 When you go into the medical journey, you go on with both the excitement of one day of being able to take care of patients, but also with anxiety of not knowing exactly what kind of doctor you plan on being. With so many choices and specialties, the options seem endless. But with medical school in the US only being four years, the time to explore them all and decide your ultimate career is pretty stressful. So in today's episode, I thought I'd break down every specialty I considered on my medical journey and there was a lot. I counted 12 changes at least, including one I only considered for three days. Let's break them all down. Hey friends, welcome back to the channel. In case you're new here, my name is Laksh. I'm a licensed internal medicine physician and now full-time cardiology fellow still to get used to saying that. Here at the MD journey, we make content to help people like you succeed on your medical journey but doing it with less stress. Now today, I thought it'd be helpful to literally break down every specialty I considered on my medical journey, why I chose to pursue them initially, some of the reasons that I chose to go away from them, ultimately leading me to the path of cardiology, which is where I am today. And I share this list and this journey with you for two reasons. One, I want you to have some comfort of knowing that it's okay to not know exactly what kind of doctor you want to be. The journey is long, so especially if you're new into your medical journey, you're early on in medical school, you will see from my list that it is okay to go through a lot of different options. And the number two is to remind you that you have permission of bouncing from choice to choice. As you'll see initially, I felt very pigeonholed from a few specialties based off of the experiences I already had, but because I was able to divert from them, I ultimately found the field that I know is perfect for me. So let's break down all the specialties along the way that I considered to now just being two and a half years from being a fully independent cardiologist. Now the first field I considered along the journey was the field of pediatrics. Now when I went to graduate in college, I finished one year early, so I've had a gap year between starting medical school and graduating college. And so the first job that I ever had that was a full-time job was working as a behavioral ABA therapist with autistic children. I worked with them one on one. And I thought that this job was a reflection of what kind of doctor I would be, which was pediatrics. I loved working with kids. Usually kids don't have diseases and diagnoses that they're at fault for. It's just bad genetics or just bad luck. And so it's easier to go to work and take care of them. It's also very motivating to see them get better. And so I remember specifically both my personal statement into medical school as well as those interviews. I talked about pediatrics a lot, using that job as an experience, and I thought this is ultimately what I would do. And the field of pediatrics really didn't fade away as an option until I started my rotations as a 30-year medical student, where I realized that one taking care of kids is tough because communication with them can vary when you're taking care of a baby all the way to a toddler. Then two, you're often dealing with both the parents and the patient. And as being a new dad myself, I know parents can be a lot. So I ultimately decided I just wanted to focus on adults, definitely more so than kids in terms of my medical career. Now specialty number two, and I feel like every dude who is interested in sports definitely considers this as the field of orthopedic surgery. I think there's definitely a glamour and a cold persona that comes with orthopedic surgery because there's often an association with sports injuries. And so if you're somebody like me who's interested in sports like basketball or football, being a doctor that takes care of those injuries and works with us, the athlete seems like a perfect combination. And so the field of orthopedic surgery was something I definitely considered during my first semester of medical school, only lasted about two or three months because I quickly realized being in the OR was not something for me, which gets me into specialty number three, knowing that yes, I didn't like the OR, but I still like sports injuries and ideally working with sports athletes. Maybe I could do something in sports medicine. I learned in medical school about the field of sports medicine after going through a residency in family medicine. So I had to go through three years of family medicine and then doing a one year fellowship in sports medicine. So for me, this initially seemed like a much better fit compared to the field of orthopedic surgery, especially because I didn't like the OR. And so while initially a family medicine with sports medicine focus seemed like a much better option for me compared to orthopedic surgery, quickly realized I didn't want to go through three years of family medicine training and have that constantly be part of what I did. Family medicine doctors are often trained on how to work with OB patients, didn't really want to do that, work with pediatrics and newborns. Again, we talked about that, didn't want to deal with the patients and the newborns, wanted to specifically work with adults. And so I didn't want to have a good part of my training focusing on both. And so I knew probably wasn't going to go down the family medicine route. Great option for others, not for me. And so that ultimately led me into a specialty I never knew existed until I started medical school. Specialty number four was the field of PM&R. This is the field of physical medicine and rehabilitation. As the name suggests, these are doctors who are experts that combining both knowledge and musculoskeletal and neurologic diseases and injuries and combining them to help their patients. And as you can imagine as a PM&R doctor, there's definitely the options for you to work with sports related injuries and athletes using your PM&R knowledge. And so during my first and second year of medical school, this seemed like a great option for me. Definitely feel like a hidden gem in medicine because a lot of people will tell you that PM&R docs have a great job satisfaction. They enjoy what they do, they make good salary. They also have a relatively good lifestyle because it's very clinic based, Monday to Fridays, depending on the practice you're working with. It seemed like a great option for me for my long term career. Now the reason that I ultimately diverted away from PM&R is that I understood that in addition to working with some of those patients that I wanted to, a lot of PM&R work is also involved in terms of taking care of patients with really traumatic injuries or conditions. Maybe you have somebody who's had a traumatic accident and they have a bad spinal cord injury and your job as a PM&R doc is also working with all the deficits that they have from this permanent injury, somebody who's quadriplegic or paraplegic. I knew that that wasn't actually the patient population that I would be motivated or satisfied of taking care of. Again, PM&R docs do great jobs and great work, taking care of these patients based on my personalities and the things that I wanted to be involved in. I knew that that part wasn't something that I would honestly be able to go to work saying, I love doing this. So now we get into my second year of medical school and I realized that all of the options I initially considered, maybe pediatrics is still there in the background, I haven't fully convinced that this is for me and so I definitely made a shift in terms of going from that sports medicine do that like sports to what other things are out there that I would really enjoy doing and I realized that there was a really cool field out there and this comes to specialty number five or six at this point, the field of radiation oncology. Now this was something I really considered in medical school probably for another year and a half. I really thought it was what I was going to do. I saw the opportunity of being a physician who could definitely take care of oncologic diseases, taking care of patients with cancer, being present for them, being able to create that rapport of taking care of them with a very detrimental disease and then combining it with really cool technology and radiation therapy and treating patients differently than chemotherapy. There was definitely a niche, it was something that still wasn't heard of enough, it was competitive, the patients did really well depending on type of radiations and diseases you were treating, it had a great lifestyle, it was definitely much more clinic based, less call, so it fit that lifestyle bucket that I needed for my future, for my family, hit that salary bucket and it definitely hit that clinical check mark where I really felt like I could enjoy taking care of the patients involved in radiation oncology. I enjoyed this field so much I did research after research paper after paper to the point where people look at my resume asking why I didn't go into radiation oncology and the main reason was that I ultimately diverted and looked elsewhere is location. For me, being close to family, both my wife and I, and coming back to the city that we are from which is Austin, Texas, I knew that radiation oncology definitely in terms of matching into residency and maybe as a future career, the job market is very minimal compared to, let's just say, if you're going into family medicine or internal medicine and so I knew that geographically it wouldn't be the most friendly in terms of job opportunities. Maybe I was wrong but that was the biggest deterrent for me to say man, I would really hate to move my wife and my family here away from the rest of our family just because the job that I love can't be found in the city that I'm from. And so ultimately I said what other options are there for me where I can find that job and geographic flexibility with the job that I also enjoy. And so this finally gets me to the sixth rotation that I ever considered which is the field of oncology. This is probably around the time that I'm about to start my third year medical school. This is where you do your rotations on every single specialty in medical school and this is the first time I honestly considered internal medicine. People told me your personality likely is going to be internal medicine doctor and I just kind of brushed it off like I'll be a pediatric doctor, I'll be a radiation oncologist. Internal medicine is probably not for me. Ultimately I ended up being an internal medicine doctor spoiler alert but this was probably the first time where I said I enjoy working with adults. Here is a pathology or a group of pathologies and cancer that I could see myself taking care of and the rest of medicine also interests me enough where I could see myself doing an internal medicine residency which is a big factor. You want to go through three years of training on something might as well enjoy most of it and I could see myself doing an oncology fellowship and so I definitely highly consider the field of oncology. A lot of my research that transitioned from radiation oncology easily went into just doing research in general on medical oncology and so I definitely gave the field of both internal medicine as well as oncology a serious chance and a lot of attention because it was very easy for me to use all that research all the hard work I did from radiation oncology and saying this kind of applies if I was applying to medicine residency to become an oncologist in the future and ultimately why I stuck with internal medicine the biggest thing that kept me away from oncology was the idea that there's a lot in terms of data that just wasn't interesting. I didn't want to keep reading studies on chemotherapy trials and how different kind of regimens of medications that I didn't really understand at that time were going to impact my patients. I felt like almost like a chemist and combining those to deal with diseases and it just didn't feel satisfying. I couldn't put 2 plus 2 equals 4 in terms of taking care of those patients. It was kind of like I hope this helps this based off the data and there's so much data and studies in the field in oncology as a medical student it was definitely overwhelming. It at least gave me enough permission to balance to other options both in internal medicine as well as out. To speaking of having that permission of jumping away from oncology specialty number seven that I considered for a little bit of time was the field of interventional radiology. Now I say this shamelessly is that it is okay to consider fields where you ask yourself how much money will I make and how happy will I be? How intriguing is the job and will the lifestyle be good? The field of IR seemed like a perfect fit for that. You get to do some really cool procedures, take care of some patients, have a high job necessity. There's always kind of a need for IR at OX because you do some cool procedures. You can put in tubes and where people can't see them. You can put in lines. You can do biopsies that other people can't as well as other things that I'm not well equipped to talk about with IR at us. But at that time it seemed like a pretty badass job and I knew that they made a good salary. There was definitely a high job market. Flexibility geographically was there so I considered it. But ultimately I was honest with myself and said shamelessly all those things that I talked about I didn't want to be the main focus on the career that I chose. It wasn't about the salary. It wasn't about the job flexibility. It wasn't about the lifestyle. I want to make sure I actually enjoyed coming to work and doing those procedures and again I wasn't a big procedural list and so that would have not fit my personality. And two coming back to the training flexibility I wanted to make sure that I could train in the cities that I wanted to that'd be keeping me close to my family. And I are super competitive. There was a good chance I would likely have to move across country or different places. I wasn't the most competitive IR applicant because I was considering it relatively late and so that definitely diverted me away from IR. And so now we seriously come back to the field that I ultimately picked, which is number eight the field of internal medicine. Now we talked about this a little bit in oncology but the most important part of internal medicine that attracted me is that I could see myself being in front of these patients with these problems that I was dealing with on my rotations, whether it was something with their GI tract, something with their heart, something with their lungs, something with their kidneys, you name it and treating them, understanding exactly how my treatment was relating to the improvement or lack thereof and having that bit of ability of saying I understand how I'm helping you. Let me explain and educate you so you can understand this too. Especially in cardiology as we'll talk about the variant. I could see that connective here's where this patient is. Here is how my treatment is going to help them. Here is how I educate this patient on this gap so they can also be a surrogate and understanding of what care they're going to be provided so they can make sure that they get better. And so you think with all those things that I mentioned that my internal medicine rotation is a third-year medical student freaking rock like I loved it. We had eight weeks and that was true for half of it. The first four weeks was freaking awesome. This was the field that I was going to do. My resume was amazing. My attending was amazing. I was working at the VA population, which there's a lot of bread and butter medicine so I learned a lot, got to do a lot. In my second four weeks I really just deterred the field. I feel like it was much more academic. It was really busy. It didn't feel like I was getting attention from the team that I was working with. Thus I didn't feel as interested in the patients or medicine that I was learning. And so I ultimately left my internal medicine rotation very conflicted. The first half was amazing. The latter half I wasn't sure if it was the field for me. So I happened to just keep enough open mind which led me to a field that I considered just for three days, which is the field of emergency medicine. I thought I really, really thought going into my sub internship, which is my latter half of my third year medical school, going into my fourth year from applying to residency, that I was going to become an emergency medicine doctor. A medicine rotation already told me that I enjoy doing procedures. I enjoy diagnosing patients. I love looking at patterns in labs and treating patients and explaining and educating them. And I like fast-paced medicine. Emergency medicine seemed like a perfect fit. And so not only did I apply to do a sub internship, which is where you're acting like a resident on the emergency medicine rotation, which is part that is needed for emergency medicine. I applied for an away rotation, which we won't get to, but doing it at another university because I need another experience. Looking for letters during my last third year semester of medical school and three days in, I realized that one, I'm decently okay at emergency medicine. My resident thought so. But the stress of being an emergency medicine doctor, where you have patients with psychiatric illnesses, with trauma, with patients who are poor historians, basically people are coming at their sickest or at their most neediest. And you are not able to have the most streamlined form of communications. You have the least amount of information. You don't have the labs. You barely have the vitals. You may not have their meds. You may not have any history from the patient, depending on how confused or alert or oriented they are can lead to a lot of stress. And then combining that with the medical system, which is very broken of having nurses who are overworked of having doctors who have way more patients that they probably should be seeing, people can definitely show personalities that they normally probably wouldn't be proud of doing. And on my third day of my emergency medicine sub eye, I saw an attending who behaved in a way that I told myself I would never want to be put in that position to ever treat other people that way. Now full disclosure, I later worked with that same attending and she was a total sweetheart. But that just goes to show you that that amount of stress can take and transition somebody who's amazing to somebody who is probably not the most pleasant person. And I didn't want to be that and I didn't want to go into a work environment where I'd be subjected to becoming that. So that experience told me that I was not the right person to be an emergency medicine doctor, which is okay. I used that to cancel that away rotation that I had, and I went through the rest of that sub eye the rest of that month with the monkey off my shoulder and knowing that I'm going to become an internal medicine doctor of some kind. I'm going to apply to residency and thankfully I got into my number one spot. Now we're in the transition past medical school to where I'm in residency. I know I'm at least going to be some kind of internal medicine physician. I'm either going to be a generalist, or maybe I'll pick one of these specialties, these sub specialties and choose to do these the rest of my life. And so, although it was easier to make the choices, there are still choices left to be made. These are the first option and internal medicine that I considered was the field of endocrinology. Now one experience that I did for two summers in medical school was working with type one diabetic kids. And this was probably one of the coolest experiences that I did in medical school, which is two summers, I was a medical staff that dealt with all these kids with type one diabetes, managed their insulin, made those adjustments on a meal to meal basis. And I really felt for the first time that I had some control in terms of practicing medicine and seeing outcomes in terms of better sugar control for these patients. I absolutely loved the field of endocrinology, especially the field of diabetes. As somebody who comes from a South Asian descent, diabetes is definitely something that's unfortunately very prevalent. And so having that in my family and being able to think of a bit kind of cool of managing this kinds of diseases pretty well as an expert, as an endocrinologist who again, make a good salary, have a good lifestyle, and I could see myself enjoying what I could do and educating those patients on those diseases. It seemed like a very good fit. Now, ultimately, I chose to go away from endocrinology because while I checked off a majority of my boxes, it just wasn't fast paced enough for me. I could simply see myself enjoying managing diabetes or lipids on a day-to-day basis, but on every single day basis, I'd probably get bored of it. And so ultimately, it led me to having a question of making a decision between two fields. Do I go into the field of cardiology, or do I go into the field of just doing hospice and medicine as a hospice? So let's talk about becoming a cardiologist. Now I've made an entire episode of why ultimately chose to become a cardiologist, and so I'll link those down below if you guys are interested or considering the field for yourself. The field of cardiology I ultimately fell in love with as a fourth-year medical student. I chose to do my sub-internship in medicine just the same way I did in emergency medicine, but this time I chose to do it in the cardiology ICU. Thankfully, when you're in the cardiology ICU as a fourth-year medical student, very few people have expectations that you're going to really know anything. Cardiology is pretty advanced, especially when you get into the minutias. Being a medical student, your expectation is like, learn what you can, enjoy it. And so I took that opportunity to just learn as much as possible, and I freaking loved it because the education and training that I got on that rotation was probably the most amount of learning and the shortest amount of time that I ever had, and it definitely led me to an attraction because most importantly, I could say that makes sense, and I could see how I can use that to educate my patients so they can definitely take care of themselves better when they get discharged. And that was definitely a part of saying cardiology would definitely be a great field for me in the future. I was competitive enough, and everything else didn't seem attractive enough. Now my second year of residency, which is usually a time where you have to make a decision of are you going to apply for fellowship in the field of anything, in cardiology, in renal and GI, or are you going to apply for a job and become a hospitalist or a PCP? And when I was making that decision between hospitalist or cardiologist, I didn't really know. Being a hospitalist sounded pretty attractive. You worked seven days on, seven days off. Every other week was a vacation. You could go travel with your family. You made good income. You could see and deal with all kinds of medical problems. And again, you got a good lifestyle, so your family's definitely got to see you. And the field of cardiology, there's definitely an intellectual intrigue to it. It was difficult. There was a lot of learning involved. You made a good salary. Lifestyle probably not as great as being a hospitalist because you're always busy, so I didn't know what to do. And ultimately I said I will set myself up to applying to cardiology fellowship if I ever choose to do so. But if I'm not quite sure, let me just take a gap year where I work as a hospitalist and I can use that experience to direct me on whether I want to apply to fellowship or not. That's ultimately what I ended up doing. I graduated residency. I got a job in the city that we're from and it was amazing. It was great lifestyle, highest salary I've ever seen, especially because as a resident you barely make anything. And I did the job and it was actually not that bad. I actually enjoyed it. But I told myself, could I see myself doing this in 10, 12, 13 years? As a hospitalist, as I made videos about why I ultimately went away from being a hospitalist and to become a cardiologist, is that a lot of your job is focused on getting patients out in the hospital and out of the hospital. So if you take care of somebody, you want to make sure you get them home or to their next destination as quickly as possible. So discharge is really your main job as a hospitalist. Not that attractive when I'm 55 talking about Miss Smith needs to go to another SNF or rehab center. It gets boring after a while. And knowing that, I'm saying, well, I need to make sure that as a 29 year old, 28 year old, I'm setting myself for a career where I'm actually enjoying going to work every day, not only challenge but in treat. And so ultimately I made the decision to apply to cardiology fellowship and become a cardiologist. Thankfully that worked out. And I was able to match into the number one program that I, my wife and I hoped for. And now I'm about three or four months into my final specialty, which is the field of cardiology. And I absolutely love it. I can tell that there's so much to learn. I can tell that there is that education that I can give patients. I can feel that there is a sense of niche where I can create my expertise and have people ask me about what do you think about this EKG? What do you think about this echo? And how can you use it to help and improve patient care has been amazing. I'll definitely make an episode more about my updated thoughts on white cardiology. But I know after this long-winded way of those 12 or 13 specialty changes that I made, all of them pointed me to this direction where I realized I love working with patients. So I'm not going to be a radiologist. I'm not that big of doing procedures. So not interventional radiology or with the peak surgery. I love the education. I love the fast paced approach, but probably not something where it would make me pissed off at people like emergency medicine because there's a lot of stress in that field. And I found my favorite blend. I found my niche in the field of cardiology. And ideally, again, you can use this episode of understanding it is okay to bounce back and forth as long as you're using each and every specialty of saying, what did I like from this? What did I not like from this? And which specialty better blends the likes and the dislikes to where I just get most of bang for my buck. But hopefully this big timeline of my medical journey allows you to have that permission of saying it is okay to not know what you're doing and to bounce from thing to thing. As long as you're understanding this is what I got from this experience. And I'm going to use it to point me into another specialty, which is going to be a better fit. Promise you ultimately where you end up. If you use that approach, you'll likely will end up in the place that you ultimately belong to will be just fine. Now, if you found this episode helpful, this is literally the tip of iceberg in terms of all of the tips that we have to give you for your medical journey. If you click down below, you'll see a lot of our videos and definitely one of my favorite free resources is our med school success handbook. This is a document that I'm updating literally on a weekly basis with tips and strategies that I wish somebody had given to me on my first day of medical school, everything from here's how to study better, here's how to be more productive, here's how to be more motivated, pretty much everything that I wish somebody had given to me. And thus I'm giving to you and thousands of other students have already taken advantage of it. Again, it's absolutely free just to click down below to get access to it. If you want our more refined step-by-step strategies and just crushing it throughout your entire medical journey, then definitely check out our domination bundle as hundreds of students I've done before. That'll be linked down below. And then finally, if you're interested in working with myself and my team personally one-on-one to help you get those personal strategies on how to study better and more, and just want to see those type of results that we've managed to get our students over the past two years, that'll be linked down below. But as always, my friends, I make this content, we make this content to really just help illustrate that this journey is hard. It can be a little bit easier and hopefully the content that we make here helps elude and gives you some permission of going through those difficulties without the stress that comes with it. Let me know what questions you have in the comment section down below if you're watching on YouTube. And if you made it to the end of the episode, if you're watching on YouTube, hit that like button to show your support. If you're listening to that on this podcast, hit that subscribe or follow on whatever platform you're listening to. If you enjoy this episode and you'll enjoy this episode, some most popular one that we have on how to use Anki like an absolute pro, as well as this one right here on all of the strategies that I use to get a 3.9 GPA in medical school, enjoy these. And as always, hopefully I was a little help to you guys on your journey. Thank you as always for being a part of mine. I'll catch you guys in the next one. Peace.