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Feeling exhausted... How do I decide on a specialty?

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I'm coming towards the end of my pre-clerkship (I'm in a 3-year program) and I'm still feeling pretty unsure of what specialty I want. 

To be honest, I'm mentally tired. I've been thinking about this so much lately (what with COVID impacting our clinical opportunities and the compressed timeline looming over me), on top of doing a lot of research projects and studying. It's a lot of stress and I feel so lost. I've been doing a lot of reading about specialties and discussions happening on this forum and it's cleared up some things for me, but there's nothing I've come across that feels "right" yet. I'm stuck between being practical and just building my CV towards something versus first finding something that really fits.

I'm considering FM partly because the idea of getting out sooner is appealing right now, but I don't want to/think I should choose based on that. I'm usually a very ambitious person, but I also want to be happy. There are specialties that are more interesting to me, medically, and I enjoy research/innovation, but when I imagine doing residency and my future career, I just feel exhausted about the prospect of it. Thinking about all the stress, lack of free time, exhaustion, the constant grind of having to prove yourself... it makes me not want to do anything at all. And right now, the stress of not having it figured out, in case I do want a competitive specialty, is eating at me.

I know there are worse things in the world going on right now and I'm fortunate to be where I am, but this is almost all that I can think about. Not sure what I'm exactly looking for, posting here, but any advice and words of wisdom on how to move forward are appreciated. 

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Do FM. Get in and get out in a chill 2-years and start making money/living life anywhere in Canada.

For many FRCPC specialties, you need to do a fellowship(s)/and or graduate degree to have a chance to work anywhere and your life in residency will suck. 

 

Chill 2 year residency, get a job anywhere in Canada, many niches      Vs     Difficult and stressful 6-8 years of residency, lack of jobs, worse work-life as attending 

 

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18 minutes ago, Haribo7173 said:

What else are you interested in? 

Also thinking about radiology and IM, mainly. There are a lot of specialties I ruled out based on limited clinical experience or simply reading about them, so nothing is really set in stone for me

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It sounds like your a bit burnt out from medicine. Take a vacation, make a change in your life.

If you don't like the idea of proving yourself, you may not enjoy radiology or IM. In radiology you attend hot seat rounds where one or multiple attendings will pimp you on cases in front of all your colleagues on a near daily basis. In IM your attendings will constantly question your decision making process after admissions. And both regularly do 24 hr call (or night float) schedules for residency. To be honest as a resident in any specialty, you will have to prove yourself to some extent (generally less so for specialties that deal with lower acuity/less sick patients).

I would definitely try and explore specialties that students don't get a lot of exposure to though. Radiation oncology, radiology, genetics, pathology/other lab specialties, public health, and some of the less known IM/surgical subspecs. That, or see if there's something in FM you enjoy.

 

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I feel the same as you. I'm pretty set on FM because I am content with it (I don't mind the "negatives") and have chosen to focus more on other aspects of my life that make me happy. I think it depends on your personality. Personally, I used to be much more ambitious when I was younger. But I saw what pursuing success at all costs leads to and I realized it wasn't worth it to me. I like the rest of my life too much. Case in point: As intellectually satisfying and enjoyable it can be to understand something, I find that whatever pleasure I get from an intellectual pursuit is the same pleasure I get from simpler things, like having free time, being around family, and pursuing my hobbies. If you cannot live life without feeling as if you've reached your maximum career potential, then that's the only reason I'd say you should consider a specialty; but understand that pursuing your maximum career potential means sacrificing other areas of your life. There's much more balance with FM that I think is appealing and only becomes more appealing the older you get. But maybe clear your headspace first to make sure that you're not choosing FM just because it's an escape.

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If you enjoy or can tolerate FM I think it's a great choice. Most of my friends in FM find pleasure in their job and if not find good balance with their other life goals. I think doing a specialty doesn't preclude you from achieving other life goals but it is more of a challenge or compromise for sure. At the very minimum residency can be a very long and rough part of your life. Even though I enjoyed the subject matter and the work the long hours and lack of autonomy and independence does weigh on you heavily. Also the exam year is no joke unlike FM.

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I was in the same boat during clerkship and decided to pursue FM. I enjoyed the cerebral aspects of IM and really digging deep into patients' issues, however, realized that I am one of those people who work to live, not the other way around. I wanted the flexibility and time to spend it with my significant other and the thought of relocating potentially three to four times up until staff life was not something I wanted. At the end of four years, I just wanted to be 'done' and move on with life, rather than go through another gruelling 5-6 years of stress and uncertainty. 

I think my happiness stems from time with family, ability to live where I want, and time that I am able to spend on hobbies etc.

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I've found asking staff about how they picked their specialty to be quite helpful. I've also found the podcast Northern Exposure to be quite helpful (along with The Undifferentiated Medical Student but that seemed to be really US-centric for some specialties).

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