best medical speciality for someone who likes diagnosis ( apart from GP)

I’d say neurosurgeon because they can plan and plan to figure out what’s wrong but once the skull cap is removed, the plan goes out the window because seeing the brain changes everything. It’s all about looking at the brain and figuring out how to fix it without damaging it. Like a huge puzzle. (That is if you wanna be seeing brains hahaah)

This is how it works on TV, not so much in real life

Not really, my cousin is a neurosurgeon, it’s how she’s personally described it

The laboratory disciplines have a solid degree of detective work. Haematology specifically I find to be fascinating! (No bias here at all ) Reviewing peripheral bloods, dealing with transfusions and numerous referrals and of course constantly attending specialty seminars on microscopy 👍🏼

I'd say histopathology is probably the most 'diagnosis/problem-solving' oriented specialty. The workload is a few cases a day, where you get all the slides and mull over them. Then ordering immunohistochemistry/immunoflorescence/cytogenetic analysis/PCR as needed. As a trainee, you're also receiving the specimens and dissecting/choosing where in the specimen to make slides from.

Things like haematology offer a half-way house between pathology and internal medicine. You'd see and assess the patient in the ward/clinic, but also look at their blood film/order further lab tests. But I think nowadays, the more complicated bone marrows and definitely lymphoma biopsies are going to histopathologists specialising in haematopathology.

That said, I still think the problem solving in clinical heamtology is interesting in its own right! Some internal medicine specialties are also pretty heavy on it - neurology and renal I reckon to name a couple.

Op:

I’d say neurosurgeon because they can plan and plan to figure out what’s wrong but once the skull cap is removed, the plan goes out the window because seeing the brain changes everything. It’s all about looking at the brain and figuring out how to fix it without damaging it. Like a huge puzzle. (That is if you wanna be seeing brains hahaah)

Sounds like you just want a lot of time per patient, in which case i would suggest ITU. Sickest patients in the hospital, lots of resources thrown at them, generally a fair amount of time spent per patient on consultant ward rounds (which generally happen twice per day, rather than e.g. once per week!)



I'm trying to think of a speciality which is less diagnosis-orientated and really can't think of one. I have never, ever seen a neurosurgeon act without a scan and report by radiologist. They help diagnose cancers, but by getting the radiologists to tell them where to put the drill, doing it, then sending it to the lab who actually do the diagnosing. There is no improvising involved i assure you! Perhaps some of the spinal stuff they might get involved with actually diagnosing, but many of them don't even do spinal stuff!

Honestly, i think neurosurgery is the antithesis of what you put in the OP.

nice thanks is there a lot of problem solving in ITU?

Depends what you mean by 'problem-solving'. Your patients have a lot of problems, and they need solving i suppose! You do get more time per patient though which means you can consider unlikely diagnoses, unusual treatment strategies, do lots of tests and do routine tests more frequently.

There is, however, a lot of airway management too, if doing it from the anaesthetic side, and a fair few technical procedures, which was not what you asked for.