I just wonder how many of you had an idea of what specialty you wanted to enter before med school? This is purely a curiosity on my part.

I would strongly suspect that most of us at least had a ‘direction’ of interest we adopted as pre-meds. However, statistics show that most med students end up doing something other than their intended specialty upon graduation. No, I do not recall any specific numbers - have had to cram too many other factoids into my squash in the last 12 years…the one musta fallen out somewhere. And, I have no idea if anyone has kept or even cares if that stat differs for non-trads vs. traditionally-aged med students.

On a personal level, I sought to enter medical school to become a Peds ICU physician. By the time my clinical years rolled around, I was seriously contemplating vascular surgery. I had done PICU as an RT for ~10 years & loved it. I spent a month on-service with a vascular surgeon & found it very challenging & very interesting. But, I had to admit, my personality did not fit with the vascular surgeon crowd - any of you who have worked with them will know what I am referring to. Much of choosing YOUR specialty is, or very much should be, a selection process based upon what you are passionate about doing (referring to Judy Colwell’s “makes your eyes dance” corollary) and where “you” fit as a person. Believe me, the skill sets vary drastically with each specialty. Every bit as important is the ‘personality’ of each specialty. I believe that is you choose a specialty where either of those parameters are not an excellent fit for YOU, you will have a much higher probability of finding yourself miserable as a professional. That inextricably carries over to be miserable as a person. Yes, it is a high stakes decision that should be based upon elements important to you and not such shallow aspects such as money made, status, competitiveness - those are the hallmarks of immature decision making.

As my eyes were progressively opened to all of the options available to me as a physician, I learned that I loved & truly felt at home in the OR as an anesthesiologist. Fortuitously, I also discovered an equal passion for adult critical care. As a person, I know I become bared very easily & therefore must keep myself intellectually challenged. I love to do things with my hands. And, shock of all shocks, I am a people person & love to ‘entertain’ people & make them laugh. Professionally tying all of this together was hard. My school required an anesthesia rotation - uncommon among med schools - and I rapidly knew, I have found a home.

All of the things I sought were critical skills for both anesthesia & critical care. The work is never boring, constantly changing, high-stress and demands that I multi-task & parallel-process at all times (this is a place where ADD-like/right-brained thinking folks can morph their thinking-style into a huge attribute). I just chuckle when people ask, “don’t you get bored doing anesthesia?” Anyone who asks that is truly remarkably CLUELESS about what I am doing…and I am happy for them to remain that way. The same goes for another question I am asked, “you’re so much of a people person, how can you do anesthesia where you just put folks to sleep?” Again, the chuckle. I see my patient encounters as focused visits where I have to earn the trust & confidence of someone who is afraid because they are about to fully loose control of what happens to them AND we’re gonna cut them open. That will push you to hone sharp people-skills…I am not there yet, but getting better at it all of the time.

Hands on - dude, I do tons of procedures! From intubations, to regional & central blocks, to lines and so on. There is a whole lot of ‘artfulness’ in doing those well. Airway management is the thing that scares most every practitioner the most and it is my central skill. I do several times a day what scares the piss out of most docs. Sound like heaven for an adrenalin junky? You bet it is!

All of this equally applies to the arena of critical care. I feel like a fish in water!

But, had I chosen like many do (prestige, income, competitiveness…), I could be just as surly & miserable as they are. So, be careful. Invest time being honest with yourself about who you are, what makes you tick & where you best fit. While it is good to enter med school with a direction of interest, wisdom will tell you to keep your eyes & mind open. Approach every clinical rotation you undertake as if this were what you planned to do permanently. Who knows, it may very well be. I knew more than one med student who absolutely, flatly stated, “I would NEVER do…” Ob/Gyn or Peds or whatever. I can name 2 off the top of my head who are doing precisely the thing they firmly rejected during their pre-clinical years. Only by really trying on their shoes can you know for sure how well they do or do not fit you.

Look forward to this. Have fun doing it. Know when to laugh, cry & when to be stone-cold serious (even I have times where I am dead-assed serious…really).

Thank you for the response, I have not made any statements regarding what I will or won’t do as a doctor because I don’t feel I know enough about the many specialities to pick one just yet and I was getting some pressure from family members asking well what kind of doctor are you going to be? And my answer that I’m not sure yet but I’m interested in this and this…that seems to trouble them to death!

People who aren’t that familiar with med school, residency, medical practice have an uninformed notion of what the whole process is like, and I think the idea that you could clearly want to be a doctor, but not know what type, is unsettling to these folks - they just don’t know. Those of us IN medicine understand that it’s perfectly reasonable to be attracted to the science AND interpersonal aspects of medicine without needing to know exactly where you’ll fit in.

Just tell your relatives that you are sure you fit the profile of a physician, and one of your important tasks in med school will be to determine which particular physician profile suits you best. AND that one of the jobs of your med school will be to help you make that determination.

You can’t really prove anything to people without actually doing it - all of you will believe it when you see it.