Why Should I Choose Your Specialty?

Stephanie K. Nguyen

Disclosures

February 28, 2017

Before I ever set foot into medical school, I was already thinking about which specialty I would choose. Most of us enter school with a narrow exposure to what medicine is and are not fully aware of the choices we have. In terms of medical specialties and subspecialties, there are more than 120 from which to choose. With this many options, it is no surprise that the process of selecting a lifelong career is an especially daunting one.

Some of my classmates claim that they knew what specialty they wanted to go into from their first day. However, for most students, the specialty that we think we want to go into changes a handful of times; that is perfectly normal. Personally, I don't think it is particularly wise to settle on a specialty until first experiencing rotations. I am still navigating through these waters to find the right fit for myself. My hope is to help shed light on the types of real questions that students actually consider when choosing a specialty.

What's the Compensation?

Starting off with compensation just makes sense. This is often near the top of priorities, probably because of the outrageous educational debt with which medical students now graduate. Although we will probably be making a livable income as doctors, regardless of specialty, the variable length of training time and effort makes considering pay warranted.

I do not think compensation alone should exclude a field in which a student is particularly interested. However, I am aware that this is a concern for many, especially those who are supporting a family or are in other situations where earning a higher income is important.

How Fair Is the Work/Life Balance?

Many of older physicians I encounter scoff at the idea of work/life balance. In "their day," work was the only concern! With the physician workforce approaching an equal proportion of men and women—and considering that it is becoming more socially normal to share child-rearing and domestic responsibilities—work/life balance is a factor that weighs heavily in specialty decisions.

Personally, I would eventually like to have a family and be an active part of my children's lives, so the feasibility of this may tip the scales. Even for those who are not particularly concerned about dedicating time to family, having adequate time for nonwork endeavors (eg, artistic interests, sports, maintaining well-being) is important.

Hand-in-hand with work/life balance is burnout. I assume that most of my colleagues have experienced burnout at least once during medical school. Its symptoms can mimic depression, and it leads to emotional exhaustion and feelings of inadequacy. Although many medical schools are now addressing this issue with improved student health and well-being programs, the greater culture within medicine can be calloused; the atmosphere can encourage those involved to push certain feelings aside to "power through." This mentality is not conducive to the health of physicians or to the care that our patients receive. Burnout rates for physicians as a whole are much greater than the general population, and they vary by specialty. Before committing, knowing the specific factors that influence the rates of burnout within a specialty is important.

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