Infant-Parent Mental Health Fellowship Program - University Of: Fill & Download for Free

What political propaganda has been so successful that people still believe in it today?There are actually there are three common miss conception in American Politics that are used as propaganda tag lines.Republican Administrations are better with EconomicsDemocrats are weak on National DefenseUniversal Health care will ruin level of care and destroy innovation in the medical field.All of these would be a multi-page answer as you will see from just working out on one and that one that I have chosen to respond with is :Universal health care will lower standard of care . Under universal health care medical advancement would stop.It is based on a false argument about free market rooted in pre Great depression economic philosophy which was all basically proven wrong by… wait for it … The Great DepressionThe level of Care argument is based in 1900s criticism by health lobbyistActually in the late 1980s early 1990s with the emergence of HMOs Physicians had created an elegant model that could have been applied to and was taken from the same universal health care system established by the US as part of the reconstruction of Japan.We would have universal health care at an affordable rate through no governmental means had insurance companies not destroyed the HMO model by leveraged buy outs and political lobbyingNot having it is killing babies.I am disabling comments on this because I know this topic very well. I know the history , the counter arguments and the history of the counter arguments and to be honest those who would argue the opposite tend to be very snide in comments and not accurate as I have said below in all the answers is that they date back almost 100 years and over a century of the it working in the rest of the world proves it wrong : You are more than free to write your own answer or if I trusted alt conservative readers to respond in an objective voice I wouldn’t, but life is too short to ignore the condescension I get in these replies while researching and counter-citing the outlandish rebukes that have no result in altering opinionUniversal health care will lower standard of care . Under universal health care medical advancement would stop.This dates back to the beginning of the new deal when Medicare was initially conceived as a different system than Medicare . Medicare like the ACA was a compromised deal.The way the argument works and has worked since 1929 is this. Democratic administrations and congresses fight for universal medical care they propose a watered downed version of what we know works because we … (this is what kills me) designed the policies and methods that have been adopted by other countries. So administration and congressional bill introductions offer a weakened plan that then gets more weakened and strip to pass at which point the opposition use these mauled ripped apart pieces of policy to attack the opposition. Basically I force you to compromise even more on a compromise then throw the passed legislation back in your face as how your plan doesn't work and this is why it seems democrats always lose the debate because they are saying “what the hell that is not our plan, it was your plan we dint want it but its what passed” Which is exactly why both Ryan and DJT were not and still are not able to offer a health care package unless they steal it completely from the democratic platform but then can not sustain an argument about why their opponents are wrong.( You can see how this can start to become a book because right now we could go into the argument I stated at the beginning that Republicans are better at the Economy : at this point we could extend into the entire argument about government involved and partnered in corporations we know works because we designed Japan at reconstruction that way … .but this answer even at this juncture is huge and we do not really have the time to go through how we know 40 years of Republican economic myths about unregulated industry doesn't work because we deliberately excluded those systems when we rebuilt both China’s and Japan’s economy after world war 2. Oh yea, missed that one in both high school and college history; what Reagan did not tell us and what DJT will not tell you are does not know, is that the the looming economic destruction from the Japanese in the 1980 and losing jobs to them and fearful they were holding so much debt: and China today is because we designed their systems with all of the stuff we refuse to put to work in the American economy because of the GOP fear of socialism and its not a fear of socialism its a fear of lower share holder pay outs.. I have to digress here because this is an entirely different topic and this is already a long parenthetic digression)Brief History of Universal Health Care in AmericaIn 1993, President Bill Clinton pushed for universal health care to lower the Medicare budget. First Lady Hillary Clinton led the initiative. Hillarycare used a managed competition strategy to achieve its purpose. The government would control the costs of doctor bills and insurance premiums. Health insurance companies would compete to provide the best and lowest cost packages. The plan encountered too much resistance from doctors, hospitals, and insurance companies to pass Congress.In the 2008 presidential campaign, Senator Barack Obama outlined a universal plan. Obama's health care reform plan offered a publicly-run program similar to that enjoyed by Congress. People could choose it or buy private insurance on an exchange. No one could be denied health insurance because of a pre-existing condition. The federal government would expand Medicaid funding and add subsidies.In 2009, President Obama proposed the Health Care for America Plan. It provided Medicare for all who wanted it. Monthly premiums were $70 for an individual, $140 for a couple, $130 for a single-parent family, and $200 for all other families.Employers could continue offering their plan if it was as good as the national plan. If they elected the national plan, they would pay a 6% payroll tax. The federal government could have bargained for lower prices and reduce inefficiencies. That would have lowered health care costs by 1.5% per year. It would have reduced visits to the emergency room by the uninsured.Too many people were afraid of universal health care. In 2010, Congress passed the Patient Protection and Affordable Care Act. More than half or 57% of Americans incorrectly think the ACA is universal health care. It attempted to enforce mandatory health insurance, similar to Germany's plan. But it allowed too many exemptions. It also allowed states to decide whether they would expand Medicaid. As a result, 13 million people still went without insurance. Trump's tax plan removes the mandate in 2019.2020 presidential candidate Bernie Sanders proposes a Medicare-for-all universal health plan. The government-run program would enroll all Americans. They would have no deductibles, copayments, or out-of-pocket expenses. Sanders would raise taxes to pay for it. The country would transition from Medicare, Medicaid, and all insurance to the new program over four years. The Veterans Affairs and Indian Health Services would remain.The plan would cover hospital visits, primary care, medical devices, lab services, maternity care, and prescription drugs. It would also cover vision and dental benefits as well as long-term care. Obamacare dropped long-term care because it was too expensive.The plan would cut administrative costs associated with the variety of insurance plans available today. The New England Journal of Medicine estimates that U.S. administrative costs are double that of Canada. A 2011 study estimates U.S. doctors spend four times as much as Canada dealing with insurance companies.“It was an effort to get universal health insurance, really, in the beginning of the 20th century,” admits Nancy Altman, president of Social Security Works. But FDR underestimated how contentious the idea would appear, especially given states like California had already introduced legislation (albeit failed) around universal health care.”Universal health care was almost part of the original Social Security Act of 1935The counter argument to it was completely generated by the GOP responding to fears of the nations conservatives at the speed that FDR was pushing new policies. You have to remember the country, like when President Obama took over, was on the verge of economic collapse.Some will try and compare the Great Depression and the Economic meltdown and argue that the Great Depression was worse. It was only because of the length of response to it. The truth is that the effects were basically the same the difference being that the Great Depression lasted longer and took longer to recover from because of the policies and safeguards that FDR implemented that Reagan and the Bushs administrations chipped away at or maybe we are going to ignore that every Republican Administration since WW2 has come with an economic crises, the S&L Crisis of the 1980, the economic meltdown , The Great Depression etc. The only reason Nixon was able to avoid one was because he stole out of the democratic play book took us off the Gold Standard and increased the debt ceiling causing the formation of the Libertarian movement. I do not want to dwell that long on this because it will drift of topic.This is how it works , since Theodore Roosevelt the Democratic Party has been pushing for health care for all and since then it has been being fought . FDR, Truman and Johnson all pushed the goal further as well as Clinton and Obama. Even Nixon was in favor of it , however, did not have the political capital to spend on it.The argument had no factual basis then as it still really does not now . Any statistical proof offered is based primarily on push questions . The reason for it being blocked initially was for two reasons Hoover and later completely politic retribution for FDR winning the Presidency. Thats it that is why we have not had universal health care since 1930.“ GOP and private medical lobbies like the American Health Association, which accused FDR of socialist conspiracy and government overreachHoover did not propose universal health care because he was very close to being by today”s standard. In fact the Libertarian party only was formed as a result of Nixon wanting to increase the debt ceiling and remove us from the gold standard.“His predecessor, President Herbert Hoover, had upheld a policy of federal distance when it came to economic matters. A proponent of the free market, even amidst crisis, Hoover instead called on states to stabilize income and private charities to serve the immediate needs of the poor. It didn’t work. In 1931, the unemployment rate hit 15.8 percent. By 1933, the year FDR took office, it would reach 25 percent. Families were homeless and starving. Those who did work could not afford any sick time. The effects of nationwide poverty impacted all Americans.” Universal health care was almost part of the original Social Security Act of 1935“Because Roosevelt was pushing quickly, and had offhandedly mentioned the potential of comprehensive health care, Americans grew concerned. Their suspicions were fanned by the GOP and private medical lobbies like the American Health Association, which accused FDR of socialist conspiracy and government overreach.”Universal health care was almost part of the original Social Security Act of 1935Why America Is the Only Rich Country Without Universal Health CareAdditionally believe it or not we have a really bad form of it independent of the ACA and Medicare .The reason hospital costs are what they are is because uncollected and unpaid costs are dispersed across those costs that can be covered . So the cost of care would actually go down as the level of care would remain.The medical breakthroughs and new techniques have nothing to do with private insurance or medicine. These are developed by research grants and the like and not paid for as standards of care . In fact these procedures are more likely to be covered via universal health care as private insurance does not cover anything seamed experimental.In truth universal health care has been basically a fact of life for the rest of the world since the 1900, FDR was attempting to pass a policy that would con temporize American Medical Economics with the rest of the industrialized world:Many European countries were passing the first social welfare acts and forming the basis for compulsory government-run or voluntary subsidized health care programs.The United Kingdom passed the National Insurance Act of 1911 that provided medical care and replacement of some lost wages if a worker became ill. It did not, however, cover spouses or dependents. U.S. efforts to achieve universal coverage began with progressive health care reformers who supported Theodore Roosevelt for President in 1912, though he was defeated.Progressives campaigned unsuccessfully for sickness insurance guaranteed by the states. A unique American history of decentralization in government, limited government, and a tradition of classical liberalism are all possible explanations for the suspicion around the idea of compulsory government-run insurance.[The American Medical Association (AMA) was also deeply and vocally opposed to the idea,which it labeled "socialized medicine". In addition, many urban US workers already had access to sickness insurance through employer-based sickness funds. History of health care reform in the United States - WikipediaHere is the worst part we are supposed to be the most advanced country in the world. we are supposed to have medical care that supercedes everyone. Universal health care is supposed to destroy standard of care. Yet, in response to all these claims the opposition of universal medical coverage is at a failure to explain why America is on par with some of the worst places in the world for pre-nadial care and infant mortality. If universal health care ruins standard of care then how come so many babies born in the system do not survive compared with other countries that have it.We want to be pro-life because human life is sacred ( but our medical care system is resulting in an infant mortality rate on par with the third word.This argument should sound familiar it is the exact same argument used today and has been being used by the medical lobby and later the medical and insurance lobby since the 1900 adopted by the GOP in order to assist in winning political elections.The truth is that universal health care does and has worked for over a century around the rest of the civilized industrial first world and any one who is a governmental employee or a servicing military member can attest to the low cost and complete care. The tricare and other government plans are actually based on the pre-medicare compromise proposed under the New Deal:Here is a comparison of how universal health care works as well as a complete understanding of it :Summary of Seven Countries' Universal Health PlansAustralia: Australia adopted a two-tier system. The government pays two-thirds, and the private sector pays one-third. The public universal system is called Medicare. Everyone receives coverage. That includes visiting students, people seeking asylum, and those with temporary visas. People must pay deductibles before government payments kick in. Half of the residents have paid for private health insurance to receive a higher quality of care. Those who buy private insurance before they reach 30 receive a lifetime discount.Government regulations protect seniors, the poor, children, and rural residents.In 2016, health care cost 9.6% of Australia's gross domestic product. The per capita cost was US$4,798. The Organization for Economic Cooperation and Development disclosed that 22.4% of patients reported a wait time of more than four weeks to see a specialist. On the other hand, only 7.8% of patients skipped medications because the cost was too high. In 2015, the Australian life expectancy was 84.5 years.Canada: Canada has a single-payer system. The government pays for services provided by a private delivery system. The government pays for 70% of care. Private supplemental insurance pays for vision, dental care, and prescription drugs. Hospitals are publicly funded. They provide free care to all residents regardless of the ability to pay. The government keeps hospitals on a fixed budget to control costs. It reimburses doctors at a fee-for-service rate. It negotiates bulk prices for prescription medicine.In 2016, health care cost 10.6% of Canada’s GDP. The cost per person was US$4,752, and 10.5% of patients skipped prescriptions because of cost. A whopping 56.3% of patients waited more than four weeks to see a specialist. As a result, many patients who can afford it go to the United States for care. In 2015, the life expectancy was 82.2 years. Canada has high survival rates for cancer and low hospital admission rates for asthma and diabetes.France: France has an excellent two-tier system. Its mandatory health insurance system covers 75% of health care spending. That includes hospitals, doctors, drugs, and mental health. Doctors are paid less than in other countries, but their education and insurance is free. The French government also pays for homeopathy, house calls, and child care. Of that, payroll taxes fund 40%, income taxes cover 30%, and the rest is from tobacco and alcohol taxes. For-profit corporations own one-third of hospitals.Patients give care consistent high ratings.In 2016, health care cost 11% of GDP. That was US$4,600 per person. In 2013, 49.3% of patients reported a wait time of more than four weeks to see a specialist. But only 7.8% of patients skipped prescriptions because of cost. In 2015, the life expectancy was 85.5 years.Germany: Germany has mandatory health insurance sold by 130 private nonprofits. It covers hospitalization, outpatient, prescription drugs, mental health, eye care, and hospice. There are copays for hospitalization, prescriptions, and medical aids. There is additional mandatory long-term care insurance. Funding comes from payroll taxes. The government pays for most of the health care. It limits the amount of the payments and the number of people each doctor can treat. People can buy more coverage.In 2016, health care cost 11.3% of GDP. That averaged US$5,550 per person. Only 3.2% of patients skipped prescriptions because of cost. Also, 11.9% of patients reported a wait time of more than four weeks to see a specialist. But most Germans can get next-day or same-day appointments with general practitioners. In 2015, the life expectancy was 83.1 years.Singapore: Singapore's two-tier system is one of the best in the world. Two-thirds is private and one-third public spending. It provides five classes of hospital care. The government manages hospitals that provide low-cost or free care. It sets regulations that control the cost of the entire health care system. People can buy higher levels of deluxe care for a fee. Workers pay 20% of their salary to three mandated savings accounts. The employer pays another 16% into the account. One account is for housing, insurance, or education investment.The second account is for retirement savings. The third is for health care. The Medisave account collects 7% to 9.5% of income, earns interest, and is capped at the $43,500 income. More than 90% of the population enrolls in Medishield, a catastrophic insurance program. The Medifund pays for health costs after the Medisave and Medishield accounts are exhausted. Eldershield pays for nursing home care. Once an employee turns 40, a portion of income is automatically deposited into the account.In 2009, Singapore spent 4.9% of its GDP on health care. That's US$2,000 per person. In 2015, life expectancy was 83.1 years.Switzerland: The country has mandatory health insurance that covers all residents. Quality of care is one of the best in the world. Coverage is provided by competing private insurance companies. People can buy voluntary insurance to access better hospitals, doctors, and amenities. The government pays for 60% of the country's health care. Dental care is not covered. Vision is only covered for children. The government subsidizes premiums for low-income families, about 30% of the total. There is a 10% coinsurance cost for services and 20% for drugs.These out-of-pocket costs are waived for maternity care, preventive care, and child hospitalization. The government sets prices.In 2016, health care spending was 12.4% of GDP. It was US $7,919 per person. There were 11.6% of patients who skipped prescriptions because of cost. Also, 20.2% of patients reported a wait time of more than four weeks to see a specialist. In 2015, life expectancy was 83.4 years.United Kingdom: The United Kingdom has single-payer socialized medicine. The National Health Service runs hospitals and pays doctors as employees. The government pays 80% of costs through general taxes. It pays for all medical care, including dental, hospice care, and some long-term care and eye care. There are some copays for drugs. All residents receive free care. Visitors receive care for emergencies and infectious diseases. Private insurance for elective medical procedures is available.In 2016, health care costs were 9.7% of GDP. The cost was US$4,193 per person. Only 2.3% of patients skipped prescriptions because of cost. But 29.9% of patients reported a wait time of more than four weeks to see a specialist. To keep prices low, some expensive and uncommon drugs aren't available. Hospitals can be crowded with long wait times. In 2018, the flu outbreak extended wait times to 12 hours. But most measures of health, like infant mortality rates, are better than average. In 2015, life expectancy was 81.2 years.Comparison to the United StatesThe United States has a mixture of government-run and private insurance. The government pays most of the cost, but also subsidizes private health insurance through Obamacare. One-third of the costs is for administration, not patient care. Health care service providers are private. Sixty percent of citizens get private insurance from their employers. Fifteen percent receive Medicare for those 65 and older. The federal government also funds Medicaid for low-income families and the Children's Health Insurance Program for children.It pays for veterans, Congress, and federal employees. Despite all these, there are 28 million Americans who have no coverage. They either are exempt from the Obamacare mandate or can't afford insurance.In 2016, health care cost 18% of GDP. That was a staggering US$9,892 per person. Exactly 18% of patients skipped prescriptions because of cost. But only 4.9% of patients reported a wait time of more than four weeks to see a specialist. In 2015, life expectancy was 79.3 years. The third leading cause of death was a medical error. The quality of care is low. It ranks 28th according to the United Nations.Why does the United States have such high costs and such low quality? Most patients don't pay for their medical services. As a result, they can't price-shop doctors and hospital procedures. There is no competitive reason for providers to offer lower costs. The government can negotiate lower prices for those covered by Medicare and Medicaid. But competing health insurance companies don't have the same leverage.Insurance and drug companies want to maintain the status-quo. They don't want the government restricting prices. They lobby to prevent universal health care. But 60% of Americans want Medicare for all. California, Ohio, Colorado, Vermont, and New York are moving toward universal health care in their states.Affordable universal health care was at its closest before being dessimated by the insurance lobby with the rise and fall of the HMO :The problem with American health care is not the care. It’s the insurance.Both parties have stumbled to enact comprehensive health care reform because they insist on patching up a rickety, malfunctioning model. The insurance company model drives up prices and fragments care. Rather than rejecting this jerry-built structure, the Democrats’ Obamacare legislation simply added a cracked support beam or two. The Republican bill will knock those out to focus on spackling other dilapidated parts of the system.An alternative structure can be found in the early decades of the 20th century, when the medical marketplace offered a variety of models. Unions, businesses, consumer cooperatives and ethnic and African-American mutual aid societies had diverse ways of organizing and paying for medical care.Physicians established a particularly elegant model: the prepaid doctor group. Unlike today’s physician practices, these groups usually staffed a variety of specialists, including general practitioners, surgeons and obstetricians. Patients received integrated care in one location, with group physicians from across specialties meeting regularly to review treatment options for their chronically ill or hard-to-treat patients.Individuals and families paid a monthly fee, not to an insurance company but directly to the physician group. This system held down costs. Physicians typically earned a base salary plus a percentage of the group’s quarterly profits, so they lacked incentive to either ration care, which would lose them paying patients, or provide unnecessary care. Opinion | How Did Health Care Get to Be Such a Mess?A Regulated System of Health PlansOne way to achieve universal coverage is through a system of competing private health insurance carriers. In the Netherlands and Switzerland, people are legally required to buy private insurance or else pay a fine. The Dutch choose between plans offered on a national marketplace, while the Swiss shop on regional marketplaces. These systems resemble the marketplaces introduced in the U.S. by the Affordable Care Act (ACA).1But there are key differences. In the Netherlands, financing is shared between individuals and their employers, and insurance plans also cover dependents. But the Swiss pay the entirety of their plan costs, and children require the purchase of separate plans.The Dutch also pay lower premiums, averaging around $115 to $150 per month, compared to $385 per month in Switzerland. In comparison, average employee premiums in the U.S. in 2017 were $118 for single-person plans and $435 for family plans. Approximately 40 percent of the Dutch, moreover, receive tax subsidies to purchase insurance, similar to the subsidies introduced by the ACA.Cost-sharing is also lower in the Netherlands: there is none for primary care and preventive services, while copayments for other services are capped at $475 per year, after which they are free. By contrast, the Swiss face copayments for all services up to a deductible of their choosing, between $248 and $2,065. After this, 10 percent to 20 percent coinsurance applies on all services, capped at $579 per year for adults. All told, average annual out-of-pocket costs in Switzerland are nearly four times higher than those in the Netherlands ($2,313 vs. $605).A Single Public PlanIn countries that have public insurance systems, also known as “single payer” systems, national, regional, or local governments are the main payer of health care. In the United Kingdom, the National Health Service is funded by national taxes, while other systems are decentralized, with revenues raised through regional taxes (Canada) or local taxes (Sweden). In Norway, funding is split: primary care is funded through municipal taxes, while national taxes pay for hospital and specialty care.The House and Senate bills that would introduce a single public plan for the U.S., however, differ from the approaches taken in other countries in two important ways.First, many of these proposals would impose no patient cost-sharing. This is in contrast to Scandinavia, where patients pay copayments for most services. Norwegians pay $17 (U.S.) for primary care visit, $39 for specialist visits, and up to $51 for prescription drugs. At the same time, total annual out-of-pocket spending is capped at $221 per year (as of 2017), after which services are free; also, vulnerable populations such as children and pregnant women are exempt from most cost-sharing. Even in countries where physician and hospital services are free, such as the U.K. and Canada, patients pay some portion of prescription drug costs.Second, the single public plans that have been proposed in the U.S. so far would provide everyone with a wide range of benefits, including vision, dental, and long-term care. Most countries with universal coverage, however, cover vision and dental benefits only for targeted populations such as children and low-income adults. Similarly, long-term care is not typically covered. Instead, these services are financed separately, whether through national long-term care insurance or local taxes.Variations on a Theme: A Look at Universal Health Coverage in Eight CountriesCONCLUSION“Although more than half Americans support the idea of universal health care, U.S. health care is not as inclusive as in Germany, Switzerland, France, Singapore, and the United Kingdom. Obamacare is the closest to universality the United States has ever implemented, but it falls short because of its many exemptions.For universal health care to work, everyone, including healthy people, must pay premiums or additional taxes to pay for health care. This funds the security health blanket for all citizens. Ideally, with a health care system under government regulation, everyone will have access to quality treatments at low costs. Such a system would provide very affordable preventative care and implement strict control of pricing and quality of drugs and medical services.”Why America Is the Only Rich Country Without Universal Health CareThe truth is that the reason we do not have health care is because of lobbyist working on behalf of privatized health care in the 1900 and basically a libertarian President in Hoover. The Great Depression taught us that most economic theory leading up to it did not work, and we know this because we built hybrid economies all over asia when we reconstructed them. That there is no correlation between level and care and universal healthcare and in most instances level and speed of care increases. We know from medicare, governmental plans, and service member health care that administration can be cheaper when not paying out to share holders and bonuses to sales people , adjusters and CEOs. We know that 35 percent minimum of the amount you spend on insurance and closer to 43 percent to the hospital goes to administration and share holders and not the level of care. We know that it has nothing to do with medical advancement because this is done through grants and non directed research money and fellowships and never covered under health insurance anyway. It is not in private health cares best interest to develop new procedures because the cost of a new procedure though better takes a minimum of a decade to become mainstay. We know from the opiod epidemic exactly what private health care does to the medical system (if you do not understand this statement suggest that you watch any of the many videos easily available. John Oliver has a perfect summary of it on Last Week Tonight titled Opiod Epidemic 3) But the bottom line is that universal health care saves babies.History of health care reform in the United States - WikipediaThe Nation: Health Care Through FDR's LensesUniversal health care was almost part of the original Social Security Act of 1935Opinion | How Did Health Care Get to Be Such a Mess?Variations on a Theme: A Look at Universal Health Coverage in Eight CountriesWhy America Is the Only Rich Country Without Universal Health CareVariations on a Theme: A Look at Universal Health Coverage in Eight Countries

Q. How and when does a medical student discover that he or she is interested in a specialty? Is it during rotation or internship?A2A. Most people choose their specialties of interest during required clinical rotations in the third year. Senior year they take electives in the specialties of interest and then do more of the specialty chosen, perhaps away rotations at outside institutions to see different settings and as an audition where they hope to apply to.Internship would be too late although there are always first year residents who want to switch specialties or programs. It is different being a fourth year student in certain programs than actually perform as a lowly intern.The following are many different ways people choose their specialties.Personality, I was at a quandary after the required rotations since I had no strong interest in Internal Medicine, General Surgery, Psychiatry, Pediatrics and Obstetrics and Gynecology. My senior year I took electives in Anesthesiology and Diagnostic Radiology. I chose the latter. So the first few senior year electives are crucial. I had senioritis the rest of the year , until internship loomed and I had to prepare for FLEX (now USMLE 3)All the best!choosing your medical specialty: 7 factors to consider and 3 lists to makeJanuary 30, 2016 in CareerOkay guys, I'm going to take a first pass at this HUGE topic. I also recommend our career profile series. Elyse"When you're choosing a specialty, you're deciding an old man's life with a young man's mind. Think about what you want for the future, not what's cool today. - unknown orthopedic surgery attending.Recently, I found a post in evernote titled “What I want to be when I grow up” written 11/11/2013. I’ve mentioned before that I wanted to to go to Emory and become a dermatologist since freshman year of undergrad, but there were other options that almost swayed me from both of those decisions (how I chose a medical school coming at a later date).Choosing a specialty is a huge decision. Unlike most other professional fields, changing medical fields as a physician is a huge ordeal that requires additional years of scut level training. It’s not impossible, but like most things - it’s easier just to get it right the first time.In this article, I’ll discuss factors to consider when choosing a specialty and then I’ll show you the contents of my “What I want to be when I grow up” note and encourage you to make your own. This article is based on the American system, but I hope that it will be useful for everyone. PS: I'm really enjoying learning about how the medical school process works in different countries. Thanks for your emails on the Australian and UK systems Florah and Louise!Factors to Consider:[ 1 ] intellectual curiosityWhen you choose to practice medicine, you make a commitment to life-longer learning; this is your duty to your patients. For this reason, it’s essential to go into a field you find interesting! Cardiology has many of the functional features I loved about dermatology (see below), but I could not make myself excited about lipid profiles or statins. With that point, every specialty has one or two really cool procedures, but you should ideally find the most mundane things the specialty does interesting because that will be your “bread and butter.” Chest pain is not interesting to me, but I can talk to you about acne all day, everyday. On my medicine rotations, I was always blown away by the medical students who knew all the recent NEJM studies. When were they reading this stuff? They were reading it on Friday nights when I was reading about acne. That’s why we’ll both be more successful in our chosen fields than if we tried to do something else. Be true to your own mind. Don’t let what other people think is important determine your life. Most people find the topic of dermatology to be the absolute worst. To me, that’s just job security.What topics do you find yourself reading about out of pure curiosity? In my opinion, this is the most important factor of them all.[ 2 ] skill setBe honest with yourself. What are you good at?If you're not a "people person," maybe you shouldn't go into a predominately clinic setting. With that said, just because you hate one clinic setting does not mean you do not like clinic at all. Clinic is a completely different experience depending on the patient population, your attending, your role, and the topic. I didn't care for primary care clinic, ophthalmology clinic, or breast clinic but ENT, derm, melanoma, and gynecology clinic were my favorite rotations of medical school.If you're clumsy with your hands, maybe you shouldn't go into a surgical or procedural specialty. If you're a third or fourth year, realize that your skill set will increase with residency, but if you're significantly less coordinated that a normal human being, do some soul searching on this; residency and the match might be very difficult for you. If you're a first year and you're interested in a surgical or procedural specialty (this includes dermatology, anesthesiology, and emergency medicine) I suggests you pick up a hobby that requires good hand-eye coordination - such as video gaming, knitting, or cooking.i was explicitly asked "are you good with your hands?" during interview season.[ 3 ] lifestyleIt pains me a little to write this section because I genuinely think dermatology is so freaking cool, and I can’t imagine myself doing anything else. It was really frustrating having to compete with people who were doing dermatology solely because of desired lifestyle and their aptitude for standardized tests, but it is not my place to judge, especially since I have come to realize lifestyle is also important to me.For whatever reason, the idea of lifestyle gets a bad rap in medicine - as you can tell by the previous sentence, I've been brainwashed myself. There’s the idea that if you’re a doctor, that is your primary identify and the most important thing in your life. Don't drink this tea.don’t let anyone make you feel bad for wanting a life outside of medicine. at the same time, don’t let anyone make you feel bad for not caring about a life outside of medicine. we all want different things and that’s okay.What’s important is that you’re honest with yourself. As a dermatology resident, I will have more time outside of the hospital than my surgery counterparts. I will be able to attend more weddings, more funerals, more trips to the dog park, etc. However, I will never acutely save anyone's life and I will never guide another infant into this world. This summer, the UAB orthopedic, trauma, and vascular surgery teams saved my seventeen year old cousins life when he was at the brink of exsanguination. Now, he's going on college interviews. I am so grateful to all of my friends who are becoming surgeons.As more women become physicians and more men fight for the privilege to be present in their family's lives, every field becomes more lifestyle friendly. Obstetrics, for example, used to be notoriously awful for both attending and resident, but now it's common for attendings to share call and obstetric responsibility with their group members. The same is true of internal medicine now that hospital and ambulatory responsibilities are mostly split. The residency training for both of these careers are still incredibly tough though.Also keep in mind that academics is a skewed view of what most of medicine actually looks like. If you have the time, reach out to someone in private practice to get a good view of all of your options. Although, I will say, the doctors at my private hospital appear to work way more clinical hours than my attendings in academics.Final note - one of my colleagues was advised that "If you can see yourself being equally happy in two fields, chose the one with the better lifestyle."[ 4 ] length of trainingA popular piece of advice people give is to “look at the attending’s lifestyle - not the resident’s - because that will be your life.” I agree and disagree with this depending on how long your residency training will be and at what point you’re at in your life. Residency occurs during most people’s late 20s/early 30s - this is a very important time of life where most people are starting families, making lifelong investments, etc. If those things are important to you, you should think long and hard about a 7+ year residency.image source: scutmonkey comics[ 5 ] expected salaryThis is another thing that medicine demonizes, but don't lose sight of the fact that you are choosing your career. If you expect to live a certain lifestyle, you should be able to afford it. If you have a significant amount of loans, you will need to earn more money than a classmate who doesn’t have any loans to maintain the same lifestyle. Most of my friends who went into pediatrics don’t care about money. That’s important because they won’t make a lot of it (relatively speaking), but they won’t be resentful to their career or their patients because they knew what they were getting themselves into.The other side of the coin is medical reimbursements are volatile and will most definitely change during our lifetime. A primary care attending once told me that when he was a resident, the smartest people went into primary care because specialties didn’t make any money at that time. bahahaha. Oh how things have changed. So, keep expected salary in mind, but this should be a small consideration. Also, keep in mind that salaries can be very variable depending on your patient population and your "niche." Skin cancer and cosmetics are two of the highest paying areas of dermatology, but I'm not particularly interested in either. I want to work with inpatient dermatology, skin or color, and patients with systemic rashes.[ 6 ] colleagues/environmentThis one is somewhat tricky. Usually certain personality types are attracted to certain specialties, but programs tend to have clusters of certain personalities. So, just because everyone in your dermatology program is mean (are there mean dermatologists?) does not mean that is true everywhere. I wouldn’t let this factor too much into your decision. It’s very unlikely that you can't find a group of people that you like who practice your same specialty; you just might have to do some searching. “Eventually soul mates meet, for they have the same hiding place” applies to more than romantic lovers. Away rotations are a good way to get a better glimpse into this.image source: scutmonkey comics[ 7 ] competitivenessI hate that this is a factor, but it very much is. Have an honest conversation with someone about your chances of matching into your desired specialty. We’ve reached a point where every specialty is continually becoming more and more competitive. There are a few options when applying to a competitive specialty - 1) apply to that specialty with a backup plan if you don’t match 2) apply to that specialty and a less competitive specialty at the same time 3) take time off before applying to boost up your application and then do option 1 or 2. If you have your heart set on something that you're maybe not competitive enough to do, realize that there are probably less competitive alternatives. All hope is not loss. For example, instead of orthopedic surgery, you could do an internal medicine or family medicine residency then do a sports medicine fellowship. Charting Outcomes in the Match is a great resource that makes everyone wet their pants. It's published every two years. I've linked to the most recent 2014 data.Keep in mind that grades are not the only way to be competitive. There are multiple components of your application including clerkship grades, step I & II scores, AOA status, research experience, and letters of recommendation. Each of these items hold different weight in different specialties. Letters of recommendation matter a lot in small fields because all of the applicants are so spectacular. It just makes sense to take someone that your respected coworker vouched for.My clerkship grades were above average, but not perfect, and in the words of my mentor, my step I score was "fine, but won't blow anyone away" (my step II score was in the blow away range). I think the strongest aspect of my application lied in the fact that Emory is a highly regarded dermatology program and the chair and vice chair of the department put onto paper how highly they regarded me. Don't get me wrong, I worked my butt off for a dermatology spot. I have JAAD publications from the first year of medical school to just this month. I worked with everyone in the department either in clinic or on research. The faculty in the department watched me grow up from a little first year that didn't know anything to a confident and competent fourth year. That consistent and productive interest and energy, in my opinion, was my most competitive feature. (Disclaimer: I don't actually know why programs ranked me.)Related articles: Find your competitive advantage with our personal SWOT analysis and the 5 people to have in your inner circle for successOne question I got on instagram while making this post is the question of exposure:how do you decide on a field that you've had very little exposure to?You don't! This is why it's so important to take advantage of your time as an M1 and M2 to shadow different physicians. Dermatology, ophthalmology, ENT, orthopedics, radiation oncology, urology, and emergency medicine are fields that people are notorious for changing into at the last minute (read TeawithMD's story here), or switching to during residency, or completing a second residency for, or just missing out on all together. Take the time before rotations start to read about different specialties and then get exposure to fields that peak your interest. Ask residents in fields you are interested in what else they considered (I'm working on a list for the blog too). Of course, the shadowing experience you get as an M1/M2 won't be enough to decide on a specialty, but it will be enough to peak your interest in doing an elective early on.If you're a third year and already into rotations, try hard to make time to get exposure to these fields. Definitely talk to residents about their experiences so far, why they chose that specialty, and what they're planning to do after residency. Always talk to residents. You can also use our career profile series as a resource. I ask all of the residents how they made their specialty decision.The AAMC careers in medicine is also a useful resource.okay, with all that said - here are the contents of that evernote document i mentioned earlier:I encourage you to make three lists:Things that are important to you (your values)Topics that interest you (what do you want to know more about). These topics don't have to be obviously related to medicine. This will allow you to imagine different career paths in different specialtiesThe specialties you're deciding between with a quick word vomit about how you feel about each specialty.Related articles: I wrote this post before Yentil wrote "From dreams to objectives: Identifying your vision, mission and values," but it's amazing how similar the approaches are!When I made this list I'd completed all of the rotations except for cardiology, dermatology, and allergy.things that are important to me (in no particular order):strong doctor-patient relationship; long-term relationshipsfeeling like I have accomplished something at the end of the dayI have to use my handsvariety in day to day worklifestyle / salaryi want to make people feel beautiful. i want to help people fall madly in love with themselves.topics that interest me (in no particular order):the philosophy of beauty - what does it mean to be beautiful? how the perception of beauty changes over time, between cultures, and between individuals within the same cultureimmunology - autoimmunity, gut microbiomenutrition - how what we eat affects us physiologicallywomen's healthddx:dermgood mix of quick procedures/chronic medical conditions, happy, friendly patients, RASHES ARE AWESOME, large quality of life impact, I get to use my hands and my mind; very competitive.. (because it’s awesome)ob/gynwomen’s gynecology clinic has good balance between procedures/routine follow-up, happy, healthy patients, I would love to support women through specific issues, but hate the political air that surrounds the field, also, i hate obstetrics, surgeries are fun and quickpsychIs there a greater betrayal than to be betrayed by one’s mind??? It would be an honor to help people through difficult times. I find the concept of how we perceive ourselves vs how society perceives us very interesting. Really interested in the budding research into how autoimmunity and inflammation affects (causes?) psychiatric conditions. Such a good feeling to discharge a patient that came in psychotic or depressed at the VA, but horrible feeling working at mental health hospital for lower socioeconomic patients; they have no social support, that makes me very sad and frustrated, I had a couple of patients threaten me or become infatuated with me during my rotation. I don’t think I would like that for the rest of my life.. plus, psychiatrist aren’t the best at interpersonal relationships themselves. also, i need to use my hands.med/psychI could really see myself as an eating disorder specialist or a physician who specializes in medical care of psychiatric patients. hmm...cardiologyumm dr. love the cardiologist that fixes broken hearts??? SOLD! I like the idea of a clinic based practice and I could read echos 1-2 half days a week for a break from clinic. Oh you have chest pain after you walked a mile for the first time in 8 years? okay.. here’s a statin. I'm absolutely not interested in gunning for another 3 years to get a cardiology spot.allergy and immunologyatopic kids are my favorite patients! This is a niche I am most definitely comfortable with. After all, all of my research is in chronic pruritus, most of which has an allergy component. I would have to do a medicine residency though because peds is out of the question.. Also, i like the allergic component of different diseases, but I also like non-allergy related aspects of dermatology - acne, hyper pigmentation, hair loss, etc. However, derm doesn’t deal with asthma and food allergies which I also find interesting. I’m particularly interested in the new budding idea of “sensitivities” vs complete allergies. I wonder if I could do an allergy fellowship after dermatology?Without going into my personal statement, I chose dermatology because of the fact that I find the pathology really interesting and the day to day practical aspects enjoyable. My small group, to this day, insists that I should be an ob/gyn. haha.Specialty Profiles (wire.ama-assn.orgThe Ultimate Guide to Choosing a Medical Specialty, Third Edition: Brian FreemanHow to Choose a Medical Specialty: Sixth Edition: Anita D. TaylorMedical Specialty: How To Pick?!'Whatever you are, Be a good one.' - Abraham Lincoln.When we are in medical school we find some students who are firm about what they want to do. Some of us, like myself, are in a constant state of confusion. There are people who affect our opinion would be our parents, inspiring teachers, someone in the family with an illness, successful doctors, a relatives hospital, and our own whims and fancies that make us consider varied specialties.I've picked and rejected my choices very often. To the extent of considering specialties beyond medicine. Cardiology, radiology, family practice, radiation oncology, sleep medicine, endovascular surgery, biomedical engineering, healthcare management, health policy, palliative care, allergy, hospitalist, aerospace medicine...the list is endless!But after all the confusion I have realised that there is a certain way of going about it. First, you must list your priorities; the basis on which you would pick specialties. The length of training, satisfaction, amount of patient contact, amount of procedures, lifestyle, average salaries, the type of patients you see, type of research opportunities, and some more things that you think are relevant to you.Next you must try the Pathway Evaluation Program For Health Professionals. It provides students with current information about 42 specialties based on data compiled from surveys completed by 2,407 practicing physicians. I have tried this at different points of time because with time my ideas of what I want to do and what I feel I would be good at, has changed.Another test helping students pick their specialty, is the Medical Specialty Aptitude Test by University of Virginia. Here, tendencies of students and that of physicians in each specialty is compared.I would also recommend taking a personality test like Carl Jung and Isabel Briggs Myers Personality Test or Advanced Jung/MBTI Personality Test or the newer Big 5/Global 5/SLOAN Test or the IPIP NEO (Long or short version). The purpose of personality testing is to help you increase your self-knowledge. Self exploration of this kind is a useful part of the decision-making process. The results of self-analysis can also be used effectively to narrow the number of specialties to include.The NHS Website correlates your personality with the specialty that suits it. Also, a study done on ~5000 physicians to correlate their Myers Briggs Personality Type and Choice of Medical Specialty.Also, have a look at the Medscape Physician Lifestyle Report of 2012 to get an idea about the lifestyle of doctors in the field of our choice.Once you come down to a few choices, try and do extra rotations/shadowing in that field. You could also do rotations in a specialty that you aren't going to pick so that by the end of the rotation you are no longer hesitant about you you are not picking it.The key is to arrive at a few differentials to diagnose your specialty confusion. If you haven't rotated in them, try to. Finally make a choice, and work hard to achieve it. Whatever path you take, you will be helping patients eventually. I end this post by an inspiring line by Abraham Lincoln, who said "Whatever you are, be a good one."Thank you for reading.Kushal NaikOther recommended sources would be:Canadian Medical Association Journal: The Goo Tolerance Index.BLOG: How To Pick A Medical Specialty. Advice For Medical Students.LANGE BOOK: The Ultimate Guide To Choosing A Medical SpecialityPOWERPOINT: Personality Type & Medical SpecialtiesAssociation of American Medical Colleges - Career Planning and Specialty ChoiceHow to Choose a Medical Specialty (schools.studentdoctor.net)How to choose your medical specialty (rcplondon.ac.uk)The World's Most Sophisticated Algorithm for Choosing a Med Speciality - The Almost Doctor's ChannelPOSTED BY DR. FIZZY ON OCT 24, 2013 IN MED SCHOOLDecisions, decisions… You’ve spent the majority of your life in school working hard for the big prize: the prestigious two letters after your name, “MD”. But, now that your real life dream is creeping closer, you have to make that difficult decision, what kind of MD? This highly accurate algorithm is for the “almost” MDs who are still clueless and could use some help.Personality types and specialist choices in medical students (researchgate.net)Myers-Briggs Type and Medical Specialty Choice: A New Look at an Old Question (researchgate.net)How Should I Choose a Medical Specialty? (medscape.com)I realize that the specialty I choose will largely define my medical career, but there are so many things to consider. How do I decide which specialty will suit me best?Response from Daniel J. Egan, MDDaniel J. Egan, MDAttending Physician, Emergency Medicine Department, St. Vincent's Hospital, New York Medical College, New York, NYThere is something very strange about medical training. Early on, students are forced to make decisions about their future on the basis of relatively minimal information. How should you make this decision? For me, the choice was easy; I had always dreamed of being an emergency physician. But my decision was also based on real-life experience, and I think that is the key element in reaching your decision.Once you reach your third year of medical school, you really begin to practice clinical medicine. You are given a responsibility that is uniquely different from the shadowing experiences you have had during the preclinical years. Every 4-8 weeks, you rotate to a new specialty and learn the subject matter in great detail. During this time, you likely will be trying to impress your residents and attendings, and you will be studying hard so that you can do well on the shelf exam. You also need to pay attention to the subtleties of each specialty to see if it may be a good fit for you.Medical students base a lot of their decision on their clerkship experiences. However, most practicing physicians will tell you that what happens during your medical school rotation is quite different from everyday life in that specialty. For example, in the world of internal medicine, many practitioners spend most of their time in the outpatient setting, forming long-term relationships with their patients. For a surgeon, not every day is spent in the operating room as it is when you are the student. In obstetrics, the labor floor and postpartum evaluations are only a small part of the practice. It is clear that what you see as a student will help you understand what it will be like as a resident in that specialty. But one could argue that even residency may not perfectly emulate a long-term career in that specialty.As you try to decide, I recommend going back to the preclinical years and thinking about role models you may have encountered. Call those people up and ask them if you can spend time with them in their practice. Perhaps there is a subject matter that grabbed your interest and you can find a clinician in that field. As you go through your clinical rotations, identify mentors who may be able to show you what life is like outside the hospital as a physician in that specialty. Also, pay attention to the consultants you encounter. Maybe radiation oncology is something you would love, but your only chance to see what they do was when they consulted on your medicine patient with newly diagnosed spinal metastases. In my opinion, there are many options available but our medical education exposes us to so few.The difficult part for physicians is that when we choose a specialty, we are locked into that field for the rest of our careers, unless we choose to pursue additional training in another field. Unlike nurses or physician assistants, who can change career paths, we are somewhat committed to one area of medicine for the long haul. Obviously, this needs to be a specialty you love. The content of the medicine must excite you. You need to try to find an area in which reading about a topic or treating a patient with a particular disease makes you crave more. Perhaps your interests are limited to the nervous system, for instance. Or, perhaps you have enjoyed all of your clinical rotations and want a field that can incorporate all of them, like family practice or emergency medicine. Or perhaps your clinical years showed you that interacting with patients on an everyday basis is not something you desire, so you might consider radiology or pathology. In addition, many would argue that certain specialties have personalities that are drawn to them. Look at the residents during your clinical rotations and see if they are people with whom you could see yourself spending several years in training.Finally, ask questions. Ask questions not only about the specialty itself but about life outside of work. People love to talk about their own specialty, and frankly, many people in medicine just love to talk about their own work in general. Try to get a sense of what life is like once residency is over. Residents have a unique perspective on things that may be somewhat limited to the lifestyle they experience during training. These are important issues to understand, as you will spend several years of your life in that role, but the rest of your life involves many more years after residency training.Quiz: What's the ideal medical specialty for your personality? - The DO

As if finishing medical school wasn’t already difficult enough, certain specialties are much harder to match into for residency compared to others.Getting into any residency program, regardless of the specialty, is no easy task. It requires completing 4 years of medical school, taking USMLE Step 1, writing a personal statement, doing interviews, and several other steps that are not to be taken lightly. That being said, your life becomes much easier if you apply to a less competitive specialty.If your specialty is not considered as competitive, this doesn’t make you a good or bad doctor. It’s just the facts, without any judgment, so please no butt-hurt comments.The following 6 medical specialties are those that ranked lowest, and are therefore the easiest to match into, relatively speaking.1 | Family MedicineFamily medicine is by far the least competitive specialty to match into.Family medicine is the specialty devoted to the comprehensive medical treatment of patients across all ages. Think of them as the first-line defense when it comes to maintaining health. Family med doctors are central to routine checkups, preventive care, health-risk assessments, immunization, screening tests, and acting as the coordination hub to manage the patient’s big picture treatment across several specialties. While less common, some family medicine doctors also deliver babies and provide prenatal care to pregnant women, which is now more commonly performed by OB-GYN doctors.Family medicine is a foundational specialty to medicine, with nearly one out of every four office visits being made to family med physicians — that’s 208 million office visits each year, with the next closest specialty at 83 million visits. They’re also the ones doing most of the heavy lifting in treating America’s underserved and rural populations.After completing medical school, you must complete either a 3 or 4-year family medicine residency. If you’d like to specialize, there are multiple fellowship options to choose from, including geriatric medicine, sports medicine, sleep medicine, hospital medicine, and hospice and palliative care.In terms of lifestyle, family physicians have predictable hours without unexpected calls in the middle of the night. In terms of compensation, however, they’re toward the bottom, making on average $231,000 per year.2 | Physical Medicine & RehabilitationPhysical medicine and rehabilitation, or PM&R for short, and also called physiatry, is the specialty focused on restoring functional ability, reducing pain, and enhancing the quality of life for individuals with physical impairments or disabilities.PM&R doctors use non-surgical methods to treat conditions such as spinal cord injury, traumatic brain injury, stroke, limb amputation, chronic pain, and a variety of sports injuries and musculoskeletal disorders. When I visited the PM&R clinic as a medical student, we saw several cerebral palsy patients as well. While it may be easier to get into PM&R residency, I would consider the specialty anything but easy. Dealing with this sort of patient population day after day can be highly taxing and discouraging without high degrees of patience, compassion, and optimism.Treatment modalities, of course, include medication, but also physical modalities such as heat, cold, ultrasound, or electrical stimulation. PM&R doctors also make use of adaptive equipment and devices such as braces, artificial limbs, and wheelchairs, and also perform spine and joint injections, often under fluoroscopic or ultrasonic guidance.Including intern year, PM&R residency is a total of 4 years. If you’d like to subspecialize further, you can complete a fellowship in musculoskeletal & spine, stroke, multiple sclerosis, neurorehabilitation, electrodiagnostic medicine, cancer rehabilitation, or occupational and environmental medicine.As for lifestyle, PM&R doctors have predictable hours, no crazy call, and make mid-range physician salaries at an average of $306,000 per year.3 | AnesthesiologyNext up is anesthesiology with 29 points. You may have heard of the ROAD to success, standing for radiology, ophthalmology, anesthesiology, and dermatology. These are four specialties with good pay and fantastic lifestyles. Despite its high pay of $392,000 and a flexible lifestyle, anesthesiology is less competitive, likely a function of supply and demand, with many residency spots going unfilled each year.Most typically, anesthesiologists handle anesthesia for patients undergoing surgery or other procedures. This can be general anesthesia, where the patient is unconscious, sedation anesthesia, where the patient is somewhat conscious but not feeling pain, or regional anesthesia, such as a spinal, epidural, or regional nerve blocks.While the surgeon is responsible for doing the surgical procedure, the anesthesiologist is the patient’s guardian angel, monitoring their vitals, ensuring they are comfortable, and keeping them stable on the operating table.Anesthesia residency lasts four years, after which you can sub-specialize further with a fellowship in pain management, sleep medicine, cardiothoracic anesthesiology, pediatric anesthesiology, neuro anesthesiology, regional/ambulatory anesthesiology, obstetric anesthesiology, or critical care medicine.There are two types of doctors working in the operating room – surgeons and anesthesiologists. I think anesthesia is an excellent field if you have the right personality for it. That means you’ll need to be comfortable being second in command and watching the surgery rather than actually doing it yourself.4 | PediatricsNeck-and-neck with anesthesiology is pediatrics, scoring 30 points. This is the branch of medicine involving the medical care of infants, children, and adolescents. Think of it as the equivalent of internal medicine, but for patients who aren’t adults. Just like internal medicine, peds is a 3-year residency. And just like internal medicine, there are dozens of subspecialties to choose from through fellowship training, like pediatric cardiology, emergency medicine, nephrology, oncology, infectious disease, and many more.Working with kids is a mixed bag. On one hand, it’s incredibly gratifying to help children in need. On the other hand, it can be tremendously disheartening to care for a child with cancer or another terminal illness. As a pediatrician, you’ll essentially have two patients — the child and their parents, and you’ll quickly become well versed in handling upset or crying babies as well as highly neurotic parents. As a college student and first-year medical student, I was aiming for pediatric gastroenterology, but after working in the department for a few months, I realized working with kids and their parents every day wasn’t a challenge I was excited to take for the rest of my life.In terms of lifestyle, pediatrics is so broad and varied that you can be anywhere on the spectrum. On average, however, pediatricians are one of the lowest compensated physicians, making on average $225,000 per year.5 | PsychiatryPsychiatry, not to be confused with psychology, is the practice of medicine devoted to the treatment and management of mental disorders. It wasn’t until I started doing YouTube that I learned of the negative stigma some people have against psychiatrists, which puzzled me. It turns out this misplaced distaste of the profession arises from questionable and unethical practices regarding the use of lobotomy and electroconvulsive therapy in the mid 20th century. Since the 1970’s, however, psychiatry as a profession has tightened up ethical codes and addressed the misconducts of the past.Psychiatry is a favorite rotation amongst medical students because it’s… well, chill. You won’t be working before 9 or after 5, and in fact, you’ll probably have many days shorter than that. On the other hand, while the subject material of mental illness is endlessly fascinating, the practice of psychiatry leaves many medical students feeling lethargic. You’ll be speaking to one patient sometimes for close to an hour, you’ll need to be incredibly patient, and sometimes it may feel like you’re just talking to them and not doing enough.Psychiatry residency is 4 years, after which you can subspecialize in addiction, child and adolescent, forensic, geriatric, psychosomatic, and more.In terms of lifestyle, you’ll be working at a slower pace and usually won’t have to deal with call at odd hours in the night. In terms of salary, the average psychiatrist is in the bottom quartile in terms of physician compensation at $260,000 per year.6 | Emergency MedicineLast, we have emergency medicine, which received 42 points. If you like shift work and fast-paced exciting medicine, then emergency medicine might be a good fit. Emergency medicine physicians work in the emergency department, or ED, although most laypeople say ER for emergency room.EM residency lasts 3 or 4 years in duration, after which you can subspecialize with a fellowship in palliative care, critical-care medicine, medical toxicology, wilderness medicine, sports medicine, disaster medicine, hyperbaric medicine, and more.Emergency medicine physicians are essentially the first-line defense, dealing with acute conditions requiring immediate treatment. Or at least they’re supposed to. Given the high rates of uninsured patients in the U.S., the ED is often crowded with uninsured patients that can’t get care elsewhere. That problem, and the prospect of universal healthcare, is a topic for a future video.TV shows portray the emergency department as exciting, fast-paced, and adrenaline-fueled. Truth is, during my multiple rotations on emergency, I was dealing with abdominal pain and chest pain more than anything else. Don’t get me wrong, when a patient comes in with cardiopulmonary arrest or tension pneumothorax, it is exciting. Just know that most of your time in the ED won’t be like that.In terms of lifestyle, emergency medicine physicians are unique in that they have shift work, meaning they clock in and clock out at a predefined time, and you have flexibility in choosing your shifts such that you could have several days off in a row. Emergency physicians are well paid, at an average of $353,000 per year, but they do unfortunately experience very high rates of burnout.Don’t let the data fool you. Just because these are the six least competitive specialties doesn’t mean they aren’t hard to get into! Every specialty in medicine is competitive, just some more so than others. Particularly if you want to get the best training at a top program, you’ll have to be a stellar candidate.