Choosing the right specialty is an important decision that shapes your entire future. With so many options available, it can be difficult to know where to start.
Medicine is a field of continuous learning, so pursuing residency training is the usual route for most graduates. Whether or not to go into residency training is a big decision in itself. With a little bit of introspection, research and time, you can make an informed decision that will best suit your interests and career goals.
How I Became a Pediatrician
Choosing the right specialty can be an intimidating task, especially if you are still unsure of what you want to do. Believe it or not, I told myself during my medical clerkship that I would never be a pediatrician, which is why it is kind of funny that I ended up where I am. uring clerkship, there are so many things to do that you just focus on finishing all the work. I later realized that my basis for not liking Pediatrics was shallow, because it was based on my experience as a clerk alone. When I said I didn’t like Pediatrics, I wasn’t looking at the big picture nor taking into account factors that would impact the kind of future medical practice that I wanted.
It wasn’t until my internship that I realized that Pediatrics as a medical specialization is not so bad after all. I enjoyed working with kids and I enjoyed the thought process of diagnosing pediatric diseases and being more involved in their management. I already knew the ins and outs, and work didn’t feel like work no matter how tired I was. Yet after the internship, I still wasn’t 100% committed. I still did a lot of thinking and asked myself questions about how to choose a medical specialty. There were many factors that ended up influencing my decision.
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6 Factors to Consider in Choosing the Right Specialty
It is essential to understand the various specialties available and what factors to consider before choosing a medical specialty. Every person will rank and prioritize these factors differently when deciding on a medical specialization. No single factor will be solely responsible for your decision; your decision can result from a compromise of all of them. However, your medical specialty will shape the direction of your medical career, so it is important that most, if not all, of these factors are somehow met. Here are some of them.
1. Interest
The medical specialty that you choose must be something that sparks your interest. You will be dedicating years of your life to training in this field. Those years will feel like torture if you are doing something that you don’t like.
Which areas do you feel drawn to? Which medical specialization do you feel you are passionate about?
Sometimes interest and passion can be indeterminate factors. Our interests can change as we experience more of the various medical fields. This also happens to medical students who seem set on a specialty during med school but then choose a different path after graduation.
2. Strength
The medical specialty you choose must be something you are good at. It doesn’t mean you have to be the best, nor does it mean you will never make mistakes, but the right specialty for you is something that you are competent and efficient in. Strengths can include which medical subjects you were good at, but can be even better assessed based on your rotations during clerkship and internships, where you’ve experienced the practical application of what you’ve learned.
If you are a good listener, psychiatry can be a good specialization to consider because it entails detailed history taking and a lot of probing and listening. If you have an eye for detail, radiology can be a good specialization because you will evaluate a lot of images and scans. If you have strong fine motor skills and can stand for long hours, surgery might be a specialty to consider. If you don’t like regular patient interaction, you may consider radiology or pathology as a medical specialty. Knowing what you are good at and knowing where you have difficulty can direct you to a medical specialization fit for your skills.
3. Money
Most of our decisions at some level revolve around money. There are some medical specializations that are more financially rewarding than others, but this shouldn’t be the sole deciding factor. I believe that money follows excellence and great service. There are many other factors apart from money that can make your medical career fruitful and rewarding.
4. Duration of training
Training duration is one of the practical factors a medical graduate has to consider. Not everyone can afford to study further with all the student loans that need to be paid.
5. Lifestyle
The medical specialty you choose can determine the lifestyle you have. There are some medical specialties, such as Emergency Medicine or Surgery, that are very action-packed and give an adrenaline rush. Other specialties are more laid back and predictable.
Furthermore, the medical specialty you choose determines where your life will be centered.
Surgical specialties are hospital-based, and you will find yourself in the operating room most of the time. Medical specialties like Internal Medicine and Pediatrics allow you to have clinics in your own time and space. You should also consider any lifestyle factors that may be important to you, such as the hours worked and the type of patient population you treat. Some people might not like working with kids, so should not choose Pediatrics. I, on the other hand, preferred kids over adults.
6. Personal goals
Being a doctor is important, but your life shouldn’t only revolve around becoming one. As you grow older, you will have other personal goals that you want to achieve. Some people might want to start a family while others may want to pursue hobbies they had set aside during med school. Other people might want to travel and want a short residency training to be able to fulfill their goals. Life is not confined within the four walls of the hospital, so your other personal goals are equally important things to consider in choosing the right specialty.
Questions You Can Ask Yourself
These are some of the questions I asked myself when I was choosing the right specialty for me:
- What do you enjoy? What are you good at?
- What skills do you want to develop further?
- What do you envision your future clinical practice to be like?
- Who do you see as your future patients?
- Do you want to see patients on a regular basis? How much patient interaction do you like?
- What kind of illnesses do you see yourself treating or managing?
- How flexible are you in terms of time and work-life balance?
Some of these questions I found easy to answer. However, there were some that needed more time, patience, and reflection. This might be the same for you.
4 Things You Can Do to Help in Choosing the Right Specialty
It is normal to not make a decision right away. Choosing the right specialty is a process, and sometimes there can be setbacks or uncertainties. These are other things you can do to help choose.
1. Group specialties and narrow them down
Grouping medical specialties and deciding by elimination can help. You can group medical specializations into fields that you like and do not like and then choose among the ones that you are interested in.
Which rotations did you enjoy, and which were the ones you don’t want to experience again?
One practical pivot point I used to categorize medical specialties is surgery. You can separate surgical and nonsurgical specialties and discard the one that doesn’t resonate with you. This was a big deciding factor for me, as I had poor stamina in the operating room. I couldn’t see my work involving standing for long hours and didn’t like the idea of being in the operating room with a sleeping patient. So I removed anything that had surgery (Surgery, Orthopedics, OB-Gynecology, ENT, Ophthalmology) and significantly narrowed down the medical specializations I had to choose from.
2. Talk to colleagues and seniors
Talking to people who pursued the medical specializations you are considering can give you a better idea of their work, lifestyle, and other factors that may be important to you. You can speak with physicians, residents, and other healthcare professionals to get a better sense of the daily responsibilities and challenges of each specialty. You can ask them how they were able to choose their medical specialty and what factors became big decision-makers or deal-breakers for them. You can observe what their day-to-day life is like. Look at how they work, because this will be the exact training you will go through once you graduate. Is their lifestyle something that you see yourself having in the future?
There was one very important message that my medical supervisor said about her choosing Pediatrics as a medical specialization. She said,
“Being in Pediatrics is such a lighthearted job because you know that the moment a child is talkative, smiling, and running around, it is likely that the patient can go home. You also don’t have to worry about them being grumpy about the bill.”
Even after many years of practice, this is something that I still see and which rings true.
3. Be honest with yourself
Take a good look at all the factors and be mindful of what resonates with you. It is easy to be swayed by what your parents might want. It is easy to be tempted to choose a medical specialty just to be with your peers. It can be tempting to choose a specialty that is high paying or that will make you look and feel “cool,” but being honest with yourself and taking the time to contemplate what you really want can save you a lot of trouble in the future. It will also prevent you from blaming other people when challenges arise or things don’t go your way, because ultimately it was a decision you made for yourself.
4. Don’t rush it
There is no need to rush. Your choice will affect the next several years of your life, so it’s important to take your time in making sure you make the best choice.
Great decisions take time, and although things might be uncertain at the start, they will all work themselves out in the end.
How to Know if a Specialty is Right for You?
There is a Japanese concept called “ikigai” which means “your life purpose”. It is best represented by the overlap of four circles. Each of these circles represents different aspects that contribute to one’s life purpose: What you love, what you are good at, what the world needs, and what you can be paid for. In the middle where all these circles overlap is your “ikigai”. Choosing the right specialty is similar to finding your “ikigai”.
You will know if a specialty is right for you if work feels easy.
You may feel tired when things are hectic and days are long, but there are more energizing moments than draining ones. A specialty that is right for you has a good supportive community that allows you room to grow, learn, and be inspired to work.
Final Thoughts
Choosing the right specialty and where to train are big decisions. These questions may not have immediate answers because there are many paths one can take after graduating with a medical degree. There is no right or wrong way to choose a medical specialty. Even after you have decided on the medical specialty perfect for you, there will still be struggles and hurdles that will test you and may dishearten you. But no matter which hospital you end up in or what medical specialty you choose, the right specialty is one where you thrive, enjoy, continuously learn, and passionately serve.
If you still feel you need help choosing a medical specialty, you may want to consider working with a career coach or advisor to help you through the process.
