Specialty interests?

I know this thread is premature, but I’m curious about the specialties oldpremeds are interested in.

When I joined this site 10 years ago, NO ONE could tell me that I wouldn’t become a Pathologist one day. But with an empty nest looming in the near future, I’m now interested in patient care, specifically Internal Medicine/Oncology (where my path background should come in handy).

As a side note, it also seems that most nontrads tend to go into one of the primary care specialties especially Family Medicine.

Emergency Medicine is my area of interest.

I’ve not volunteered anywhere yet, but I think I like EM for several reasons:

  • lifestyle:income

  • the jack of all trades aspect of EM

  • potentially immediate results

    In my nearly 15-yr engineering career, the things I enjoyed most were project startup and closeout, the hectic activity and the near immediate results and decisions spurring from meetings, etc. My interest during the “in-between” or execution period really flags. So I don’t think I’d enjoy the “continuity” aspect that would be typical of IM or the hospitalist profession. However, the way things are going, I’ll be nearly 50 by the time I’m done and the physical demands of EM worry me. So I don’t know - perhaps FM + urgent care would be a good compromise. These are my premed thoughts.

Dullhead, your thoughts mirror mine pretty closely regarding EM.

I worry about age being a factor as well (I’ll be ~43 when I get out if things go according to plan). I figure I’ve got a good 10-15 years still left in me at that point (I hope). One of the doctors at the primary care/urgent care clinic near us is an ABEM certified EM doc, so that’s an option if you want to transition. My options for later on in life would include urgent care, medical direction, or academia.

If you’d asked me last year I would’ve said 100% EM. Now? I’m all over the map, well sorta. EM, IM, PM&R, and FM.

EM because that is my area. I worked as an Hospital Corpsman with the Marines and an EMT and absolutely love EM. Hours of boredom punctuated by moments of sheer terror. However my mentor who’s IM tells me that I will not want to be going through those moments at 50 and the shift work will not be as cool then as I remember as a 20 year old. He’s pushing for IM working with him.

PM&R because I’m into fitness and the whole physical medicine seems like it’ll be a good fit. Basically coming in and helping people to get back to normal or as close to normal function as possible. The pain fellowships also intrigue me because of the amount of pain I’ve been in the last few years and when I learn that doing this or injecting here takes it away…well you kinda fall in love with the one who takes away the pain.

Finally FM because I’m definitely leaning toward doing locum tenems work and FM is the most versatile in that arena. As a corpsman a lot of what I did during the day was sickcall which is IM/FM for lay people. However my mentor cautions me about having to work with kids in FM. I loves kids…just dealing with the mommas ain’t my cup of tea. I definitely have to look at specialties where I’m the boss and not an employee and will probably do a lot if not all work via locums. My experience with my previous boss has solidified that I need to be my own boss without the pressures of starting up my own practice. Since we ain’t gots no kids my wife is game to travel with me and live elsewhere for a few months each year. She’s an Army brat and ready to move…and move…and move…and move.

So there you have it. My 20 year old heart is deadset with EM. My 40 y/o knees want PM&R. My Cuban hot temper wants FM or IM as they are the most marketable and I can go anywhere, work, and pay back Sallie Mae…and maybe have enough left over to buy some cafe con leche.

I am going to be applying for critical care fellowship this year.

  • croooz Said:
I definitely have to look at specialties where I'm the boss and not an employee and will probably do a lot if not all work via locums.

Cuban huh? Now I know where the "spice" in your posts comes from, LOL!

Estoy un poco latina también!

Depending on now much research I do, I'm also leaning toward IM locums for the sames reasons as you, working in politically charged climates which ALL employment situations are IMHO, just is NOT for me!

Psychiatry, Psychiatry, Psychiatry…Love it…have already been diagnosing and treating fr 18 years…just want to be able to also add to care with psychopharmacology and the ability to admit to hospitals when needed…

An interesting thread and I’m reading the posts with some curiosity to see if the trends here match what I’ve seen my former post-bac students go into as “older” students. Over the last 20 years, several specialties have dominated my students’ choices: emergency medicine, internal medicine, and psychiatry. In the past several years more students stated that they’re interested in primary care but I don’t know if that will bear out to be true when they’re done with med school.



Interesting thread. I still am quite undecided, and it is not like I am anxious, but after all this, I wouldn’t want to make the bad choice.

I know some specialty I won’t do for sure, including OBGYN, FM, Pediatrics, Derm.

I am considering the following possibilities, top being #1

  1. Radiology

  2. Surgery (likely General), I am afraid that the lifestyle and the demands of the job may be beyong what I can handle.

  3. EM, I like the idea, but after seeing some of the things that happen in there, I am not sure.

  4. IM with fellowship (Cardio OR Immuno OR Endocrino).

    So up in the air. I just don’t know. My preference would be Radiology, but I keep reading stuff about the job prospects and the job demands that may not be what I am looking for.

    I am waiting for the rotations, Hopefully, it will help decide.
  • redo-it-all Said:
So up in the air. I just don't know. My preference would be Radiology, but I keep reading stuff about the job prospects and the job demands that may not be what I am looking for.

IMHO, potentially outsource-able fields like Path and Rads are supremely unappealing. I'm also VERY concerned that about job prospects in fields that could be managed by DNP's, like Anes and FM.

It's pretty clear that the overall future of medicine is bright, it's just unclear to me about whom it's brightest for. But despite this fact, I'm still moving forward!
  • pathdr2b Said:

IMHO, potentially outsource-able fields like Path and Rads are supremely unappealing. I'm also VERY concerned that about job prospects in fields that could be managed by DNP's, like Anes and FM

I agree. While I find the subject matter of Radiology quite interesting and it fits well with some of my engineering background, I can't see doing it as a career. I think if I went that path, I'd have to further specialize in Interventional Radiology or something like that.

Path, Rads, and Gas are fields that IMO are fields whose future seems bleak. I’ve heard of Path & Rads guys having a tough time finding work. Gas is becoming the domain of the Nurse Anesthetist and from a business standpoint makes sense. Why hire a bunch of Gas guys when you can hire one and the rest be NA’s? I don’t think every single field is in danger of midlevels taking over because ultimately places will pay for a physician. The issue is will it attract them. That is what I’m banking on, being willing to go where others won’t.

Nothing is guaranteed. However I do need a field that gives me plenty of flexibility. EM is where my heart is but IM is probably where I’ll land. Gives me enough flexibility and without some of the stuff from FM. Of course that could all change but the one thing I do know is that I will not end up in Surgery.

Do what you have a passion for. Everything else will fall into place. I just finished draft 1 of my personal statement. The question is whether it would be best to go for it right away or work as a hospitalist for a few years and then go back for fellowship. I have heard both sides of the argument.

We shall see.

  • gabelerman Said:
Do what you have a passion for. Everything else will fall into place.

With all due respect and though ideal, I don't think this is the type of world we live in anymore.

For example, I had a serious passion for research until I was asked one two many times to report false data. Now I'm just on the fence about it all because this happened to me in industry multiple times, but never in academia. So we'll see.

I guess my point is that given the cost in terms of time and money invested in becoming a Doc and the future of the medical field in general, we'd all better be considering more that what we feel passionate about.

I’m leaning towards OBGYN, because I love the continuity of care and being able to develop relationships with patients (my dr delivered both my daughters, helped us through a painful miscarriage, has treated me for almost ten years, etc.)…on the other hand, I love that you get to do so many procedures too. My OBGYN even does really cool micro robotics surgery, etc.

Plus, I’m just really interested in women’s health issues. All this bias may have to do with the fact that I just gave birth…so I might laugh about it in eight years…but right now, it feels right.

I always heard it was a nightmare for lifestyle (babies come on Christmas) but I’m learning that it’s manageable if you structure your deal with your partners wisely. It also helps that my doctor is already trying to recruit me. LOL

We’ll see… I am also interested in gastroenterology, anesthesia, and maybe…maybe…a specialized Hospitalist of some kind.

My dr friends say to keep an open mind and the right specialty will choose you. I guess I’m about to find out!

Great thread, Path!

Because of my experiences with Surgery, I can see myself in GS/Trauma, Uro, or ENT.

EM would be a good follow-up, but, I feel that I would miss the OR.

It’s good to ponder these things now before medical school begins. Heck, for all I know, I could end up in FM or Peds!

At the end of my first year, having been exposed to so many visiting doctors in a variety of specialties, and having had the realities of my debt reinforced by the fact of a $20 per DAY interest rate… my decision is the same.

I will go into whatever specialty is most interesting and challenging, with the types of people who I’ll enjoy working with and the knowledge that walking into work will be a joy.

So, orthopedic surgery is now at the bottom of the list. EM, pediatrics and family med alternate at the top, depending on the day. All 3 fulfill my goals, and have reasons to love them - 3rd year is when I’ll have the chance to be fully immersed and better discover the highs and lows of each. Or even fall in love with something I hadn’t considered. No need to decide right now, although I will have to pick only one conference to attend next year.

There is an absolute dearth of psychiatrists out there. Every agency I have worked for in the last 18 years - medical and mental health, is struggling with finding and recruiting psychiatry. ESPECIALLY pediatric psychiatry. As near as I can tell, the field is WIDE OPEN in this area - just through my personal experiences. The more you venture away from cities, the less, and less, and less there is psychiatry available. My current agency is looking for 2 right now, and the last community health center I worked for was just barely piecing it together with per diem hours from 3 psychiatrists. I would do primary care as well…I love the diversity in the community health centers…but psychiatry is my first choice and, I am pretty sure, a “safe bet” for job security.

Met a carpenter who was a pediatrician. He was passionate about pediatrics until it didn’t pay the bills. Found his passion in building things but wasn’t passionate about ortho while in school. His passion with kids quickly turned into repugnance. Then there is the real estate agent who was an internist. I also ran into the same things with research as pathdr2b.

The best article I read talked about being passionate about being a physician regardless of specialty.