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Choosing what path to take in a medical career can be daunting. There are many factors to consider. Many of these choices will have to be made prior to the third year of medical school in order to stay ahead of the curve and maintain a competitive edge. It is important to have a clear vision of your specialty choice so you have no regrets on Residency Match Day. Most importantly, self-reflection and self-understanding are key steps to choosing the right specialty and deciding what to do after medical school. It is never too early to begin this discernment process.
Variety - What kind of variety is best for your personality and stamina? For someone who desires a lot of variety and quick decision making, a position in an Emergency Room might be a good fit. For someone who prefers less variety and more predictable situations and outcomes, employment in a specialty like ophthalmology might be more suitable.
Stress Level - What kind of stress level is right for you? If being responsible for someone's life or death is too much pressure, a lower-key specialty like dermatology or radiology might be preferable. However, if saving lives is fulfilling and losing lives isn't too overwhelming, pursuing more high-risk specialties like critical care medicine or trauma surgery might be more appropriate options.
Knowledge - In the medical field, you must be prepared to be a life-long learner. Most physicians who look back on their training feel that they learned more from their peers and superiors during medical school than from textbooks and lectures. In order to choose the best path after graduating medical school, make sure to build meaningful relationships with residents and attending physicians on your clinical rotations. Find out what their lives are like outside of the hospital or clinic. Is your personality a good fit with theirs? Prepare yourself for residency interviews by asking other physicians what type of questions you might be asked to answer. Preparing for interviews can also help narrow down your options and will force you to explore the reasons behind what path you want to take.
Medical Resources - When you are choosing a particular medical field, it is important to have the right resources to keep you up to date with the latest advances in clinical medicine. General resources can be found in a variety of places: The National Library of Medicine/National Institutes of Health and DoctorCPR are two examples of resources that are very useful for medical professionals. You need to explore not only where medical specialties are headed in terms of research and innovation, but you also need to be aware of where they are headed in terms of opportunities for employment, salary trends, and quality of life factors such as burnout rates for doctors in the field.
Patient Population - Think about what type of patient you would prefer to interact with long term. Are you gifted with the elderly, or are you a natural with children and teens? Is a patient relationship important to you, or would you prefer a medical job with less human interaction? A career as a surgeon, pathologist, or radiologist might be more suitable for someone less concerned with direct patient care. Alternatively, working as an oncologist or psychiatrist might be more fulfilling for someone who treasures the deep, interpersonal connections with patients.
Competition - It is extremely important to be aware of the competition that exists when applying for your internships and first-year residency positions. Be sure you are a competitive candidate before choosing to apply to a particular specialty. Find out where you are ranked within your medical school class and whether your Board scores are strong enough to get you a spot in highly competitive fields such as dermatology, ophthalmology, neurosurgery, or plastic surgery. If settling down in a particular location is important to you, you may have to choose a less competitive specialty. Many residency programs have very strong ties to certain medical schools and certain influential attending physicians at those medical schools. These ties can land you a spot in a competitive specialty despite average academic performance in school. Get recommendations from attending physicians who have strong ties to the residency programs you are considering. Make sure they also make personal phone calls to program directors at your favorite residency programs. Find out how many students from last year's medical school class matched at programs you are considering.
Support Group - It is essential to have a good support group during and after medical school. Be prepared to work a variety of hours and have an irregular sleeping and eating schedule. You will need to be able to perform well on little sleep and with little time to spare. Friends and family can be sympathetic, but they may not fully understand the rigor of training unless they have also been through medical school. Constantly seek out other medical students and physicians whom you can turn to for guidance and encouragement. Attend networking events, join social media groups exclusively for physicians, and don't be afraid to pick up the phone. In order to survive and excel in any medical career, it is important to find people who understand and who can help you decompress after a long day.
No matter what medical specialty you choose, make sure you select it for the right reasons. Do your research, explore your options, and reflect on what matters to you the most so you can make an intelligent, sustainable decision.