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At What Point Should I Have A Speciality Decided On?

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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  :P

 

 

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.

 

 

Good to know, thanks! It's reassuring that there is a somewhat formal/official process to the whole thing

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Hard to say by what point you should have it figured out, im entering my 4th year and still have no idea what I wanna do. A lot of people seemed to have had an idea of a speciality they wanted before they got into med, but as the years went by they changed interests. Originally I wanted orthopedics, but the job limitations is a real downer. Luckily you have time to figure it out, but it may happen that you changed interests a few times during your 4 years, and that is completely normal.

Edited by a1b1

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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.

At what point during first year is it common/acceptable to start doing observerships in things we might be interested in? I'm guessing not right away, but by later in the first term are physicians generally accepting of having students observe for a day?

 

Although I'm sure they don't expect observing first years to understand everything that's happening (realistically probably next to nothing) I'm guessing it's a more valuable experience once you've at least learned a bit?

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At what point during first year is it common/acceptable to start doing observerships in things we might be interested in? I'm guessing not right away, but by later in the first term are physicians generally accepting of having students observe for a day?

 

Although I'm sure they don't expect observing first years to understand everything that's happening (realistically probably next to nothing) I'm guessing it's a more valuable experience once you've at least learned a bit?

 

I don't know how Toronto is, but you can do it as soon as your school's system is set up, which might take a month or so, or might be ready to go on Day 1. Jump in right away. You're going to be pretty clueless at the start, yes, but you're going to be pretty clueless at the start of your 3rd year too. Physicians have low expectations of medical students in general, they won't care how far along in pre-clerkship you are.

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I don't know how Toronto is, but you can do it as soon as your school's system is set up, which might take a month or so, or might be ready to go on Day 1. Jump in right away. You're going to be pretty clueless at the start, yes, but you're going to be pretty clueless at the start of your 3rd year too. Physicians have low expectations of medical students in general, they won't care how far along in pre-clerkship you are.

 

 

My friend is just starting medical school at the UofC and she's already started shadowing in two different specialties.  The medical school helped her arrange the opportunities, so it seems like you can start shadowing before the official start of medical school.  Not sure how common this is in general though.

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Really depends on the school. At Mac, we weren't allowed to official register our horizontal electives/observerships until end of September due to insurance policies. The preceptors I've been with generally allow us to take patient histories and perform physical exams (by ourselves and/or with supervision) so I'm guessing that's why they won't let us until the insurance is set up.

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My friend is just starting medical school at the UofC and she's already started shadowing in two different specialties.  The medical school helped her arrange the opportunities, so it seems like you can start shadowing before the official start of medical school.  Not sure how common this is in general though.

Depends on the school - UBC does not allow it until school starts and you are under the university insurance.

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I'm going to hijack this thread to ask a related question to the OPs.

 

I've often wondered about how people approach specialties when they already have a background related to medicine.  Let's assume that this background is something the person enjoys and want to expand upon, such as research or a business.  If you've invested so much time into publications and establishing yourself in the community, it would be pretty devastating to not match into a specialty that compliments that work.  Are people in this position more likely to take risks during the match process?  Is it very common for people to walk away from medicine all together if they're unable to match into a desired specialty?  

 

On a more optimistic note, how would you determine what aspects of each interest need to overlap?  For example, if your research is centred around radioligand synthesis, should you be focusing on residencies in radiology or maybe nuclear medicine?  Those are certainly the two specialties that come to mind on a superficial level, but from a practical stand point, research has a very narrow scope compared to practicing as a radiologist.  Would being in radiology improve the quality of research you could do be doing, or would those same benefits be achieved by practicing in any specialty?  I phrase the question that way because synthetic work is bench research and there's a very large gap between that and clinical trials.  In all likelihood that research would have no immediate impact on your practice of medicine.  On the other hand, if you're practicing in a completely unrelated specialty, your research may suffer because it's hard to stay up to date in two unrelated fields.  

 

I'll use another example to address an alternate angle.  What if you run a business, such as designing medical devices or prosthetics.  In a world where you're able to relinquish some of the day to day responsibilities during medical school and residency, do you strive for a related specialty?  Perhaps one where the opportunity exists for a clinic to run analogous with the business?  I think this example is quite a bit more complicated then accommodating research goals, but I know these specialty clinics exist (admittedly they're mostly in the States).

 

Just a few things I've thought about, I apologize for the naivety. 

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I'm going to hijack this thread to ask a related question to the OPs.

 

I've often wondered about how people approach specialties when they already have a background related to medicine.  Let's assume that this background is something the person enjoys and want to expand upon, such as research or a business.  If you've invested so much time into publications and establishing yourself in the community, it would be pretty devastating to not match into a specialty that compliments that work.  Are people in this position more likely to take risks during the match process?  Is it very common for people to walk away from medicine all together if they're unable to match into a desired specialty?  

Sometimes having a background and publications related to that specialty can give you a leg up, I suppose it would be devastating to not match but your background seems to already give you an advantage.  It is not very common people walk away from medicine altogether, people tend to be flexible and end up liking their 2nd choice or whatever they match into 2nd iteration.

 

On a more optimistic note, how would you determine what aspects of each interest need to overlap?  For example, if your research is centred around radioligand synthesis, should you be focusing on residencies in radiology or maybe nuclear medicine?  Those are certainly the two specialties that come to mind on a superficial level, but from a practical stand point, research has a very narrow scope compared to practicing as a radiologist.  Would being in radiology improve the quality of research you could do be doing, or would those same benefits be achieved by practicing in any specialty?  I phrase the question that way because synthetic work is bench research and there's a very large gap between that and clinical trials.  In all likelihood that research would have no immediate impact on your practice of medicine.  On the other hand, if you're practicing in a completely unrelated specialty, your research may suffer because it's hard to stay up to date in two unrelated fields.  

Even if your research is in a different field from the specialty you want, there are general skills you develop through research that can benefit ie. wet lab work, writing papers, grants...etc. You should choose the specialty b/c you enjoy it, not because you have research in it. But then again, if you enjoy the research in it and the specialty, then it's a plus. I've had classmates who have PhDs related to a certain specialty but not want to do that specialty at all b/c in the process of doing their PhD, they realized that this area of research is of no interest to them.

 

I'll use another example to address an alternate angle.  What if you run a business, such as designing medical devices or prosthetics.  In a world where you're able to relinquish some of the day to day responsibilities during medical school and residency, do you strive for a related specialty?  Perhaps one where the opportunity exists for a clinic to run analogous with the business?  I think this example is quite a bit more complicated then accommodating research goals, but I know these specialty clinics exist (admittedly they're mostly in the States).

Again, if you end up liking a specialty that's not related to your business eg psych instead of surgery, I'm sure you can find a way to incorporate the two interests. There are also many clinicians who have multiple interests and not just dedicate everything into one niche.

 

Just a few things I've thought about, I apologize for the naivety. 

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Hey, thanks for your response mononoke!

 

I just used theoretical scenarios in my post, because personally, I feel like I could make my current research work within a few different specialties.  I'm certainly planning to keep an open mind about it all if I'm admitted.  I also think that picking a specialty based on genuine interest over trying to fit an ideal is wise advise.  Thank you.

 

It makes sense that after residency there's more flexibility in how many hours are spent practicing.  It would certainly be great to strike some sort of balance between my professional interests at the end of training.  Glad to hear it's feasible! 

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I'm going to hijack this thread to ask a related question to the OPs.

 

I've often wondered about how people approach specialties when they already have a background related to medicine.  Let's assume that this background is something the person enjoys and want to expand upon, such as research or a business.  If you've invested so much time into publications and establishing yourself in the community, it would be pretty devastating to not match into a specialty that compliments that work.  Are people in this position more likely to take risks during the match process?  Is it very common for people to walk away from medicine all together if they're unable to match into a desired specialty?  

Sometimes having a background and publications related to that specialty can give you a leg up, I suppose it would be devastating to not match but your background seems to already give you an advantage.  It is not very common people walk away from medicine altogether, people tend to be flexible and end up liking their 2nd choice or whatever they match into 2nd iteration.

 

On a more optimistic note, how would you determine what aspects of each interest need to overlap?  For example, if your research is centred around radioligand synthesis, should you be focusing on residencies in radiology or maybe nuclear medicine?  Those are certainly the two specialties that come to mind on a superficial level, but from a practical stand point, research has a very narrow scope compared to practicing as a radiologist.  Would being in radiology improve the quality of research you could do be doing, or would those same benefits be achieved by practicing in any specialty?  I phrase the question that way because synthetic work is bench research and there's a very large gap between that and clinical trials.  In all likelihood that research would have no immediate impact on your practice of medicine.  On the other hand, if you're practicing in a completely unrelated specialty, your research may suffer because it's hard to stay up to date in two unrelated fields.  

Even if your research is in a different field from the specialty you want, there are general skills you develop through research that can benefit ie. wet lab work, writing papers, grants...etc. You should choose the specialty b/c you enjoy it, not because you have research in it. But then again, if you enjoy the research in it and the specialty, then it's a plus. I've had classmates who have PhDs related to a certain specialty but not want to do that specialty at all b/c in the process of doing their PhD, they realized that this area of research is of no interest to them.

 

I'll use another example to address an alternate angle.  What if you run a business, such as designing medical devices or prosthetics.  In a world where you're able to relinquish some of the day to day responsibilities during medical school and residency, do you strive for a related specialty?  Perhaps one where the opportunity exists for a clinic to run analogous with the business?  I think this example is quite a bit more complicated then accommodating research goals, but I know these specialty clinics exist (admittedly they're mostly in the States).

Again, if you end up liking a specialty that's not related to your business eg psych instead of surgery, I'm sure you can find a way to incorporate the two interests. There are also many clinicians who have multiple interests and not just dedicate everything into one niche.

 

Just a few things I've thought about, I apologize for the naivety. 

 

I knew what specialty I believed that I wanted before starting medical school. Having said this, I was flexible and had an open mind. I published a literature review in this field, followed by a presentation. I got by LORs and got my interview! There were 3 residency spots for 40 qualified interviewees. However, I applied and received interviews in 2 other fields. I was accepted for my second choice. I felt confident that I could be happy in any of these fields. Each had pros and cons. My first choice would not have given me a good balance with family life. I love the surgical field where I was accepted. It will give me an amazing work-family life balance. I did no research in the field that accepted me and I only gave thought to it one week before the deadline for CaRMS. I beat out many gunners. Luck was involved big time in the process.

 

It is important to be flexible, to be open minded if you do not achieve your first choice. I have a US friend who only wanted one field. It took him 3 years to achieve his dream field and he was lucky. If he had not secured it, he would have been devastated.

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How do people 'decide' which specialty they want to do? especially given limited experience 

 

My preference was to be involved with surgery. I have good hand/eye coordination, I have been fixing things my entire life, I enjoy new and exciting challenges - so surgery mirrors my personality. I happened to do a 2 week elective in this specialty, the attending encouraged me to apply, and I did although it was not my first choice. I had never given serious thought to this field and only considered it at the urging of the attending. So, I never really decided as such, rather I through my hat in the ring. Luck did the rest.

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