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Medical Student Perspectives: How to Choose Your Specialty

Deciding to go to medical school seemed like a big enough ordeal in itself. And now that you are in medical school, you have to take the next step and decide in a very short amount of time what you want to do with your life. The task of picking your medical specialty is daunting, to say the least. Aside from those rare few medical students who matriculate into medical school with the foreknowledge of what they want to do with their lives, most medical students change their minds several times. That being said, here are my tips on how to choose your medical specialty from among the near limitless possibilities.

Do Not Panic
Every medical student is going to feel unsure about which specialty to choose. At least half of the medical students I know did not know what specialty they were going to choose until after the completion of their first rotation during fourth year. There is plenty of time to figure out where you belong, if you take advantage of your first three years.

Get Involved Early
As clinical exposure opportunities tend to be limited to third- and fourth- year medical students, professional societies and interest groups are invaluable resources to first- and second- year medical students who are ready to start figuring out what they want to be when they grow up. Your school’s Internal Medicine Interest Group and your ACP Chapter, for example, are your best opportunities to begin exploring internal medicine as a specialty. From information nights to a-day-in-the-life of your favorite internist (cardiologist, neurologist, rheumatologist, etc.) to mentor-mentee shadowing opportunities and networking, these groups can begin to show you the working life and behind-the-scenes world that such specialists have created. These events and relationships will often enlighten a student to a much greater degree than would the few weeks spent on a third-year rotation in general medicine.

Experience Everything
Nothing will substitute for the value of diversity in experience. Explore everything; observe any procedure to which you are invited. If you follow a patient on your service, go with the patient for any and every auxiliary diagnostic test offered or therapeutic procedure scheduled. These are often your best opportunities to work one-on-one with an attending in that field and to see first-hand what working in that field would entail. Also, as you go between rotations third year, try to keep an open mind. Start each block with a goal of fully exploring it before you cross it off your list. I have personally known many medical students who began a rotation so sure that they would hate it just to realize that they loved the field and would ultimately pursue it. By not limiting yourself, you can be more objective in your evaluations of these one-in-a-lifetime opportunities. This will help you to realize more than just whether you are a procedure-oriented person vs. an intuitive-oriented person, but more importantly whether you have a true passion for the medicine involved.

Ask Questions
When you meet physicians in a specialty you are considering, talk to them about their careers. Remember, you are on this rotation to see patients and learn medical content, but you are also there to explore the specialty as a future practice. Your questions will demonstrate your interest in the physician’s personal experience and may provide you with valuable information. Interestingly, most practicing physicians that I have spoken with suggest that the medical school clerkship is quite a different experience from the everyday life in their specialties. Here is a favorite question to ask your attending: “If you were in my shoes in today’s medical environment, would you choose the same specialty again?” The answer to this question could very well provide you with real insight into the future prospects of the specialty.

Only You Know the Answers
Since choosing your specialty is such a subjective decision, I suggest that you ask yourself the following questions as you experience and learn about each specialty. 1. Does the specialty interest you? 2. Are you a competitive applicant for this specialty? 3. Could you do this for 30 or more years, instead of the few short weeks of the clerkship/rotation? 4. Are you satisfied with the attending’s lifestyle? How about the resident’s lifestyle? 5. Are you satisfied with the compensation? 6. Are you satisfied with the length of training required? 7. Can you accept the intensity of residency training? 8. Are you interested in private, hospital, or academic practice? Are you interested in teaching or research? Will this specialty allow whatever flexibility you would like? 9. How will this specialty change in the future?

The Take Home Message
Take advantage of your first three years of medical school to get information and to research lots of medical specialties. Join every interest group that you medical school offers, and especially use the opportunities available during your third year to figure out what you want to do with your medical career. See as much as you can, because you really need to love the specialty that you choose.

Helpful Website
This is a popular link to the Medical Specialty Aptitude Test (based on the book "How to Choose a Medical Specialty" by Anita Taylor), designed to help medical students find the specialty for which they are best suited.

John Paul Henao
Council of Student Members Representative, North Central Region
Drexel University College of Medicine, 2009
Email: jph32@drexel.edu

Back to September 2008 Issue of IMpact

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