About a year ago, I made a list of specialties that I was considering.

Now at the start of third year, I am writing down the top five specialties currently in the considering. I’ve had more time to shadow and do electives in a variety of fields. So here they are, my shortlist at the end of M-2, with explanations below.

Top 5

1. Internal Medicine – Still tops the list, especially since my favorite subjects so far has been in internal (cardiology, pulmonary, GI, oncology). The diversity along with the chance to further subspecialize appeals to me a lot. I like problem solving, working on complex cases, team environments and interacting with patients.
2. Family Medicine – Diverse, flexible, wide variety of practice. Can never rule out primary care.
3. Gen Surg / Ortho - Unfortunately or fortunately? I haven’t ruled out surgery yet. Although I am pretty confident I am more for medicine, I like working with my hands, working on teams and seeing positive results. The satisfaction knowing that you made a difference, that your hands fixed something, makes surgery highly appealing. Though I don’t think I am focused enough to do a sub-specialty surgery that has a narrow scope like ENT, Ophtho, Urology, etc. Though I think plastics is super cool.
4. Neurology / Physical Med & Rehab – A different pace of medicine, often more focused on management instead of cure. Similarities to internal perhaps?
5. Emergency Medicine – Things I like: Quick, fast-paced, great learning experiences in past, wide scope of practice and skillset. Dislike: Shift work, no continuity of care (not having “your” patients, following up after admission)

Bottom 5 - (no particular order)

1. Pathology – No interests at looking at slides, cells and cadavers. It doesn’t make pathologists any less of a doctor. It just wasn’t meant for me.
2. Anesthesiology – Puts me to sleep, just like it does for patients undergoing surgery.
3. Psychiatry – After learning about it in class, I found it fascinating. A super important field that often goes neglected but again just not for me. Psych is part of every field of medicine, hopefully I’ll see my share of psych patients in another field and do a good job caring for these under-served patients.
4. Cardiac / Neurosurgery – I don’t have enough passion in these two fields to give up the rest of my life
5. Medical Biochem / Genetics / Microbiology & Lab Med – Had enough research experiences to know I can’t spend the rest of my life doing lab work. Would much rather be at the bedside than the bench.

Changes

Decrease

• Ophthalmology – The eye is still pretty cool topic and restoring vision is still admirable work. But it’s narrow focus and few procedures makes it less appealing to me. I enjoyed studying Ophthalmology (spelled with two H’s!) a lot this year but I didn’t have any special interest to pursue a surgical career in eye care. Still an important topic to know no matter what you end up in.
• Radiology - I thought long and hard about this one and after multiple electives, I can happily say, it’s not for me I liked my experiences in interventional radiology and ultrasound. Learned a lot reading Xrays and CTS. Was bored to sleep in nuclear imaging. Reading radiology accurately is an essential skill that all clinicians should have. I feel like if I go into Internal, I’ll get my fair share of radiological interpretation to satisfy me. As for interventional, I can’t bear the thought of going through a five-year residency program reading films just to get the chance to do procedures.

Increase

• Dermatology – I was actually quite engaged and interested when we learned about dermatological problems in class. Not all just acne and botox. Though I feel like what they showed us in class (all the interesting rare stuff) is quite different from real life practice.
• OBSGYN – Not a bottom 5 specialty but nowhere near the top either. I was lucky enough to scrub in on a few C-sections this year. The miracle of life is unlike anything else, it really is beautiful. Though the frequency of malpractice/lawsuits and preference for females in this specialty are enough to rule it out for me.