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Choosing specialties at McMaster, my take on COVID, AMA


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Been asked this question a lot in PMs so here it goes,

I will advise you to keep your eyes open. In every year, students come into medical school "thinking they know what they want" when every year they really don't. Premeds know nothing of the medical field because they haven't experienced anything yet. No matter what people tell you or some half-measure to compensate for it, you need to be in the hospitals to know what you want to do. Every year most people from (in your case) august 2020 to march 2021 have to narrow down specialties to 2 at most and they will need to pick 1 if they want to start early for something very comeptitive (ie plastic surgery, dermatology, ophthalmology, etc.). Students will change their mind up to 10 times before March but they can only do this because they get to see the clinical enviornment. People get stressed without COVID, I'm sorry to say but this will be worse for incoming McMaster students.

For example, some people think they love the brain because it is the coolest organ they have learned from textbooks. Then they get to see neurosurgery and say, wow I hate the lifestyle, I hate that I have to wake up every night and not sleep at all, I hate that my days are 12 hours long, I hate how much risk it has, and more. All of these things no matter how much you read won't help you. The only way to decide your future for something as patient-centered as medicine is to early on be in the hospitals AND SEE PATIENTS. 

I have been getting lots of questions from PMs about choosing specialties.

The unfortunate reality is that people generally struggle picking specialties in time before clerkship since you have less than a year to plan in advance. When students every year enter, they will go on a lot of shadows (horizontals) to see doctors. Your first year at Mac will be online, you will not have these oppurtunities, and you will be at the bottom of the food chain, anyone who tells you otherwise to decide before Post-MF4 (summer electives) and clerkship is lying to you or trying to sell their school. 

I will tell you why. Right now many residents (specialty trainees) are not being trained how they should be for a variety of reasons. For example, surgical residents who are not doing elective surgeries to train because the province stopped them for COVID-19 are now behind in their surgeries. Many non-surgical residents have been sent to the COVID-19 ward areas to help with demand so now they are not getting trained in their specialty fields. All these residents need more time in the clinical enviornment because they still need to graduate on time. Residents take first priority.

Secondly, all medical students have been not allowed at the clinical enviornment or in hospitals because of COVID-19. They don't care if you are deciding specialiteis because that is what they had to do. 

McMaster has already announced that the class of 2021 will be first priority after residents to return to the clinical enviornment which is not for another few months (and possibly longer if there is a second peak in COVID-19 cases but nobody if that will happen). Then it will be the class of 2022 which need to start clerkship but they will probably be pushed signficantly back and if they haven't explored specialties by now, well they are probably screwed and they will go through clerkship and have to decide with less experience because the province demands everyone graduate on time. Then at the very very bottom ARE YOU GUYS where you have no medical use as incoming students. You are least priority to get into the clinical enviornment because you are the newest with the least training. Clerkship students actually benfit the hospital by helping out, you guys as incoming students slow doctors down more than you can help because you all know nothing, so it will be a long time before they let you guys go back to clinical experiences because we don't have that luxury now. 

McMaster and students can spin this anyway they want but if you are not getting into the clinical enviornment with a good amount of time before important elective selections (at McMaster this is March 2021 for you guys) then you will just not have enough time to explore specialties. 

McMaster is a fantastic school and I believe it is the best school if there are no interruptuions in their normal schedule but COVID-19 has thrown a meteor right through it. If people want me to cite statistics, I can post them here to PM them to you about specialties. 

You have to decide for your own benefit. If you think you can decide a specialty without much clinical experience, then go for McMaster, if not go for a four-year program. Simple as that.

You can either start making important decisions about specialties in March of 2021 at Mac or the summer of 2022 at a four year program. 

Tl;DR  - Read the bolded (lol sorry for the long post) or PM me. 

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Honestly doing an information interview with a specialist, or attending Interest Group events talking about what working in a specialty is like are good ways of getting pre-clerkship exposure to different specialties and often times more representative of that specialty than a one day horizontal elective! There are other ways to explore, it's not the end of the world, you will find out what you like one way or another. The issue right now in Hamilton isn't "slowing doctors down" as much as it is inadequate PPE across the country and ensuring safety protocols for students so that no student contracts COVID-19. It's not about "slowing doctors down" but rather the question is whether or not doctors will be able to safely manage a clerkship student AND a horizontal elective student after we have started return to clinical duties. These scaremongering posts are not helpful in my opinion. As always if you have the privilege of choosing between Mac and other schools, do what makes the most sense to you. Just take these posts with a grain of salt.

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It's about being informed. Interest groups are not that helpful but maybe you have a different opinion. Mostly people just go for the free pizza and it is not that helpful. I don't see how 1 hour of a club meeting can be more informed than spending half a day or a full day with a specalist and actually seeing the patient population you would want to work with. 

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2 hours ago, Dr.Strange said:

It's about being informed. Interest groups are not that helpful but maybe you have a different opinion. Mostly people just go for the free pizza and it is not that helpful. I don't see how 1 hour of a club meeting can be more informed than spending half a day or a full day with a specalist and actually seeing the patient population you would want to work with. 

I think both have merits - you cannot easily act certain questions in either setting that would work for the other, and networking has to start somewhere. My involvement in the radiologist interest club allowed me to jump into clinical exposures later as well, but every place is different. 

I will say in general it is truly quite hard to understand the day to day of any speciality as a preclerk - if you are seeking that knowledge know that it  takes some effort. You can ask your questions but it is what you don't know you don't even know that is the issue. I always suggest starting early and make it one of your priorities. 

Edited by rmorelan
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Truthfully I think most of us match into specialties still without fully understanding what it will be like. I went to medical school to become a psychiatrist, I never liked anything else, I became a psychiatrist (or will in July assuming I don’t drop dead in the next six weeks) and am very happy with that, but I still really had no clue what I was actually getting into until like...PGY4  

The fact is that many people don’t have like a one true love soulmate kind of specialty. They all have ups and downs and most people can learn to be happy in multiple specialties. Not me, everything other than psychiatry makes me want to claw my own eyes out from boredom, but many people can I think. And I always knew that was true. 
 

In the wake of COVID people will do what they’ve always done - make the best choice you can with the information you have and then deal with the consequences. And get creative. I suppose probably people who are deadlocked between a few highly competitive specialties might have some hot water. But of all the catastrophes of COVID I suspect this one is surmountable. 
 

 

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For me, I didn't know what I wanted to do when I started, but I knew I liked kids, so peds was one of my early horizontals and i loved it.The other early decision to make is surgery vs not, and I tried to do gen surg as a post-mf4 but didn't get the lottery, but turns out peds surgery was available, so I ended up doing peds and peds surgery as my post mf4 and it made it clear that I  was not meant to be a surgeon so that narrowed it down pretty quick. Then through the MFs I did horizontals with the units, like a half day of GI, half day of endo, etc. and nothing matched pediatrics in my mind, so by the time we had to choose clerkship streams I was involved in the peds interest group and requesting a stream that seemed optimized for pediatrics.

For others, I suggest doing horizontals in your interests asap, as well as surgery, to rule it out or in early, as that makes it a lot easier to narrow things down.

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12 hours ago, bearded frog said:

For me, I didn't know what I wanted to do when I started, but I knew I liked kids, so peds was one of my early horizontals and i loved it.The other early decision to make is surgery vs not, and I tried to do gen surg as a post-mf4 but didn't get the lottery, but turns out peds surgery was available, so I ended up doing peds and peds surgery as my post mf4 and it made it clear that I  was not meant to be a surgeon so that narrowed it down pretty quick. Then through the MFs I did horizontals with the units, like a half day of GI, half day of endo, etc. and nothing matched pediatrics in my mind, so by the time we had to choose clerkship streams I was involved in the peds interest group and requesting a stream that seemed optimized for pediatrics.

For others, I suggest doing horizontals in your interests asap, as well as surgery, to rule it out or in early, as that makes it a lot easier to narrow things down.

That's the problem I fear to come because they can't do those horizontals that are so essential to career exploration because of COVID-19. Especially at Mac where you have less time to decide

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