Deciding on a medical specialty can feel like a daunting task. So much of the lead up to medical school and even the experience in medical school is focused on the next test, the next rotation, the next application process, and don’t forget to study, study, study! Some people were born knowing that they want to be a Pathologist or a Pediatric Cardiologist or an Interventional Radiologist. But for many people, the decision is not as straight-forward. How does one go about making the choice of what specialty to go into? (Besides looking at parody YouTube videos…)
First, keep in mind that “Your life is not graded!” In the end, it doesn’t really matter what everybody else says or thinks about your specialty choice. You have worked too hard, spent too much money, blood, sweat and tears and lost too much sleep to just do what everyone else says that you should do. You have earned the right to decide your own direction. Just because you have a Step score that can get you into the most competitive specialties doesn’t mean that you must do one of those specialties. Do what interests you and specialize in what you are passionate about.
So, how do figure out what you are interested in? A number of good resources can guide your future. The Association of American Medical Colleges (AAMC) has a great web portal, Careers in Medicine, to help you consider what specialty choice best fits you and your skill set. This includes the Physician Values in Practice Scale and the Medical Specialty Preference Inventory (log in required for both). Both will give you results that you can then further explore with a mentor or advisor. “Iserson’s Getting Into a Residency” is an excellent book used by countless previous students to help narrow their interests. (I have no connections or investment in this book. I just think it is good.)
Narrowing to one specialty from over twenty can be a daunting task. To break the list down to a more manageable size, look for specialties that you know you don’t like. Are you not interested in procedures? Then you can easily knock the surgical specialties off the list and you already have a list that you can better handle.
But how do I really know what my specialty is? Unfortunately, there is no simple answer to that question. Some people were born knowing that they were going to be a Dermatologist. Others could be quite happy doing any number of things. Many students talk about starting on the first day of a clerkship and getting that “magic feeling” where they just knew this was the one. However, just because you never get a “magic feeling” doesn’t mean you haven’t found your specialty yet. Many people say the same thing about buying houses. They “just get a feeling” and they know it is their house. I have been lucky enough to own two houses in my life. The first house I bought, as soon as I walked inside of it, I got “that feeling”. The second one, not so much. Yet both houses have been the perfect house at the perfect time.
When it comes down to choosing, I ask students to think about what the worst part of that specialty is. If all of the great parts of the specialty more than make up for all of the boring or tough parts, then you have probably found your specialty. For example, people think Emergency Medicine is all traumas and cracking open people’s chests, running codes and emergently intubating people. However, that might be 5% of your day, if that. Most of your time is going to be spent seeing run of the mill kids with runny noses, grandmas with chest pain and people who are “doctor shopping”. If dealing with the “run of the mill” parts is worth all of the exciting parts, then Emergency Medicine just might be for you.
In the end, think about who you are, what you are good at, what you temperament is and the lifestyle that interests you. And remember, while the IU School of Medicine is an excellent place to learn and practice medicine, that doesn’t mean that life here at the academic center is how life is in the rest of the outside world. Even not too far away places like IU Health North and IU Health West have a significantly different pace and style of practice. Consider doing electives outside of the academic center or at other institutions to get a more complete picture of what the specialty really looks like. Talk to a wide variety of people, not just the Career Mentors but other faculty in the department. And you can always ask me questions. You can never have too much information.
Finally, your residency and your career shouldn’t change you unless you let it. Certainly each specialty has its own particular time and workload demands that you must work within. But you always have choices. I have often times found that the people who complain the most about how they don’t have any time, continue to make choices that take them away from their friends, family and other loved ones. Whatever your goals and values are, when the opportunity comes, continue to make choices and tradeoffs that prioritize them. And you will have totally earned that right to choose. Because your life is not graded.
The views expressed in this content represent the perspective and opinions of the author and may or may not represent the position of Indiana University School of Medicine.
Dr. McKenna is a graduate of IU School of Medicine, where he also completed a pediatric residency. He served as chief resident and was an Assistant Professor in the Department of Pediatrics and the Associate Program Director for the pediatric residency p...