At What Point Should I Have A Speciality Decided On?

[sdj78we9jtf2o3mgfvj298j]

Entering med school this fall.

 

A lot of my newly-accepted friends seem to be obsessed with matching, research, getting into competitive specialities, etc. Personally I don't know what field I'd be interested in or even be good at. My friends have been talking about trying to get into emerg, derm, etc and are planning on doing research as soon as med school starts (some of my friends currently in med school say they they're on 2-3 research projects in a desired field). Most fields seem pretty interesting to me in an academic sense, and I don't think I'd get a good idea of the work/lifestyle of each speciality until clerkship. I don't think I can narrow down much at all at this point (especially since I haven't started). 

 

I honestly don't want med school to be this competitive game where all I think about is matching (much like undergrad was for getting into med school). I'd rather just enjoy the learning opportunities and not think about the future so much, at least in the early years.

 

Would it be disadvantageous for me to try deciding later on in med school (like in 2nd or 3rd year)? 

[JohnGrisham]

 Unless you already have inclinations to due something super competitive like dermatology, ophthalmology, neurosurgery etc.  You are perfectly fine just approaching M1 at least with an open attitude and just focus on your didactic work.  

Ignore the overly keen students. Just focus on doing well in M1, the rest will come with time. 

You are FINE.

[_ _]

But....how do they even know yet that they want to do those things? Like, really know that out of all the different things that it's the right one for them? 

 

Is it terribly uncommon to have not a clue what I want to do yet? I just feel like it would be so presumptuous to worry about that before even starting. I feel like anything I think I might know at this point is probably very different than the reality.....

[ralk]

Being about half way through third year is a good time to know or at least to have it down to 2. Before that it mostly doesn't matter.

 

It does help to have an idea of what you might like or might not like, and it's worth exploring options early. It makes the final decision easier in third year. It can also set you up better for succrss if you're mulling a competitive field, though that's a more minor consideration.

 

Basically, don't freak out. Plan to jump into an OR or two in pre-clerkship to potentially rule in or rule out surgical specialties, otherwise just do what interests you.

[JohnGrisham]

But....how do they even know yet that they want to do those things? Like, really know that out of all the different things that it's the right one for them? 

 

Is it terribly uncommon to have not a clue what I want to do yet? I just feel like it would be so presumptuous to worry about that before even starting. I feel like anything I think I might know at this point is probably very different than the reality.....

Some people come into med school with prior exposure to certain fields, or simply like the subject matter or alure of high paying wages of some of the super competitive specialties. Hence they want to "gun" for them from day 1 etc. 

[_ _]

Being about half way through third year is a good time to know or at least to have it down to 2. Before that it mostly doesn't matter.

 

It does help to have an idea of what you might like or might not like, and it's worth exploring options early. It makes the final decision easier in third year. It can also set you up better for succrss if you're mulling a competitive field, though that's a more minor consideration.

 

Basically, don't freak out. Plan to jump into an OR or two in pre-clerkship to potentially rule in or rule out surgical specialties, otherwise just do what interests you.

Thank you. That's very much a relief to hear. 

 

I do realize that sooner is better, so with the wednesdays off next year in my school, I'm hoping to set up some observerships to at least cover major different areas (like med/surg) in the next year. 

[SleeyPanda]

But....how do they even know yet that they want to do those things? Like, really know that out of all the different things that it's the right one for them? 

 

Is it terribly uncommon to have not a clue what I want to do yet? I just feel like it would be so presumptuous to worry about that before even starting. I feel like anything I think I might know at this point is probably very different than the reality.....

 

Realistically, how do most people know they want medicine without direct exposure to the field...and no, "Hospital Volunteer" hardly counts as clinical experience.

[_ _]

Realistically, how do most people know they want medicine without direct exposure to the field...and no, "Hospital Volunteer" hardly counts as clinical experience.

By that logic, how does anyone know what career they want? 

 

The difference is, if you can make a decision after 2+ more years of exposure, a decision that will have a pretty big impact on your life, it surprises me that people would risk making one they may be less happy with based on assumptions, if you have this opportunity to try and avoid that. 

[Lactic Folly]

 Personally I don't know what field I'd be interested in or even be good at. My friends have been talking about trying to get into emerg, derm, etc and are planning on doing research as soon as med school starts (some of my friends currently in med school say they they're on 2-3 research projects in a desired field).

 

Most fields seem pretty interesting to me in an academic sense, and I don't think I'd get a good idea of the work/lifestyle of each speciality until clerkship. I don't think I can narrow down much at all at this point (especially since I haven't started). 

 

I honestly don't want med school to be this competitive game where all I think about is matching (much like undergrad was for getting into med school). I'd rather just enjoy the learning opportunities and not think about the future so much, at least in the early years.

I'm going to differ somewhat from the general opinion and suggest that you do indeed start thinking about what you'd be interested in or good at.

 

This doesn't have to be about matching or competition at all - it is about your future and what type of physician you'd like to be. 

 

As SleeyPanda has noted, (based on your post) even with limited exposure working in medicine, somehow you were able to decide on this as a career.

 

I'll also note that your peers spending a lot of time in one area early on are by no means committed to that area if they change their mind, and many do. But, if they do change their mind, it is likely to be a more informed decision since they have so thoroughly explored their initial leanings.

 

I do not necessarily think that clerkship offers all students the clarity that they are looking for. If you are interested in practising in one of the core 6 rotations in a similar setting (academic teaching unit), sure, but otherwise there are a lot more fields and settings that you will likely never see during the course of 3rd year.

 

If someone wishes to explore path or rad onc, for example, being a 3rd year student really doesn't offer that much more advantage in understanding the work/lifestyle, than going in shadowing as a 1st or 2nd year.

 

You don't need to feel any pressure to decide right now, that's for sure, but that's different from not taking advantage of whatever opportunities you have to explore, gather information, and reflect. You'll enjoy the learning more that way too, when you can try tying it to a potential career.

[SleeyPanda]

By that logic, how does anyone know what career they want? 

 

The difference is, if you can make a decision after 2+ more years of exposure, a decision that will have a pretty big impact on your life, it surprises me that people would risk making one they may be less happy with based on assumptions, if you have this opportunity to try and avoid that. 

 

The idea of starting early in med school for a certain specialty actually makes more sense to me than realizing you wanted to do medicine from Undergrad. You end up either being competitive for the specialty you want, or you realize you want to avoid it at all costs and earn yourself more research/clinical experience. 

[Doc_911_doc]

I think you need to think about what you want to do. Not in this crazy high pressure "I NEED TO GUN" type mindset that your colleagues seem to have. But do think about it - in a calm, appropriate manner.

 

Med school is hard - MS1 is about conquering the basics and doing well at medical school. Focus on that. But think about general characteristics about yourself - do you like actively working with your hands? Are you super into academia? What's your attention span like? I think starting to figure out what you like and don't like and what fits into your personality is worthwhile even from early on.

[Hanmari]

The advice that I was given and one which made sense to me is to rule out competitive specialties early on. Sometimes it's difficult to rule them out after a few days to week of shadowing, and that is fine; but sometimes you can, which is great. This doesn't need to involve any gunning, just some casual shadowing here and there to get the gist of things. With that you are able to quickly strike out at least a few competitive specialties that you no longer need to worry about.

 

Ruling "in" specialties, i.e. finding ones you might actually want for a career - is considerably harder and you'd be fine waiting until clerkship to figure that out unless you have prior interests in a particular field. A good way to start thinking, I think, is start broadly - e.g. "surg vs. not-surg", "pt interaction vs. less interaction vs. no interaction", etc.

[Birdy]

I started med school about 95% sure I'd pursue one specialty, but open to the idea of falling in love with something else. Now I'm just about 50% sure I want that one, and my desire to pursue another of my initial three interests has grown considerably, to the point I'm setting myself up to be able to apply to residencies in that specialty if I still want to when the time comes to that.

 

Timing is a bit different for me, being at Mac, and considering I need to get most of my pre-CaRMS clerkship electives booked relatively soon, but I'm booking them in such a way as to leave my options open. So with 17 months to go until CaRMS applications, I'm as-yet undecided, and I don't think I'm out of the norm at all.

 

I'm not sure how things are at Schulich for setting up preclerkship electives/observerships, but if the option is available to you, take advantage of it. Go out and follow doctors around, learn from them, talk to them about what they like and don't like about their specialties, try things out, learn what you like. Preclerkship is a fantastic time to explore and learn what kind of doctor you want to be.

[Bambi]

I entered med school knowing of my interest in one field. I got my CaRMS interview but did not make my first choice. Just prior to CaRMS deadline for application, I was doing a surgical rotation and the attending encouraged me to apply. I did at the very last minute, was interviewed for this surgical specialty and was selected, thereby changing my career path and life. There was absolutely no preplanning, it was a combination of circumstances, luck and being flexible. Other interviewees were gunners, did research, made connections and now are in family medicine residencies. There is no one recipe.

[psychoswim]

Agreed with Bambi. I started med school 100% sure I wanted to do a surgical specially. I did 2 summer research projects in that field and put my CaRMS effort towards my application in that field. I started having second thoughts about it this past winter during the interview process. I ended up not matching in the first round and instead matching to family med in the second round but in the program and city I now realize I should have applied to and ranked first!

 

Life has a way... I have a graduate degree in computer science yet I'm now a doctor. My swimming career was ended by multiple shoulder surgeries yet now I've discovered a sport I enjoy even more. I was going to be a surgeon yet now in 2 years I'll be a family doc.

[Dr. Why Bother]

So if someone is interested in something competitive like Derm or Plastics, is it imperative that you start gunning and hit the ground running on the first day of Preclerkship? 

[_ _]

I'm going to differ somewhat from the general opinion and suggest that you do indeed start thinking about what you'd be interested in or good at.

 

 

 

You don't need to feel any pressure to decide right now, that's for sure, but that's different from not taking advantage of whatever opportunities you have to explore, gather information, and reflect. You'll enjoy the learning more that way too, when you can try tying it to a potential career.

Oh I agree completely. Going in with an open mind, as I am, isn't the same as waiting around until third year to think about things. I mean that maybe it's a bit of a disservice to yourself to not take advantage of all the opportunities you have to exposure yourself to as many different areas of potential interest as possible, to make the best decision for you. 

One of the things I most excited about is to learn what all the different areas are like, to see if any of the thoughts I've had about things I may or may not like are as I imagined. 

[sdj78we9jtf2o3mgfvj298j]

One of the things I most excited about is to learn what all the different areas are like, to see if any of the thoughts I've had about things I may or may not like are as I imagined. 

There's actually a lot of things we'll be privileged to see that people outside of med school could never get a chance to witness... we could go see neurosurgery or cardiac surgery if we really wanted to. That's what I'm really excited about!

[ralk]

So if someone is interested in something competitive like Derm or Plastics, is it imperative that you start gunning and hit the ground running on the first day of Preclerkship? 

 

The joke gets made often that it's necessary to gun hard and gun early for these specialties, but that's probably an exaggeration. They're competitive specialties, and so it certainly makes things easier to be setting yourself up well earlier rather than later. They're not all that different from other specialties though, and the bulk of the work done to match will occur during clinical rotations, particularly during electives with programs you want to match to - people have come to these specialties late and matched, but have often had to work their butts off to get a bit of research experience and contacts in the field.

[okidoki]

thank you for this wonderful discussion. As a med student entering first year, I am not quite sure what it is that you need to match to those specialties and what you need for carms. Obviously your transcripts won't show them much - is it about research, shadowing, and maybe some leadership activities? When you apply for residencies, do you upload your CV? 

 

What do you guys suggest we do in the first 2 years of pre-clerkship? Get involved with some research and shadowing?

 

Sorry, I feel like a premed entering first year asking if research is important to get into med school lol... 

 

thanks again guys

[ralk]

thank you for this wonderful discussion. As a med student entering first year, I am not quite sure what it is that you need to match to those specialties and what you need for carms. Obviously your transcripts won't show them much - is it about research, shadowing, and maybe some leadership activities? When you apply for residencies, do you upload your CV? 

 

What do you guys suggest we do in the first 2 years of pre-clerkship? Get involved with some research and shadowing?

 

Sorry, I feel like a premed entering first year asking if research is important to get into med school lol... 

 

thanks again guys

 

Research is probably the most useful thing you can do for CaRMS in pre-clerkship, but that is a very relative term. Truth is very little you do in pre-clerkship will have a major effect on your CaRMS application. It's your clinical rotations, particularly your elective performance, which will be the far greater determinant of your ability to match.

 

Now, you do submit your CV, so it is a factor. You don't want it to be completely bare, since that could stand out negatively. In addition, for very competitive specialties, more minor things like research and other ECs can start to matter as there are enough applicants performing well enough on their clinical rotations. For this reason (as well as for your own learning), it's generally advisable to be somewhat active in pre-clerkship doing something, though there's usually no need to overload yourself with ECs as you might have had to as a pre-med.

 

In the end, most students hit CaRMS falling into a broad grey area of being good without being great. It's hard to distinguish yourself with limited time when everyone else is trying hard to distinguish themselves as well. Fortunately, when it comes to your CV, being average is more than good enough for most specialties, provided you're doing well clinically.

[Edict]

Entering med school this fall.

 

A lot of my newly-accepted friends seem to be obsessed with matching, research, getting into competitive specialities, etc. Personally I don't know what field I'd be interested in or even be good at. My friends have been talking about trying to get into emerg, derm, etc and are planning on doing research as soon as med school starts (some of my friends currently in med school say they they're on 2-3 research projects in a desired field). Most fields seem pretty interesting to me in an academic sense, and I don't think I'd get a good idea of the work/lifestyle of each speciality until clerkship. I don't think I can narrow down much at all at this point (especially since I haven't started). 

 

I honestly don't want med school to be this competitive game where all I think about is matching (much like undergrad was for getting into med school). I'd rather just enjoy the learning opportunities and not think about the future so much, at least in the early years.

 

Would it be disadvantageous for me to try deciding later on in med school (like in 2nd or 3rd year)? Would I be limiting my choices if I have no interest in pursuing research?

 

If you are at all interested in some of the more competitive specialties (derm, plastics, emerg), shadow those first in M1. The reason being that those specialties you really do need to start sooner than others. If you can rule those out first you can pretty much enjoy your M1 and M2 years. 

[RedLily]

If you are at all interested in some of the more competitive specialties (derm, plastics, emerg), shadow those first in M1. The reason being that those specialties you really do need to start sooner than others. If you can rule those out first you can pretty much enjoy your M1 and M2 years. 

 

 

I also feel like I'm asking an obvious dumb question, but once you're in med school, by "shadowing" do mean you go to a prof in med school, or doc/surgeon you know, if you can watch them do stuff and interact with patients? (Asked with much more eloquent language of course lol). Just wondering about the etiquette, etc.   

[lolabean]

I also feel like I'm asking an obvious dumb question, but once you're in med school, by "shadowing" do mean you go to a prof in med school, or doc/surgeon you know, if you can watch them do stuff and interact with patients? (Asked with much more eloquent language of course lol). Just wondering about the etiquette, etc.   

 

I believe there is a shadowing coordinator and you can apply/ask them to set you up with a physician that is offering shadowing time...to my knowledge it's a little more sophisticated when you actually are in med school..I could be wrong though 

[ralk]

I also feel like I'm asking an obvious dumb question, but once you're in med school, by "shadowing" do mean you go to a prof in med school, or doc/surgeon you know, if you can watch them do stuff and interact with patients? (Asked with much more eloquent language of course lol). Just wondering about the etiquette, etc.   

I believe there is a shadowing coordinator and you can apply/ask them to set you up with a physician that is offering shadowing time...to my knowledge it's a little more sophisticated when you actually are in med school..I could be wrong though 

 

Most schools will have an official or at least semi-official process of some sort to arrange observership opportunities in pre-clerkship. It might be as simple as giving you a list of contacts willing to take on medical students, but at least you know how your requests will be received. A polite "sorry, I can't right now" is the worst I've heard of. You can often also arrange observership opportunities on your own, if you meet a particular physician you'd like to spend some clinical time with.