What’s the right specialty for you?

Perhaps the most pressing question for all third and fourth year medical students is “what do I want to do for the rest of my life?” During pre-clinical basic sciences, we are all exposed to the different disease processes and medical/surgical specialties. With each change in semester or block, students’ career interests shift. When we study the musculoskeletal system, every student wants to pursue orthopedics. When the topic of discussion is cardiovascular diseases, the same phenomenon happens as if orthopedics was not on their minds a week ago.

Just like in middle and high school, everyone starts to ask us what specialty we want to pursue when we officially land on the floors for clinical rotations. The biggest mistake that students make is levitating towards a specialty because “it is cool,” or because “they do interesting stuff.” It is legitimate to be attracted towards a specialty that interests you, but much more should go into the final decision than just what meets the eye. By this I am not even referring to the lifestyle or the financial factors. Forget it — we are all in medicine, we will all work hard, and in the future we will work even harder for even less. I want to say that lifestyle and financial compensation should not be part of the decision but this article is not about the politics or the money. It is rather a guide to help lost souls find the right specialty.

Consider this scenario: you are a seasoned attending physician with 25 years of experience. You are at home with your family at 11 PM and you hear a ringing sound all to familiar that still never fails to induce PTSD and diarrhea even after decades since you’re internship ended. The pager reads: “Chest pain, E12-16, please call #####.” You rush out of your home with one sock on your foot and reach the emergency department to examine the patient only to learn that he just loaded up on spicy Chicken Tikka Masala 2 hours ago and hadn’t taken his Prilosec that day. You complete your clinical documentation and as you get into your Tesla to drive back home you catch yourself in an upbeat mood. Congratulations, you’ve found the right specialty for you — only if you had known it 25 years ago.

Obviously not all specialties have crazy calls, but the point of the scenario above is to convey a specific message. You should consider the most redundant, boring, bread-and-butter, annoying, mundane “thing” or chief complaint of each specialty, and if it does not bother you that you have to get up at 3 AM to do/see it, then you’ll most likely be happy doing it for the rest of your life. On the other hand, if you base your decision on the “cool things,” of a specialty, you will be miserable because frankly speaking, that one “cool thing” will only come every once in a long while — and that won’t be enough to keep you going.

Your satisfaction will be driven by that and that only when you do the same thing day in and day out.

To give yourself the fair exposure to different specialties, select unique rotations during your fourth year. Do not waste the entire year with “easy” rotations just because you’ve set your heart on a specialty already and just want to breeze through the rest of medical school.



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