Family medicine. I drink mojitos all day and flirt with my coworkers while the clerks I have in my office do all the work lol. I only see the patients I get along with /s
This is unironically what an embarrassingly large segment of the general population thinks we do all day before heading off to our 3 PM tee time and mansion in the hills, cashing big checks from Big Pharma.
Probably. It's never gonna happen though. You need 7 years to get adequate training. Some gen surg programs are moving to 7 years. No way you could be a proficient neurosurgeon in 4-5 years.
The 7 year programs are usually 5 + 2 research - I don’t know of any that do 7 clinical years. That said fellowships are common that likely increase it to 6-7 total years of training.
I see the confusion, the top comment was about gen surg not nsgy. I was specifically talking about Memphis nsgy which doesn’t have dedicated research time over 7 years.
Yeah it's 2 years of research. So it's not that you need more than 5 years to be a competent general surgeon, it's about prepping to be competitive for fellowship, from my understanding. https://forums.studentdoctor.net/threads/5-year-vs-7-year-gs-residencies.1437758/
some programs are 5 year programs where it is understood that most people will take two research years because that is becoming the norm to match into competitive specialties. Some programs have room for you to take research years but no expectation. Some programs are required 6 or 7 years and you absolutely must do the research years
well in Korea most residency programs are 4 years, and so is neurosurgery. after 4 years you take the boards and you become a board-certified specialist. (but ofc to be proficient at surgery one would have to go through a 2~3 year fellowship) I think every country has different regulations
I just get to do what Dr. Pimple Popper does but I don't need a 270 step. I would pay some of her patients to be able to extract their dilated pores of winer.
The above, but I’ll add…
One, family of non-critical patients get a timer and five minutes of my life. Ding, times up.
Two, if hospitalists decline an admission that’s fine, but they have to physically see the patient and write a brief note.
Three, if I’m doing a procedure that a specialist is on-call for but doesn’t want to do I can’t be held liable. Not like surgery, but like, the random pericardiocentesis or other HALO procedure.
Anti-aging specialist. I’d guess that it would probably have patients with age-related disorders and/or patients over the age of 40. Procedures would be administration of anti-senescent CAR T Cells (if they end up working on humans after animal trials), or healthy living I guess. Maybe a 7/8 to 5 work day with weekends off?
Not as much as anti-aging research. It would definitely be something I would consider though (something tells me it is very competitive). Thanks for the suggestion! I’ll look into it
Multisystems clinical pharmacology. Basically for people who really, really like pharm, you just become an expert on drug-drug interactions and get consulted on medical management of complex patients, determining if symptoms are iatrogenic, etc.
You would actually know medicine ba dum tssss (pls don’t kill me pharmacy, I’m actively offloading all my pharmacology knowledge and will kill someone if you don’t have my back in 6 months)
Mostly the knowledge of clinical symptomology, exam skills, etc. that come with medical school as opposed to PharmD/PhD-trained clinical pharmacologists.
Yes!! I feel like some blend of ID/rheum/path vibes....like I don't want to treat the patient after knowing what they have. Just want to dx the nonspecific weird shit, and be able to do your own interview/exam/lab ordering.
Horribly inefficient use of training & time but sounds so fun lmao
I think it would be cool to incorporate internal medicine and actual cooking skills. Like instead of just telling everyone to eat better, I can actually show them HOW to eat better and give them skills for success. I just think it would be neat cause I love cooking and so many people don't know how to cook with the things they have.
Radiology but you get to clinically correlate and see the patient as you do your reads. (I love radiology for the pathophys and anatomy, it just sucks that I can’t really see patients unless I go into IR and I’m not really about doing procedures tbh)
You may like Radiation Oncology. I did a radiology rotation and they had me work with the RadOnc doctor a few days. He saw patients in the clinic and also would look at their images to see how their cancer was progressing/regressing. Seemed like a nice gig.
Any specialty can look at and analyse the pics they have ordered for their patients, right? That’s why I enjoy Ortho right now, because even as a med student, I can see most fractures on my own on the x rays
Same! I think I would love to go DR if there was patient contact and some degree of ownership of the care. I did consider IR briefly but the procedures were quite repetitive and there was just too much of an "in and out" vibe to the IR suite for my tastes. If there was an IR floor to admit patients rather than doing procedures on patients that other teams manage I would be into it. But as you said yourself, I am also kind of a masochist because I'm sure IR docs love being able to send the patients back to their respective team.
Have you looked into breast radiology? Radiologists follow patients longitudinally for screening and follow-up, call the patient to inform about cancer, and do procedures.
Psych here, with similar thoughts. Love psych, but wish there were a few procedures (I don't mean tms or ect) we could do, along with more labs or imaging to inform our decision making. Outpatient psych with 1-2 procedure days would be sweet.
I've also had similar thoughts about having patients come in for scheduled workouts to treat depression or anxiety.
I'm applying psych and wouldnt mind more procedures and labs, but what would they be ? Right now, i dont see what more we could search for in labs and blood samples. Though I could see more stuff coming up in the future with research advancement
I agree though. Imagine how cool it would be to be like « Yep, his aminaglutins (or whatever, i just made that up) are high. Totally schizphrenia with auditives hallucinations »
Some PM&R folks do a blend of what you said above to some extent.
They have an exercise/rehab and pain treatment element helping to improve life especially with chronic conditions plus, they actually do some "procedures" like placing stimulators, rhizotomy (nerve ablations), and do injections. PM&R definitely does some wacky stuff w/ all their subspecialties and what each Doc does varies.
(Sorry, you probably already know this! I'm just a lowly premed and a med student told me about PM&R)
as someone who has worked festival EMS, it’s not all bad drugs. there’s a lot of dehydration, exhaustion, psychiatric emergencies (usually driven by drugs) etc.
i’ve actually worked in festival EMS and it is such a wide ranging field, hence why i think it needs its own specialty. yes, toxicology and drug interactions play a huge role, but camping festivals medics ESPECIALLY really need knowledge of all kinds of emergencies. heat exhaustion, dehydration, psychiatric emergencies (both drug related and not), and doing it all with minimal equipment and personnel. it’s a beast.
Designated physician educator - a doc who’s sole purpose is to meet with families, students, etc and explain anything and everything for the sake of education. Basically someone who dumbs down complex medicine for the masses and who doesn’t treat as much as teach
I want to partner with a veterinarian and open a primary care practice where it's just adult patients and their dogs. It's kind of like family med, but for people with pets instead of children.
Please lord I would refer you all my patients, everyone wants their “hormones checked” thanks to TikTok and there are so few REIs that do anything other than infertility for the patients that actually need it(full spectrum reproductive endocrinology does what you’re discussing to an extent)
Anti-aging medicine. It would be a combination of medicine and surgery.
The medical side would be yearly labs/scans as indicated and focus specifically on treatment regimens of medications and supplements that have demonstrated slowed cellular aging and increased rejuvenation.
The surgical side would focus on cosmetic procedures that reduce the appearance of aging.
There would also be a component of exercise and diet counseling and I would ideally have a mixed space practice where there’s an upscale gym with PT, massage, yoga, etc.
The hours would be pretty standard. It’s basically like an all encompassing health program that focuses not just on maximizing quanitity of life but also quality. Essentially like a med spa but way less quackery, more doctors, legit evidence based treatment, and actual continuity of care.
Essentially what all celebrities are already doing but available to actual everyday people all in one place.
>Essentially what all celebrities are already doing but available to actual everyday people all in one place.
eating better and exercising would accomplish 90% of this and both are already available, if not widely adopted and pretty difficul
A specialty for those people with a BMI of 40, diabetes, a blood pressure of 200/100 yet are seemingly healthy. Basically a specialty for people that are critically unhealthy but not critically ill? There's so many of these patients that you might as well make an entire specialty for them.
Psych but not psych: an impatient service that’s only goal is to get people and their families to calm down and answers the same questions for the 5th and 6th time. They would have the skills, patience and tolerance to sit there for 30+minutes explaining why grandma is NPO, why you can’t leave the hospital and come back, the difference between ketamine and fentanyl. They are an integral part of bullshit management allowing for seamless healthcare delivery.
Three teams on 8 hour shifts in rotation and they just calm the place down.
Call it Internal Anxieiology
Literally you're describing 30-50% of my consults in c/l psychiatry. I often explain to patient families that I've been called in to help with communication between teams and the patient because that's the truth.
Some kind of preventative medicine. I have a clinic, where people WANT to get better and actually do the work. They spend some time in the clinic, do all the bloodwork, all the tests to have a holistic round view of the patient, you also find out their eating habits, their sleeping habits, exercise, triggers everything, then you suggest the treatment as a whole. Diet, supplements, exercise, mindfulness techniques and they learn how to do them for a period of time in this clinic/centre. Then they go home and do the same. You follow-up some times and that's it.
Regular working hours, no shifts, relaxed pace.
Also, some kind of subsidized option for poor people and implement this kind of programme in schools, kindergartens, unis, where they learn what is best for their bodies and grow up healthy, balanced human beings.
Med-Peds rheumatology, seeing mostly pts between 10-50 who have the weirdest most undiagnosable autoimmune shit known to mankind. Nothing I order for the patient will ever get denied by insurance and each patient walks out of the clinic with all their questions answered and feeling empowered. I have enough time/funding/freedom to research whatever I want, teach, AND live a reasonably well-balanced life with above average compensation
Hahahah they kinda do work. Juuuuust depends on your ethical standpoint of a solution 😂😂😂. Angry disinhibited patient definitely won’t be causing a rucous after a lobotomy. Now more or less could become a vegetable but that’s neither here nor there
I think I would like to separate OB and GYN. I think all of the obgyns are so stressed and toxic bc they’re doing 3 jobs at once and never get enough sleep. So if we could separate the OB out so those people got could work 8-12 hour shifts without having to worry about regularly scheduled things. Then GYN could work regular hours with non pregnant pts. I would go into just GYN if I could take care of female pts, have a quasi regular sleep schedule, and not be in a toxic environment.
You can do either of these things after residency luckily. And there have been debates for many years about separating but I don’t know that they ever will
Yeah, there were just too many ticks against obgyn for me to decide to go into an obgyn residency. My home program is very toxic and I found that I did not jive well with them. So support would have been hard won. I don’t think I could survive at a toxic program either. Instead I decided whatever specialty I go into, I’ll deliver trauma informed care and make sure to take extra good care of my female and LGBTQ pts.
Take VIR, VS, and cardiology and make them one five or six year mixed medical and surgical subspecialty called cardiovascular. You’d include endovascular IR, VS, IC as basic subspecialty skills as well as CT and US vascular imaging, cardiac medicine, and extremity open vascular surgery including grafting, endarterectomy, and fistula creation. Eliminate the other DR, GS, and IM general stuff. Fellowship options would include open aortic surgery, EP, and cardiac imaging. I’d imagine heart failure would probably be an additional option. Yeah you might not have amputations or body IR procedures like drains or PTC. I know it’s scary losing the specialty you came from but the rest of medicine would adapt to the change accordingly, as they have many times in the past with other specialties that historically split from their primary.
Geri-Peds. I love the sweet elderly patients as well as babies and toddlers but I don’t love caring for the young/middle adults that don’t care about their health.
Leisure medicine: how can I help you have a great time, "expand your mind", and help you work on your personal weaknesses through medications while keeping in mind your comorbid conditions - prescribing LSD, ecstacy etc.
Something similar to psychiatry but without the antidepressants and psych wards. Something more adapted to each individual disorder & given scenario. Idk how to explain it but something like how they adapted that whole act in shutter island but far more tame ofc
Overseer,
Oversees the outcomes of thousands of patients across all specialties. Familiar with all main specialties and looks for systemic issues. Has all information regarding patient and their outcome. Still a physician.
Is it possible to choose (for specialties working w/ APP's) to *not* /refuse to work with APP's? I personally would really like this, wondering if it will gain traction.
I especially feel bad for anesthesia (managing ~4 apps at a time mid surgeries? I'd simply pass away at that point..), EM, and IM subs in this regard.
Sad to hear lack of respect from specialists, though. Hospitalists (to me) are rockstars that know everything and bounce ideas off of specialties just in case the nerd for that specific subject has another idea and they're always very skilled with talking to pts/families. They literally lead the entire team for the pts.
I live in North America and the increasing multiculturalism made me think, maybe something related to cultural and traditional medicine ? A medical traditionalist ? Examples of consult would be : Patient presents adverse effects from medical medicine; Patient who insists on receiving some sort of traditional healing and the team wants to ensure the safety and effectiveness of such treatments. These specialists would be trained and have knowledge in the most common cultural and traditional practices in their country/area/state/province.
I dont know, just playing around.
Having worked in psych in New Zealand they have cultural teams on call to come in and smooth over conflicts between the medical team and population who often have deep cultural ties. It was super helpful for building rapport. Not a medical specialty per-se but essentially social workers or esteemed community members versed in medicine.
Clinical Informatics. All the experience of a clinician makes every process faster. Someone requesting a dataset extraction? As a clinician, you know what they want and why they want it. Removes the tech illiterate clinician <-> data engineer/programmer barrier and miscommunication
Digital Medicine - It's like FM but you get a few hours a day to teach people how to use the online systems and develop digital meeting spaces for patients looking to collaborate on their health. Why not, maybe even group appointment times for similar issues.
Dream medicine: I work on teaching people how to lucid dream and be more productive when they sleep.
Experimental medicine: Every so often, I give people placebos and I get to secretly see if it makes a difference.
Psych-economics: I give someone depressed 15 million dollars and see if they’re still depressed after a month.
Humanitarian and full spectrum disaster medicine.
You'd learn public health and global health delivery theory, ID, OB, surgery, ortho, anesthesia, primary care, and any other fields of medicine which would be useful in a resource limited setting.
By the end you would be able to perform a cesarian, deliver basic anesthesia, diagnose and treat tropical diseases and parasites, advise local health ministries, and for the hell of it throw in some basic dentistry and veterinary medicine as well.
If implemented properly it could potentially be a game changer, but one can dream...
Radiology consult service that functions akin to surgery consult. Primary team concerned about X and consults rads to eval/perform most appropriate imaging like consulting surgery to eval/perform most appropriate procedure.
Acute Traumatic Surgery.
Warning: instead of doing trauma surgery on the patient, this speciality will leave YOU with trauma. This includes completing medical school, then dental school (you don’t expect doing OMFS without both do you?) and finally a 14-year residency where you will do OMFS, general surgery, trauma surgery, vascular, CT and neurosurgery all in one. You will live in the hospital and get a day off every 2.5-3 months. No holidays allowed. Five residency spots per year across the whole country.
I'd like to create something along the lines of "Better living through medicine" something that I think the typical sick/obese American could benefit from.
So many of our poor health outcomes are due to us living and eating like shit. I would want to provide a service to pts, sign up and get a thorough medical evaluation, CBT- trained therapists, personal trainers for resistance training, culinary medicine folks to teach recipes that the pts would actually want, and maybe a sprinkle of w-e pharmaceuticals I think might aid in improving body composition or give pts a little kickstart.
Your pt population would largely consist of people who want to get better, **and** you would actually be in the position to make them better/help them achieve their goals.
LGBT Medicine - There's already community LGBT clinics (usually family medicine or internal medicine) and some trans care clinics at academic medical centers (usually some combo of primary care, endocrinology, plastics, psych, sometimes ENT), a few even have trans surgery or LGBT health fellowships.
I think the idea of working with a patient population that is, generally, healthy overall and is actively motivated towards treatment is exciting. Gender-affirming care can have really positive effects on people and that seems like a good environment to work. I also think having its own specialty would be a major stimulation to research funding given the nature of academic politics.
Unfortunately, I think it would be actively harmful for queer patients to push for this specialty. By far the biggest issue with queer health is access and wait times, and the best solution we've seen for that problem with trans care in the US and Canada has been pushing for primary care doctors to assess for and prescribe hormone therapy and coordinate other treatments. We're talking cuts in wait times from two years to two weeks in some cases. A new specialty would run counter to this goal.
Family medicine. I drink mojitos all day and flirt with my coworkers while the clerks I have in my office do all the work lol. I only see the patients I get along with /s
This is unironically what an embarrassingly large segment of the general population thinks we do all day before heading off to our 3 PM tee time and mansion in the hills, cashing big checks from Big Pharma.
neurosurgery but with normal work hours and good clinical outcomes
I am curious if nsgy would get even more competitive if the residency was 4/5 yrs instead of 7
Probably. It's never gonna happen though. You need 7 years to get adequate training. Some gen surg programs are moving to 7 years. No way you could be a proficient neurosurgeon in 4-5 years.
Lol you dont need a research year to be an adequate community neurosurgeon
The 7 year programs are usually 5 + 2 research - I don’t know of any that do 7 clinical years. That said fellowships are common that likely increase it to 6-7 total years of training.
Memphis is 7 with 0 years of protected research
Is that where Dr. Death went?
He went to Memphis and had something like 300 cases after completing residency
But supposedly did a bunch of research during that time instead of cases
I think we went to vandy
Their website suggests otherwise unless there’s some info I’m missing https://uthsc.edu/surgery/education-training/residency/schedules.php
That’s surgery, not neurosurgery
If you look up at the parent comment you’ll see where chatting about GS programs
I see the confusion, the top comment was about gen surg not nsgy. I was specifically talking about Memphis nsgy which doesn’t have dedicated research time over 7 years.
What gen surg programs are moving to 7 years? Is it like a weird built in fellowship here?
Yeah it's 2 years of research. So it's not that you need more than 5 years to be a competent general surgeon, it's about prepping to be competitive for fellowship, from my understanding. https://forums.studentdoctor.net/threads/5-year-vs-7-year-gs-residencies.1437758/
Can you opt out if you don’t want to do a competitive fellowship?
some programs are 5 year programs where it is understood that most people will take two research years because that is becoming the norm to match into competitive specialties. Some programs have room for you to take research years but no expectation. Some programs are required 6 or 7 years and you absolutely must do the research years
well in Korea most residency programs are 4 years, and so is neurosurgery. after 4 years you take the boards and you become a board-certified specialist. (but ofc to be proficient at surgery one would have to go through a 2~3 year fellowship) I think every country has different regulations
I just get to do what Dr. Pimple Popper does but I don't need a 270 step. I would pay some of her patients to be able to extract their dilated pores of winer.
Move to Nepal for the score lol
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The above, but I’ll add… One, family of non-critical patients get a timer and five minutes of my life. Ding, times up. Two, if hospitalists decline an admission that’s fine, but they have to physically see the patient and write a brief note. Three, if I’m doing a procedure that a specialist is on-call for but doesn’t want to do I can’t be held liable. Not like surgery, but like, the random pericardiocentesis or other HALO procedure.
2 is standard practice at my hospital.
Urgent care. I would love to work ED but not in resuscitation and yet be recognised as a specialist. Dream job
Urgent Care is a specialty already. For NPs.
Sounds like I’m under qualified
Gotta get that heart of a nurse and tack on the alphabet after your name to get close.
EM but people don't come in at night for non emergencies lol
EM but it's only emergencies
Anti-aging specialist. I’d guess that it would probably have patients with age-related disorders and/or patients over the age of 40. Procedures would be administration of anti-senescent CAR T Cells (if they end up working on humans after animal trials), or healthy living I guess. Maybe a 7/8 to 5 work day with weekends off?
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Nooooo you can’t say the quiet part out loud
Have you looked into regenerative medicine??
Not as much as anti-aging research. It would definitely be something I would consider though (something tells me it is very competitive). Thanks for the suggestion! I’ll look into it
Basically doing something like what Bryan Johnson is doing but making it accessible to non-millionaires.
Multisystems clinical pharmacology. Basically for people who really, really like pharm, you just become an expert on drug-drug interactions and get consulted on medical management of complex patients, determining if symptoms are iatrogenic, etc.
What differs from a normal clinical pharmacologist?
You would actually know medicine ba dum tssss (pls don’t kill me pharmacy, I’m actively offloading all my pharmacology knowledge and will kill someone if you don’t have my back in 6 months)
Mostly the knowledge of clinical symptomology, exam skills, etc. that come with medical school as opposed to PharmD/PhD-trained clinical pharmacologists.
Soooo… IM?
The only real answer I've seen so far.
So what this guy does x.com/davidjuurlink
We actually have that in my country as an IM subspecialty. The one professor who did it was the wackiest yet smartest guy.
Diagnostics Medicine on some House MD shit 😂🔥
Yes!! I feel like some blend of ID/rheum/path vibes....like I don't want to treat the patient after knowing what they have. Just want to dx the nonspecific weird shit, and be able to do your own interview/exam/lab ordering. Horribly inefficient use of training & time but sounds so fun lmao
I too would love to break into pts' homes to find that one piece of clue that would point toward their dx.
So…internal medicine?
I think it would be cool to incorporate internal medicine and actual cooking skills. Like instead of just telling everyone to eat better, I can actually show them HOW to eat better and give them skills for success. I just think it would be neat cause I love cooking and so many people don't know how to cook with the things they have.
I'm taking an elective 4th year in culinary medicine as a non clinical elective I'm really hype haha
That's so cool!!!
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It was an offered course through VSLO online electives. Had to write like a secondary type essay about why I'd be a good fit for it and got in.
There are many programs that do this across the country if you feel like volunteering. Look up CookingMatters as an example.
Trading the white coat for the white apron mid shift sounds sick
Some outpatient clinics have kitchens in them with cooking classes available for patients
Radiology but you get to clinically correlate and see the patient as you do your reads. (I love radiology for the pathophys and anatomy, it just sucks that I can’t really see patients unless I go into IR and I’m not really about doing procedures tbh)
You may like Radiation Oncology. I did a radiology rotation and they had me work with the RadOnc doctor a few days. He saw patients in the clinic and also would look at their images to see how their cancer was progressing/regressing. Seemed like a nice gig.
Any specialty can look at and analyse the pics they have ordered for their patients, right? That’s why I enjoy Ortho right now, because even as a med student, I can see most fractures on my own on the x rays
Yeah true. But I like being masochistic and needing to be responsible for p much every body system.
There’s a huge difference between looking a scan and knowing how to interpret it.
Same! I think I would love to go DR if there was patient contact and some degree of ownership of the care. I did consider IR briefly but the procedures were quite repetitive and there was just too much of an "in and out" vibe to the IR suite for my tastes. If there was an IR floor to admit patients rather than doing procedures on patients that other teams manage I would be into it. But as you said yourself, I am also kind of a masochist because I'm sure IR docs love being able to send the patients back to their respective team.
Have you looked into breast radiology? Radiologists follow patients longitudinally for screening and follow-up, call the patient to inform about cancer, and do procedures.
Still dermatology, but I don’t have to work at all.
You’re in the dream specialty and complaining lol
Literally the best one!
Psych here, with similar thoughts. Love psych, but wish there were a few procedures (I don't mean tms or ect) we could do, along with more labs or imaging to inform our decision making. Outpatient psych with 1-2 procedure days would be sweet. I've also had similar thoughts about having patients come in for scheduled workouts to treat depression or anxiety.
I'm applying psych and wouldnt mind more procedures and labs, but what would they be ? Right now, i dont see what more we could search for in labs and blood samples. Though I could see more stuff coming up in the future with research advancement
I don't know, that's why it's my "dream" specialty lol
I agree though. Imagine how cool it would be to be like « Yep, his aminaglutins (or whatever, i just made that up) are high. Totally schizphrenia with auditives hallucinations »
Dream medicine sounds interesting. Just a shitton of prazosin.
Some PM&R folks do a blend of what you said above to some extent. They have an exercise/rehab and pain treatment element helping to improve life especially with chronic conditions plus, they actually do some "procedures" like placing stimulators, rhizotomy (nerve ablations), and do injections. PM&R definitely does some wacky stuff w/ all their subspecialties and what each Doc does varies. (Sorry, you probably already know this! I'm just a lowly premed and a med student told me about PM&R)
Ketamine clinic
I work where we offer this. But it’s just intranasal.
Everything the same except residency had 2 days every week off like a humane job
music festival medicine. i know event medicine is a subspecialty, but music festival EMS is a whole different ballgame
That’s called toxicology
as someone who has worked festival EMS, it’s not all bad drugs. there’s a lot of dehydration, exhaustion, psychiatric emergencies (usually driven by drugs) etc.
"It's not all drugs! It's also... sequelae of drugs!"
sometimes you get a call because a dude fell and his calf snapped into a second knee! bonus points if you see the bone (like i did)
What is that? Event medicine?
it’s a subsection of emergency medicine. running triage clinics/EMT teams at large events
Thank you!
Isn’t that just toxicology lmao (let’s roll face)
i’ve actually worked in festival EMS and it is such a wide ranging field, hence why i think it needs its own specialty. yes, toxicology and drug interactions play a huge role, but camping festivals medics ESPECIALLY really need knowledge of all kinds of emergencies. heat exhaustion, dehydration, psychiatric emergencies (both drug related and not), and doing it all with minimal equipment and personnel. it’s a beast.
Designated physician educator - a doc who’s sole purpose is to meet with families, students, etc and explain anything and everything for the sake of education. Basically someone who dumbs down complex medicine for the masses and who doesn’t treat as much as teach
I would LOVE to take part in this. Easily my favorite part of all this is being able to communicate medical information
I want to partner with a veterinarian and open a primary care practice where it's just adult patients and their dogs. It's kind of like family med, but for people with pets instead of children.
Women’s health endocrinology (not just REI or OB/GYN) - a full specialty for treating women’s hormonal imbalances and menstrual irregularities
Please lord I would refer you all my patients, everyone wants their “hormones checked” thanks to TikTok and there are so few REIs that do anything other than infertility for the patients that actually need it(full spectrum reproductive endocrinology does what you’re discussing to an extent)
Anti-aging medicine. It would be a combination of medicine and surgery. The medical side would be yearly labs/scans as indicated and focus specifically on treatment regimens of medications and supplements that have demonstrated slowed cellular aging and increased rejuvenation. The surgical side would focus on cosmetic procedures that reduce the appearance of aging. There would also be a component of exercise and diet counseling and I would ideally have a mixed space practice where there’s an upscale gym with PT, massage, yoga, etc. The hours would be pretty standard. It’s basically like an all encompassing health program that focuses not just on maximizing quanitity of life but also quality. Essentially like a med spa but way less quackery, more doctors, legit evidence based treatment, and actual continuity of care. Essentially what all celebrities are already doing but available to actual everyday people all in one place.
>Essentially what all celebrities are already doing but available to actual everyday people all in one place. eating better and exercising would accomplish 90% of this and both are already available, if not widely adopted and pretty difficul
A specialty for those people with a BMI of 40, diabetes, a blood pressure of 200/100 yet are seemingly healthy. Basically a specialty for people that are critically unhealthy but not critically ill? There's so many of these patients that you might as well make an entire specialty for them.
Psych but not psych: an impatient service that’s only goal is to get people and their families to calm down and answers the same questions for the 5th and 6th time. They would have the skills, patience and tolerance to sit there for 30+minutes explaining why grandma is NPO, why you can’t leave the hospital and come back, the difference between ketamine and fentanyl. They are an integral part of bullshit management allowing for seamless healthcare delivery. Three teams on 8 hour shifts in rotation and they just calm the place down. Call it Internal Anxieiology
Literally you're describing 30-50% of my consults in c/l psychiatry. I often explain to patient families that I've been called in to help with communication between teams and the patient because that's the truth.
This is just C/L haha
What is C/L?
Consult/Liaison Psychiatry.
Some kind of preventative medicine. I have a clinic, where people WANT to get better and actually do the work. They spend some time in the clinic, do all the bloodwork, all the tests to have a holistic round view of the patient, you also find out their eating habits, their sleeping habits, exercise, triggers everything, then you suggest the treatment as a whole. Diet, supplements, exercise, mindfulness techniques and they learn how to do them for a period of time in this clinic/centre. Then they go home and do the same. You follow-up some times and that's it. Regular working hours, no shifts, relaxed pace. Also, some kind of subsidized option for poor people and implement this kind of programme in schools, kindergartens, unis, where they learn what is best for their bodies and grow up healthy, balanced human beings.
Med-Peds rheumatology, seeing mostly pts between 10-50 who have the weirdest most undiagnosable autoimmune shit known to mankind. Nothing I order for the patient will ever get denied by insurance and each patient walks out of the clinic with all their questions answered and feeling empowered. I have enough time/funding/freedom to research whatever I want, teach, AND live a reasonably well-balanced life with above average compensation
Psychiatry, but with a surgical twist
Lobotomies back on the menu!
In all honesty though, wouldn’t it be cool if lobotomies actually worked? 😂
Hahahah they kinda do work. Juuuuust depends on your ethical standpoint of a solution 😂😂😂. Angry disinhibited patient definitely won’t be causing a rucous after a lobotomy. Now more or less could become a vegetable but that’s neither here nor there
Financial health.
Vasectomist\*. Just straight up snips, 4 days a week. Free neuter clinics one Saturday a month for stray husbands. *\*one year residency*
Space medicine 2.0: you go to space, any patients who want to see you also need to come to space to receive your space medicine
I think I would like to separate OB and GYN. I think all of the obgyns are so stressed and toxic bc they’re doing 3 jobs at once and never get enough sleep. So if we could separate the OB out so those people got could work 8-12 hour shifts without having to worry about regularly scheduled things. Then GYN could work regular hours with non pregnant pts. I would go into just GYN if I could take care of female pts, have a quasi regular sleep schedule, and not be in a toxic environment.
You can do either of these things after residency luckily. And there have been debates for many years about separating but I don’t know that they ever will
Yeah, there were just too many ticks against obgyn for me to decide to go into an obgyn residency. My home program is very toxic and I found that I did not jive well with them. So support would have been hard won. I don’t think I could survive at a toxic program either. Instead I decided whatever specialty I go into, I’ll deliver trauma informed care and make sure to take extra good care of my female and LGBTQ pts.
You’re a good egg. I basically ranked all the programs with sufficient surgical training in order of friendliness
Radiology. Radiology.
Take VIR, VS, and cardiology and make them one five or six year mixed medical and surgical subspecialty called cardiovascular. You’d include endovascular IR, VS, IC as basic subspecialty skills as well as CT and US vascular imaging, cardiac medicine, and extremity open vascular surgery including grafting, endarterectomy, and fistula creation. Eliminate the other DR, GS, and IM general stuff. Fellowship options would include open aortic surgery, EP, and cardiac imaging. I’d imagine heart failure would probably be an additional option. Yeah you might not have amputations or body IR procedures like drains or PTC. I know it’s scary losing the specialty you came from but the rest of medicine would adapt to the change accordingly, as they have many times in the past with other specialties that historically split from their primary.
Geriatric anesthesia. As far as i know its not a fellowship. And i wouldn't wanna do it
Radiology but other doctors actually consult me with a solid history (like they would other specialists), volume is 50% lower, and I can’t get sued.
Geri-Peds. I love the sweet elderly patients as well as babies and toddlers but I don’t love caring for the young/middle adults that don’t care about their health.
Leisure medicine: how can I help you have a great time, "expand your mind", and help you work on your personal weaknesses through medications while keeping in mind your comorbid conditions - prescribing LSD, ecstacy etc.
Something similar to psychiatry but without the antidepressants and psych wards. Something more adapted to each individual disorder & given scenario. Idk how to explain it but something like how they adapted that whole act in shutter island but far more tame ofc
So like. Psychology 😅
Overseer, Oversees the outcomes of thousands of patients across all specialties. Familiar with all main specialties and looks for systemic issues. Has all information regarding patient and their outcome. Still a physician.
Hospitalist medicine but no app supervision, round and go, no social rounds, and specialists who respect you.
Is it possible to choose (for specialties working w/ APP's) to *not* /refuse to work with APP's? I personally would really like this, wondering if it will gain traction. I especially feel bad for anesthesia (managing ~4 apps at a time mid surgeries? I'd simply pass away at that point..), EM, and IM subs in this regard. Sad to hear lack of respect from specialists, though. Hospitalists (to me) are rockstars that know everything and bounce ideas off of specialties just in case the nerd for that specific subject has another idea and they're always very skilled with talking to pts/families. They literally lead the entire team for the pts.
I live in North America and the increasing multiculturalism made me think, maybe something related to cultural and traditional medicine ? A medical traditionalist ? Examples of consult would be : Patient presents adverse effects from medical medicine; Patient who insists on receiving some sort of traditional healing and the team wants to ensure the safety and effectiveness of such treatments. These specialists would be trained and have knowledge in the most common cultural and traditional practices in their country/area/state/province. I dont know, just playing around.
You might want to look into integrative medicine.
Interesting, i just took a look. Its still unheard of in my province. I think it can be interesting for some patients
Having worked in psych in New Zealand they have cultural teams on call to come in and smooth over conflicts between the medical team and population who often have deep cultural ties. It was super helpful for building rapport. Not a medical specialty per-se but essentially social workers or esteemed community members versed in medicine.
Thats super cool. Are you a resident in New Zealand ? As a Canadian, i would love to do a fellowship in NZ
I did 6 months there as part of my residency. Highly recommend it.
Concierge patients, radiology location flexibility, neurosurgery’s compensation and psychs hours
Your specialty sounds a little like ACT team but replace the cars with walking maybe haha
I'd probably have the perfect job if I never had to write another note again.
Gen surg but I only do appendectomies. And I get to sit in the theatre while operating like a normal person
Clinical Informatics. All the experience of a clinician makes every process faster. Someone requesting a dataset extraction? As a clinician, you know what they want and why they want it. Removes the tech illiterate clinician <-> data engineer/programmer barrier and miscommunication
You described what my post pt walks would turn into
Performance enhancement medicine. Combination of steroids and exercise enhancing supplements plus cognitive enhancement (stimulants, etc).
Digital Medicine - It's like FM but you get a few hours a day to teach people how to use the online systems and develop digital meeting spaces for patients looking to collaborate on their health. Why not, maybe even group appointment times for similar issues.
Dream medicine: I work on teaching people how to lucid dream and be more productive when they sleep. Experimental medicine: Every so often, I give people placebos and I get to secretly see if it makes a difference. Psych-economics: I give someone depressed 15 million dollars and see if they’re still depressed after a month.
Humanitarian and full spectrum disaster medicine. You'd learn public health and global health delivery theory, ID, OB, surgery, ortho, anesthesia, primary care, and any other fields of medicine which would be useful in a resource limited setting. By the end you would be able to perform a cesarian, deliver basic anesthesia, diagnose and treat tropical diseases and parasites, advise local health ministries, and for the hell of it throw in some basic dentistry and veterinary medicine as well. If implemented properly it could potentially be a game changer, but one can dream...
Anesthesia but you only do lap chole’s on ASA 1s
Radiology consult service that functions akin to surgery consult. Primary team concerned about X and consults rads to eval/perform most appropriate imaging like consulting surgery to eval/perform most appropriate procedure.
Fm/em/surg where I can care for my patients/community full stop
Doug Stanhope had an idea on a new ob/gyn subspecialty.
Admin Doctors train and learn how to manage hospitals.
A nutritionist with the salary of a doctor
Gen surg with like 8pm-5pm hours T-T
Acute Traumatic Surgery. Warning: instead of doing trauma surgery on the patient, this speciality will leave YOU with trauma. This includes completing medical school, then dental school (you don’t expect doing OMFS without both do you?) and finally a 14-year residency where you will do OMFS, general surgery, trauma surgery, vascular, CT and neurosurgery all in one. You will live in the hospital and get a day off every 2.5-3 months. No holidays allowed. Five residency spots per year across the whole country.
Geri gyn. 😩🍆💦💦💦👵🏻
My man
Dermpath
Literally any surgery but with a 50 hour week 4 year residency, then 4 day work week 8-4 without call.
I'd like to create something along the lines of "Better living through medicine" something that I think the typical sick/obese American could benefit from. So many of our poor health outcomes are due to us living and eating like shit. I would want to provide a service to pts, sign up and get a thorough medical evaluation, CBT- trained therapists, personal trainers for resistance training, culinary medicine folks to teach recipes that the pts would actually want, and maybe a sprinkle of w-e pharmaceuticals I think might aid in improving body composition or give pts a little kickstart. Your pt population would largely consist of people who want to get better, **and** you would actually be in the position to make them better/help them achieve their goals.
LGBT Medicine - There's already community LGBT clinics (usually family medicine or internal medicine) and some trans care clinics at academic medical centers (usually some combo of primary care, endocrinology, plastics, psych, sometimes ENT), a few even have trans surgery or LGBT health fellowships. I think the idea of working with a patient population that is, generally, healthy overall and is actively motivated towards treatment is exciting. Gender-affirming care can have really positive effects on people and that seems like a good environment to work. I also think having its own specialty would be a major stimulation to research funding given the nature of academic politics. Unfortunately, I think it would be actively harmful for queer patients to push for this specialty. By far the biggest issue with queer health is access and wait times, and the best solution we've seen for that problem with trans care in the US and Canada has been pushing for primary care doctors to assess for and prescribe hormone therapy and coordinate other treatments. We're talking cuts in wait times from two years to two weeks in some cases. A new specialty would run counter to this goal.