I have received many questions on this topic from medical students so I thought I would share my thoughts on choosing the right medical specialty for you. I hope you find this helpful.
1. Relax. The medical degree offers more flexibility than any other graduate degree. Even if you realize your selected specialty no longer fits you there are multiple areas your degree will allow you to explore. Aside from clinical practice, other opportunities exist for medical doctors such as teaching, clinical investigation, research, medical writing, physician entrepreneurship, and health care administration to name a few.
2. Find mentors. As with anything in life, this cannot be emphasized enough. Speak to a variety of physicians in different specialties and ask them why they chose their path. Ask if they would have done anything differently. Focus in on those individuals who live a life similar to the one you envision having one day. Once you have narrowed the field, speak to more physicians in those areas since you do not want to base your opinions of a particular specialty based on a few views. Do not go about doing this on your own and once you get there, help mentor others.
3. Money. It is near inevitable that you will leave your medical training with a nice amount of debt with Uncle Sam’s name on it. Don’t expect to be rolling in cash during residency but the decade of training will eventually pay off. Regardless of what specialty you choose you will be compensated well enough and should be able to pay off these loans as long as you do not live above your means. There is a wide range in physician compensation. You can get a general idea of salaries through online sources but remember there are multiple factors that may affect these values (location, specialty demand, practice setting, etc.). The medical field is being molded like no other time. There are many shifts being made regarding reimbursements, push for preventive care, and quality based outcomes. Medscape offers a good presentation on physician compensation and trends for 2014.
4. Lifestyle. Let’s face it, residency will be tough and very time consuming. I believe this is somewhat uniform across most specialties. However, once your indentured servitude is finally complete, you will then face the real world. Physician burnout is a very real and overlooked problem that has turned some physicians away from traditional practice. Unfortunately, the medical atmosphere can be a silencing force when it comes to addressing physician work burden. No matter how stressful your day was you may be coming home to a two year old who does not understand that mommy or daddy needs rest. You may not be able to spend that extra time to invest in healthy lifestyle activities such as cooking, exercising and of course sleeping. Sadly, the joy of expecting a baby may be shattered in certain environments if others feel overwhelmed by having to take on your call schedule or if the practice feels they are losing money. Medical emergencies will not respect your time either. Some specialties will require more of your time than others making your desired lifestyle extremely difficult to attain.You will need to determine how important this work-life balance is to you and your loved ones. Here is a report on physician burnout.
5. Applicability. This is often overlooked by many physicians. Consider asking yourself how applicable will this training be to my life. Knowledge is invaluable and being able to apply this knowledge with those you love can also be very worthwhile and rewarding. I have often wondered what would happen if a medical emergency occurred while flying in an airplane and doctor assistance is requested. I hope most doctors will step up to the plate and be competent enough to provide medical assistance in such cases but also would not be surprised if some will not feel so confident. Some specialties may also be more advantageous when it comes to providing advice to loved ones.
6. Be realistic. A square will not fit in a circle. I am a proponent of striving for the field that fits you best even if it takes an extra year or two to beef up your application. However, one must also be realistic and consider the possibility of not matching. If your board scores or grades are not up to par for that specialty, you really should consider having a backup plan. If there are other limitations that you have make sure to address them before entering a specialty that is demanding in that particular area.
7. Intellectual stimulation. I can only assume spending 30 or 40 years in a field you find boring will be very painful and it will probably show. Remember the words of Confucius. “Choose a job you love, and you will never have to work a day in your life.” A good test I found for this is while rounding as a medical student, pay attention to which cases you spent hours reading up on. Think about the cases you were eager to log into your computer at night to see if the labs were back yet. Which cases did you really go out of your way for? This is likely the field that offers you the most joy and reward. Stay true to yourself.
8. Trend of field. We do not have a crystal ball, but we can be certain medicine a decade from now will look very different. This again highlights the importance of having a good mentor and spending time researching historical and current events. As mentioned above, the medical landscape is forever changing. Over the past decade, there has been a decline in primary care likely due to lagging salaries and professional prestige, however, many feel this trend will soon reverse as more incentives arise. With the shortage of physicians, longer training, and higher salaries advanced practice providers (APPs) are filling these roles. All help is needed as health care access expands. APPs continue to gain more independence and duties are broadened so it is difficult to determine how this will play out in terms of competition and shifts in job niches. Technology is another welcoming field that is and will continue to greatly impact how different specialties are practiced.
9. True passion. This is self-explanatory. Always be sure to select a specialty because this is what you want to do. Many students succumb to other’s wishes for them, prestige, or even a default pick, but these may not be sufficient reasons to sustain a 30 to 40 year career. You need to make sure you love what you do. Consider the patient population you will be working with. Are you going to excited seeing that patient population day-in and day-out?
10 Research. There are multiple books and articles that can assist you with this decision. This is not a decision you should make without time investment. You have access to a diverse group of physicians through this website. Try websites such as FRIEDA. You may also consider the Myers-Brigg personality assessment to provide suggested specialties based on your score.
“Dr. Daniel” is an endocrinologist who blogs at Diverse Medicine.
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