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Tips on Choosing Your Ideal Medical Specialty

Students practice procedures together on artificial arms in a simulation lab

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? As you narrow in on the type of specialty you want to pursue, it’s important to consider factors such as your passion, preferred level of patient interaction, and ideal work environment, among others.

Let’s take a look at what to anticipate as you figure out which medical specialty is for you and the considerations you should make along the way.

Tips for choosing a medical specialty

Evaluate your interests and passions

It’s essential to start by considering your interests and passions. As you navigate the process of narrowing in on a specialty, you may notice that you’ll receive many opinions from people around you. While it may be helpful to consider outside perspectives, you must prioritize your goals. This is an excellent time to reflect on your clinical work and which opportunities ignited your interests and passion. Consider not only what you enjoy right now but what may also continue to challenge you and spark interest for years to come. Remember that you are shaping your future with this critical decision.

Prioritize decision making

While you’ll likely narrow in on a decision with more education and clinical experience, you want to be sure that choosing a specialty stays on your radar. If your selected schools allow you to explore different specialties as electives, then seize this opportunity. You may not know your true interests until you have some experience working with them first-hand. If your school doesn’t allow for electives in various specialties, then you may have to find opportunities during school breaks. Reach out to your fellow classmates, professors, and other professionals to learn about opportunities for experience. Remember, learning which specialties you don’t particularly enjoy can be just as valuable as finding the right fit.

Be flexible

It’s not unusual for medical students to start their studies with an idea of what they want to specialize in. Occasionally, people will keep the same goal, and it will come to fruition following graduation. However, more often than not, medical students change their minds several times before finally narrowing in on the right specialty. Changing your mind is normal and expected. Keep an open mind as you gain more experience and discover your passions. You never know where “changing your mind” may take you.

Consider patient interaction

People enter the medical field to help others. However, not every medical specialty has the same level of interaction with patients as others. Consider how much face-to-face interaction you would like to have with your patient. For example, a pediatric specialist will have a considerable amount of interaction with children and their families, while a radiologist is more likely to interpret images and relay their findings to a medical team member rather than directly to the patient. While both of these approaches are helpful and patient-centered, communication varies considerably. It’s important to consider your communication style, personality, and long-term goals when evaluating the type of patient interaction you would like to have.

Determine your time investment

It’s important to note that different specialties require different levels of time commitment ranging from three to six years. You should be prepared to put in the time it takes to complete a residency application (including the personal statement, updating your CV, and any other special requirements). Evaluate if you have the time and energy that it takes to do the work of a specialty program.

Define your ideal work environment

Your work environment will have a significant impact on how you feel about your career long-term. You should ask yourself what type of environment you thrive in. For example, do you enjoy the hustle and bustle of an emergency room, or would you find it overwhelming? Would you prefer a quiet doctor’s office with more routine and structure, or would this become boring over time? You should consider why you chose the medical field in the first place and the type of work environment where you can perform at your best.

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 — An anesthesiologist uses anesthesia to relieve pain before, during and after surgical, diagnostic or therapeutic procedures. Anesthesiologists may manage patients who have long-term chronic pain conditions, monitor patients during surgery, and manage comfort following surgery.
  • Dermatology — A dermatologist diagnoses, treats and prevents conditions that impact the skin, hair, and nails.  A dermatologist may evaluate the skin and possibly determine if a patient is experiencing internal issues such as a thyroid condition or kidney disease.  In some instances, dermatologists perform minor or major surgeries such as mole or cyst removal while others may provide cosmetic treatments such as Botox or chemical peels.
  • Diagnostic radiology — Radiologists interpret medical imaging to diagnose patients. Radiologists usually work as part of a medical team that diagnoses and treats a variety of conditions or injuries using medical imaging techniques such as ultrasound, x-rays, computed tomography (CT), positron emission tomography (PET), and magnetic resonance imaging (MRI).
  • Emergency medicine — Emergency medicine doctors diagnose and treat patients who need immediate medical care. The type of injuries or conditions may be far-ranging and the emergency doctor is responsible for stabilizing the patient. In some instances, the patient is treated and released while other times they are admitted to the hospital for additional care.
  • Family medicine — A family medicine doctor becomes  a well-rounded family physician, from pediatric to obstetric and geriatric care. For many patients, a family medicine doctor is the first contact for medical care. If care requires a different specialty, then the family medicine doctor will refer the patient for additional testing and diagnosis.
  • General surgery — General surgeons use a variety of surgical techniques to treat and manage diseases. Typically, this type of specialty focuses on routine surgeries performed on all parts of the body indicating that expertise is broad.
  • Internal medicine — Internal medicine doctors provide comprehensive care for adult patients. This specialty focuses on the complexity of health and the experts in this field are skilled at critically evaluating the connections of the human body.
  • Plastic and reconstructive surgery — Plastic and reconstructive surgeons perform surgeries to improve body function and correct abnormal body features caused by disease, injury or birth defects.
  • Neurology — Neurologists provide clinical care for diseases affecting the brain and nervous system. They provide essential expertise in helping patients address issues related to the mind and body connection.
  • Nuclear medicine — A nuclear radiologist utilizes small amounts of radioactive material to test and treat a host of conditions including tumors, organ enlargement and cysts. This form of diagnostic imaging helps diagnose and treat certain conditions that may not be evident with other forms of testing.
  • OB-GYN — This specialty covers both obstetrics and gynecology. A gynecologist’s aim is to support women’s health (pregnancy, childbirth and reproductive system) through a wide range of medical and surgical services. Depending on the focus of study, some practitioners may be responsible for services such as minimally invasive surgery, maternal-fetal medicine, and pelvic floor treatments. This field requires a large amount of patient interaction and communication.
  • Ophthalmology — An ophthalmologist provides medical and surgical care for patients with eye diseases. These specialists are essential in the diagnosis and treatment of disorders related to the eyes including glaucoma, macular degeneration, and diabetic retinopathy.
  • Orthopedic surgery — Orthopedic surgeons utilize a host of surgical and non-surgical procedures to treat bone, joint, ligament and muscle disorders in patients of all ages. While some will choose to be generalists, others further their specialization to address specific areas of the body like the hip and knee, hand, or spine exclusively.
  • Otolaryngology — Often referred to as ear, nose and throat doctors, physicians that choose this specialty train in both medical  and surgical treatments  to address conditions related to the ears, nose and throat. These practitioners will diagnose and treat issues such as thyroid disease, sleep apnea, hearing and balance disorders, and mechanical speech impediments.
  • Pathology — A pathologist is dedicated to the examination of specimens from the body to diagnose and monitor diseases. They work with other healthcare providers to properly identify a patient’s condition utilizing lab tests at their disposal. Pathology is often used to diagnose cancer.
  • Pediatrics — Pediatricians focus on the care of infants, children, and adolescents. Some in this field will go beyond general pediatrics into one of many subspecialties including pediatric neurology and cardiology.
  • Physical medicine and rehabilitation — Also referred to as PM&R physicians, these specialists are focused on restoring physical function to patients who have been disabled due to conditions affecting the brain, spinal cord, nerves, bones, joints, ligaments, muscles and tendons.
  • Podiatry — Podiatrists are dedicated to the study and treatment of disorders that pertain to the foot and ankle. Using both medical and surgical treatments, they can address foot and ankle related ailments including arthritis, nerve damage, hammertoes, fractures and sprains.
  • Psychiatry and psychology — Both specialize in evaluation and treatment of patients in the area of mental health. Psychiatrists diagnose and treat mental disorders with the use of medication, psychology, and neuromodulation. Psychologists also address mental disorders but by different tools.
  • Radiation oncology — Radiation oncologists specialize in overseeing the proper administration of radiation to treat patients with cancer and certain non-cancerous conditions. Some oncologists step into even greater specialization, tackling specific body parts or levels of complexity.
  • Urology — Urologists are doctors that specialize in conditions related to the urinary tract in children and adults. They diagnose and treat diseases of the urinary tract and reproductive system. Challenges such as kidney stones, urinary tract infections and kidney cancer would fall under their purview.

FAQs About Becoming a Doctor

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 US 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 the 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.”

When should a medical student settle on their medical specialty?

It's important not to allow pressure to negatively sway you into a specialty before you're ready to commit. In reality, there is no hard and fast rule about when you need to settle on your decision. With that said, there are some things to keep in mind to help bring things into clearer focus.

It's important to keep an open mind during your pre-clinical years. The first and second years should be focused on exploring the infinite number of possibilities in front of you. This season of learning is also going to lead to a lot of self-discovery. Students will be able to get a better sense of their likes, dislikes, strengths, and weaknesses. This will help them better assess their fit later on.

Core rotations that happen in your third year of medical school will give you real-world exposure to a host of different specializations and the settings they take place in. Most students tend to settle on a specialty during this time.

Still, there are some that won't figure it out till their fourth year. Some students will even add an additional year to give themselves time to finalize their decision. When it comes to the ideal time to choose, it comes down to what works best for you.

What if I can't choose a specialty? Should I wait to apply for a residency or just choose multiple specialties?

Be sure not to hit the panic button. Medical school is an incredible investment of time and resources that have brought you to this place of decision. You have several options if you are at the point of applying for residencies and have yet to settle on a specialty.

Some students will opt for the most accessible specialty on their list of considerations and be done. Others will dual apply, choosing multiple specialties and taking on the additional hurdles that come with it.

One of the best options recommended by many advisors is for undecided students to take an extra year, pursue an advanced degree, and defer their decision for another year.

What extracurriculars should I pursue to better my chances of getting a residency in my desired specialty?

Extracurriculars increase in importance the more competitive your desired specialty is. It's best to get started as early in your medical school career as possible.

Medical school is extremely demanding, and time will be precious. It's important to prioritize extracurriculars correctly and say no to the ones that will not benefit you as much in the future.

The two most important things to prioritize are your relationships and research. Does this opportunity allow me the ability to enhance my research capabilities within my desired field? Will this opportunity help me cultivate valuable relationships that will vouch for me when I apply for a residency?

Keeping these two considerations in mind will help you choose your extracurriculars wisely.

Should geographic location factor into my decision-making process?

Where you choose to do your residency affects your medical career on multiple levels. Your location will often be a determining factor in the types of opportunities you will be afforded in the future after your time is finished.

As an example, physicians that do their residency in large metropolitan areas like Philadelphia or New York will have a greater likelihood of working in similar kinds of hospitals in the future than physicians that did theirs in a smaller Midwest hospital.

It will be important to choose a residency program that best reflects your long-term professional goals and lifestyle aspirations. Many students consider factors such as the cost of living and earning potential when settling on a geographic location for their residency.

What if I want to go into a specialty with little experience? Can I still apply?

The answer to this question will be unique to every situation. While it's possible to apply with little experience, your odds of acceptance drop in direct proportion to how competitive that field is.

You'll have a better chance with less competitive specialties like pathology, physical medicine, and psychiatry than highly coveted postings in dermatology or orthopedic surgery.

There are some things that can bolster your chances. A prolific dedication to research and strong relationships throughout your medical school career may be that extra edge to get you through. Another option is to take an extra year, possibly go for an advanced degree and focus your energy on building the best package possible to apply for that specialty at a later date.

Are there any special considerations when it comes to choosing between an osteopathic medicine or an allopathic medicine residency?

Special considerations such as these don't factor into what hospitals you can get into, but it does affect the kinds of specialties you'll be matched with.

Now that the major accreditation councils have merged, it has made placement virtually equal between the two. Osteopathic doctors now have virtually the same access to hospitals as allopathic doctors.

While the ability to be placed in a given hospital is essentially equal, it is worth noting that large disparities occur when it comes to matching for residencies in more competitive specialties. In that regard, a Doctor of Osteopathic Medicine (DO) tends to be less likely to be matched.

For example, Doctor of Medicine (MD) seniors were matched to vascular surgery residencies at a rate of 69%, while DO seniors sat at just 23%.

Learn more about medical education at RUSH University.