Medical Career Selection

7/23/2019 Medical Career Selection

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Selecting the MedicalSpecialty That Is Right for

You

Jim Holliman, M.D., F..!.".#.

#rogram Manager, fghanistan Healthcare Sector Reconstruction #ro$ect

!enter for Disaster and Humanitarian ssistanceMedicine

%niformed Ser&ices %ni&ersity of the HealthSciences

!linical #rofessor of "mergency Medicine

'eorge (ashington %ni&ersity



)uestions to s* Yourself s Youre Deciding on a Medical !areerSpecialty

ƒ +. Do I li*e diagnostics or therapeutics or oth-

ƒ . Do I li*e predictaility or unpredictaility,and can I deal /ith more than one case at atime -

ƒ 0. Do I ha&e any pre$udicial disli*es of certain

*inds or ages of people - ƒ 1. Do I need de2ned limits to /hat I need to

*no/ -

ƒ 3. !an I /or* in a team en&ironment -

ƒ 4. Do I ha&e &eral communicationlimitations -

) i * Y lf Y




+. Do I li*e diagnostics or therapeutics8procedures9 or oth -

ƒ If you don:t ha&e any manual de;terity, thendon:t choose a procedural specialty

ƒ <#ure procedural= specialties > #lasticSurgery, ?rthopedic Surgery

ƒ <#ure diagnostic= specialties > @eurology,#re&enti&e Medicine, RehailitationMedicine

ƒ <Mi;ed procedural and diagnostic=

specialties > "mergency Medicine, 'eneralSurgery

) ti t * Y lf Y




. Do I li*e predictaility or unpredictaility,and can I deal /ith more than one case at a

time -6 If you don:t li*e or tolerate unpredictaility,then you /ant to choose a clinic or oAceased practice, such as Internal Medicine,

Family Medicine, or #ediatrics 8perhaps/ithout hospital admission pri&ileges9

6 Specialties /ith unpredictaility of patientpresentations include "mergency Medicine,Trauma Surgery, and 'eneral Surgery

6 Some specialties such as !ritical 8Intensi&e9

) ti t * Y lf Y




ƒ 0. Do I ha&e any pre$udicial disli*es of certain*inds or ages of people 8or do I /ant to treat

all types and ages of people9 - ƒ For e;ample, f you don:t li*e *ids, then

don:t go into #ediatrics or Family Medicine

ƒ In "mergency Medicine you ha&e to li*e to

deal /ith all types and all ages of people ƒ If you don:t ha&e patience /ith the elderly,

then don:t go into Internal Medicine or"mergency Medicine

) ti t * Y lf Y




1. Do I need de2ned limits as to /hat I need to*no/ B study -

- Some people are &ery uncomfortale /ith aspecialty such as "mergency Medicine in/hich the ody of clinically importantinformation to *no/ and study is essentially

unounded- So if you /ant de2ned limits as to the*no/ledge ase reCuired for clinical practice,then choose <more focused= specialties suchas ?phthalmology, nesthesia,?tolaryngology, etc.

) ti t * Y lf Y




3. !an I /or* in a team en&ironment -

6 If you:d rather /or* solo, then pic* an oAce

or clinic ased specialty6 "mergency Medicine and Rehailitation

Medicine particularly reCuire close team/or*/ith other department personnel

) ti t * Y lf Y




4. Do I ha&e &eral communication limitations -

6 If you don:t li*e to or are not good at Cuic*ly

estalishing rapport and &eralcommunications /ith patients, then youshould choose nesthesia or Radiology /herethese aspects are not as important as in

specialties such as Family Medicine, InternalMedicine, #ediatrics, and "mergency Medicine

)uestions to s* Yourself s You




5. Is my 2nal career goal a su6specialty ormultiple specialties -

6 If so, you need to consider the ase specialtyyou /ill need to complete 2rst efore goingon to the suspecialty.

For e;ample, you can enter !ritical !are

Fello/ships &ia nesthesia, InternalMedicine, Surgery, or "mergency Medicine.

6 If you /ant to e certi2ed in more than onespecialty then you can enter one of se&eral

comined residencies > "M IM, "M #eds,"M FM, etc.

)uestions to s* Yourself s You




7. !an I tolerate the humdrum and disagreealeaspects of the specialty I ha&e chosen -

- This is often the most important Cuestion toconsider

- For e;ample, if you /ant to e a neurologist,then you must e ale to tolerate patients

/ith chronic undiEerentiated headaches- Rememer that in many surgical specialties

you /ill e doing the same limited numer ofprocedures o&er and o&er

- lso rememer that in most clinical practicesyou /on:t see the &ariety or se&erity of cases



)uestions to s* Yourself inDeciding on an cademic !areer

ersus #ri&ate #ractice -

ƒ !an I tolerate turning o&er care of my

patients to trainees - ƒ Do I prefer to do e&erything myself to ma*e

sure itGs done right -

ƒ Do I /ant to listen to my spouse yell at me

for /or*ing t/ice as hard for half as muchmoney in academic practice as my medicalschool classmates are ma*ing in pri&atepractice -

ƒ Do the re/ards of teaching and scholarshipout/eigh the e;tra political hassles of



(hy Is "mergency

Medicine 'reat !areer - ƒ @ice mi; of diagnostics B therapeutics

8procedures9

ƒ (ide &ariety of patients B medicalprolems

ƒ !hallenging

ƒ ene2ts to patients B %. S. health care

are o&ious

ƒ !ore component of %.S. health caresystem

ƒ Young, &irant specialty manypractitioners ha&e e;tensi&e interests



(hat out #rimary !are

!areers - ƒ !lassic primary care specialties include >

–#ediatrics

–Family #ractice–Internal Medicine

ƒ The degree of go&ernmental support forthese to the e;clusion of other specialties

is /aning ƒ %sually do not include any trauma training

ƒ True longitudinal care in these may note practiced



Disad&antages of"mergency Medicine s a

!areer ƒ You /onGt ma*e as much money as in

cardiac surgery

ƒ Kimited longitudinal care ƒ @o aility to pre6select patients

ƒ %sually spatially limited /or*en&ironment

ƒ @eed to stay current in all 2elds ofmedicine

ƒ ReCuires a lot of political s*ill 8the art ofma*ing other doctors actually do /hat

you oth *no/ is the right thing to do9



%niCue d&antages of"mergency Medicine s a

!areer ƒ %nlimited international de&elopment

opportunity

ƒ Relati&ely small numer of academicpractitioners 8easy to rise to the topfast9

ƒ !ontrol o&er, B predictaility of, /or*

schedules ƒ #otential for administrati&e

in&ol&ement in prehospital care

ƒ Interact /ith e&ery other medical

specialty'eo ra hic Le;iilit



(hat Does the FutureHold for "mergency

Medicine - ƒ They may 2nd a cure for cancer they

may 2nd a cure for heart disease ut they/ill ne&er 2nd a cure for stupidity, so there/ill al/ays e accidents B a need foremergency physicians

ƒ Is currently an undersupplied specialty in

the %.S. ƒ Is $ust eginning to de&elop in other

countries the %.S. is the unCuestioned/orld leader in this specialty



Important #rinciples to Rememerin Deciding %pon a Medical !areer

Specialty ƒ Does my chosen career mesh /ith my

personality -

ƒ Does my chosen career match /ith mysigni2cant other:s long term /ishes -

ƒ !an I stand the dull, humdrum, anddisagreeale aspects of my chosen 2eld, and dothe interesting or infreCuent e;citing aspectsof my chosen 2eld suAciently ma*e up forthese other aspects -

ƒ 8Seriously9 > It is est to *eep an open mind asyou are doing your third year rotations you

may 2nd you really li*e a specialty you had nothad e;posure to efore

a ou o an



a ou o anDecide on a Specialty Kate in myThird Year -

ƒ If you can narro/ it to t/o specialties > for your2rst fourth year rotation ta*e an actinginternship in one follo/ed y a second actinginternship in the other, follo/ed y one montheach of a rotation related to each specialty prepare t/o diEerent personal statements o&erthe summer ma*e a 2nal decision and apply to

only one specialty at the end of Septemer. ƒ If you still ha&e no decision y your fourth

year > apply to transitional internships,schedule rotations related to your specialty

interests early in the transitional internship,then reapply to a single specialty the ne;t year



My Recommendations for StudentsInterested in pplying for ". M.

Residencies ƒ Ta*e ".M. electi&e early in 1th year, then ta*e a

rotation that /ill uE your clinical s*ills such asSurgical I!%

ƒ Then ta*e second ".M. electi&e at another center/ith an ".M. residency

ƒ 'et 0 letters of recommendation from ".M. facultyat these places

ƒ ?&er the summer draft and edit your ! andpersonal statement

ƒ !omplete all @RM# application materials y?ctoer

ƒ Ta*e the time and e;pense to tra&el to any

residency that oEers you an inter&ie/ ƒ Do an o&erseas electi&e in March or pril /hile



Recommended 1th Year "lecti&es forStudents Interested in ".M. 8in

addition to the ".M. electi&es9

ƒ Medical, Surgical, and or #ediatricI.!.%.

ƒ ?utpatient #ediatrics ƒ ?utpatient ?rthopedics

ƒ nesthesia

ƒ Dermatology

ƒ %rology

ƒ Medicine or Surgery Suinternship

ƒ #lastic Surgery

ƒ Trauma Surgery



Fourth Year "lecti&es @?TRecommended for Students

Interested in ".M. ƒ Radiology

ƒ Radiology suspecialties

ƒ Radiation oncology ƒ Medicine suspecialties

ƒ #sychiatry

ƒ Rehailitation

ƒ ?ncology

ƒ Family practice



dditional Items to !onsider toolster Your Residency

pplication

ƒ 'et faculty to re&ie/ your !.. B personalstatement

ƒ Join se&eral student interest groups ƒ Do some pulic ser&ice pro$ects

ƒ Do a decent research pro$ect8s9

ƒ Join MS, M, !"#, S"M, etc.

ƒ ecome *no/ledgeale aout currentaEairs B political aspects of medicine

ƒ De&elop some interests esides readingB sleeping



(hat Should You Do if Youpply to ".M. #rograms B DonGt

'et In - ƒ DonGt reapply if youGre actually a dor*

ƒ If you are not a dor* >

6 Ser&e out your 'M? time and thenreapply

– pply to transitional internships 8these arereCuired for the #'Y ,0,1 programs

any/ay9– Ta*e a research position B reapply ne;t

year

– nalyNe /hat /as /ea* in your 2le and try

and 2; or augment it– (or* as an ".D. &olunteer or in prehospital



RecogniNed Suspecialties of

"mergency Medicine ƒ To;icology

ƒ #ediatric "mergency Medicine

ƒ Sports Medicine ƒ #alliati&e Medicine

ƒ ".M.S. 8prehospital care9

ƒ eromedical !are

ƒ !ritical !are

ƒ Disaster Medicine

ƒ International ".M.

@ote the 2rst 1ha&e oAcialsuspecialty

certi2catione;ams



Ho/ to Find ?ut MoreInformation on "mergency

Medicine !areers ƒ Consult the unbiased Dr. Holliman and / or Dr. Burns

in the office anytime and shadow them when they’re

on clinical duty

ƒ Come to "Career Night" at Dr. Holliman's house

(arty for students held twice a year!

ƒ al# to the $.%. residents at & or &eorgetown

ƒ al# to the $.%. attendings at any of the localhositals

ƒ )oin *C$+, -*$%, the student $.%. nterest &rou

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Medical Career Selection