Different Specialities

[MarsRover]

Hello,

 

 I am just wondering what specialities would have the most day to day variance. I am just applying to medical school now, so obviously I will find out what I like in the future (hopefully), but I was also just curious. I have heard from several doctors that their fields are very narrow, one oncology radiologist told me he spend 70% of his day looking at prostate cancer and the rest GI cancer.

 

 So i am just wondering what fields would have more variability. Obviously a super specialized surgeon would not, but what about fields like infectious disease medicine, rheumatology, etc. 

[MarsRover]

 Also not to suggest there is anything wrong with less variability, just interested for myself. 

[mononoke]

variability can be found in generalized specialties like family med, emerg, anesthesia, general internal med...

but even so, you can be specialized in these fields, like being a family physician with a special interest in derm or women's health

fields like rheum or infectious diseases are already more specialized than general internal

[ralk]

Hello,

 

 I am just wondering what specialities would have the most day to day variance. I am just applying to medical school now, so obviously I will find out what I like in the future (hopefully), but I was also just curious. I have heard from several doctors that their fields are very narrow, one oncology radiologist told me he spend 70% of his day looking at prostate cancer and the rest GI cancer.

 

 So i am just wondering what fields would have more variability. Obviously a super specialized surgeon would not, but what about fields like infectious disease medicine, rheumatology, etc. 

 

Depends on what you mean by variance. Variance in subject matter? In patient population? In practice setting? In tasks?

 

A family medicine physician or emerg doc will probably get the widest variety of patients and conditions, but all in a single setting and largely in the same role. More specialized physicians might be dealing with the same population, but in a variety of ways - for example, I worked with a highly-specialized surgical oncologist who was doing remarkably different things (surgery, clinic, consulting, minor procedures) each and every day of the week. Hard to give you an answer without a more specific question. 

 

Also, keep in mind that there's some choice about variability in each specialty - those who focus their practice on a very specific part of medicine often do so by choice either directly (by choosing that hyper-specialization) or indirectly (by making other career choices that necessitate hyper-specialization).

[MarsRover]

Yea, I guess I meant to elaborate more. I meant variance in the sense of a variety of tasks. I meant sort of how the specialized radiologist i talked to was just doing the same task over and over, or a very specialized surgeon just doing same surgeries a lot. I just assumed infectious disease, or say reconstructive surgeon may have same techniques they use but on a variety of different cases in different ways. So you wouldn't be going in the day know yes i will just be seeing if these tumours grew or shrank today sort of thing. 

[ralk]

Yea, I guess I meant to elaborate more. I meant variance in the sense of a variety of tasks. I meant sort of how the specialized radiologist i talked to was just doing the same task over and over, or a very specialized surgeon just doing same surgeries a lot. I just assumed infectious disease, or say reconstructive surgeon may have same techniques they use but on a variety of different cases in different ways. So you wouldn't be going in the day know yes i will just be seeing if these tumours grew or shrank today sort of thing. 

 

Well they don't pay that super-specialized radiologist to just say if the tumors shrank or not As any surgeon will be quick to tell you, no two surgeries are exactly the same, so even in practices where it seems like everything is routine, there's actually a lot of variation. That's part of the reason we have highly specialized physicians - if everything was routine in those fields, a physician with a more generalist training would do just fine.

 

In terms of variety of tasks, there are a lot of options and certainly many specialties can be tailored to variety. Emerg is probably the classic example, with a decent variety of tasks and no warning as to what you'll be encountering during the day. Anesthesia can have some interesting variety - lots of pain management stuff and minor procedures, in addition to their headlining role of knocking people out during surgery. Surgeons, even very specialized ones, can have quite a bit of variety depending on their exact field, and not just in terms of surgeries - surgeons don't typically operate every day they work, but spend a fair bit of time in clinics or consulting. OBGYN can have an interesting mix of surgery (albeit a small variety of surgeries), clinic, and deliveries. Family, of course, can be tailored to do a wide variety of tasks (minor procedures, surgical assist, delivering babies, etc), particularly in a rural or remote setting.

 

In terms of what has less variability, I'd say anything that has no or few procedures, and practices with a specialized population probably qualifies. Rheumatology and infectious diseases deal with rather interesting conditions that can often present in odd or atypical ways, but they're generally doing the same sorts of things with those patients. Pathology might count here too. These are typically very cerebral fields, requiring a deep, detail-oriented knowledge base (especially Pathologists, those guys seem to know everything), but their actual practices involve a lot of similar activities.

 

Every field has their bread-and-butter stuff that's typically impossible to avoid. By the same token, no field does the exact same thing every single day. For the most part, you can adjust your practice to have more or less variety, depending on patient needs and available resources.

[NLengr]

If you want something that has a lot of variability in tasks, look for the specialties where you are managing both the medical and surgical aspects of a system. Urology and ENT come to mind. For example, those guys might have clinic 2 days a week, be scoping one day a week, have half a day of minor procedures and a day of OR during the week. Half a day off for paperwork. That's pretty varied.

[NLengr]

Of all the specialties, urology probably has the biggest variety of surgeries. Those guys do urinary tract scope work, lap, robotics and open surgery. I don't know if another specialty comes close to that.

[Lactic Folly]

Suggest that your particular practice / position will have as much effect, if not more, on the level of day-to-day variability as the field itself. e.g. the oncologic radiologist you met seems to be an outlier in terms of subspecialization, but a general radiologist could be in and out of their chair all day doing biopsies / fluoroscopy / injections / scanning ultrasound, in between reading all modalities / body parts, covering the gamut of outpatient and inpatient clinical questions from all specialties. There's also admin/teaching/research to throw into the mix.

[sleeping_sickness]

you can find variability in most fields. 

for example, you'd think colorectal surgery is highly specialized where you're just 'doing the same surgeries over and over'. but really it's quite variable. you operate, you have clinic, you perform colonoscopies. your patient population is variable. you deal with cancers and inflammatory bowel conditions and emergency bowel obstructions or perforations. 

 

i bet most specialties, even highly specialized sub-specialties, are quite variable - you just need to get a little closer to them to see it. 

[MarsRover]

Yea, now that you guys explain it more I definitely see more what you mean. I think it is likely that the few really specialized people I was dealing with here maybe just being a little pessimistic.

[A-Stark]

Kind of a difficult question. I wouldn't worry too much about variance at this point, since almost every specialty will give you a lot of different exposure in your base training. If you're interested in radiology, you will have lots of opportunity to consider less highly sub-specialized areas, and it's actually far more likely you'll end up working somewhere in the community where you'll divide your time between different imaging modalities and, of course, diagnoses. 

 

More important to think about is what kind of populations you want to work with, whether you want long-term relationships with patients or episodic ones, whether you want to do procedures, and whether you want to be a surgeon.