HealthMay 11, 2020|UpdatedAugust 26, 2020

Choosing a medical specialty: Where to learn what you need to know

By: Shikha Jain, MD, FACP

For students who aren’t sure where their passion lies, choosing a medical specialty can seem overwhelming. Medical school and residency don’t always allow for a deep dive into every specialty, and it’s extremely difficult to get a real understanding of a field in the two to six weeks of a typical clinical rotation.

So where can you learn what you need to know to make the right decision? In order to truly grasp a specialty, it’s important to evaluate the field from various angles. Here are three places to go to find the information you need.

Your medical training

Coursework

First, the science of each specialty is a key component to consider when choosing a medical specialty. In order to remain passionate about a field and enjoy the day-to-day work, it’s essential to enjoy the science behind the medicine you will be practicing.

Specialty interest groups

You’ll be able to learn about the science from lectures and the curriculum, but some specialties aren’t as covered as others during medical school. If this is the case, student interest groups can be an excellent resource for supplementing medical school classes. Try to get involved with these groups as early as possible so you can learn as much as you can about the field you are interested in.

Clinical rotations

It’s also important to get a feel for the field in the setting where it’s practiced the most. For example, oncology is a subspecialty that’s primarily practiced in the outpatient setting, so if you’re interested in oncology, it would be best to schedule a rotation or plan to do some shadowing in an outpatient clinic setting. Meanwhile, subspecialties like trauma surgery or pulmonary critical care are practiced primarily in the inpatient setting, so arranging inpatient rotations would provide the most useful information on the field.

That said, there are some fields where the decision to focus inpatient or outpatient can be made at a later time. For example, internal medicine physicians have the option to be primarily inpatient as hospitalists, primarily outpatient as urgent care physicians or a hybrid of both as primary care doctors. As you’re choosing elective rotations, be mindful of the fact that there are some specialties that aren’t represented during core medical school training or clinical rotations. You’ll need to request those as elective rotations if you’re interested in them.

Experts in the field

To get a true feel for a field, it’s necessary not only to rotate in the specialty but also to speak to physicians in the field. Listening to their insights and seeing how they balance their work and home life can be extremely useful when determining if a particular field is in line with how you envision your future career and personal life.

Talk to these practicing physicians both about their day-to-day as well as what they enjoy about their specialty and what frustrates them. Find out if they had misconceptions about the field or what they realized about the specialty only after joining. If you’re able, talk to physicians in the specialty from different types of practices. The daily work of a private practice physician is different from someone in academics, and the person in academics will have a different career from someone who is hospital-employed. There are many ways to build a career in different specialties, and it’s best to understand the different types of practice settings.

Lastly, ask to learn how much time is spent on direct patient care versus other responsibilities. Different specialties have varying levels of patient interaction, so when you’re choosing a field, think about how much direct patient care you want to have.

Your own motivations and passions

Finally, think about what made you want to be a doctor and attend medical school in the first place. It’s also beneficial to think about where you excel. For example, if you’re great at dissection, surgery may be a good option.

Of course, passions and skills can evolve as you learn more about each field, and it’s OK to be interested in multiple specialties. It’s not uncommon to enter medical school with one specialty in mind and change several times throughout the course of your training. If there are still multiple specialties that interest you when you’re finishing medical school, internal medicine will give you the opportunity to explore further subspecialties as a resident, as will general surgery. Many other fields have fellowships that can be completed after specialization.

At the end of the day, your goal is to learn enough about your options to feel confident in choosing a field that you feel passionate about, that you feel fits your personality and where you can envision being able to accomplish both personal and professional goals.

Shikha Jain, MD, FACP
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