brent schnipke

Applying for Residency

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Last month I wrote about the early part of 4th year as a kind of second-look for medical students – an occasion for confirming specialty choice, or perhaps changing one’s mind altogether. For me, it has been an enjoyable and enlightening process to revisit the specialties I was most interested in and examine them more thoroughly, paying attention to finer details as I considered what a career in that specialty would entail beyond the years of residency. The specialty decision is often made on just a few weeks of exposure and may be highly influenced by observing residents, but it is important to remember that residency is relatively brief in the context of a career, and thus it is imperative to get opinions on the field of choice from practicing attending physicians. I have been grateful for opportunities to do just this; rotating through a field a second or third time has enabled me to make this aspect more of a priority.

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How To Choose A Medical Specialty: A Book Review

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By Brent Schnipke

Central to the skillset of every physician is the differential diagnosis; this is the process by which new patients are evaluated to establish the most likely diagnosis. Similarly, the first clinical year of medical school is like a differential for each student, except instead of a medical diagnosis, students are seeking to determine which specialty they will choose. This column explores this differential: experiences from each rotation by a current third year student.

Note to reader: This month’s post is going to be a little different than previous articles, as I will be offering my book review of How to Choose a Medical Specialty. I’m currently on my Surgery clerkship, and will be writing about this clerkship in December’s post, so stay tuned!

In addition to providing snapshots of my clerkship experiences and a summary of each specialty rotation, this column is also about the process of choosing a medical specialty. After all, this is a major component of the third year of medical school for many students. Although learning the fundamentals of each specialty is essential, the exploration of different paths with the intention to eventually choose one is centrally important for third-year students. The first two years of medical school are generally pre-clinical (mostly classroom work), and applications for residency spots are submitted early in fourth year; therefore, third year is the main opportunity for students to explore fields that might be interesting to them, and to get exposure to many fields. This is the idea behind the title of this column, and one of my purposes in writing it has been to explore this dynamic and to share with other students some of my observations about each specialty, which may help some to make their own choice.

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Pediatrics In Review: A Look at Clerkship #2

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Central to the skillset of every physician is the differential diagnosis; this is the process by which new patients are evaluated to establish the most likely diagnosis. Similarly, the first clinical year of medical school is like a differential for each student, except instead of a medical diagnosis, students are seeking to determine which specialty they will choose. This column explores this differential: experiences from each rotation by a current third year student.
In my first rotation, Women’s Health, I wrote about the humbling experience of helping with the birth of a child. This miracle of life is what attracts many people to the field of obstetrics, but working directly with the baby during the newborn period and throughout his/her childhood is, of course, the role of the pediatrician. As I’ve heard many times on this clerkship, “children are not simply small adults,” and understanding human development, the unique diseases of childhood, and the specific needs of young humans is often complex. For this reason, pediatrics is one of the oldest medical specialties, and remains the third largest by volume in the United States.[1]

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Column Intro: The Third Year Differential

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Central to the skillset of every physician is the differential diagnosis. This is a list of possible diagnoses that helps guide clinical decision-making. By asking specific questions, performing a focused physical exam, and ordering lab tests, all through the lens of the differential, physicians are able to rule in or rule out each item on the list. The differential is not fixed, however; it is a fluid list that can be rearranged or completely changed at any time given new information. This information often comes in the form of an extra piece of history from the patient, a new finding from an imaging study, or frequently, from several lab tests coming back negative.

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