friend's sister is a PGY2. Supposedly year 1 residency was 7-5. Year II 8-5. IN FREAKING RESIDENCY. If I sell out, i might as well sell out all the way and do something like this and make more money vs anesthesiology. With my software background I'm pretty good thinking in 3d and always got the highest or one of the highest scores on the anatomy slide exams. The hours are supposedly good, the pay is ridiculous, and I could probably do some computer science hobby stuff on the side. Sure there's no patient interaction... but I can get probably get good people satisfaction when I give them rides in my M3 and pay for their dinners and such. Helping people? I can roll up on a bum and afford to give him a benjamin.
Peds / Family Medicine
I'm in a lot of debt. End of story. Pride factor comes into play here too.
...
I probably missed a couple and forgot some big points but I have to go to bed soon and fix my retarded sleep schedule. So far it looks like:
ENT
Internal Medicine
Emergency Medince
Radiology
with maybes for
Ortho
Anesthesiology
posted by Gerlad at
1:03 AM
8 Comments:
Dude, do Radiology and let me borrow your M5.
You have to learn to spell ophthalmology before you can practice it.
I vote for internal medicine. I hear there's a great residency program at Santa Clara Valley Medical Center.
Then you can be my bitch in three years! :) Heehee, j/k. IM rules... Neuro is a good 2nd.
just sell out and do radiology or anesthesiology
YES, chang!
how can i resist comment on this one?
G-surg
i agree... a bunch of angry dudes and frumpy girls
IM
yeah, i think you'd like it a lot...but the days of 2 hour H&Ps are done for you and soon every GI bleed and cocaine-induced angina is just one more obstacle between you and sleep.
EM
haha, you know very little about very little...and a very disrupted lifestyle
Path
eugh
Ophtho
yes! you'd be surprised by how much there is to know about the eye. i was just thinking...in my first year or residency, i'm expected to learn everything that optometrists learn in their 4 years of school and more. i only had 2 hours of eye-related lectures during med school so i am wasting even more of it than you would. =)
anesth
i dunno where you are getting your information from, but as far as i know, it is ultra-competitive now. except for rare cases, they get paid more than the surgeons on the other side of the drape. but their hours are pretty rough...you have to get there before the surgeon and stay until the case is done. and at least as a resident, all the education time comes either on weekends or AFTER all the surgical cases...so you are talking about long days
ortho
i dunno...lots of jocks. its like all the surgical subspecilaties- you forget all of medicine once you go in
Uro
ugh
ob-gyn
don't even consider it. my libido went to -50 when i was on the rotation and it took a good few weeks for it to return to normal. its almost all bitchy girls who are synchronously PMSing and being catty
neuro
i guess i should have good things to say about it since it dominates my family. but usually you aren't dealing with seizures...unless you are my sister. its all CVAs and headaches. and all the dementia/mental degen stuff is intellectually interesting but futile, as you say
Derm
i dunno...ivy seems to love it. she tells me there is hypercompetition to be thin, fit, and beautiful.
ENT
i think it is much like ophtho in the sense that you chuck almost everything you learn in med school and have to start from square one. and this is THREE organ systems to learn. yeesh
Rads
yeah, you'd probably like it. their residencies are pretty intense because you are once again learning just about everything from scratch again.
Peds/FM
eh?
i think in general, every subspecialty will feel like you are learning everything from the beginning. this applies for ophtho, ent, ortho, derm, neuro, uro, etc etc. doing internal medicine last year i felt like it was a good extension from med school, but everyone that i know doing non-IM is struggling in their first years with the vast amount of stuff to learn.
but anyway, don't sweat making your decision too much. i didn't decide on ophtho until may of 3rd year...so it all works out somehow.
congratulations to you if you read through this all
Nice summary, Jer. I concur :)
wow jer, that was like the most insightful comment i've ever had
:)
good point about IM. i'm guessing the 15 minutes allocated to each patient won't leave much time for shooting the breeze.
some of the anesthesiology stuff i got from a friend who's gung ho about anesthesiology (for lifestyle reasons) and he told me of some stat that 99% of US med students with a passing board score matched. admittedly he probably doesn't know much else but i thought I had heard (from interest group meetings) that the lifestyle was pretty chill- shiftwork (i thought you could clock out inbetween surgeries- switch anesthesiologists) and they def. make a crapload of money.
yeah, i think the post-residency lifestyle is pretty good...and you are right about the shift changes in the middle of cases and cash flow. but i'm pretty sure the residency is fairly competitive nowadays
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