How To Choose Your Specialty

Apr 3, 2019 by Elad Eylat

How to choose a medical specialty that's right for you. Advice from a fourth year medical student.

As I’m writing this, I find myself at the end of the process of choosing my specialty...I think. Maybe by the time you have read this post, I’ll have already changed my mind a couple of times. Since, I’ve been doing my clinical rotations, the topic of choosing my specialty has been on my mind lately. While I might still be figuring it out, these are some strategies I’ve taken to deciding.

Research the requirements for your specialty interest.

After you get your USMLE® Step 1 score, you’ll face a reality check of what specialties are an option. Is your desired residency even possible? Each year, the National Residency Matching Program (NRMP®) reveals the data concerning each program, including mean Step 1 scores for matched and unmatched candidates. Students that have received a low score (20-25 points below the mean) should focus on less competitive specialties. While it is not impossible to get into a competitive program with a low score, candidates will have to supplement their application with years of research and clerkships. Even then, there is no guarantee of getting invited to interviews. Once you’ve determined how your Step scores stand up, you need to check the other application requirements to make sure you’re on track.

Understand what kind of person each specialty needs.

Though there’s hardly enough time in medical school to really get an idea of the daily grind in a particular specialty, you can still get a pretty good idea of your personal strengths and weaknesses. Psychiatry needs a doctor with a lot of patience and good listening skills. A pediatrician should have an innate ability to interact with children and their parents. A radiologist ought to have the eyes of an eagle for the hundreds of CT scans and X-rays they encounter. Figure out what you’re good at, what you struggle with, and what you wouldn’t be able to do even if your life depended on it.

The AMA has prepared a Specialty Guide to provide more info into each specialty.

It’s hard to choose one out of thirty. Less hard to choose one out of three.

Use the process of elimination to narrow your search. During your clinical years, you’ll experience a lot of things that will make you think, “I’d never want to do this the rest of my life.” Recognizing what you don’t enjoy doing helps lessen the noise of making a decision about your specialty.

Once you’ve eliminated the specialties that are definitely not for you, focus on getting more experience, an extra clerkship, perhaps, and see which one pleases you the most.

Money matters, but so does the actual job.

It is no secret that some specialties have higher salaries than others. Most medical students graduate with a heavy burden of debt. Often it takes doctors about 20 years from graduation to pay off student loans. Not to mention, most doctors start making money many years after the average person has been taking in income. But while money is of great importance, as a doctor, you’ll likely be working at least 60 hours per week. You could make more money at one specialty over another, but you’ll still be spending a lot of your time at one of them either way. It’s hard to imagine what will satisfy you in 50 years of work while you’re doing rotations during third and fourth year, but try to ask yourself this, “If you woke up tomorrow with all the money you could ever need, what would you prefer to do?”

Be honest with yourself.

We’ve all met that first-year student (or pre-med) who watched too much Dr. Strange and proudly proclaimed that he or she was destined to be a neurosurgeon. While fantasizing is fun, you need to be practical and true to yourself. While some specialties have that “cool” factor (plastic surgery, neurosurgery, orthopedic surgery, surgery in general?!), not all of us are interested in the same things. Some may find more stimulation in pondering a patient’s diagnosis, others may prefer manual work and minimal patient contact while some enjoy watching other people sleep (no offense anesthesiology).

You only choose once (or not).

Finding the right specialty is a long and tedious process. Pay attention to what is required of you for your desired specialty, and stay practical. It is one of those life choices that truly matters, but if you’re careful and honest with yourself, you can nail it.


About Elad

Elad is a 4th year medical student in Charles University in Prague. He is currently preparing to begin the application process for Internal Medicine residency programs in the US. In his free time, he likes to read books, play the piano and compete in local tennis tournaments.


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