How and when to choose a medical specialty

February 6, 2018 - Mariam Zaidi

One of the most common questions I remember being asked as early as my first year of medical school was, “So tell me, what specialty are you thinking of going into?” Initially, this would flood a mixture of emotions within me as I wasn’t sure if this was the right time to be thinking of something which seemed many years away. I felt anxious and slightly worried about not having given this supposedly important issue much thought. I also felt at times quite excited at the thought of choosing what I’d actually like to be when I’m older. At 18 years of age, as most prospective medical students are, the only concern I had was ‘will I even get into medicine’, let alone thinking what type of doctor I’d like to be. For some, having a plan of what your goals for the next 5-10 years is clearly very important.

Before medical school

Before attending medical school, I had the opportunity to undertake a few weeks of work experience at some local hospitals. I chose to spend this time in paediatrics and cardiology. This choice was partly due to the placements offered to me but also because I enjoyed learning about the cardiovascular system at school during GCSEs and A-Levels so I thought I may be able to relate to some of the physiology and pathology within this specialty. I thoroughly enjoyed the few weeks of my work experience. Even though I had not yet witnessed medicine through other specialities, I knew that I had an interest in cardiology at this stage. I didn’t spend much time researching options and specialities at this stage as my A-Levels were fast approaching and the most important issue on my mind was preparing for my medical interviews.

At 2 of my medical school interviews, however, I was asked about my work experience placements and for another moment, I seemed to reflect on my time back on the cardiology wards. The joy and enthusiasm that I expressed in my answer when describing my placement instantly planted the question, “So you want to be a cardiologist then?” Naturally, I answered yes (that was probably the only answer I could think of in a tense interview setting!).

By the start of medical school

Fortunately, having received my offers and being set to start medical school a few months later, I came across various student-led academic societies. Many first year students took an interest in attending these student-led talks for choosing a medical specialty, so I decided to go along. It was interesting to hear specialty trainee doctors describe their day to day lives and the pathway that led them to their position. It was at this stage in my first year, that I began to think of specialities other than that of a cardiologist. Surgery seemed a fascinating entity on its own, posing even more opportunities. There was also the option of endocrinology (metabolic medicine), dermatology (with skin specialisation), and respiratory medicine which at the time interested me.

Speaking to older students for some helpful advice allowed me to realise that it was still “too early” to know what I want to do in the future. Their advice was to focus on my first year of studies and not get too carried away with choosing a specialty so early on. Reassured, I took their advice, however, I have come to realise through experience and observation that deciding early on can be useful to help understand which areas suits you best in one respect. Establishing whether you want to work in hospital or in the community, choosing medicine or surgery or deciding to work with adults or children are easy ways to help you begin narrowing down your options.

Benefits of choosing early on

1.Stay focused: for example, if you know you enjoy renal (kidney) medicine then you may wish to attend relevant conferences to help you establish if this is the right path for you.

2. Stay organised: an important aspect of professionalism is keeping up to date with current medical research and attending workshops relevant to your interests. For example, if I was interested in surgery, I could attend a surgical workshop where I would learn more about sutures and wounds. This would demonstrate my interests whilst helping me to be organised and show off my time management skills.

3. Faster progression in the future: many doctors after their second year of foundation training in the UK decide to embark on a ‘F3’ or foundation year 3. This ‘extra’ year is popular amongst doctors who may want a sabbatical or for those who are unsure of what they may want to do in the future so decide to spend a bit more time deciding and gaining experience. However, those who are sure of what they want to do, can start their pathway soon after their second foundation year and effectively reach their desired consultancy or similar level earlier on.

Though it is beneficial to at least start thinking about this topic early on in your medical career, it is important not to let it stress you out. In the vast majority of cases, students and even doctors are unsure of what exactly they want to do and this is perfectly normal. It just means you have many interests and that you simply need more time to think about it! The most important thing is not to feel that you have to ‘choose’ a specialty for the sake of it.

Top 3 ways of how not to choose a specialty

1. External influences: sometimes it’s so easy to allow friends to distract you, especially if they or other people around you have decided and express their confidence in a field. This can feel undermining and worrying at times, but it is important not to let this affect you.

2. Pay: face it, we all want to earn a decent salary, but as you may know, medicine is not a career that should be entered for monitory gains. Choosing a specialty because of the intrinsic satisfaction that it provides is far more important.

3. Competitiveness: just like you may have been told when choosing a medical school you should base your choice on the university location, extracurricular opportunities, teaching methods etc. In the same way, choosing a medical specialty should be in accordance to your interests and personality and not because it may be “easier to get into”. Specialty training can take several years and just because somebody may have mentioned it being easier to get into one year, may not necessarily hold true for you in years to come. If you genuinely enjoy getting involved with research for instance, then the academic specialty pathway may be suited to you. This will also help you do well as you are genuinely motivated to do well.

Final thoughts: when to choose a specialty?

The biggest advice on this question that I have received is “there is no right time to choose a specialty”. Though this seemed reassuring, I also saw that doctors who knew exactly what they wanted to do were more organised and were able to better prepare their CV and tailor it to the specialty they were going to apply to. I then came to the conclusion that though there is no right or set time to choose a specialty, certainly, the earlier you decide which one to consider (or in my case, which ones not to) would be favourable in the long term by helping you get involved with extracurricular activities related to that specialty

Now in my 4th year, I’ve experienced a multitude of medical and surgical specialities. Having been taught and gone on clinical placements within these specialities has allowed me to get a better grasp of what parts of medicine I enjoy and what I don’t enjoy as much. This has helped me to exclude specialities in order to narrow down to exactly what I may want to do.

Coming back to cardiology, I haven’t excluded that one yet! I enjoyed the medical specialities over the surgical ones on the whole. Who knows, I may end up becoming a keen cardiologist in the end but if I hadn’t gone through thinking of other specialities during my medical school years, I may not have been firm about my decision now. So, don’t rush into it, choose carefully and go with your interests. Worst comes to worst, you choose a specialty and don’t enjoy it – you’re still a great doctor, and can always change paths – it’s never too late!


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