in a future doctor's life there are a
few decisions as important and as
nerve-wracking as deciding on a
specialty everything from your life
during medical school to your life in
residency to your life beyond residency
are all dramatically influenced by this
singular decision how much money will
you make how much time will you have for
your family will you be burned out and
miserable or will you love what you do
this is how you should go about choosing
a medical specialty doctor jabal med
school insider.com will cover the
thought processes and practices you
should go through to ultimately land on
a specialty that is best suited for you
but an important part of the decision
making process is hearing from other
doctors and learning what drew them to
their field what they loved about it and
what they wish they had done differently
for that reason we've started an all new
series called the insider scoop
available exclusively on the med school
insiders blog where we highlight
individual doctors across various
specialties if you'd like to receive
updates any time a new specialty is
featured be sure to subscribe to our
weekly newsletter at med-school
insider.com
forward slash newsletter data from a
2018 survey conducted by the double-a MC
on medical students specialty choice
revealed that over the course of medical
school most medical students change
their preferred specialty only a quarter
of respondents indicated the same
specialty between matriculating and
graduating and I can identify with that
statistic I initially started med school
wanting to go into Pediatric
Gastroenterology but I ultimately
switched to plastic surgery I go over
that journey and the process that led me
to my decision in a video on my vlog
channel linked in the description below
interestingly students that had the
highest rate of congruence meaning they
did not change their specialty chose
Orthopaedic Surgery at 50.2% pediatrics
at 42.9%
and neurosurgery at 35.5% I'm not quite
sure what to make of those numbers what
do you guys think let me know down in
the comments below we now know that the
specialty you decide on has tremendous
immediate as well as long-term
ramifications on your life we also know
that in most medical students end up
changing their mind over the four years
in med school so where do we go from
here and how can we create a
to decide on the best suited specialty
for ourselves most commonly people refer
to compensation as a significant factor
to help sway your decision and I don't
blame them particularly when medical
students graduate with close to $200,000
in debt I've covered the top paid
specialties in a previous video
including the factors that lead to
certain specialties being highly
compensated and others less so link in
the description below
while compensation is important I would
argue that most physicians are quite
comfortable and compensation differences
between specialties will be far less
important than other factors in helping
you lead a happy and fulfilling life
therefore compensation should not be a
primary or even a secondary factor in
making your decision other more
important factors to consider include
what type of relationship and
interactions you want to have with your
patients the work/life balance you
desire how much or how little you enjoy
performing procedures the types of
patients you generally work with and who
your colleagues will be there's the
specialty excite and captivate you can
you imagine doing this for the rest of
your life oftentimes medical students
fixate on rare cases or procedures that
are particularly exciting in their field
however it is important to remember that
these zebra cases are few and far
between more importantly you need to
determine whether or not the
bread-and-butter
meaning those things that you are more
likely to see day after day is something
that you can actually live with will now
cover a systematic approach to help you
narrow down a category or group of
specialties for you to deliberate on
first what organ system or clinical
questions do you find the most exciting
and stimulating if you enjoy
pharmacology and physiology anesthesia
may be a good fit for you if you love
anatomy like I did then consider a
surgical specialty if you are fascinated
by the brain and how it works the
neurology or neurosurgery or appropriate
considerations next assuming you plan to
practice clinically do you want direct
patient care or in direct patient care
in direct patient care would include
specialties like radiology or pathology
direct patient care would include most
everything else next assuming you want
to have direct patient care determine
whether you'd like a primarily surgical
practice where the operating room is the
focus of your day-to-day
or a primarily medical practice where
procedures are relatively rare surgical
specialty examples would include general
surgery plastic surgery orthopedic
surgery and the like medical specialties
include internal medicine pediatrics
psychiatry family medicine and other
less procedurally focused specialties on
average these medical specialties
emphasize patient relationships and
clinical reasoning but they will often
require a higher degree of patience you
can also opt for a middle ground like
urology dermatology OB ein or anesthesia
that allow for a mix of both another
important consideration when answering
these questions is the level of patient
contact and continuity that you prefer
do you enjoy talking to patients and
forming long-term relationships and if
so internal and family medicine provide
ample opportunity or do you prefer brief
and efficient patient interactions if so
emergency medicine anesthesiology and
many surgical specialties are better
suited for this preference now when I
first started medical school I remember
thinking that work-life balance wasn't
all that important this is a common
sentiment amongst pre-med and medical
students however by the time you reach
the end of medical school and you've
been put through the wringer you begin
to realize how important lifestyle is
it's easy to simply correlate
challenging or unpredictable hours with
higher rates of burnout but it's much
more nuanced than that on average
surgical specialties have much more
challenging hours than non surgical
specialties but the burnout rates are
not necessarily higher in surgical
specialties the 20-19 Medscape national
physician burnout depression and suicide
report provides data on burnout rates
across various specialties the highest
rates of burnouts are found in urology
at 54% neurology at 53% physical
medicine and rehabilitation at 52%
internal medicine at 49% and emergency
medicine at 48% the lowest rates of
burnout were found in public health and
preventive medicine at 28% nephrology at
32% pathology at 33% ophthalmology at
34% and Otolaryngology and plastic
surgery at 36% factors that were cited
as most contributory to burnout included
too many bureaucratic tasks such as
charting and paperwork at 59% spending
too many hours
at work at 34% and increasing
computerization of clinical practice at
32% and often understated yet highly
important factor in your decision is
determining the type of patients and the
outcomes you are most comfortable with
entering my surgical rotations I felt
drawn to neurosurgery given my interest
in anatomy and love for Neuroscience
which is what I majored in
however the surprising lack of precision
in neurosurgery but more importantly the
poor outcomes of neurosurgery patients
turned me off from the specialty
consider the typical patients you will
encounter in your specialty of choice
for example the types of patients and
interactions that emergency medicine
physicians face on a daily basis is
going to be very different from what the
average pediatrician or orthopedic
surgeon would face lastly there are a
few considerations you should keep in
mind although these will likely not be
as important as those previously
mentioned first assess your own skills
while most skills can be learned there's
also some benefit to plank to your
strengths on average we enjoy things
that we are good at if you're a klutz
and particularly uncoordinated then
procedural focus specialties may not be
a good fit next consider the
competitiveness of a specialty if you
are barely managing to get by in medical
school then the chances of you matching
into something like plastic surgery may
be relatively slim that being said I'm a
firm believer that the majority of one's
performance in college or medical school
is dictated by their study strategies
habits and systems if you are struggling
in college or in medical school
our team of exceptionally qualified and
effective tutors at med school in
satakam can help you turn things around
we stand for results at med school
insiders and our tutoring is a perfect
example of this third consider what type
of activities you'd like to engage in
outside of clinical practice research
teaching policy work in most cases this
preference is more important in
determining your practice type meaning
private practice versus academic versus
community rather than your specialty
choice addressing these questions should
do a good job in narrowing down your
specialty of choice you now likely have
only a handful of specialties that
you're considering but prior to pulling
the trigger and committing to one it is
essential that you get clinical exposure
if it wasn't for gaining clinical
experience I would not have realized
that gastroenterology was not a good fit
for me
make sure you shadow attending
physicians in your area of interest as
much as possible
specialty clubs and talks from
physicians across the various
specialties are also a great way to gain
exposure to different specialty options
and our new series the insider scoop is
another great way to gain insight in a
particular specialty link in the
description below once you've decided
the next step is making sure you match
into a desirable residency program in
your specialty of choice for this reason
it is essential that you make your
residency application as authentic as
possible do not fall into the trap of
researching a specialty finding the one
you love only to submit a residency
application that sounds too similar to
your colleagues the personal statement
letters of recommendation and softer
parts of your application are just as
important as yours USMLE step 1 and step
2 CK scores if you need help with your
residency application our team of
advisors with real residency admissions
committee experience can help visit med
school insiders comm to learn more if
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new videos every Saturday at 8 a.m.
Pacific time thank you all for watching
let me know if you have any additional
questions and I will see you guys in
that next one