So far, I've narrowed it down to a few fields I think I'd be most happy in. Here's the list, in no particular order, with the training required for each:
1. Neurology (adult): 1 year preliminary medicine + 3 years' neurology
2. Child neurology: 2 years preliminary pediatrics + 3 years' child neurology OR 3 years pediatrics + 3 yrs child neuro
3. Pediatric rehabilitation: Same as child neuro, but put "rehab" in place of "neuro"
4. Adult rehabilitation: Same as adult neuro, but put "rehab" in place of "neuro"
5. General pediatrics: 3 years of pediatrics
So I think I'd be happy in any of these fields. The problems I have with deciding are related mainly to i) competitiveness and ii) scheduling 4th year rotations so that I have a good chance of doing well and getting a recommendation in my chosen field. Basically, I have two available slots, and I was hoping for a 'warm-up' rotation so that I could really do well in my 2nd one. I want to step it up my fourth year!
In terms of competitiveness, neurology and adult rehabilitation are not that competitive, but the 1st year -- preliminary medicine -- is. This is because everyone matching into the more competitive fields of Radiology, Ophthalmology, Anesthesia, and Dermatology (the ROAD to the good life, we call it) has to first do a prelimininary medicine year. These are the students with honors across the board, Alpha Omega Alpha (medical honor society), and great board scores as well as research in their field.
Child neurology and pediatric rehabilitation are not supposed to be competitive, but they have very few spots available each year, and so it tends to be that either you get interviewed/ranked at many programs or nobody ranks you (this refers to a complicated process known as "The Match", in which programs interview selected students applying in their field, and both rank each other so that a computer algorithm can decide who goes where).
The other issue, of course, is whether I'd like to work with children or adults more. This is a huge decision and is, I think, the biggest 'branch point' in the above decision-making. I have written out lists of pros and cons, I have flipped coins, I've asked friends/families/advisors. I get different answers depending on my mood, the person I'm speaking to, etc. My mother even wrote out a flow chart analysis thing (it's so nice to have an MBA Mom with a great deal of patience for my ridiculous anxiety). Right now, I'm favoring the kiddos. And their parents. I really like parents. Parents are adorable. But we'll see!
I love the cartoons-- so right-on! Make sure you talk with an advisor soon, if you haven't already. My sense is that you shouldn't discount any specialty you're interested in because of board scores, unless you have your heart set on a certain competitive program or very narrow geographic range. I think you're probably a really competitive candidate.
ReplyDeleteI think Rica's right, you're more competitive than you think. We have a tendency to undersell ourselves; I think I'm not going to get into grad school, but then I have to remind myself that we DID go to a top school for both our master's and med school. Maybe you have to ask yourself if you want to go to a top program in a less-sought-after specialty or an average program in a more popular specialty.
ReplyDeleteI agree with the above comments. You have a lot of tangible achievements and all round skills which you tend to undersell.
ReplyDeleteYou have analyzed the decision variables very well and I'm sure you'll pursue the right programs and succeed.
Against an excellent overall academic record, the step 1 score is but one. Even the brightest stumble sometimes. Again, you don't have to be a genius medical scientist to be a good and happy doctor!
The medical license is merely the right to practise.. The real tests and achievements have to be measured after you begin practising.
Anyhow, be confident as you move forward.You're going to do really well in yor professional career.
@Rica: Thank you for the encouragement! I have spoken to several advisors, but am having trouble deciding still. Luckily, I am willing to move around and B is looking for a relatively flexible line of work (prosecution and/or international), so the location will hopefully not limit me. And unlike grad school, I think with residency the 'snob factor' is much less of a pressing issue unless your ultimate goal is to have a prestigious academic career/go on to a highly sought-after fellowship. And at some point, I think medical students need to stop pursuing the "hardest" or "most competitive" thing in favor of the life and career that is right for them...that's a good topic for another post!
ReplyDelete@Chenoa: Another really good point. And in terms of the big fish/little fish in the pond question, I'm not sure. My impression is that the residency's dedication to teaching is more important than the prestige, unless you need to pull in big names to garner research funding and get a K-award as a resident. That's quite a stressful lifestyle, and I don't know that I would help more people with research than by practicing.
@ Anon: Thank you for the support -- it's true, and as B told me, once a medical student matches to a program, the academic slate is essentially wiped clean (although the name of our school will always follow us, I'm told). So all I hope for at this point is to be successful at matching :) And then the career really begins. Actually, interns (1st year residents) start practicing before they are licensed! Scary, huh?