One of the purposes of electives in the third and fourth years of medical school is to gain some experience in various medical specialties, to help decide on which field to enter. It is an important choice, since you will be working hard the rest of your life, and preferably it should be in a field that you truly enjoy.
In my case, having practiced neurology, ophthalmology, and family medicine at one time or another, in addition to lab research and teaching, I offer these considerations, but, of course, you will need to decide which ones are personally most relevant:
General vs Specialty Medicine?
Some people will find it more satisfying to practice in a very specialized area, since it is easier to learn one specialized field very well than keep up with the literature in a broad area. However, others may feel in a rut, always dealing with the same narrow range of problems. They may prefer to enter a broad specialty, such as internal medicine, family medicine, or general surgery and experience a wide scope of medicine.
More vs Less Patient Contact?
Some fields have less direct patient interaction, such as radiology and pathology. Others, particularly family and internal medicine, have much more. Are you more of a people person (children and/or adults) or would you prefer less patient contact? Emergency Medicine involves lots of patient contact, but the patient’s problems don’t follow you home, since ER medicine is not a continuity-of-care field; once the patient is admitted, a hospitalist takes over; or the patient’s primary physician continues the care if the patient is discharged.
High-Yield Practical Medicine?
All fields of medicine are practical in that you can help patients in any field, not just with bedside manner and laying on of the hands, but in the specific treatment measures unique to the field. Some fields are more satisfying than others in terms of well-defined practical results. Ophthalmology would be high on the list, since one can clearly assess an improvement of vision, whether by refraction or surgery. Neurology would be lower, but still there are many situations in which the neurologist provides critically important care.
People selecting General Surgery or a surgical subspecialty sometimes feel they are achieving more tangible results than in a specialty that relies more on medication. As one of my co-students, who chose surgery, put it: “I don’t want to be a pill-pusher.” His concern was that many pills are just placebos. Others feel differently. Family Medicine, despite the absence of surgery (beyond simple matters), can be very satisfying; there is a great need for physicians to coordinate the overall health care of the patient, and patients are often very grateful. But in Family Medicine, as in Internal Medicine and Psychiatry, when a patient improves, it sometimes can be difficult to tell whether it was a spontaneous or psychological cure or whether the medication truly was responsible for the improvement.
Family Medicine vs Internal Medicine? Continue reading “Career Choice In Medicine”