when deciding on a specialty we often
think about clinical interests
the bread and butter and lifestyle but
there are several more often overlooked
qualities that make up an important
component in your long-term happiness
and career satisfaction
here is what you shouldn't overlook when
considering a specialty as a medical
student
and future physician dr juval
medschoolinsiders.com
first you don't need to know what
specialty you're going into until the
second half of medical school
i thought i wanted to be a pediatric
gastroenterologist throughout college
but i didn't have any experience
shadowing one i was just a
gastroenterology patient myself
having been diagnosed with crohn's
colitis at the age of 18.
during the summer after my first year of
medical school i finally got exposure to
the field from a provider perspective
through clinical research in pediatric
endoscopy
at that point i quickly realized it
wasn't for me
luckily i had an inkling that surgery
would be a better fit
but i never stepped foot in the
operating room until my third year
when i quickly fell in love with plastic
surgery that being said
it would be strange to work tirelessly
through your pre-med and medical school
years
wanting to become a doctor without some
idea of the type of physician you're
aspiring to be
after all the life of a neurosurgeon is
much different than the life of a family
medicine physician
and it's unlikely that both are equally
appealing to you
in my previous video on how to choose a
specialty we touched on key areas you
should focus on
by watching that video in conjunction
with this you'll have a comprehensive
understanding of the various factors you
should consider
when you're young you feel like you'll
live forever i knew medicine was going
to be a long grind with delayed
gratification
but i wasn't afraid of hard work i had
already grinded hard for four years of
college without issue
so what's another four years of medical
school plus three to seven years of
residency
if you've ever ran a marathon or rode a
century on your bike
you understand the first half isn't
really an issue it's in the second half
that you're truly tested
the same thing applies here with medical
training no matter how much i or any
other physician tells you
how rigorous medical training will be
you won't truly
understand it until you get there some
thrive in it and welcome the challenge
others prefer to have a semblance of a
life and that's totally
okay at the beginning of medical school
you and your classmates will be
wide-eyed and hopeful eagerly awaiting
what lays ahead
but after a few years of slogging away
the importance of lifestyle
and more manageable training will become
front and center
your friend who was all about orthopedic
surgery first year may be applying to
family medicine
or anesthesia instead and there's no
shame in that
after medical school your training isn't
over the shortest residencies are three
years in duration
including internal medicine and
pediatrics many are four years
such as emergency medicine and
anesthesiology surgical specialties are
usually longer with orthopedic surgery
urology and general surgery at five
years
the longest in duration are plastic
surgery at six and
neurosurgery at seven some other fields
require fellowship
for example gastroenterology and
cardiology tack on
three years of fellowship training after
completing three years of internal
medicine residency
for a total of six years of additional
training after medical school
if you want to sub-specialize surgically
there's usually a one or two-year
fellowship tacked onto the end of an
already lengthy surgical training sit
down and
do the math if you imagine yourself
having kids and a family by the time
you're 30
but you also want to be a neurosurgeon
so specializing in
neuro-oncology requiring a two-year
fellowship the soonest you'll be done
is 33 that is assuming you graduate
college at 22
and go straight to medical school
without taking any time
off if you're like the average medical
school matriculant and start medical
school at the age of 24
after taking a year or two off from
college you'll be 35
and to match into something competitive
like neurosurgery
many medical students also take a
research year to make their application
more competitive for residency
which brings us to 36. you may be the
type of person who
that doesn't face and that's great you
probably have
excellent work ethic and don't mind
delayed gratification
but most people don't like the idea of
being in rigorous training until their
mid-30s
especially while their friends and peers
are happily living their lives
tying in with the timeline and training
is how rigorous your specialty will be
both during medical school and in
residency if you want to get into
dermatology or plastic surgery
by far the two most competitive
specialties you'll have to work harder
than your classmates in medical school
and
truly excel performing at the top of
your class to be a serious candidate
and while in residency understand that
most surgical specialties will be
incredibly challenging and rigorous
often pushing 80 or more hours per week
it's not uncommon for surgical
specialties to violate the 80 hour
work week restrictions mandated by the
ac gme
non-surgical specialties are less likely
to push you to this extreme
and if they do it's usually for much
shorter bouts
maybe one or two months in a year if you
choose something like anesthesiology
on the other hand you can expect to work
50 to 60 hours during your residency
or if you go with family medicine 9-5
hours are more the norm
even in residency keep in mind that your
hours as an attending
after finishing residency are also
highly variable with surgeons working
longer hours on average
it's human nature to care about how
people treat you do patients respect you
or resent you
how about your colleagues for each
person this can vary in
importance and for each specialty you'll
find this highly variable as well
for example if you work in the emergency
department you'll come across hostile
patients more frequently than the
average pediatrician
but if you don't like crying kids
pediatrics probably isn't for you anyway
as an aesthetic plastic surgeon you'll
likely come across your fair share of
entitled and difficult patients who are
impossible to please maybe
anesthesiology is a better fit
as you'll be putting patients to sleep
and won't have to deal with
much of that but as an anesthesiologist
you'll be second in command in the
operating room as it's the surgeon's
domain
surgeons and anesthesiologists are
working on the same team as colleagues
but anesthesiologists sometimes find
themselves on the receiving end of a
surgeon's bad day
you don't see it the other way around
there are some secondary and tertiary
considerations to also keep in mind
how is your specialty practice affected
by the economy and national healthcare
changes for example
aesthetic plastic surgery won't thrive
during large downturns in the economy
as most people have less discretionary
spending and
are unable to justify cosmetic
procedures however if reimbursement
through insurance decreases
reconstructive plastic surgeons can
always fall back to
an aesthetic cash-based practice and be
relatively unaffected
on the other hand an emergency medicine
physician's work is relatively unchanged
regardless of what's going on
in the economy people have emergencies
and need medical treatment whether
bull or bear market but if reimbursement
changes
there isn't much they can do about it
and while this shouldn't be a focus
particularly this early in your career
consider what type of practice you're
drawn to
for some specialties private practice is
becoming less feasible and
working as an employee at a larger
hospital or medical group
is more common if you're unsure what
type of doctor you want to be
that's totally normal but now is the
time to give this some thought
the earlier you have clarity the better
shadowing physicians is less feasible
now with the state of the world
but in the meantime check out our so you
want to be series where we highlight
individual
specialties within medicine doing a deep
dive to help you determine if it would
be a good fit for you
and regardless of what you choose it
always benefits you to keep your options
open
in case you decide to pursue something
competitive like orthopedic surgery
at med school insiders we specialize in
helping students
maximize their potential and be the most
competitive candidates possible
visit medschoolinsiders.com to learn
more thank you all so much for watching
check out my last video on choosing a
specialty and if you haven't already
go through our so you want to be
playlist to learn more about individual
specialties
much love and i'll see you guys in that
next one
you