How Am I Choosing A Specialty?

After reading the Ultimate Guide to Choosing a Medical Specialty by Brian Freeman, more than three times, scouring the internet for hints and tips, and asking every physician I’ve encountered for advice in picking a specialty, I think I may have figured out a couple things about how I am currently going about picking my favorite specialties.

At one time I had read somewhere that the best way to really chose a specialty is to sit down and think of the real reasons that you went to medical school.  This may sound stupid or naive to some, but I went to medical school to save lives.  Seriously, that was my real over-arching reason for pursuing this career.  Now, I realize that most of what physicians do isn’t saving lives, in fact most physicians just make patients lives better by managing chronic disease.  Other reasons I decided to go to medical school were to help people, have an intellectually challenging career, job security, and a salary where I know I’d be able to easily afford the necessities of life without ever worrying about pinching pennies.  Prestige, respect, reputation, and community status played a far lesser role in my decision to become a doctor.

In this context, I’m going to try to objectively think about which specialties actually do some “life-saving.”  Others could probably add some to this list, but this is the best I can do off the top of my head.

  • Emergency Medicine
  • Cardiology/Cardiothoracic Surgery
  • Neurology/Neurosurgery
  • General Surgery
  • Internal Medicine/Pediatrics
  • Anesthesiology
  • OB/GYN
  • Psychiatry 

Out of this list, there is not one acute life-threatening scenario that I can think of that this group of specialist would not be able to handle.  I am assuming of course that General Surgery can amputate gangrenous limbs and handle all but neurologic and thoracic trauma surgery cases.  One could even argue that this list could be narrowed down even farther.  But I think this is a good representation of specialties that work directly on patients in acute situations, that can and do make life and death decisions and provide life-saving treatments.  (Again, I’m just throwing this up in the 10 minutes it takes me to throw together a blog post and may be missing some – and I my mind is just racing right now so I’m just throwing down what I can).

As you can see at this point, a large portion of these make up my top list of specialties I am regarding as my top choices.

Another tip that many physicians have suggested is to decide whether one is a surgeon or a medical physician.  I’ve sat down and pondered this over and over.  Am I a surgeon or am I medical?

Over the last couple years this question has always been in the back of my mind.  Just in the last couple months or so, I think I am on venturing over to the surgery side of the fence.  After I made what I thought was a huge proclamation about myself and my future, close friends of mine said things like “yeah, I could see you as a surgeon.  I figured that’s what you’d probably do.”  And so, I wondered, where were these all knowing friends earlier?

I enjoy working with my hands.  I enjoy little things like shoveling the driveway, washing the dishes, or putting walmart furniture together.  While these are not things I jump for joy doing, I do enjoy them a lot more than mental exercises of the same type.  For example, I could do without doing bills, balancing my check book, organizing my [anything].  Are these examples enough to completely push me onto the surgery side of the fence?  No I don’t think so, but it does start to build a case towards surgery in my opinion.

There are many other things I think have helped push me in that general direction.  I thrive on a chaotic environment.  I enjoyed the hands on part of my research projects (little animal surgeries).  I like playing musical interments (guitar & violin) but I couldn’t care less about musical theory.  I am a visual individual.  I like pictures, charts, and anatomy.  I enjoy figuring out problems and then doing something about them.  I am a self proclaimed doer and I don’t like to wait around for things to happen.  I like physical puzzles like the rubik’s cube more than riddles.

Is all that enough to put me directly into surgeon land?  Maybe.  Maybe not.  But to me, it does make for a case definitely towards surgery in my opinion.

In medical school, I’ve enjoyed my OR time so much that I have been seeking out surgery shadow time in my limited free time.  But at first I was unsure if this was because anything seemed more interesting that sitting in class all day or because I was genuinely interested in surgery.  But now I’m sure, that some procedural specialty is in my future.

There you have it.  My overall thinking process on how I’ve been trying to narrow down my specialty choices.