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The Big Question: What Specialty Should I Choose?

Created 03.14.13 by Anita Taylor
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It is Match Week and Jennie, a third year medical student, is starting to panic. She has talked to many of the fourth years as they chose where to apply for residency, went on interviews and decided how to rank the programs. They all seemed to be so sure of their specialties.

Jennie, however, is not at all sure. Pediatrics, psychiatry, and family medicine all seem intriguing. But, how to make a decision? She is worried that she won’t select the specialty that will be satisfying for her.

Indecision about one’s specialty choice occurs in all years of medical school. In fact, of the approximately 38,000 applicants eagerly awaiting the outcome of this week’s National Resident Matching Program I believe that some are still asking themselves,  “Did I select the right specialty? What could I have done to confirm that this is the right lifetime career choice for me?”

First of all, let me assure the readers that medicine is the only profession that has a niche appealing to every personality type. There is more variety in clinical skills and settings than in any other type of work activity.  You can work in a hospital, medical office, or laboratory. You can be the physician for a sports team, on a cruise ship, or in a nursing home. You can do research or administrative activities in any medical specialty. You can serve as a physician in an urban, suburban or rural geographic location in the United States or internationally.

In addition, there is not just “one perfect” specialty for each person. You can be satisfied in more than one of the specialties that share commonalities. Examples of some of these clusters of specialties are:

  1. Primary care specialties with first-contact, long-term relationships with patients requiring coordination of services (family medicine, general pediatrics and general internal medicine)
  2. Surgical specialties with hands-on, immediate gratification (all surgeries, gastroenterology, invasive cardiology, obstetrics and gynecology)
  3. Consultant specialties with use of technology (nuclear medicine, radiation oncology) or little or no direct patient care responsibilities (pathology, preventive medicine, radiology)

Physicians with skills and interest in each of these clusters often share values and similar personalities. There is a reason for medical stereotypes such as the “kind family doctor,” the “decisive surgeon,” and “the detail-oriented pathologist.”

Even before you are accepted to medical school, it would be helpful to spend some time in figuring out the answer to the question, “Who are you?” One good way to do this is to analyze how you spend your time and energy–educational majors, work and volunteer activities, organizational involvement, and recreational pursuits. The satisfaction (or dissatisfaction) you experienced with these decisions may have implications for your medical specialty choice.  Knowing yourself will also make you a better candidate for acceptance to medical school.

As you begin medical school, I suggest three specific activities:

  1. Use self-assessment resources (such as the SDN specialty selector) to test and analyze your initial specialty interests.
  2. Observe physicians in clinical settings and analyze your comfort in these settings.
  3. Learn about various specialties through resources (books, specialty organization websites, and journals) and by attending departmental grand rounds and student specialty organizational meetings.

There may be fleeting flirtations with a variety of specialties, but you will start medical school with core values and lifestyle preferences that, I have found, tend to remain stable four years later.  By knowing yourself and using available resources, you can decrease the amount of uncertainty and stress associated with choosing a medical specialty.

About the Author

Anita D. Taylor, M.A. Ed. is Associate Professor Emeritus of Family Medicine and formerly Assistant Dean for Student Development at the Oregon Health & Science University School of Medicine, Portland, Oregon. She is the author of How to Choose a Medical Specialty, Fifth Edition.

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  1. Keep It Real says:

    It all depends on:
    1. What’s your Step 1?
    2. How much money do you want to make?
    3. Do you have any hook-up in a program?

  2. big blue says:

    Find out which specialty pays the most..then go for that. Also include lifestyle. Life aint worth working 120 hours a week for 110K. Ask my bro..He does primary care. Hates it.. Works his ass off. If you calculate his hourly wage it works out to a 60K a year job. Its just he works twice the hours so he gets twice the money…Wished he had done derm or rads instead…

    1. thehoneybadger says:

      Is your brother working in the United States? No matter what region you work in as a licensed primary care physician, you should not be making 110k for a 120 hour week. If your brother does work 120 hours a week as a licensed primary care physician in any region in the United States he should be making at least 200k+ if not much more. I see offers in many big cities and small towns that offer 170k starting salary + full benefits (insurance, malpractice, CME, retirement, student loan repayment, etc.) to freshly graduated residents. These jobs have an average of 50-60 hour work weeks.

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