Selecting a Specialty for Medical School

Along with absorbing vast amounts of information and learning clinical skills, an important task you need to complete as a medical student is choosing a specialty. The major exposure you have to various specialties occurs during your clinical rotations as a third- and fourth-year student. You spend time doing rotations in many different areas of medicine and get a sense of what you like — and what you don’t.

In addition to doing required rotations in areas such as internal medicine, family practice, surgery, pediatrics, and obstetrics and gynecology, you take electives that allow you to explore other fields. Take electives for specialties you’re interested in as early as possible so that you can have your decision about a specialty made in time to submit applications to residency programs in the fall of your fourth year of med school.

Keep in mind that what you experience during a rotation may not give you a full picture of a specialty. For example, taking care of pediatric patients during a rotation in a hospital is very different from seeing patients on a mostly outpatient basis as a community pediatrician. Therefore, if you’re considering entering a field, be sure to speak with attending physicians in the specialty about their practices and experiences.

Some of the factors to investigate as you research specialties are

  • Patient population: Is the patient population seen in the specialty composed of adults, children, or people of various ages? Are patients generally healthy (think pediatrics), or do they suffer from multiple chronic conditions?

  • Continuity of the physician-patient relationship: Do physicians in the specialty care for their patients over many years, such as with family medicine? Or do they typically see patients for a relatively short period of time, such as in emergency medicine or anesthesiology?

  • Training requirements: Residency training can last from three to seven years, and fellowships required for some specialties can add another one to three years.

  • Lifestyle: Some specialties have long, irregular hours. Others allow for set shifts and don’t involve middle-of-the-night emergencies.

  • Job outlook: If you pick a specialty that isn’t in high demand, you may have to be more flexible about location when you go to establish your practice than you would if you chose a field whose practitioners are highly sought after. For example, physicians in primary care fields such as family practice and general internal medicine are currently in demand.

    To find out the need for various types of physicians in a state where you may be interested in practicing, search online for physician workforce studies that have been conducted by state medical societies, health departments, or task forces.

  • Compensation: Physicians as a group are generally well compensated; however, some specialties typically pay better than others. Primary care fields tend to be less highly compensated than more specialized areas of medicine.

Finally, how much you enjoy a field is one of the most important factors. You spend many years practicing your specialty, so take the time to make your decision carefully.

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