Choosing a specialty, part 3

So, this will be the last "choosing a specialty" post. I have been asked to render my opinion on emergency medicine, plastics, ortho, and someone couldn't help but pipe up about radiology. These four specialties probably accounted for the career goals of a third of my med school class. I can't stress enough that these are my opinions, and are likely in no way applicable to you.

The most important thing for me to say is that one should not go into ANY profession in medicine with your primary concerns being lifestyle and reimbursement. Those are shitty reasons to do any field of medicine. You should do what you love. You did not go through eight years (minimum) of school plus another three years (minimum) of training to do something that you hate. You'd be a fool.

I remember quite clearly in college I realized that I could actually do anything. It dawned on me that if I put my heart into it, I actually could do anything that I wanted to do with my life: scientist, doctor, engineer, lawyer. That is a privilege that extremely few people have. How dare you waste that privilege doing something just for the money and hours? If you do not want to make use of such a precious opportunity, there are millions of others who would make better use of it. Please, have a better reason for choosing a career than 'shift work.'

People make fun of ortho. Take the smartest and make em the dumbest. FOOBA. Honestly, I'm all right with ortho. I love ortho consults. I get to manage diabetes and high blood pressure, and I don't have to do a discharge summary? Excellent. I couldn't do ortho after I saw one procedure where they were hammering away at a femur. Felt like passing out. I like wood work. Not too crazy about sawing and hammering people.

Plastics is a funny one. Everyone thinks that plastic surgery is all boobs. In reality, the vast majority of plastics is wounds, skin grafts, minor reconstructions, and hands. If you are lucky, you can do some cosmetics, but you're not going to be on Dr. 90210. I still think it's really cool, but there's far more to plastics than making little ones bigger. But I'm no surgeon, so no plastics for me.

Someone mentioned how I knock radiology, which blew my mind. I actually like rads. I wish I could do it, but I needed the patient contact. What kills me about rads is that a lot of my med school colleagues went into rads for easy lifestyle, money, and 9 to 5 hours, and I loved rads far more than them. I was talking Houndsfield units and reviewing criteria for V/Q scans. They couldn't have cared less. And now, they're radiologists? It kills me.

Now, to emergency. I was trying not to comment on emergency medicine, since my opinion of emergency medicine is toxic at best. Keep in mind that my med school class was part of the "ER" tv show boom in emergency medicine interest. I quite clearly remember having ER parties on Thursday nights in college.

I wrote a very long tirade about ER docs, which had nothing to do with my reasons for not choosing emergency medicine, so I have created a separate post for it. I should mention that I do not counsel students at all about ER medicine. I point them as far away from me as possible.

Personally, I had no interest in ER because I liked having continuity of care, and I despise acute care. It was fun, but entirely without satisfaction for me. Also, what I did enjoy about ER was the primary care. Nearly everything I saw in ER was a primary care issue that if they had seen an internist a week before, they could've probably avoided going to the ER. Instead of leg edema, it was decompensated heart failure. Instead of exertional fatigue, it was acute MI. Instead of abscess, it was fasciitis. What ER made me realize is what these people needed wasn't more ER physicians, but they needed a primary care doc.

And so, here I am.