Three Tips for Choosing Your Specialty and Preparing for the Residency Application

By Erin Santos

Deciding what you're going to do in the next 20 to 40 years based on 4 years of medical school can be daunting. I list here three tips that may guide you through the process.

Tip 1: Pursue your interests throughout medical school even though they may not all fit cleanly within one specialty.

Opportunities to pursue your interests include research projects, social events, interest groups, and volunteer opportunities. Being informed from exposure to different specialties may help you narrow down the list of specialties to consider.

Some students have a clear idea of the specialty to which they're applying even before medical school or during the first 2 years of medical school. They may choose to focus their school activities on that specialty to demonstrate their deep interest in it.

For me, choosing a specialty was less clear. I was considering internal medicine, anesthesiology, and general surgery during my first 2 years of medical school based on past interactions with physicians in these fields. However, I wanted to explore other specialties and remain open. One of my mentors, a nephrology attending, said that he wished he'd done more in other specialties during medical school as that would have been the time to explore and get immersed in them.

Thus, I participated in an ophthalmology research project. I was curious about the aim of the project, which was to develop patient-reported outcome questionnaires for patients with retinal degeneration. These became the Michigan Retinal Degeneration Questionnaire and the Michigan Vision-Related Anxiety Questionnaire. I also wanted to interact with a thought leader in the field, Dr. K. Thiran Jayasundera, to augment what I learned from the ophthalmology sequence in our preclinical year, which was much shorter compared with other organ sequences. Then, I joined a urology research team, pursued a nuclear medicine elective, and signed up for a plastic surgery rotation to explore these areas in which I was much less informed.

From these experiences, I gained answers to questions that helped me narrow down the list of specialties to consider, while pursuing my interests. What did I like about the specialty? Could I imagine doing what the residents and attendings did for years to come? Did the challenges of this patient population motivate me to take action? Were the care-decision discussions intellectually interesting? What were the things that I liked less about the specialty? Was I energized to learn how to navigate and address those scenarios?

You can narrow down the list of specialties you're considering as you get more informed from exposure to different specialties. You can tailor your school activities to what's on your list as you get closer to the residency application period, which is usually from June to September in the year prior to your graduation year.

Tip 2: Seek mentors and talk with advisors. Mentors and advisors provide guidance in assessing specialties and preparing your residency application.

During downtime in clinical rotations, I would ask the residents and attendings about their motivations for pursuing their specialty. I was able to compare my own reasons for considering the specialty with their motivations. I evaluated areas of their practice in the context of my existing expectations about the field. Stereotypes about members of a specialty still exist based on what I've heard. Speaking directly with members of a specialty was helpful in getting a more informed perspective and realizing that there is a variation of personalities within one field.

Some students dual apply to more than one specialty. I've heard from a resident and a senior medical student who did this because they were unsure of their competitiveness for one specialty. Another reason may be that they were equally interested in two specialties. It may be helpful to speak with others who've gone through the dual-application process and advisors in your school who have experience with this.

Senior medical students are another helpful resource in preparing your application. Some specialties prefer or expect away rotations, that is, you rotate outside of your home institution. Senior medical students can give advice on how they navigated this and how away rotations helped in their residency application. Speaking with more than one senior medical student is also helpful in giving you different perspectives about the application process. For instance, one student gave me specific advice on what to include and how to enter information on ERAS (Electronic Residency Application Service®, the online application platform for residency programs) to make it more efficient. Another emphasized that having four to five anecdotes can answer the 20-plus questions that an interviewer might ask. Overall, these conversations have decreased my anxiety about the application process.

Tip 3: Update your CV periodically.

I wasn't updating my CV regularly until I applied to medical school. I realized that I did forget some of my professional and volunteer experiences. I would update my CV in the past usually just prior to a job application. Since starting medical school, I've updated my CV periodically or soon after I've started a new commitment or role. If I was in the middle of a busy rotation, I would make a list on my phone of what to add to my CV. Thus, it's been easier to enter my experiences on ERAS.

I hope that these steps have been helpful in clarifying what you can do to choose a specialty and how you can prepare for the residency application process.

Erin Santos
University of Michigan Medical School
Graduating Class of 2022

Back to the June 2022 issue of ACP IMpact