Monday, July 20, 2009

Thoughts on specialties...

Although I am trying to keep an open mind through out medical school as to which specialty I would like to pursue, I do have a few preferences... which I would like to document on my blog so I can see how I've changed over time.

I must admit, I really want to be an ER physician. Ever since I've had the doctor bug, I've wanted to work in the ED. From watching 1000's of hours of ER and Trauma, Life in the ER, to working in the Beth Israel Deaconess Hospital ER in Boston, and working as a firefighter....I've always seen myself best suited there. My reasons are as follows:

1. Exposure to every kind of pathology, and you aren't just limited to one part of the body. I'm not going to be staring exclusively at eyeballs or vaginas all day long. And you never know what you're going to see. And for those of you thinking "but you'll really just consult everything out", I KNOW... but I still like it.

2. Awesome schedule. Shift work = no call. Plus you can schedule shifts tight together for a few weeks and then have time off for travel or whatever.

3. No patient follow-up. I don't have to continuously tell the same guy to stop smoking, or to lose 20 lbs, or to PLEASE take his damn metformin.

4. Since EM is a relatively "new" residency training program (just for the past 20 or so years), there are fewer 500 year old doctors who stand there and say "we do it this way because that is how its always been done"

5. I don't have to wear dress up clothes. Just throw my scrubs on and save my money for clothes I actually want to buy.

6. I really like the personality of most ED staff I've met. A little more quirky, a little less stoic.

7. I feel that emergency medicine gives me a strong skill set that I can use if I want to work rurally or internationally in under developed countries.

8. I can work abroad for part of the year and moonlight (picking up shifts on the side) at most any ED I want in order to finance my work abroad.

9. You get a lot of procedure-based medicine.... deliveries, extractions, suturing, intubations, etc. Cool.

10. You can consult out anytime there is an "eye" thing. I don't do eyes. Yuck!

I also really like family medicine for some of the same reasons as above. Lots of exposure to medicine, depending on what type of residency program you are in. You don't want to get bumped by the medicine docs all the time.

My mom and my boyfriend want me to be a dermatologist... but I can tell you I didn't come all this way to be a damn dermatologist. I mean, the lifestyle seems ok, but it just seems so damn boring. Hmm. You have a rash. Well THIS looks like a rash. That would be an um... lets see... my best guess would be a rash. Maybe you'd get lucky occasionally and get to excise a mole?

My friend and mentor wants me to do GI, but I really don't think that suits my personality. I thought about ID, since I have a degree in tropical medicine and I do think its incredibly interesting and relevant to working internationally... but ID has essentially no procedure-based component. You basically treat everything with meds.

OB could be cool... but the schedule sucks... and no varied anatomy and pathology... but you get to do surgery... which could be fun.

I really have no opinion on surgery, anesthesiology, radiology, ortho, peds, IM, cardiology, PMNR, urology, etc... so I guess we'll see.


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