What kind of doctor do you want to be?

A common question I have been getting recently is, "What kind of doctor do you want to be?"  I understand that it is a natural followup question for when someone finds out you are going to MedSchool.  After all, most people understand that there is a wide range of doctor types out there.

My first thought when someone asks me this is, "I don't know!"  I think that saying I don't know, makes me seem like I haven't done much research into medicine.  But it is the closest to the truth.

From what I have learned from people who have gone through med school is that they often do not end up with the specialty they had intended to become before med school.  This makes sense to me, because even the most prepared student doesn't know exactly how the knowledge of one field or another might ignite their own personal fire.

I think it is much like asking which Baskin Robin flavor you like without allowing one to first sample.  I could guess, well -- in the past I have liked chocolate varies of Ice Cream.  But would I like Rocky Road, Moose Tracks, or Double Chocolate fudge better?  How can you tell without actually trying them? What if I try orange sherbert and just fall in love?

I am about 60% sure that I want to go into some form of primary/internal medicine/family practice.
The reason for this is that I know there is a shortage of PCP docs out there, and I like that they are trained in a wide variety of medicine.  You get to do all sorts of things, and it would never be boring.  Of course, they make on average the leist of all the docs out there.  Depending on my financial situation with loans this may not be a possibility, and why walk away from an additional 60-100 k per year if you don't have to?

A sub-fantasy with primary care is to be a rural medicine doc and have some kind of organic food co-op on the side.  Maybe start my own vineyard.  Just a thought.

My next most likely specialty is Psych.  I love psych and think it would be fun to practice.  My background is in neuroscience research, and would love to just talk to people about what is going on with them each day.  The drawbacks of this field is that it is increasingly becoming a 15 minute patient visit every 6 months or so to just adjust meds.  I know of very few Psychiatrists who see patients for an hour and think that they would prob make less money.  Also, there is a higher threat that a patient would want to kill you.  Psychotic patients may not even be in the same reality as you or I and so there may be such a risk.  Of course this can be the case with about any type of medicine, but I think it is a higher risk with Psych.

Third on my list would be Neurology.  This specialty goes along with the whole neuroscience type field.  This is no longer the field of babysitting vegetables.  More and more advances are being made with TBI patients from the recent wars, rehab of spinal cord injuries, Huntington's Disease, Parkinson's Disease (the lab I worked in).  Etc... I think this is a growing field and the knowledge base in this field will continue to grow.

Fourth - Cardiology.  As someone who has lost a significant amount of weight, I would like to be there to help people to recuperate from bad eating /exercise habits.  The drawback I see in this field is first that it is currently a very male dominated field, and so family issues may arise.  (they may not be happy if I took time off to have a kid)  Also, I may get jaded quickly if most of my patients opt for surgical solutions to their problem instead of diet/ exercise changes.    Inside this field there is Internationale and non-Internationale.  I think I would gravitate toward non-I.

Fifth - Bariatric Surgery sub specialty of surgery.  The biggest deterrent to this is I do not want to do a surgical residency.  Surgeons for the most part are ass holes and I don't want to become an asshole surgeon or live with them for 6-8 years of my life.  However, I would think it would be awesome to help people to change their lives through weight loss surgery.  If there were a fast track to bariatrics somehow that I could take a shortcut through the live of a surgical resident that would be fine.

Radiology - I find this unlikely as it is a highly competitive field and probably wont' be taking a lot of DO students, but I love photography and could spend hours and hours looking at films.

Pathology - I was told once that I have the personality of pathologist, whatever that means.

Orthopedic surgery - this is a field where you can find a problem, fix it, and send the pt on their way.  Very straight forward and very lucrative, as it is very procedural. 

Fields I know I probably won't like

• Peds - Kids frighten me
• OB - Just doesn't appeal to me.

Having said all that, I haven't even touched the entire breadth of the medical field and what is out there.  Academic medicine, research, working for pharma, all of the other specialties and sub specialties.  

I think it is realistic to suspend judgement until I have had a better chance to sample all possibility.

Post Script:

After writing this the other day, I have had time to reflect on this a bit more.  All of the reasons for or against a certain specialty seem to be based on rumors, hearsay, and just stereotypes of different fields.  How can I say that all surgeons are assholes?  That is their stereotype.  How can I say that kids would drive me crazy?  They might be better than psych patients?  I am just reiterating the point that I do not not know enough about medicine yet to make such a big decision.