Change of "specialty" heart?

With just one rotation (Anesthesiology/OR) left, I'm about as thoroughly confused as to which field of medicine I'm going to end up in as I've ever been. I absolutely LOVED Peds Inpatient but found Peds outpatient just so-so clinically speaking. But the really great thing about Peds outpatient for me was that I LOVE, LOVE, LOVE babies!! Not only that, seeing so many of them well (save for the shots for their well baby check-ups) was especially nice! Of course, the flip side is that well baby check-ups are kinda boring clinically speaking, so I'd have to balance it with some inpatient duties to keep it mentally stimulating. One thing I do know is that if I choose this field, I'd do a combined residency in IM/Peds just  because I like the idea of having ALL my medical bases covered and because the two Black female Attendings that led the teams I was on suggested it. Speaking of Attendings, one of them is on the adcom of one of the schools on my list so obviously meeting her was an added plus.

I also thought a LOT this week about how much my interest in ANY lab based research is pretty much nil and that may be a problem for the MD/PhD program at one of the schools on my list. Plus, I'm getting ideas all the time about Health Informatics flavored dissertation projects and that's great!! Not surprisingly, I have my clinical rotations to thank for that because I really didn't have much in the way of ideas about how to make something happen and now I do!

So if I had to pick a specialty today, I would pick......................................

ER MEDICINE, and here's why in NO particular order of importance, with a list that is FAR from exhaustive:

1)  I'd be on the "front lines" of providing care to people of color in emergent situations.

2) The absolute most chillest people I met were ED Docs.

3) I thrive in high pace/high stress environments combined with periods of calm.

4) It appears to be a speciality that's easier to balance with a research career/academic medicine.

5) NO call, when you're "off" you're "off".

6) The field doesn't appear to be "threatened" by mid level providers like some specialities such as Anesthesia or Family Medicine.

7) The opportunity to do some procedures.

8) I'm a "night owl" who also doesn't mind working weekends/holidays.

9) The chillest folks in medicine, closely followed by Pediatricians, my second residency choice at this point in the form of Peds/IM.


"Cool people" is listed twice because I've had a lifetime of working with people who are so NOT chill.  And at this point in my life, I'm looking for something MUCH different. So for example, my MICU rotation was fantastic from a clinical point of view, but the "intensity" of the environment and the people who work there, was a little too much for me. ED also seems to be handling the transition to EMRs MUCH more smoothly that any of the other specialities I observed and given that EHRs/EMRs are such a HUGE part of my life right now, it seems like it could be a great fit.

Now for the list of things I "worry" about being a Doc in the ED:

1) Making the wrong clinical decision with the limited info most ED docs have initially.

2) Body fluids that are green.........and smell..............REAL bad.

3) My biggest concern, drug addicts seeking their next "fix" at my expense. But I think I have just the personality to look a patient I think is addicted square in the eye, and say "Hellz Naw, here's some tylenol, now get ta' steppin'"!!!!


Once again, this is obviously VERY premature but it's kinda fun to think about it now! :)