5 Things Medical Students overlook when choosing their medical specialty

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Medical school is incredibly busy for students and making time to research a medical specialty is more difficult than it seems. Deciding on the best specialty isn’t straightforward, especially when you consider regional differences in pay and market size. Broad specialties can have a half-dozen sub-specialties within them, too, with additional focuses on individual body parts, ages, and more.

All of these medical specialties are hard to assess objectively, and students may think they already have their specialty decided. There are many key considerations to keep in mind. Pay and working hours are important, but there are many other factors that can affect the quality of your career and the rest of your life. Here are five things to consider and discuss with your advisors while choosing a specialty.

1. Local Jobs

If you’re willing to live anywhere for your dream job, then this may be less of an issue. However, if you’re looking for work in a specific city or region, you’ll want to carefully consider how many jobs are available in a particular specialty. The market factors get even more complicated if you’re hoping to work overseas long- or short-term.

Big cities tend to have demand for almost any specialty. However, rural or low-income areas may not have as much need for preventive care specializations, or may only be able to sustain jobs in the largest specialties. There tends to be a demand in those areas for family primary care doctors, so if you want to stay close to home in a rural area, family medicine may be your best bet. Do some research on specific areas and ask your advisors if you’re looking to stay near your med school.

2. Personality Type

While doctors may all be very studious, they certainly don’t all have the same underlying personality. For example, doctors who enjoy a fast-paced work environment may be able to enjoy at least some of their duties as an emergency room doctor. If guesswork and chaos stress you out, a different specialization might work better.

Naturally, people who are good with children make good pediatric doctors. However, some people don’t have a personality that’s predisposed to a given age group. During your time in med school, pay attention to doctors who are similar to you and ask them about what attracted them to their current specialization.

3. Emotional Reward

Some medical fields, like dermatology and sports medicine, are important for quality of life but rarely save a patient’s life. Others deal with life-threatening illnesses and emergencies every day. These high-risk fields can be incredibly rewarding, especially if you get to work with patients long enough to get to know them.

There’s a trade-off, of course: physician burnout can be much higher in these emotionally-charged fields, and the trauma from patient deaths can be intense. However, if you’re up for the challenge, fields like neonatal care and emergency medicine may be an excellent fit for you.

4. Related Fields

Maybe the specialization you’ve had your eye on seems perfect, and you’re not even considering other fields. However, there may be a related specialization that’s even more perfect for you.

If you like working with kids, consider child neurology or immunology instead of a more generic pediatrics field. On the opposite end of the age spectrum, geriatric doctors get to work with older patients in a more holistic way than cardiologists and rheumatologists.

Keep in mind that in many cases, you can pursue a more specialized sub-field after you complete your initial specialty residency. However, investigate residency and other training routes for all of your options before making any decisions.

5. Residency and Fellowships

On the one hand, the amount of training required shouldn’t seriously deter you from pursuing your dream job. Realistically, though, additional years of residency could be the deciding factor between two fields that are otherwise equal. The low salaries associated with residency can be a financial burden, especially for fields that require seven years of residency instead of three.

Some specialties even require additional years of fellowship after residency, and some require extensive overtime or on-call hours despite the low pay. If you’re hoping for work-life balance and financial stability soon after medical school, talk to recent graduates in that specialization about their working conditions.

Making the Decision

Choosing a medical specialty isn’t supposed to be easy. It’s a decision that will shape the rest of your life, including your income, working hours, level of burnout, and even where you can afford to live.

The best course of action is to talk to advisors at your medical school, as well as more recent graduates in the specialty you’re considering. While experienced advisors can provide a broad view of the field, current residents and young doctors can give a more detailed image of the position and what it entails.  

If you’re attending a medical school far from home or from where you want to live, you may need to do more careful research into how many doctors are in that specialization regionally. Either way, start by making a list of your priorities – pay, working hours, emotional investment, and more – and plunge into the search.

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