Choosing a medical specialty:
How to Pick a Medical
Specialty.
Advice for Medical
Students.
Choosing a medical specialty is a big decision. It will be
fun to see what people think. But the decision making process is famously
difficult and many different strategies have been devised to help the
indecisive.
It’s a tough process, full of uncertainty and soul-searching
and fears about locking into the wrong option.
It can be overwhelming. The choices are practically endless.
And there’s not all that much guidance out there to tell you how to narrow down
your options for the best possible outcome for YOU.
So here are a few things we tell all students to keep in
mind when they’re doing their rotations, and so far they seem to think it’s
helpful.
The best choice of medical specialty will be something you
enjoy AND something you are good at:
Most people drop out the second condition. But think hard
about this: If you pick something you enjoy but that you are no good at, it
will be a disservice to your patients. If you pick something you’re good at but
that you don’t enjoy, it will be a disservice to you. Look for something that
will satisfy BOTH conditions, and you’ll be set.
Pay attention to what you DON’T want to do:
If you hate Pediatrics or you couldn’t stand General
Surgery, THAT’S A GOOD THING! Negative experiences provide you with good, solid
information about the kinds of work you want to avoid, and why. It’s especially
helpful if you’re overwhelmed with the typical too-many-options brainfreeze.
Discarding the rotations you hate will cut out some of the noise from the data,
and then it may be easier to see your eventual specialty stand out from the
fewer options that are left.
It’s okay to take lifestyle into account:
As a matter of fact, you should. You want nights and
weekends to yourself? Go into Dermatology. You want a lot of money? Look at some
of the surgical sub-specialties like Plastics. You’re all right with staying at
work late to stabilize a patient? Think about something like Internal Medicine.
Want shift work with solid start and finish times? How about Emergency
Medicine? Take your personal preferences into account when picking what to do,
because if you pick a lifestyle that won’t work for you, you’ll burn out.
Confusion is a GOOD thing, even if it’s getting close to the
time where you have to commit yourself to an option!
How can we possibly say that? What if the deadline for
applications is right around the corner, and you STILL don’t know what you’re
going to pick? Think about it this way. If you hated OB/GYN, that’s not going
to be an uncertain thing; you will feel no confusion about it. Confusion means
you have a bunch of options to pick from, and YOU THINK THEY’RE EQUALLY GOOD.
That takes the pressure off, because no matter which one you pick, you’ll be
satisfied with the result. (Unless you didn’t like any of them at all, in which
case you may have a considerable amount of soul-searching left to do.) Don’t
get scared if you’re still confused; you’ll land on your feet somewhere, and
someday you’ll look back and realize that you made the right choice. No matter
which one you pick.
Pick for yourself:
You don’t care if your father wants you to be an orthopedic
surgeon. you don’t care if your mother has been grooming you your entire life
to take over her Neurology practice. This is your life and you have to be
satisfied with your job.
Pick for your community:
As a doctor you have a responsibility to serve society. Pick
something that’s needed, something that will contribute a valuable service to
the community you live in.
Pick for the future:
Specialties are not static. While you’re always going to need
generalists, it’s important to realize that there are a lot of forces pushing
and pulling at the medical specialties. Some specialties have only a limited
pool of patients, but a lot of doctors who want to go into that field. You may
graduate med school to find that your chosen specialty has a LOT of
competition, both for residency positions and eventually even for patients.
Family Practice doctors are in trouble these days due to the pressures of
reimbursement patterns and the advent of physicians’ assistants and nurse
practitioners who can provide similar services but aren’t paid as much. As the
space program shuts down, Aerospace Medicine is probably going to focus more
and more on airline pilots and suchlike.
It’s important to recognize where your
chosen specialty fits into the grand pattern of things. It’s important to look
to the future. So keep your eyes and ears open. Read the news and keep up on
health policy trends. Listen to what people say about their doctors. Watch how
different kinds of doctors are portrayed on TV and in movies. Use every
resource at your disposal to try and predict what will happen five, ten, or
twenty years from now. Plan ahead; this will be your specialty for life. And
it’s easier to roll with the punches if you know what direction they’re coming
from.
When in doubt, leave your options as open as possible:
What if the application deadline is RIGHT NOW, and you still
have no clue what you want to do? PANIC! PANIC! No, actually…please don’t.
Okay, it’s a tough place to be. At this point, you’re going to want to pick
something that gives you the most flexibility. Internal Medicine and General
Surgery can be good options. They both have tons of sub-specialties that you
can sample throughout residency, and either one of them will allow you to
fine-tune a career for yourself out of the available options.
Best of luck!
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