Your favourite / most hated specialties

This was going to be a rant about my particular least favourite specialties in medicine after a particularly rubbish day but I figured it'd be nice to know which departments people happen to love.

So which are your favourite and most hated specialities in medicine and why?

Personally, one of my favourite (despite not wanting to be an anaethestist or intensivist) is ICU:

• Probably because the docs there have had to learn a hell of a lot of physiology and therefore find easy ways for them to understand concepts, I find ICU docs are very good at teaching and explaining medicine in a way that makes sense and sticks

• The job involves a good mix of acute and chronic considerations and quite a wide variety of clinical skills

• You get a good mix of conditions and patient types

• The satisfaction of knowing that the work ICU does is pretty much the only thing keeping your patients from death is pretty exhilerating

One department is really cannot stand though is neurology. I find neurology really fascinating but it seems like whenever I am being taught or assessed by neurologists it's on everything but the interesting stuff.

• They tend not to be great teachers in my experience, pitching things at the wrong level, not being very interactive etc. talking down to you if you don't read their mind and understand the exact intricacies of the questions they ask you - I am sure there are great neuro teachers out there, this is just my experience but it's been annoyingly universal so far

• They assume you know neuroanatomy to PhD level no matter what stage you're at, it doesn't matter if it's clinically relevant or not

• Even when you do diagnose a patient, half the time there is almost nothing you as a doctor can do for them other than give them updates on their inevitable slide towards death - it seems to be the MDT that actually makes a difference to a lot of these patients

^ I know this is a massive generalisation and I am sure there are lots of exceptions, but we all have fav/least fav specialities and because of my experiences these are mine. If someone can convince me to think otherwise, please try, I would love to enjoy my time in neuro more than I am..

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Reply 1

Daveo

Love radiology and A&E, hate psych!

Reply 2

Lu-x

Just finished my first placement - Orthopaedics. Really didn't enjoy it. I love the problem-solving aspect of medicine, and didn't feel there was enough of that involved. Doing Cardioresp next, hopefully will enjoy it more!

Reply 3

Hygeia

Anaesthetics is awesome :awesome:

Psych

(edited 13 years ago)

Reply 4

junior.doctor

I love palliative medicine.

- Plenty of acute medicine - spinal cord compression, hypercalcaemia, acute bleeds, cerebral mets, neutropaenic sepsis....
- Need a good pharmacology knowledge
- Proper problem based medicine - symptom control is all about a good knowledge of physiology, pathology and pharmacology whilst also a good knowledge of the individual patient.
- practical procedures such as paracentesis
- Good communication skills
- Holistic care
- usually have more time to spend with patients than in other specialties

From what I've done so far, what I disliked the most was vascular surgery.
- Most of the patients have serious arteriopath comorbidities / heart disease / diabetes / COPD etc etc and the SpRs / consultants don't know much medicine. But the patients were SICK. So as a junior I ended up managing all of the medical problems that were exacerbated by the surgery. I worked on an insanely busy unit which operated electively 5 days a week and received all the region's emergency surgery as well. The ward always smellt of gangrene / necrotic feet. I regularly ended up debriding nasty feet on the ward (minion job). When the patients bled, they really haemorrhaged.

I couldn't deal with necrotic feet and legs all the time, it's not a very hours-friendly job (called at all hours for AAA repair etc) and the patients have a lot of medical as well as surgical problems. I don't feel surgery is for me anyhow.

Reply 5

RetiredAccount89

Original post by Lu-x

There is a fracture. I need to fix it.

http://www.youtube.com/watch?v=3rTsvb2ef5k

Reply 6

Becca-Sarah

Love: Orthopaedics. I was deprived of Meccano as a child and feel the need to make up for this in my adult life.

Dislike: GP. Too much fluffy social crap.

Reply 7

Ciaran88

Gotta add GUM clinic to my list of favs, I don't much enjoy looking at gnarly downstairs bits but that aside

• "Interesting" patients, to say the least

• GUM clinics in hospitals are like a little microcosm of all of medicine, patient comes to you for the first time like they would a GP, you do the investigations as a hospital doc (taking a swab), you get to chuck the swab under the microscope and make the diagnosis of which bug they have as a microbiologist would, and then you get to treat it. I love that, you can (sometimes) get the whole patient picture in one consultation.

• Everybody working there has a wicked sense of humour and lots of interesting stories

• Good working hours compared to other hospital specialties, more exciting than general practice

I won't be going into GUM but it is awesome and I love the GUM docs here at the Derriford, they're pretty damn cool

Reply 8

junior.doctor

Original post by Ciaran88

Ahh GUM. Won't ever be doing it as a doctor but as a med student the brief stint I did was one of the placements I enjoyed the most. Partly because of the fantastic team I think. It's pretty staightforward - 1g azithromycon fixes most things, and for the rest (syphillis) there's penicillin. For the more medical side there's HIV, which is pretty fascinating. You get to be really nosy into people's personal lives too.

When I was on placement at the big GUM clinic in the middle of town there was a fire drill and all the patients had to line up outside next to the big sign that said SEXUAL HEALTH CLINIC alongside the main dual carriageway into the city centre - they were not amused and were all trying to hide / generally not be seen by the whole world to be attending a GUM clinic. Cruel, but funny :colone:

Reply 9

xXxBaby-BooxXx

Original post by Hygeia

Anaesthetics is awesome :awesome:

Psych

You must be gutted to hear that by the time I get into year 5 (if I do!) then they will have drastically cut down on the amount of time we spend on psych. I think it's going down to about 8 weeks to allow more time for FY1 prep :p:

(edited 13 years ago)

Reply 10

Hygeia

Original post by xXxBaby-BooxXx

You must be gutted to hear that by the time I get into year 5 (if I do!) then they will have drastically cut down on the amount of time we spend on psych. I think it's going down to about 4-5 weeks to allow more time for FY1 prep :p:

They're only planning to cut it to 8 weeks afaik, still pissed off that I've had to do 14 (and have 4 months of psych in F2 as well) but that's the way things go I guess.

Reply 11

xXxBaby-BooxXx

Original post by Hygeia

They're only planning to cut it to 8 weeks afaik, still pissed off that I've had to do 14 (and have 4 months of psych in F2 as well) but that's the way things go I guess.

See 8 was in my head, but I was thinking that was the length it was originally :colondollar:

And you never know, actually practising it in FY2 you might suddenly love it! :p:

Reply 12

Hygeia

Original post by xXxBaby-BooxXx

See 8 was in my head, but I was thinking that was the length it was originally :colondollar:

And you never know, actually practising it in FY2 you might suddenly love it! :p:

Not likely :p:

But I've got ICU before it and acute med afterwards so I'll tolerate it and use the shorter hours to try and find something to boost my CV with :smile:

Reply 13

Ciaran88

Original post by Hygeia

Not likely :p:

But I've got ICU before it and acute med afterwards so I'll tolerate it and use the shorter hours to try and find something to boost my CV with :smile:

Research!

I've lost count of the number of retrospective chart reviews I've done lmao, nothing more satisfying than asking yourself a question and once you've gotten all the data together plugging it into a stats app and boom, there's your answer.

Getting it published on the other hand..

And yeah I've hated psych so far, I don't understand why at medical school you spend such a disproportionately longer amount of time there than some other core departments.

Reply 14

Madprof

Jamie

There is a fracture. I need to fix it.

http://www.youtube.com/watch?v=3rTsvb2ef5k

Loving it!

Favourite: Psych, GP (I love the 'fluffy social crap' :smile:

)
Least favourite: Orthopaedics, O&G (apart from the actual baby-catching!)

Reply 15

Neomaster121

Original post by Jamie

There is a fracture. I need to fix it.

http://www.youtube.com/watch?v=3rTsvb2ef5k

This video seems to suggest that orthopaedic surgeons are retarded

they can't be like that in RL can they

Reply 16

j00ni

Original post by Neomaster121

This video seems to suggest that orthopaedic surgeons are retarded

they can't be like that in RL can they

How much are you willing to bet?!

When I was an ortho F1, the SpR asked me to write a paper referral and fax it to the cardiologists and wait for their opinion before starting treatment for a patient w/ NSTEMI (but not before the consultant had asked what an NSTEMI was!!)