How to Pick a Specialty as a Med Student

Choosing a medical speciality is the next step after med school. Here are many factors to consider when picking your medical speciality.

So you’ve studied ALL the systems, learned ALL the physical exams (even the neuro one!), and the moment has arrived: it’s time to pick a medical specialty and apply to residency. This decision creeps up MUCH faster than most people expect, so here are some questions to keep in mind during your first couple years of med school to help you choose that perfect specialty when the time comes. 


Go with your gut!

the-big-punch-figureWhen the first ember of becoming a physician began to glow all those years ago, you probably had a couple specialties in mind. Maybe a psychology class during undergrad piqued your interest, and you’re thinking about psychiatry. Maybe you’ve always loved working with your hands, so you have a hunch you’d like surgery. Whatever these feelings may be, listen to them! When you hear that a professor is a physical medicine and rehabilitation doctor, does that make you want to run up to them and talk about all the great exercises a recovering stroke patient can do? We recommend following up with any and all people who are involved in fields you have a remote interest in, especially early on in your tenure as a medical student. Now’s the time to learn, so go for it!

That being said, sometimes our guts are confused and the message isn’t so clear…what to do then?


Go beyond your gut!

Whether or not you have a gut feeling about what medical specialties may interest you, go beyond your gut! Medicine is a wild world with many nooks and crannies, so there are   medical specialities out there that you’ve most likely never heard of. Did you know you can 

specialize in fetal surgery?! As in, operating on a fetus while IN UTERO??? Yeah, that’s a thing. Also, sometimes you don’t realize you’ll like something until you experience it firsthand. Your trusty blogger here had written off radiology until she shadowed a radiologist and realized that looking at films was kinda like a giant game of I Spy! Rarely in your life will you have access to SO many opportunities. The variation is truly mind boggling, so take a chance! 


Do you enjoy the pathology?

small kid with tiny sample 1Inevitably, you’ll narrow down your list to the top two to three (or four to five…to six) specialties. Now is the time to ask yourself some concrete questions about what the job would actually entail. For example: do I enjoy the pathology that this medical specialty deals with? You know how attendings are always harping on about “bread and butter” cases? That’s because you’re going to be eating that toast every day once you go into actual practice, so make sure you find the standard pathologies of a particular specialty interesting…even during the 500th time (or 5,000th!). We’re not saying COPD exacerbations (what’s up internal medicine!) or chronic low back pain (we see you primary care!) ALWAYS have to make you super excited, but make sure you at least like COPD exacerbations or chronic low back pain if you’re considering either of these medical specialties. If you don’t know what the bread and butter pathologies of a particular specialty are, ask an attending what the top 5 things they see are, we’re sure they’ll be able to answer right away! 


Do you enjoy the lifestyle?

Even though a transplant surgeon and a dermatologist are both doctors, their schedules are wildly different. When the job happens is as important as what the job entails. Are you someone who likes a set schedule? Then maybe you should look into medical specialties that have a large clinic component. Are you okay with not sleeping all that much? Then perhaps labor and delivery is the place for you! Some specialties have a steep time curve: the earlier years are tough, but the further you get into your career, the hours let up. Others demand long hours no matter how high up the ranks you climb. Be realistic with what you think is a sustainable lifestyle for you and the person you think you’re going to be in 5, 10, 15+ years time. While there isn’t a crystal ball, and life can (and will!) throw some curveballs, the question of whether you can see yourself being happy and healthy working on a particular schedule is just as important as the specialty itself.  


Are there subspecialties within the field that interest you? 

Sketchy Character - 008Every type of speciality that has a residency also has a myriad of sub-specialties with fellowships. If one of these sub-specialties interests you, it’s important to know the path that will lead you there. Want to become an interventional cardiologist? You’re going to have to do internal medicine residency and then a cardiology fellowship. How about a hand surgeon or our aforementioned fetal surgeon? Both require residency and fellowship to get to, but if it’s really what you want, the path is worth the wait. Sometimes there are even multiple paths to get where you want to go, so make sure you talk to someone at your school, or even better, a mentor in your desired field, to understand all of your options.

Picking a specialty is one of the most important decisions you’ll make while in medical school, so it’s important to start thinking about it early on. This doesn’t mean that you have to commit to a medical speciality or even know what the medical speciality is, it just means that you should be open from the very beginning in learning about as many specialties as possible to give yourself the best chance of finding the perfect match. When evaluating each speciality, ask yourself the questions we’ve laid out above. We suggest even keeping a journal with notes about each of these questions so that when the time comes, you’ll have done a lot of the leg work already! Good luck!

Want to learn more about picking a speciality, check out this FREE guide on everything you need to know. 

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