Reasons for entering your specialty

[wjm7]

Hello all,

 

I'm a first year PA student, but I'm thinking ahead to rotations/jobs. I'm curious: What reasons/motivations led you to choose the specialty (including primary care) in which you practice? I'm curious about all the factors that played into your decisions: prior experience, general interest in a certain aspect of physiology, a love for procedures and the hands on, economic motivations, job availability, etc. Anything that motivated

 

I will appreciate your responses and value any advice that you have as I consider my future career path.

 

Thanks!

 

PS: I've never posted a new thread before, so let me take the opportunity to say hello to everyone. I've thoroughly enjoyed carefully perusing the forum and getting a feel for what matters to PAs. I feel like I have a better grasp of the issues facing the profession because of all of your discussions. I very much look forward to a career as a PA, and I'm excited to become a part of the effort to improve the profession.

[Houstonian]

I chose to specialize so that I could develop real competency in a specific field and primary care just seemed too broad to me. I also liked hospital work, and had prior related experience in my field, as well as a personal connection to the specialty, since many of my family members had been afflicted with heart problems. (I work in cardiology now).

 

I liked internal medicine, and cardiology is one of the broadest fields of internal medicine. There is plenty of variety in it, and you get exposed to a vast array of illnesses in other fields as well. I also liked pediatrics, but did not care for outpatient pediatrics (patients unable to relay history and anxious mothers) and at the time I was making choices, there was essentially no job market for inpatient pediatric PA's.

[EMEDPA]

as a former paramedic moving into emergency medicine was a natural transition.

I like shift work and flexible scheduling. I like the kinds of folks who work in em and I like all the procedures. it was a no brainer for me.

in em you can make an impact you can see right away as opposed to many other fields where you need to wait to see if an intervention helped.

go ahead and say it. yes, I have a short attention span. a long therapeutic relationship with a patient is anything longer than 1 hr...:)

[bobuddy]

I am in Family Practice. I have a PhD in the Dept of Neuro/Molecular Bio. I thought that I would go into the Neuro field when I was entering PA school but when I did my rotation in Neuro I was bored. I am friends with one of the local Neurologists and he always jokes that he can diagnose things but is never able to make anything better. :)

 

After graduation, I worked for two years in Peds and then went to Cardiology for a year ( yeah, big leap there). I found when I went to Cardiology, I missed that continuity of care that I had in Peds. With Family Practice, I have no two days alike, get my fill of Peds, Internal medicine, gyne/ob, neuro, derm, psych, endocrine, etc,and I get to develop relationships with my patients (although some patients, I would love to limit my relationships to 1 hour like EM above).

[dmdpac]

as a former paramedic moving into emergency medicine was a natural transition.

I like shift work and flexible scheduling. I like the kinds of folks who work in em and I like all the procedures. it was a no brainer for me.

in em you can make an impact you can see right away as opposed to many other fields where you need to wait to see if an intervention helped.

go ahead and say it. yes, I have a short attention span. a long therapeutic relationship with a patient is anything longer than 1 hr...:)

 

 

This. Pretty much exactly this.

[physasst]

Ummmm..

 

http://journals.lww.com/jaapa/Fulltext/2012/07000/A_descriptive_analysis_of_factors_influencing.12.aspx

[UGoLong]

Like Houstonian, I ended up in cardiology. As a paramedic, I had spent a fair amount of time learning about the heart. As an engineer, I liked the fact that the heart is electrical, chemical, and mechanical. As a PA student, I enjoyed learning about the many pharmaceutical and surgical interventions, as well as all the applicable tests that can be ordered.

 

In school, I loved my primary care rotations (my program gave you two -- starting and ending your clinicals -- and in the same office). I would have stayed there for a job if there had been an opening, mostly because I really enjoyed my preceptor, his office staff, and our salt-of-the-earth patients. I'm not sure what would have happened by now if I had been able to stay, but such is life.

 

I enjoy cardiology and, over time, I think you get better at it. I also enjoy the relative independence I have. My day starts at a few hospitals, proceeds to several hours of clinic, and ends at another hospital or two. Most days, my SP wants me to be where he isn't, so I'm on my own quite a bit. I can call him if I need to, which can be comforting, but other docs, nurses, and patients expect me to be able to pull rabbits out of the hat on an ongoing basis. I think I enjoy trying to do that as much as I do my chosen area of specialty.

 

I believe you learn a lot in clinical rotations and I encourage the students I precept to do more than focus on the unique pathology, etc in a given rotation. To me, the bigger question is, "in what environment do you want to work?" If you are in surgery, you are probably going to be side-by-side with your SP much of the time. In the ER -- at least in my part of the country -- you will be also be close by one of a large number of possible SPs, depending on the day and the shift. In primary care, you will probably be in the office, going room to room most of the day. As a hospitalist, it will probably be going room to room, mostly seeing people you may never see again.

 

These intangibles can have a lot to do with how you feel about your job. Consider them well.

[ventana]

Grew up thinking I would be a small town doc.....

 

got business undergrad degree - not mature enough to study in undergrad... did a hitch in USAF and a business degree. Realized as a white male at 28 years of age I had a snowballs chance in #$%^ of getting into med scholl (USAF makes you grow up!) so applied to PA school.....

 

Got out of school and worked 5 years in a small walk in clinic for occ health and primary care. Really enjoyed it and learned a huge amount..... tried specialties, partly for the $$, partly for the challenge, partly for the exposure, partly because I could........ Realized a few very important things about myself...... and RETURNED to primary care

 

1) I enjoy relationships with patients

2) I find that I personally enjoy out of work life in the off hours (ER work is to crazy a schedule)

3) I really enjoy thinking and having the FIRST say in the delivery of care - who I send a patient to determines what they do for treatment - send to a surgoen they get surgery, send to PT they get PT

4) I get bored, and hence the fact you can never possibly know enough in Primary care it fits me

5) Sometimes I want to not have life and death decisions, but instead talk about something trival

6) I like caring for the whole person as best I can, but then when needed referr to a specialist

 

Then I got tired of only being a "Cog-in-the-wheel" of a large practice and started my own practice!

 

So now my speciality is a little bit of everything in the Geriatrics IM world, along with all the stuff of business ownership

 

 

 

BUT I set my own schedule, work when I want to, and "eat what I catch" as far as pay.

 

 

 

 

For me the small town doc like position was always in me

[toyotabike]

Grew up thinking I would be a small town doc.....

 

got business undergrad degree - not mature enough to study in undergrad... did a hitch in USAF and a business degree. Realized as a white male at 28 years of age I had a snowballs chance in #$%^ of getting into med scholl (USAF makes you grow up!) so applied to PA school.....

 

Got out of school and worked 5 years in a small walk in clinic for occ health and primary care. Really enjoyed it and learned a huge amount..... tried specialties, partly for the $$, partly for the challenge, partly for the exposure, partly because I could........ Realized a few very important things about myself...... and RETURNED to primary care

 

1) I enjoy relationships with patients

2) I find that I personally enjoy out of work life in the off hours (ER work is to crazy a schedule)

3) I really enjoy thinking and having the FIRST say in the delivery of care - who I send a patient to determines what they do for treatment - send to a surgoen they get surgery, send to PT they get PT

4) I get bored, and hence the fact you can never possibly know enough in Primary care it fits me

5) Sometimes I want to not have life and death decisions, but instead talk about something trival

6) I like caring for the whole person as best I can, but then when needed referr to a specialist

 

Then I got tired of only being a "Cog-in-the-wheel" of a large practice and started my own practice!

 

So now my speciality is a little bit of everything in the Geriatrics IM world, along with all the stuff of business ownership

 

 

 

BUT I set my own schedule, work when I want to, and "eat what I catch" as far as pay.

 

 

 

 

For me the small town doc like position was always in me

 

 

Hi there, just curious did you have to hire a MD/DO to review your charts when owning your own practice as a PA.

[ventana]

doc owns 1% and yes I do pay him

[noapostropheplz]

I chose orthopedic surgery. I like the instant gratification of surgery. I like working with our surgical teams. I like that most of our patients are motivated to do well and get better. I like the variety (ER, ortho floor, OR, clinic, ICU). I like the hands on/physical aspect of my work. I like knowing a patient longer than an hour but less than their whole adulthood. I don't like managing chronic anything.

[greenmood]

Surgical hospitalist. I went into rotations with a completely open mind, without any preference whatsoever. I learned first that I liked the pace of inpatient specialties, so that ruled some things out. I loved my surgery rotation for the technical challenge and the pressure, and thrived there. Then I had an amazing hospitalist internal medicine rotation and realized how much I would learn in that specialty. I applied and interviewed at a number of surgery positions and the one I took was the best fit for me.

[wjm7]

Thanks to everyone who has replied so far! I've really enjoyed hearing your rationales and motivations.