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Peds123

How did you get to choose your specialty?

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I’m MS3, but I am still undecided about what I’d like to do. I’m thinking of peds or internal or obs/gyne.

At the moment, I’m quite interested in obs/Gyn but I’m concerned about the lifestyle. Do people choose specialties based on interest or based on lifestyle?

How did you make your decision? 

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I think they factor in both, but everyone weighs things like interest and lifestyle differently.

For me i recognized pretty early that i enjoyed working with my hands and that i liked emergencies, and became interested in specialties without much lifestyle.  Early on, I was happy to do something with a 60 hour or so work week, but even that wasn't enough for the specialties I was considering. Eventually i had to make a decision and I realized I was someone who enjoyed challenges and probably didn't need to have as many hobbies or didn't enjoy hobbies as much as other people did. This helped me make my decision. With that being said, there isn't a right or wrong answer, it all depends on your individual circumstances. 

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It's a balance between lifestyle and interest. Ultimately however, I think it's helpful to decide between specialties by considering what you find least tolerable among each of them and then choosing the best of the worst from there. Don't forget that you can often craft your own niche as an attending.

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13 minutes ago, Edict said:

The OBs/Gyn lifestyle isn't too terrible, probably on par with Internal Medicine. You can also find niche's that have less call, for example fertility. 

For real? You mean like residency or attending life? I thought OB/GYN would be rougher because of the call for your pt's who go into labour and such, pretty much being on-call a lot of the time. IM depending on the group size, you would be on-call a lot less. Still so much for me to learn about this stuff xD.

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2 minutes ago, IMislove said:

For real? You mean like residency or attending life? I thought OB/GYN would be rougher because of the call for your pt's who go into labour and such, pretty much being on-call a lot of the time. IM depending on the group size, you would be on-call a lot less. Still so much for me to learn about this stuff xD.

I was referring to the first 3 years of residency. But even staff life is variable, you can find niche's with better and worse lifestyles. 

https://www.cma.ca/Assets/assets-library/document/en/advocacy/ObGyn-e.pdf

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1 hour ago, IMislove said:

For real? You mean like residency or attending life? I thought OB/GYN would be rougher because of the call for your pt's who go into labour and such, pretty much being on-call a lot of the time. IM depending on the group size, you would be on-call a lot less. Still so much for me to learn about this stuff xD.

Not many OBs deliver all of their own patients. They typically work in groups and there is a call schedule and whomever is on call delivers. That’s not to say that OBs who deliver all of their own patients don’t exist, but they’re not as common these days. 

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I was very interested in OB and family med and (later on) emerg as well. I still love OB and in some ways there are aspects of it I am sad about not being able to do - like infertility medicine and gynae surgery - but I eventually chose family medicine (I did not apply to any other specialties) because of the flexibility, and because I can integrate a lot of the stuff I love about OB into my practice. Plus I can do emerg too, which I really enjoy  

OB residency is pretty brutal and, honestly, I just don’t think I’m up for five years of working like that. Lots of people told me ‘oh it’s only five years, then you have the rest of your career!’ But I’m tired. I don’t want to be almost forty before I’m earning staff income, and I’d be paying off my student debt until my oldest kid is in university. That wasn’t what I wanted for myself or my family. 

Family med - which I legitimately like because I can do a bit of whatever strikes my fancy - gives me the flexibility I need, a shorter, less brutal, and somewhat customizable residency (especially my program, which is amazing and I love it,) and it means I’ll be able to pick up and go work where I want. 

If you’re interested in such a variety, I strongly encourage you to consider family med. 

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At my center (rural secondary care hospital), the gyne's don't do routine deliveries. That is done by a family doc. Gyne only comes in if there is trouble or if it is a planned section. 

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On 10/13/2018 at 2:14 PM, freewheeler said:

It's a balance between lifestyle and interest. Ultimately however, I think it's helpful to decide between specialties by considering what you find least tolerable among each of them and then choosing the best of the worst from there. Don't forget that you can often craft your own niche as an attending.

I would agree with that :) There are always going to be parts of any specialty that you find annoying - and you can work to minimize your time on those in your practise

 I chose mine because I like to solve puzzles more than any other part of medicine and radiology is all about solving the puzzle. Plus in my subfield I am mostly solving acute problems. 

I did consider however many other types of medicine as well - wasn't an easy choice.

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I think a lot comes from just doing the rotations too. I thought i would love family because i imagined getting to do everything and coaching patients on preventative medicine. Turns out I really do not enjoy long term management of msk complaints - or managing DM2. 

In fact I just prefer acute/emergent/definitive management of things-  but prior to doing some stuff I could've imagined in my head liking anything and everything.

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Also flexibility: Many people enjoy the flexibility of location, hours etc involved in certain specialties like FM, GIM, Psych - work as little or as much as you want often.  Hard to do in many specialties, say wanting to work part-time etc.

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I also think that in large part the idea that you have one single perfect specialty is overblown -  there is enough wiggle room between many fields with overlap in various factors people mentioned above that it is quite likely you would be equally happy between multiple fields. You can be overwhelmed when stuck between 2 or a few fields but if you reach the point where they are so close you cannot tell them apart then going either way won't likely matter very much at all. 

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9 hours ago, rmorelan said:

I also think that in large part the idea that you have one single perfect specialty is overblown -  there is enough wiggle room between many fields with overlap in various factors people mentioned above that it is quite likely you would be equally happy between multiple fields. You can be overwhelmed when stuck between 2 or a few fields but if you reach the point where they are so close you cannot tell them apart then going either way won't likely matter very much at all. 

Unless you’re me :) Love psychiatry, hate everything else lol. But I went to medical school purely to become a psychiatrist so it’s a bit different. 

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