Shadowing and The Struggle Of Picking A Specialty. #447

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Thank you for your consideration and would love the opportunity to learn from your expertise , michael F , so I thank you for submitting your question . I don't know if I've ever been asked to be , shadowed through the show , but I do . I mean , we get shadowed trauma surgeons .

At my job there's always a medical student , there's always a pre-med student , there's also a pre-PA student or a PA student that is shadowing us or doing their clinical . So , yes , that opportunity exists . But before I give you a definitive answer , I want to let you know how I work . Okay , so I work roughly about 10 to 14 days a month .

I don't live where I work , right ? So when I'm there , I'm working , that's when I'm there and that's where the opportunity exists . When I'm not there , I'm five and a half hours away .

So what I oftentimes will say is , if you're coming , don't come just for me , come for the experience , right , come for the trauma surgery experience , which in our case would be a level two trauma experience . That's a little bit different oh , my bad , I'm tapping on the table .

That's a little bit different than trauma at a level one , right , because trauma at a level one more than likely , you have residents , you have attendings , you know , it's just a little bit of a different feel . But if you want like a true , like level two experience , come , you know , and spend some time here , but likely for you's an incoming , oh , okay .

Now I do not recommend you do a sub-I at my spot because we're not connected to a residency program Sub-internships . That's in essence . Basically , you're sub-interning at a residency that you want to do residency at right . So we don't have , we're not connected to a residency , so you don't want to do that . So , yeah , we do that .

What I would recommend is just contacting the clinical . We have like a DIO or a clinical . I'll reach out to you and tell you who to contact .

But anybody else who's thinking about doing like , for example , if you want to shadow Dr Renee , usually what you have to do is like reach out to like the hospital they have like a department of education and then you say , hey , I want to shadow this person , I want to shadow that person , and then they'll let you know what you have to do and usually you

have to like sign off on some things and then you have to get the permission of the person who you want to shadow and then you can go ahead and do it and go from there . The way how my days go , you know , usually I'm starting at seven in the morning and then we're done by 7 pm .

And then vice versa , if I'm doing night shift , we start at 6 45 and then we're done at 7 in the morning and I do everything from being an intensive care unit to being in the ER , to being in the operating room , to being on the regular floors and it's it's a really good experience .

Now I will say this like for me I don't I'm going to ask you how you do it , but what I do is when people shadow me . I don't , they can shadow , but I always am trying to get them ready to actually do something that's realistic .

That is a realistic endpoint , right , but I think , like , what ends up happening is you're skipping the process for that student , right , right .

So for me , I like to prep them by saying hey , you got to get to the hospital before me , you got to see the patients before me and you got to present in soap note style , which I think is a lost art right now .

Right , I think that you think it's a lost art Because I rarely hear medical students , you know when I even first medical students you have shadowing you , then we have medical students shadowing us and they're in their third and fourth years and when they're presenting to us , they're not presenting to us in a soap note fashion .

So long story short is I prefer that , if you're going to present , present in a SOAP fashion , and the reason why is it's a very systematic way that I know that you're thinking about the patient , that you're assessing the patient not only just the patient , but you're getting information from the nurse , you're getting information from the patient and then you're

looking at all the important things , the vitals , and then you know in general what we're treating and then at the end you let me know what your plan is . It's extremely systematic , it's archaic but it's effective way .

things . But those are the big things , because I need to get you ready so that when you go and do your surgery rotation or you go and do your medicine rotation and they tell you what rotation did you do before this ? I was with Dr Ney . They know that I taught you , right , you know what I'm saying . So how do you do yours ? Do you even have students .

It's very , you know , when you have a program that's attached to a residency program or if you have a hospital that is just very , very busy . I think that's when you're going to see kind of the best experience , right , You're going to have the best experience . The way that I work . My hospital isn't extremely busy , right .

So there can be days when I get to work and nobody's in labor and there's nothing to do . Watch Knock on Wood is going to be all kind of crazy when I get to work today , but I'm prepared for that , but that that is literally what could happen , Right ? I don't have a ton of GYN patients , Right ?

So , whereas in my residency program there's like a whole list of GYN patients to see , I'm lucky if I get one or two GYN patients for the entire weekend that I'm working . So if you wanted to shadow me , that's fine , but I can't guarantee that you're going to have the full Monty experience of OBGYN when you're shadowing me where I am right now .

But at the previous program that I was , it was a busier program , so you know there wasn't a lot of downtime like I have right now . So I agree with you . I think that if students are looking especially pre-meds are looking to see , okay , well , what will this experience even look like ?

I think it's better to go to a hospital that is busier , a hospital that potentially has a residency program . I think that pre-meds should actually . I think so . Here's what I think . I think so here's what I think . I think what is archaic and not necessarily as effective is having pre-meds shadow full-fledged , board-certified doctors .

I think that needs to go out the window . I actually think pre-meds should be shadowing residents . That's who they should be shadowing , because that's the first experience that they're going to have as doctors . And you and I both know that experience can be extremely jarring , because if you've never experienced residency before , you're like what the hell is this ?

Yeah , what the hell is this ? It's not what . The buck doesn't stop with me and it could not stop with you for three to seven to nine years , depending on what kind of residency you do .

But I do think that part of evaluating someone is you don't spend your entire time with that person , right , like you have to be like okay , like maybe for two weeks , I'm seeing how this person practice is in an outpatient general surgery type experience .

But then also , at the same time , you need to know what it's like to go through residency , right , like , do I really want to go through five years of general surgery residency or OB residency or whatever it may be ? Do you really want to go through that residency or whatever it may be ? Do you really want to go through that ?

But then it's also you need to know what it's like at the end point . Right , because if you see an experience where you're like yeah , like me , like I don't want to be dealing with , like there's OB things that I just don't want to deal with , right , and the way in which OBs practice . That's just not for me , right .

So I think it behooves me to kind of see like , for example , like how you practice . I just don't want to do , I just don't think I should spend my entire , I shouldn't make my entire basis as to what specialty I want to go to based off of spending time with you . Do you see how something ?

The other reason I say shadow a resident is because when you shadow a resident , you will inevitably be shadowing and attending as well . Because when you shadow a resident , you will inevitably be shadowing an attending as well . Because the resident has to interact with the attending .

The attending is inevitably going to bring you in , depends on which residency you at , depends on which residency you at you will You're never not going to encounter .

No , if you're saying , if you're talking about for a few hours , well then yeah OK , because definitely hours can go by and you don't necessarily encounter , you're attending , but if you are shadowing over weeks , you're telling me that a residency program doesn't have one attending over several weeks . It wouldn't make any sense .

You're not going to see every single aspect of it , right ? Because , let's say , even if a student shadowed you , let's say they shadowed you in residency , right ? There was a point at which you were in transplant . There was a point at which you were in general surgery . There was a point at which you were in the ICU .

There was a point at which , whatever , they may see you in ICU , but they never saw you on general surgery . They may see you on transplant , but they never saw you in ICU . You understand what I'm saying ? So that's what I mean , is that ?

But , Michael F , I appreciate what you wrote in . I enjoy working with students . I enjoy working with pre-meds medical students . I know there's some people who don't like to work with .

And you know , kudos to you for being that , you know for being on the ball like that to say , hey , you want to leave Alabama and come all the way , you know , to wherever I work at and kind of do that . So we'll see . We'll see if we can make it work .

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I just found his phone number on your website where it says we'd love to hear your questions and comments .

I was wondering what . I'm just teasing .

I'm really struggling to pick a specialty and I'm afraid to ask advisors in my med school about this because of how much weight their opinions about my commitment to either field will affect my leaders , my letters . I would definitely be interested in any paid career advising that you offer cheers word . Listen , we're going on to patreon for this .

Our patreon is , uh , a thousand dollars .

Okay , the advising is the show . If you want to know about how we think and the evolution of how we think and all that stuff that's been going on from the episode first episodes up until now , Okay . Second thing , and I kept notes here , right , Sometimes I got to keep notes because I'm getting old , right ? Second thing is listen .

The struggle to you is not unique , right ? The struggle of figuring out what residency you want to go into and whether you should go and talk to certain advisors and what they're going to say if they write their letters , that ain't unique , right , I understand it's . You know it's your life and it's your journey .

So you know , yeah , like you feel like all the weight is on you , but just know that there's a lot of students in your own class . We went through it . Renee definitely went through it . As a matter of fact , you want to just jump into real quickly , quickly , your story about how you ran from Pete's to OB , please . Thank you .

So ended up wanting to do pediatric endocrinology In my third year , my elective actually , I did in pediatric endocrinology . Eventually I ended up doing my pediatric rotation . I think I did it kind of out of sequence . So I did my pediatric . We did inpatient PEDs together .

Right , we did inpatient PEDs together , but my pediatric endocrinology was an outpatient elective . That was before .

This time it was inpatient , so I had experienced some outpatient with my elective , but now we were inpatient , but now we were inpatient and I think at that point I kind of realized this is going to be the bulk of what I do for residency and potentially , if I wanted to work in the hospital which at the time I wanted to work in the hospital and I hated

it , hated it , hated it , hated it Two snaps , a twist and every kiss what's ?

After July she changed her mind when people already started applying .

So I did pediatric ER and then I ended up doing an MFM rotation as well to see if I want to do OB . So I just needed to make the decision . Eventually I chose to go to OB . I never looked back . I was very happy with my decision . But what I would say to you is that figure out what the things are that are important to you .

Nowadays we kind of talked about this in a previous episode Nowadays , I think that the whole traditional lifestyle question isn't really as much of a question , right , you know the question of , well , you know , can I do OB and have a family and this , that and the other ?

Now , because there are so many options of how you can work , it's even surgery , surgery is the things that people were too , so concerned about , like , having kids while you're a surgeon or getting married while you're a surgeon .

Ie , have you done a you know ? Have you done any type of research in that specialty ? Have you done any type of you know ? Have you done anything to kind of just let them know that ? Yeah , like , this specialty that I want to go into is something that you know you want to do and stuff Right and that helps them to understand your perceived commitment .

The only thing I did was the rotations . They are going to weigh a letter of recommendation from an internal medicine doctor more than a doctor , an OB or OB , or surgery or neurosurgeon . They're going to be like yo , like , can this person you know do well , based off of the recommendations of a hospitalist or an internal medicine doctor ?

That's something to consider . Yeah , so I would say , like , some of the things that you need to consider in order to really solidify your stuff is are you going to do like what are you really interested in Right , like , like what really interests you from a specialty standpoint Right . So have an open mind . What do you get excited about ? What do you like ?

Have an open mind . So for me , when I started med school , there was two things that I was really interested in . One was I was really interested in OB and that fell by the wayside real quick . And then I was really interested in trauma surgery .

But I knew that if I went into school thinking that I just wanted to be a surgeon or I just wanted to be OB , I think there was a strong chance that I wouldn't give the rotations in my third and fourth year a proper chance to say , like you , know , maybe a PEDS is for me Right , or maybe like OB or sorry , not OB , but maybe something else is really

for me . But because sometimes if you go in with a certain type of mentality I'm going in to do ortho or I'm going in to do surgery or whatever you don't give the other rotations a chance . So I just said , let me give everything a chance .

And I did , and I just liked surgery right , I knew this is what I wanted to do and I , specifically , I want to do general surgery .

Don't be mad , because you're mad about your personality and if you're really interested in it , if you're really thinking like this is something that I may want to go into , even , even , despite I know , even despite what your advisors say , you should do a sub-internship in there , right , friends who are so ?

And what a sub in a sub-internship , what it does , let me land and what a sub-internship is is , you know , you will go there and you will intern there as if you want to go to that program , right ? So I did a sub-internship at Morehouse January , before I was supposed to start residency at wherever I didn't know . And there I was , there before everybody .

I was rounding on patients , I was letting people know my plans , I was presenting in a soap note fashion . I would go to the operating room , I would go and do procedures with critical care . I did all these different things and I would always let people know like I'm trying to do residency here . No-transcript , that you just need to consider .

So that's why , for me , I'm like look , you know you don't need to worry about the pay of you know that specialty Cause I don't think you should worry about that . You're going to be fine . The question is is are you happy with the lifestyle ?

Right , because we know a lot of oh , excuse me , I know a lot of neurosurgeons right now who are probably listening , who make a lot of money , but they hate what they do , right , or they hate the way how they work and they're not in much control of that , right we ?

So that's that's what I would say is just listen like , have fun with it , enjoy it , think about what you want to do that you really enjoy , and then go further into it by doing some further internships or rotating electives in it and then go from there .

But listen the advisors they've seen students like you before they know , right , yeah , this ain't nothing new . This ain't nothing new . So if they don't , if they see or they sense that you're not sure what you want to do , that's okay . And don't forget also , let's say you get to your fourth year and you still don't know what you want to do , that's okay .

And don't forget . Also , let's say you get to your fourth year and you still don't know what you want to do . There's something that's called rotating internships or , um , what , what ? that's what they call rotating internships where you go and you get into into a program and you actually every month you're doing something different .

You do your rotations all over again , you do surgery you do , but this is as a resident though .

Like I said , don't come after me . I'm not trying to be canceled . I'm not trying to tell people not to go to residency , but you don't have to go to residency . There are other things that you can do with a medical degree , right , and so you know , I'm not going to list all of them right now , but I think that there are things that you can consider .

If you are somebody who decides that you went to medical school but there's not any one degree or , excuse me , anyone specialty , that really kind of floats your boat , so that's something to think about . There's also administrative residency . If you wanted to do that , you want to be an administrator , you can try a lot of things .

But look that up and see right , because it can tell you all of the different specialties out there that exist that you may not even be considering . I will tell you I didn't know about PM&R until much you know , much later , not that that's what I wanted to do , but I just didn't know about it , right , like I was just naive to that . So you know .

It just may be like the rotations that you're doing is just , the rotations that you're doing is just , or the specialties are things that you're currently being exposed to , but there's more to it . There's more out there . There's PMNR , there's also what's the other one , preventative medicine . Yeah , preventative medicine , preventative medicine , is another field .

Right , we listen , but we don't judge , unless you , renee , because then we can and we will . But I told you she's on one , you know she needs help , but it is in your school's best interest to help you to match , because if your school doesn't help you to match , that's actually a ding on the school .

So just realize they have a stake in the game of you becoming successful .

But you know , trust the process , trust your program , trust the advisors and know that what either ? Even and even if you don't just know that you will do fine , you're going to do fine , you're going to get through this process . So try not to it's tough , try not to move , thinking that everything you say may be used against you later on .

So if you are not sure , it's OK to express that that you're not sure . So , and that's it , guys .

I mean you can DM us , you can send us fan mail , you can text us , you can email us , you can leave a message at the bottom of the YouTube message . We read everything and we try to get back to you guys quickly and as soon as possible . All right , we're going to catch you guys on the next episode of what Y'all Say , friday . Peace y'all .

Deuces or you can go to docsoutsidetheboxcom did I come out the room by mistake ?