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How to choose a specialty

Choosing a specialty can be exciting yet terrifying!

What if we like all of our rotations equally?

What if we aren’t passionate about any specialty in particular?

What if we are thrown for a loop and change specialty interests at the last minute?

How am I supposed to know what I will enjoy doing for the rest of my career?!

All of these are valid questions! But let’s take a step back.

First of all, there’s no universal blueprint for choosing which specialty in medicine you want to pursue. There are so many factors that affect our decisions including personality, skillset, interests, lifestyle goals, exposure, and career aspirations.

Many of us enter medical school thinking we have it all figured out. You may have a friend who’s known from birth that she was going to be a cardiologist, a classmate whose first year anatomy skills seal his fate as a surgeon, or an acquaintance who thrives under pressure and loves the fast pace of the ER.

Although it’s important to keep your initial interests in mind, don’t limit yourself and cut yourself off from potential opportunities. There are so many specialties and subspecialties in medicine that many of us have not even explored.

When making this decision, a great place to start is to decide: surgery or not? It can be even more complicated than this because many non-surgical specialties have opportunities for smaller-scale procedures, but answering this important question first should be the first step. How do you perform under pressure? Do you enjoy working with your hands and have the potential to learn surgical skills? Do you find yourself wanting to fix a concrete problem quickly and move on or methodically think through diagnoses and have longevity of care with patients?

Once you have your answer to “surgery or not?” move to the next step. Which of your rotations did you enjoy the most? Did you find stabilizing patients and rapidly diagnosing patients in the ER exciting? Did you find yourself more drawn to the pediatric population than the adult? Did you enjoy being the first to make a definitive diagnosis by interpreting imaging and influencing further management in the radiology reading room? Were you enamored with the wide possibilities of internal medicine or even find one of its subspecialties interesting? Did you find yourself passionate about the female population and love the feeling of delivering babies? Did you enjoy clinic or prefer more specialized medicine like dermatology or neurology?

There is so much opportunity here! This process will take a significant amount of introspection but you will learn so much about yourself and your interests. And let yourself change your mind if you find something that fits your interests more!

Though there is not a one size fits all solution for choosing a specialty, we can provide some advice for creating opportunities for yourself and making sure you have as much information to work with as possible.

As we mentioned in our previous posts, shadowing in first and second year will expose you to so many specialties! Don’t be afraid to email residents, fellows, or attendings for shadowing opportunities. If you’ve joined any specialty interest groups, they may be able to help you out with shadowing as well! Spending a few hours a month shadowing in different specialties is an excellent way to explore your interests. Additionally, if your medical school gives you opportunities for summer clinical preceptorships, we would highly recommend participating in these (more on preceptorships and shadowing in our post “Planning for residency as an MS1 & MS2”). The AAMC also has some helpful specialty quizzes that we recommend taking multiple times throughout your years in medical school. The AAMC Careers in Medicine site is a great resource with many different ways to explore specialties.

Try not to feel overwhelmed! There are so many amazing specialties in medicine and we are confident that you will find your passion. Always feel free to reach out to mentors, friends, and colleagues for advice.

Don't forget to check out our post “Planning for residency as an MS1 & MS2” to see what you can do in your early years to ensure that you have your choice even when it comes to competitive specialties!

You can do it!


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