Tips on Choosing Your Ideal Medical Specialty

Tuesday, March 17, 2020

What do you want to be when you grow up? Perhaps the answer was always easy for you: “a doctor.”

Well now you’re in medical school but might still be trying to figure out what type of doctor to be. You’re certainly not alone.

You know you want to help people. Heal them. But what will that look like? Let’s take a look at what to anticipate as you figure out which medical specialty is for you.

When do medical students have to decide on a specialty?

Ideally, a decision about what to specialize in will be made by the end of the third year of medical school, because that is when students generally begin preparing residency applications. Students pick up experiences throughout medical school — whether it’s in the classroom, a volunteer activity, talking to classmates or mentors, or milestone life events — that help them make the decision.

“We want students to use their time in medical school to get exposure to all the different specialties that are out there,” says Christine Corral, PhD, director of student professional development at Rush Medical College. “At Rush, our curriculum is designed that way. You’re doing career development and career exploration activities each year of medical school.”

Every medical school is different, but here is what a typical experience might look like for a medical student at Rush:

First year (M1)

After adjusting to the rigors of medical school, you may begin to think about how to best make use of your summer. Perhaps you have an interest in global health and want to take a service trip abroad, or you’re engaged in community health and want to volunteer locally. If you’re fascinated with research, you may use the summer to help out in a lab. Programs exist that help give you exposure to your interests while continuing to follow the curriculum.

You may also decide to take the summer off for self-care. Taking time to decompress throughout medical school will keep you refreshed and help you make a sound decision about your specialty.

Second year (M2)

You will want to update your resume with details from your summer experience. Then, there will be school-sponsored events throughout the second year that will showcase different medical specialties. Program directors, physicians and residents from various specialties at Rush University Medical Center speak at these events and answer student questions. In the meantime, you will be completing the remainder of your basic science courses.

Third year (M3)

The third year is when your choice of specialty will likely get clearer if you don’t already have your heart set on one. The third year will be entirely clinical, with students gaining exposure to the following core specialties: pediatrics, primary care, OB-GYN, internal medicine, psychiatry, surgery and neurology. You will also have a total of six weeks for elective courses.

In addition, third-year students will have more opportunities to connect with physicians from different clinics at Rush.

“When I first started med school, I thought I’d be specializing in pediatrics, but I felt like something was missing” says Jessica Chin, a fourth-year student at Rush Medical College. “Then I did a clerkship in general surgery and thought I’d absolutely hate it, but I ended up really enjoying working in the operating room and solving problems with my hands. That’s when I knew general surgery was the right path for me.”

Fourth year (M4)

By the start of the fourth and final year, you will hopefully have decided on a specialty and have identified residency programs to apply to. Advisers at the college will help you prepare for questions you will be asked during residency interviews, which take place from the fall to January, and work with you to learn more about your specialty through clinical rotations.

What are the different types of medical specialties?

Some of the more common medical specialties include the following:

  • Anesthesiology — Use anesthesia to relieve pain before, during and after surgical, diagnostic or therapeutic procedures.
  • Dermatology — Diagnose, treat and prevent skin diseases.
  • Diagnostic radiology — Interpret medical imaging to diagnose patients.
  • Emergency medicine — Diagnose and treat patients who need immediate medical care.
  • Family medicine — Become a well-rounded family physician, from pediatric to obstetric and geriatric care.
  • General surgery — Use surgery to treat and manage diseases.
  • Internal medicine — Provide comprehensive care for adult patients.
  • Plastic and reconstructive surgery — Perform surgeries to improve body function and correct abnormal body features caused by disease, injury or birth defects.
  • Neurology — Provide clinical care for diseases affecting the nervous system.
  • Nuclear medicine — Make use of small amounts of radioactive material for imaging procedures that help diagnose and treat certain conditions.
  • OB-GYN — Support women’s health (pregnancy, childbirth and reproductive system) through a wide range of medical and surgical services.
  • Ophthalmology — Provide medical and surgical care for patients with eye diseases.
  • Orthopedic surgery — Use surgical and non-surgical procedures to treat bone, joint, ligament and muscle disorders.
  • Otolaryngology — Train in both medicine and surgery to treat conditions related to the ears, nose and throat.
  • Pathology — Examine specimens from the body to diagnose and monitor diseases.
  • Pediatrics — Provide medical care to infants, children and adolescents.
  • Physical medicine and rehabilitation — Restore physical function to patients who have been disabled due to conditions affecting the brain, spinal cord, nerves, bones, joints, ligaments, muscles and tendons.
  • Podiatry — Train in primary care and surgery of the foot and ankle.
  • Psychiatry and psychology — Evaluate and treat patients with mental disorders.
  • Radiation oncology — Oversee radiation treatments to treat patients with cancer.
  • Urology — Diagnose and treat diseases of the urinary tract.


What are the most competitive medical specialties?

The specialties that medical students are most interested in often change from year to year, but currently some of the more popular and competitive specialties are emergency medicine, dermatology, surgery, orthopedics and psychiatry.

  • Emergency medicine — Students like having the ability to respond to emergency situations and triage them, working with physicians from other specialties to think through how to best provide treatment. Emergency medicine is among the highest-paid specialties, with physicians earning $353,000 per year, according to Medscape.
  • Dermatology — No two skin conditions are alike, giving physicians new challenges every day. Dermatology is another high-paying field, with an average salary of $419,000.
  • Surgery — Physicians improve and save lives through a combination of clinical knowledge and the technical skills required to perform surgeries. Surgeons are some of the highest-paid physicians, making an average of $362,000 a year.
  • Orthopedics — Treating complex conditions that affect bones, muscles and joints helps patients get back to their normal routine. This is consistently one of the top five paying fields in medicine. Clinicians earn $482,000 per year.
  • Psychiatry — Like internal medicine, psychiatry gives clinicians an opportunity to have continuity of care with their patients. Jobs for psychiatrists are expected to grow by 16% from 2018-28, according to the U.S. Bureau of Labor Statistics.


What considerations should a medical student keep in mind when choosing a medical specialty?

Make sure you really take time to pause and reflect on your experiences before making a decision. You might get so caught up in the process of choosing a specialty that you don’t listen to your inner self.

“We ask students, ‘What type of doctor do you really want to be?,’” Corral says. “Some students will get emotional and say, ‘Nobody has ever truly asked me that before.’ Let’s unpack everything you have experienced through your curriculum and other activities, and figure out what makes the most sense for you and your well-being.”

Perhaps work environment or geographical location is really important to you. Do you want to work at a major academic medical center or in a smaller, community-based setting? What type of patient do you want to work with?

“A good chunk of us in medical school end up liking something we never would have expected,” Chin says. “Do everything you can to learn about every single specialty and lean on physicians for mentorship during your clinical rotations. You never know what specialty will end up being your true calling.”

Learn more about medical education at Rush University.