Help choosing a speciality
Hello!
I'm an F1 starting to narrow down my speciality decisions, I don't think I'll take an F3 so looking to apply in F2.
Thinks I like:
Things I don’t like:
I don't mind working hard and taking difficult exams (the standing thing is due to some MSK back issues more than anything).
thanks for any help
I'm an F1 starting to narrow down my speciality decisions, I don't think I'll take an F3 so looking to apply in F2.
Thinks I like:
1.
Having a team
2.
Predominately sitting down
3.
Making decisions
4.
Feeling like I’ve actually done something useful
5.
A good variety in the day
6.
Not too many nights and weekends
7.
Some practical aspects
Things I don’t like:
1.
Standing for long periods of time
2.
Being alone
3.
High stress or unknown situations where things need to happen very quickly
4.
Very long ward rounds
5.
Long, complex social discharges
6.
Conversations with families
I don't mind working hard and taking difficult exams (the standing thing is due to some MSK back issues more than anything).
thanks for any help
That's a nice clear list - it's good to know what you like and don't like.
When you say you'd like to work in a team, do you mean that you want to physically be working alongside other members of staff at all times e.g. like in theatres/ITU/A&E, or more that you want a wider MDT to confer with at various points? Or something else?
If you're interested in medicine, perhaps an outpatient based specialty e.g. rheumatology or dermatology might be what you're looking for? Mostly clinics, mostly non-acute, scope for practical work, you can work alongside specialist nurses, train your own registrars etc. That would involve having to complete at least a few years of acute medicine however.
Ophthalmology might also be worth considering?
Anaesthetics is an acute specialty so you would have to deal with stressful scenarios, but other than that it's also quite in keeping with what you're decribing I'd have thought.
When you say you'd like to work in a team, do you mean that you want to physically be working alongside other members of staff at all times e.g. like in theatres/ITU/A&E, or more that you want a wider MDT to confer with at various points? Or something else?
If you're interested in medicine, perhaps an outpatient based specialty e.g. rheumatology or dermatology might be what you're looking for? Mostly clinics, mostly non-acute, scope for practical work, you can work alongside specialist nurses, train your own registrars etc. That would involve having to complete at least a few years of acute medicine however.
Ophthalmology might also be worth considering?
Anaesthetics is an acute specialty so you would have to deal with stressful scenarios, but other than that it's also quite in keeping with what you're decribing I'd have thought.
Hey thanks for the reply!
By team I mean having people around to chat to, discuss things with, help you with decisions type thing - so probably more the first scenario you described. For example at the moment I'm on acute medicine and I really like the team atmosphere, but find the 'this patient is vomiting blood with a Hb of 49' moments less enjoyable ha.
Ophthalmology is a good shout actually! I quite enjoyed the placement at med school, maybe that does fit the bill, although I just have googled the competition ratios and it seems I have some work to do haha.
I did think about anaesthetics as I quite like the theatre environment and it's always seemed supportive and interesting, but yeah having attended arrest calls they always seem to be the person left behind to deal with it, and being called to manage complex airways and things.
I do enjoy medicine but I think even rheumatologists are getting drafted into the acute med Reg rota and I'm not sure how much that's for me - maybe this could be an F1 confidence thing, and I'm sure as I progress I'll find these situations less stressful, but in my working day I tend to more enjoy having a bit of time to mull over an interesting patient rather than having to make quick decisions (obviously not all the time). I find the lack of diagnostic certainty a bit frustrating, on my take shifts I feel like I'm just endlessly prescribing co-amoxiclav and fluids, and then moving to the next patient, and not always finding out exactly what's wrong.
By team I mean having people around to chat to, discuss things with, help you with decisions type thing - so probably more the first scenario you described. For example at the moment I'm on acute medicine and I really like the team atmosphere, but find the 'this patient is vomiting blood with a Hb of 49' moments less enjoyable ha.
Ophthalmology is a good shout actually! I quite enjoyed the placement at med school, maybe that does fit the bill, although I just have googled the competition ratios and it seems I have some work to do haha.
I did think about anaesthetics as I quite like the theatre environment and it's always seemed supportive and interesting, but yeah having attended arrest calls they always seem to be the person left behind to deal with it, and being called to manage complex airways and things.
I do enjoy medicine but I think even rheumatologists are getting drafted into the acute med Reg rota and I'm not sure how much that's for me - maybe this could be an F1 confidence thing, and I'm sure as I progress I'll find these situations less stressful, but in my working day I tend to more enjoy having a bit of time to mull over an interesting patient rather than having to make quick decisions (obviously not all the time). I find the lack of diagnostic certainty a bit frustrating, on my take shifts I feel like I'm just endlessly prescribing co-amoxiclav and fluids, and then moving to the next patient, and not always finding out exactly what's wrong.
Original post by Anonymous
Hey thanks for the reply!
By team I mean having people around to chat to, discuss things with, help you with decisions type thing - so probably more the first scenario you described. For example at the moment I'm on acute medicine and I really like the team atmosphere, but find the 'this patient is vomiting blood with a Hb of 49' moments less enjoyable ha.
Ophthalmology is a good shout actually! I quite enjoyed the placement at med school, maybe that does fit the bill, although I just have googled the competition ratios and it seems I have some work to do haha.
I did think about anaesthetics as I quite like the theatre environment and it's always seemed supportive and interesting, but yeah having attended arrest calls they always seem to be the person left behind to deal with it, and being called to manage complex airways and things.
I do enjoy medicine but I think even rheumatologists are getting drafted into the acute med Reg rota and I'm not sure how much that's for me - maybe this could be an F1 confidence thing, and I'm sure as I progress I'll find these situations less stressful, but in my working day I tend to more enjoy having a bit of time to mull over an interesting patient rather than having to make quick decisions (obviously not all the time). I find the lack of diagnostic certainty a bit frustrating, on my take shifts I feel like I'm just endlessly prescribing co-amoxiclav and fluids, and then moving to the next patient, and not always finding out exactly what's wrong.
By team I mean having people around to chat to, discuss things with, help you with decisions type thing - so probably more the first scenario you described. For example at the moment I'm on acute medicine and I really like the team atmosphere, but find the 'this patient is vomiting blood with a Hb of 49' moments less enjoyable ha.
Ophthalmology is a good shout actually! I quite enjoyed the placement at med school, maybe that does fit the bill, although I just have googled the competition ratios and it seems I have some work to do haha.
I did think about anaesthetics as I quite like the theatre environment and it's always seemed supportive and interesting, but yeah having attended arrest calls they always seem to be the person left behind to deal with it, and being called to manage complex airways and things.
I do enjoy medicine but I think even rheumatologists are getting drafted into the acute med Reg rota and I'm not sure how much that's for me - maybe this could be an F1 confidence thing, and I'm sure as I progress I'll find these situations less stressful, but in my working day I tend to more enjoy having a bit of time to mull over an interesting patient rather than having to make quick decisions (obviously not all the time). I find the lack of diagnostic certainty a bit frustrating, on my take shifts I feel like I'm just endlessly prescribing co-amoxiclav and fluids, and then moving to the next patient, and not always finding out exactly what's wrong.
A pathology speciality.
Posted from TSR Mobile
I would like a little bit of patient contact - I think if I was going to go down the limited patient contact route I would go for Radiology
Original post by Newtothis83
Original post by Anonymous
Hey thanks for the reply!
By team I mean having people around to chat to, discuss things with, help you with decisions type thing - so probably more the first scenario you described. For example at the moment I'm on acute medicine and I really like the team atmosphere, but find the 'this patient is vomiting blood with a Hb of 49' moments less enjoyable ha.
Ophthalmology is a good shout actually! I quite enjoyed the placement at med school, maybe that does fit the bill, although I just have googled the competition ratios and it seems I have some work to do haha.
I did think about anaesthetics as I quite like the theatre environment and it's always seemed supportive and interesting, but yeah having attended arrest calls they always seem to be the person left behind to deal with it, and being called to manage complex airways and things.
I do enjoy medicine but I think even rheumatologists are getting drafted into the acute med Reg rota and I'm not sure how much that's for me - maybe this could be an F1 confidence thing, and I'm sure as I progress I'll find these situations less stressful, but in my working day I tend to more enjoy having a bit of time to mull over an interesting patient rather than having to make quick decisions (obviously not all the time). I find the lack of diagnostic certainty a bit frustrating, on my take shifts I feel like I'm just endlessly prescribing co-amoxiclav and fluids, and then moving to the next patient, and not always finding out exactly what's wrong.
By team I mean having people around to chat to, discuss things with, help you with decisions type thing - so probably more the first scenario you described. For example at the moment I'm on acute medicine and I really like the team atmosphere, but find the 'this patient is vomiting blood with a Hb of 49' moments less enjoyable ha.
Ophthalmology is a good shout actually! I quite enjoyed the placement at med school, maybe that does fit the bill, although I just have googled the competition ratios and it seems I have some work to do haha.
I did think about anaesthetics as I quite like the theatre environment and it's always seemed supportive and interesting, but yeah having attended arrest calls they always seem to be the person left behind to deal with it, and being called to manage complex airways and things.
I do enjoy medicine but I think even rheumatologists are getting drafted into the acute med Reg rota and I'm not sure how much that's for me - maybe this could be an F1 confidence thing, and I'm sure as I progress I'll find these situations less stressful, but in my working day I tend to more enjoy having a bit of time to mull over an interesting patient rather than having to make quick decisions (obviously not all the time). I find the lack of diagnostic certainty a bit frustrating, on my take shifts I feel like I'm just endlessly prescribing co-amoxiclav and fluids, and then moving to the next patient, and not always finding out exactly what's wrong.
Med onc...? It's in group 2 now, so no need (theoretically) to do med reg year. Not very high-stress (in the sense you described, where you have to quickly make a decision. High stress for being cancer ofc), minimal weekend/nights, no general take req, done something useful, and most of it is outpatient based with probably a quick round on new onc consults for inpatients. Probably only downside is no practical aspects?
(edited 5 years ago)
Original post by hslakaal
Med onc...? It's in group 2 now, so no need (theoretically) to do med reg year. Not very high-stress (in the sense you described, where you have to quickly make a decision. High stress for being cancer ofc), minimal weekend/nights, no general take req, done something useful, and most of it is outpatient based with probably a quick round on new onc consults for inpatients. Probably only downside is no practical aspects?
I would say Oncology scores very high on '6. talking with families'. It's effectively a gianormous box full of difficult and often intense conversations - including situations in which the patients will be young (teenage) people, which are often some of THE MOST intense and difficult family conversations you can imagine.
GP could potentially fit most of you likes. The only exception would be having a team as you would be seeing patients alone, but you can discuss things with colleagues in between patients . You would also get to know the practice team very well as there is relatively little staff turnover compared to hospital.
Ooh thanks for all the replies! Strong shouts for outpatient-ish medical specialities. You've sold Neurology well... and I actually did my medical elective in oncology. I loved how interesting, holistic, and complex it was, but struggled with the emotional burden. I love talking to patients, but I find families a bit more taxing...
It's just thinking about getting through IMT I suppose, the current core medical trainees don't seem like the happiest bunch but 3 years isn't massively long in the grand scheme of things.
I went up to an Ophthalmology clinic on my zero day today and very much liked the focused exam, clean technical surgery, interesting pathologies, and the patients all seemed quite happy!
You've given me food for thought
It's just thinking about getting through IMT I suppose, the current core medical trainees don't seem like the happiest bunch but 3 years isn't massively long in the grand scheme of things.
I went up to an Ophthalmology clinic on my zero day today and very much liked the focused exam, clean technical surgery, interesting pathologies, and the patients all seemed quite happy!
You've given me food for thought
Original post by Anonymous
For example at the moment I'm on acute medicine and I really like the team atmosphere, but find the 'this patient is vomiting blood with a Hb of 49' moments less enjoyable ha.
For what it's worth, these situations get significantly less stressful as you move through your career. Once you've seen a few haematemesis with an Hb in their boots, you've seen em all. You will probably notice that your registrars and consultants are rarely panicking in these situations. There is the potential for truly surprising and unknown things to happen occasionally in any specialty, but these moments get rarer and rarer as you progress, and unless you are a very stressy person you will probably get over it.
Bingo.
As a radiology registrar and consultant, you are constantly working as a team - running reports past other registrars/consultants, discussing cases with clinicians to work out best investigation, working with radiographers and sonographers, lots of teaching opportunities...
Constantly making really important decision which change management in every department in the hospital - you are often the first to find out what is wrong with the patient and decide what the findings on the scan mean for their diagnosis/management - bearing in mind that unless you do interventional radiology you will not be responsible for the management of above findings.
Lots of variety, you never know what you're going to see on a scan and often what you see is completely different from what was expected e.g. yesterday - acute pancreatitis in a query aortic dissection.
Nights and weekends you will do as a registrar but not a huge volume, and as a consultant on call is usually from home and it is rare to be called in except in extreme cases e.g. multiple victim trauma.
Lot's of practical aspects too - ultrasound, barium swallows, biopsies - don't be put off by lack of patient contact as this is a myth, I see at least 30 patients a week (50 over an ultrasound weekend) and this definitely feels like more than enough at the end of the week.
As for very long ward rounds, long, complex social discharges and conversations with families - I forget what these even feel like.
.... all whilst (mostly) sitting down. Suggest a taster week in radiology - you'll never look back!
As a radiology registrar and consultant, you are constantly working as a team - running reports past other registrars/consultants, discussing cases with clinicians to work out best investigation, working with radiographers and sonographers, lots of teaching opportunities...
Constantly making really important decision which change management in every department in the hospital - you are often the first to find out what is wrong with the patient and decide what the findings on the scan mean for their diagnosis/management - bearing in mind that unless you do interventional radiology you will not be responsible for the management of above findings.
Lots of variety, you never know what you're going to see on a scan and often what you see is completely different from what was expected e.g. yesterday - acute pancreatitis in a query aortic dissection.
Nights and weekends you will do as a registrar but not a huge volume, and as a consultant on call is usually from home and it is rare to be called in except in extreme cases e.g. multiple victim trauma.
Lot's of practical aspects too - ultrasound, barium swallows, biopsies - don't be put off by lack of patient contact as this is a myth, I see at least 30 patients a week (50 over an ultrasound weekend) and this definitely feels like more than enough at the end of the week.
As for very long ward rounds, long, complex social discharges and conversations with families - I forget what these even feel like.
.... all whilst (mostly) sitting down. Suggest a taster week in radiology - you'll never look back!
Original post by Anonymous
I would like a little bit of patient contact - I think if I was going to go down the limited patient contact route I would go for Radiology
Thanks for the reply - very convincing! What do you feel like the cons are?
I do always enjoy going to hot seat, we have a nice bunch of radiologists at my current hospital and they talk through the scans and teach a little bit
I do always enjoy going to hot seat, we have a nice bunch of radiologists at my current hospital and they talk through the scans and teach a little bit
Original post by coffeestorm
Bingo.
As a radiology registrar and consultant, you are constantly working as a team - running reports past other registrars/consultants, discussing cases with clinicians to work out best investigation, working with radiographers and sonographers, lots of teaching opportunities...
Constantly making really important decision which change management in every department in the hospital - you are often the first to find out what is wrong with the patient and decide what the findings on the scan mean for their diagnosis/management - bearing in mind that unless you do interventional radiology you will not be responsible for the management of above findings.
Lots of variety, you never know what you're going to see on a scan and often what you see is completely different from what was expected e.g. yesterday - acute pancreatitis in a query aortic dissection.
Nights and weekends you will do as a registrar but not a huge volume, and as a consultant on call is usually from home and it is rare to be called in except in extreme cases e.g. multiple victim trauma.
Lot's of practical aspects too - ultrasound, barium swallows, biopsies - don't be put off by lack of patient contact as this is a myth, I see at least 30 patients a week (50 over an ultrasound weekend) and this definitely feels like more than enough at the end of the week.
As for very long ward rounds, long, complex social discharges and conversations with families - I forget what these even feel like.
.... all whilst (mostly) sitting down. Suggest a taster week in radiology - you'll never look back!
As a radiology registrar and consultant, you are constantly working as a team - running reports past other registrars/consultants, discussing cases with clinicians to work out best investigation, working with radiographers and sonographers, lots of teaching opportunities...
Constantly making really important decision which change management in every department in the hospital - you are often the first to find out what is wrong with the patient and decide what the findings on the scan mean for their diagnosis/management - bearing in mind that unless you do interventional radiology you will not be responsible for the management of above findings.
Lots of variety, you never know what you're going to see on a scan and often what you see is completely different from what was expected e.g. yesterday - acute pancreatitis in a query aortic dissection.
Nights and weekends you will do as a registrar but not a huge volume, and as a consultant on call is usually from home and it is rare to be called in except in extreme cases e.g. multiple victim trauma.
Lot's of practical aspects too - ultrasound, barium swallows, biopsies - don't be put off by lack of patient contact as this is a myth, I see at least 30 patients a week (50 over an ultrasound weekend) and this definitely feels like more than enough at the end of the week.
As for very long ward rounds, long, complex social discharges and conversations with families - I forget what these even feel like.
.... all whilst (mostly) sitting down. Suggest a taster week in radiology - you'll never look back!
1. Anesthesia, Non-acute medicine subspecialties, Radiology, Ophthalmology
2. Definitely not: general internal medicine, geriatrics, surgery, ICU
2. Definitely not: general internal medicine, geriatrics, surgery, ICU
Original post by Anonymous
Hello!
I'm an F1 starting to narrow down my speciality decisions, I don't think I'll take an F3 so looking to apply in F2.
Thinks I like:
Things I don’t like:
I don't mind working hard and taking difficult exams (the standing thing is due to some MSK back issues more than anything).
thanks for any help
I'm an F1 starting to narrow down my speciality decisions, I don't think I'll take an F3 so looking to apply in F2.
Thinks I like:
1.
Having a team
2.
Predominately sitting down
3.
Making decisions
4.
Feeling like I’ve actually done something useful
5.
A good variety in the day
6.
Not too many nights and weekends
7.
Some practical aspects
Things I don’t like:
1.
Standing for long periods of time
2.
Being alone
3.
High stress or unknown situations where things need to happen very quickly
4.
Very long ward rounds
5.
Long, complex social discharges
6.
Conversations with families
I don't mind working hard and taking difficult exams (the standing thing is due to some MSK back issues more than anything).
thanks for any help
Sorry, just logged in for first time in months!
Cons:
- No continuity of care
- Radiology is in a sense a 'service' specialty i.e. some might say we do what we are asked to do by other clinicians (in reality most clinicans are highly respectful of radiologist and value their opinion)
- Bread and butter can be slightly dull e.g. lots and lots and LOTS of chest x-rays, but still some exciting pathologies to be found and always rewarding to pick up the early cancers etc.
- No banding in ST1 as no on-calls, so you do take a pay dip for that year
- Often supernumerary as it is very much a training rather than service program (this never bothered me though I know some don't take well to taking a step down in responsibility)
- Exams are tough (aren't they all!)
Those are the main ones I can think of. Let me know if any other questions (I promise to check sooner this time!)
Cons:
- No continuity of care
- Radiology is in a sense a 'service' specialty i.e. some might say we do what we are asked to do by other clinicians (in reality most clinicans are highly respectful of radiologist and value their opinion)
- Bread and butter can be slightly dull e.g. lots and lots and LOTS of chest x-rays, but still some exciting pathologies to be found and always rewarding to pick up the early cancers etc.
- No banding in ST1 as no on-calls, so you do take a pay dip for that year
- Often supernumerary as it is very much a training rather than service program (this never bothered me though I know some don't take well to taking a step down in responsibility)
- Exams are tough (aren't they all!)
Those are the main ones I can think of. Let me know if any other questions (I promise to check sooner this time!)
Original post by Anonymous
Thanks for the reply - very convincing! What do you feel like the cons are?
I do always enjoy going to hot seat, we have a nice bunch of radiologists at my current hospital and they talk through the scans and teach a little bit
I do always enjoy going to hot seat, we have a nice bunch of radiologists at my current hospital and they talk through the scans and teach a little bit
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