Choosing a specialty

As most of you know, I have had to pick a specialty for my career over the last 8 months. I had it down to 3 specialties:

1. Pediatrics
2. Emergency medicine
3. Radiology

My first 3 rotations of my 4th year of medical school were those 3 specialties. I liked them all a lot. I found out during my year at the CDC that I might not need to see patients every day to be happy as I enjoyed that year a lot. This means that radiology might be a good specialty for me.

Radiology was a lot of fun. The attendings and the residents are all very nice and all laid back. They are all very smart and incredibly important in modern day medicine to the diagnosis and daily management of patients.

The emergency department is a lot of fun. You have the enjoyment of seeing patients for the first time. No one knows what the actual problem is. You work quickly to fix them or admit them to the hospital. In most cases, you know what the problem is by the time they are done with the ED. You get to do procedures which is fun. I really liked seeing a patient, hearing what there problem was, and trying to get it fixed quick. If my team couldn't fix it, we sent them to someone who could and on to the next patient. You really feel like you are helping.

Then there is pediatrics. The attendings and the residents are generally the nicest of them all. Pediatrics, or peds, is generally a specialty that pays as little as any. A pediatrics cardiologist gets paid less than an adult cardiologist and a pediatric dermatologist gets paid less than the adult counterpart, etc. But there are several things that I like about peds. These are generalizations, not black and white facts.
-Kids are so cute. If you have to be at the hospital every day, it is nice to see cute kids every day. Even if they are sick, some may cry, but there are a lot more happy cute kids than you might expect. I get a lot of energy from that compared to older patients.
-I could be wrong, but I felt like there were more acute and less chronic problems. At least in my experience, more kids come to the hospital looking and feeling really sick, you make them feel better, and then they go home. Adults more often had problems where you patched them up until they return to the hospital next time.
-When you prevent a child from dying or becoming disabled, you are making a large contribution to society. That child will likely become a working adult in the economy and contribute many productive years. This is a little different than prolonging patients lives near the end.

A point for pediatrics versus emergency: I can always do a pediatric emergency fellowship later. If I want to do something besides emergency, it is difficult to do after an emergency residency.

A point for pediatrics versus radiology: I am very interested in global health, in preventive medicine, and public health. Radiology has a lot of potential but not a lot of opportunities currently. There is a good chance I might end up returning to the CDC and pediatrics is much more suited for a global health career. If I end up at a public health department or agency, a more general field like pediatrics would be better suited for looking at patients overall status. Also pediatrics has a shorter residency and lower pay so switching to public health wouldn't be as big a sacrifice.


If you can't tell I have chosen pediatrics. I realize I am giving up future salary and possibly working harder hours, but I am quite sure I will live with more fulfillment and happiness.

I am quite sure I will do a fellowship and specialize. The main possibilities are
1. Public health/global health, returning to the CDC
2. Pediatrics infectious disease
3. Both 1 and 2
4. Pediatric emergency medicine
5. Pediatric cardiology

Now I just have to match to a residency program.