How to CHOOSE A SPECIALTY | 6 Steps

How to CHOOSE A SPECIALTY | 6 Steps


In a future doctor’s life, there are few
decision as important and 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. Dr. Jubbal, MedSchoolInsiders.com. We’ll 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 love
about it, and what they wish they did differently. For that reason, we’ve started an all new
series called The Insiders 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 newsletter at MedSchoolInsiders.com/newsletter. Data from a 2018 survey conducted by the AAMC on medical student 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 medical school wanting
to go into pediatric gastroenterology but I ultimately switched to plastic surgery. I go over that journey and the process that
led to my decision in a video on my vlog channel. Link in the description below. Interestingly, students that had the highest
rate of congruence, meaning they did not change their specialty, chose orthopedic 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 most medical students end
up changing their mind over their 4 years in medical school. So where do we go from here and how can we
create a system to decide on the best suited specialty for ourselves? Most commonly, people refer to compensation
as a significant factor to help sway your decision. 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 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 little you enjoy performing procedures, the types
of patients you generally work with, and who your colleagues will be. Does the specialty excite and captivate you? Can you imagine doing this for the rest of
your life? Often times, medical students fixate on rare
cases or procedures that are particularly exciting in their field. However, it’s important to remember that
these zebra cases are few and far between. More importantly, determine whether or not
doing the bread and butter, meaning the things you are more likely to see day after
day, is something you can actually live with. We’ll 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, then neurology or neurosurgery are appropriate considerations. Next, assuming you plan to practice clinically, do you want direct patient care or indirect
patient care? Indirect 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 will often require a high degree of patience. You can also opt for a middle ground, like
urology, dermatology, OB/GYN, or anesthesia that allow for a mix of both. Another important consideration when answering
this question 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 important. This is a common sentiment amongst pre-med
and medical students. However, by the time you reach the end of
medical school and have been put through the wringer, you begin to realize how important
lifestyle is. It’s easy to simply correlate challenging
or unpredictable work hours with higher rates of burnout, but it’s more nuanced than
that. On average, surgical specialties have much
more challenging hours than non-surgical specialties, but the burn out rates are not necessarily
higher in surgical specialties. The 2019 Medscape National Physician Burnout,
Depression, & Suicide Report provides data on the burnout rates across
various specialties. The highest rates of burnout are found in
urology at 54%, neurology at 53%, physical medicine & rehabilitation at 52%, internal
medicine at 49%, and emergency medicine at 48%. The lowest rates of burnout were found in
public health & 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 include 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%. An often understated yet highly important
factor 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. The types of patients and interactions emergency
physicians face on a daily basis is far 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 playing to your strengths. On average, we enjoy things we’re good at. If you’re a klutz and particularly uncoordinated,
then procedural focused specialties may not be a good fit. Next, consider the competitiveness of a specialty. If you’re 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’re struggling in college or medical school, our
team of exceptionally qualified and effective tutors at MedSchoolInsiders.com 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 vs academic vs community,
rather than your specialty choice. Addressing the previously mentioned 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, however, it’s 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 areas of interest as much as possible. Specialty clubs and talks from physicians
across various specialties are also a great way to gain exposure to different specialties. And our new series, The Insiders 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’s essential that you
make your residency program application as authentic as possible. Don’t fall into the trap of researching
a specialty and finding one you love, only to submit a residency application that sounds too
similar to your colleagues. The personal statement, letters of recommendation,
and soft parts of your application are just as important as your USMLE Step 1 and Step
2CK scores. If you need help with your residency application,
our team of advisors with real residency admissions committee experience can help. Visit MedSchoolInsiders.com to learn more. If you guys want to chat with me in real time,
make sure you’re subscribed with the notification bell enabled. I spend the first hour after a new upload
responding to your YouTube comments in real time. New videos every Saturday at 8AM 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.


100 thoughts on “How to CHOOSE A SPECIALTY | 6 Steps

  1. I started off wanting to do GI, then considered Neurosurgery and Orthopedic surgery, but ultimately landed on Plastic Surgery. Here's my journey and thought process: https://www.youtube.com/watch?v=Gyqu5AER7gg

  2. 18 years old have a year until i graduate wanting to know your thought on nurse practitioners I hear a lot about doctors and surgeons I don't know if this can aply to me in my position.

  3. If you classify Plastic Surgery under a fairly time-consuming practice, how do you manage to upload YouTube videos? My main question here is how much time do you have outside of surgery to focus on day to day life. Asking as someone who wants to go into ortho.

  4. Great video. Your content is super helpful and insightful.

    Is it possible to choose more than one specialty, or switch from one specialty to another after some time?
    I'm really interested in both emergency medicine and internal/family medicine and really like the idea of both. I hear wanting to branch to different specialties that it might be better to becoming a PA… any thoughts?

  5. I came across orthopaedic surgery and liked but, however i saw that its very time consuming and surgeons dont have a proper life due to on call duties,is that true?if so is there any other similar professions that have more life work balance?

  6. Thanks for your YouTube channel. I teach advanced physics in high school, and many of my seniors are considering pre-med as an undergrad path. I direct them to your videos, which have proven helpful to them.

  7. I'm 13 and I'm thinking about surgery of some sort but I'm not sure which! I wish I could get a start in trying to learn more about it and study up on it throughout highschool and stuff but idk how lol just checking out all your videos!

  8. I am from France and have to choose my specialty in less than 2 weeks and it's a huge struggle for me. I asked myself the same questions that are adressed in this video and am still hesitating between medical (neurology or pediatrics) and surgery (neurosurgery or pediatric surgery, and very recently wondering about plastic surgery because it is one of the surgery that offers the best balance between work and personal life…). For every specialty I see some good and bad points and don't manage to get anywhere in the end…
    I dont know if some of you who have experienced this struggle and went through one of these specialty would have some advice …

  9. Students, know this: the healthcare industrial complex will determine the arc of your career a LOT more than you can possibly imagine. You will have NO control over any of this, and it will only get worse as time goes on. Make sure you understand that the tide has changed, that medicine foremost is a business, and there is a great deal of lip service paid to the notion of "patient safety."
    Anesthesiology is my career, and I love it. I had a soul-crushing experience on my internal medicine rotations as a 3d-year student; my faculty mentor had a similar experience in her education. She's an anesthesiologist, the rest is history.
    What makes anesthesiology great: you are often the smartest guy in the room, because the anesthesiologist needs to know everything about the patient to plan the proper anesthestic; you also need to know at least the basics of the surgical procedure at hand. The anesthesiologist needs to know what medications are indicated, contraindicated– AND how much they cost (I. Am. Not. Kidding. Don't get too happy with that brand-new wonder drug during your residency, bc chances are that homey little community hospital that you decide to practice will NOT have that drug (or that equipment, or that whatever). The anesthesiologist is the internal medicine person in the OR (and oftentimes knows more than the actual internist). The anesthesiologist has to anticipate how the patient will react to surgical conditions, and be ready to act in instances where the conditions are wholly UNexpected. It's often quick-paced; it's also boring as hell more often than anyone will likely admit. However,
    KNOW THIS: no matter how wonderful a person you are, no matter how technically skillful you are, no matter how knowledgeable and clinically adept you are, you will be abused by just about every other person on the surgical team. "PATIENT'S MOVING!" "I HAVE TO DO MY CASE RIGHT THIS MINUTE!!!!" "THE CASE IS ONLY GONNA TAKE 5 MINUTES!" growls the surgeon. "YOU DIDN'T COMPLETE THIS UTTERLY USELESS BUREAUCRATIC NONSENSE BEFORE WE BROUGHT THE PATIENT INTO THE ROOM", admonishes the OR nurse. "YOU HAVE A NARCOTIC DISCREPANCY!", "I NEED AN ORDER FOR THISTHATANDTHEOTHERTHING– RIGHT NOW, SO STOP POUNDING ON THE OTHER PT'S CHEST!!" hisses the PACU nurse.
    And although most surgeries performed these days are IMPOSSIBLE to perform without an anesthesiologist, we get blamed for all sorts of poor surgical outcomes, whether they make physiologic sense or not. "The pt exsanguinated after the surgeon lacerated the thoracic aorta during a laparoscopic cholecystectomy, you say?" Well, if "anesthesia" had put the OR table in 23° of trendelenburg like I asked, I'd have had better exposure and…" Keep calm and blame anesthesia (that is a REAL tshirt design!)
    My mantra: I love practicing anesthesiology. I just wish I didn't have to do it in the hospital or surgicenter.

  10. At 8:13: REALLY? A shameless plug for your business during a video where you are supposed to be offering unsolicited and unbiased advice? There is no shame anymore, none

  11. I get stressed out just by hearing “medical school” I’m barely 16 years old and still don’t know if I wanna be a doctor 🙁

  12. You know there are other specialties other than ortho, plastics, and neuro. There's fetal surgery, cardio-thoracic surgery, general surgery, pediatric surgery, trauma surgery, facial and maxillofacial surgery, and so many others. Please include other surgical specialties other than just those three. Especially plastics, as it reconstructive surgery, not transplant or cardiovascular surgery.

  13. I'm 16 and I really love neuroscience. I'm pretty sure I want to get into neurosurgery. I'm also aware it is a very difficult field but wish me luck!

  14. I'm trying to decide if I want to go to PA school or med school but I'm just not sure what I want. I have loved medicine for so long and I know that one of those places is where I want to be and I think I want to become a doctor but I also want to make sure I have time for my family in the future and I'm worried I will feel like I'm not doing enough or I could have been more if I become a PA

  15. Me being like (7th grade now): who has a bullet in their brain i will do the honour to remove it. By doing surgery obviously XD

  16. My interests now is urology , It never crossed my mind I'd consider this speciality
    😂
    But I am highly interested and consider it my passion
    Btw I'm a female 🙂

  17. You should do a series where you highlight other options for those uninterested in going the M.D. or D.O. route and instead having professional doctorates for specialized clinical professionals.

    Audiology – Au.D.
    Optometry – O.D.
    Podiatry – D.P.M.
    Occupational Therapy – D.O.T.
    Nurse Practitioner – D.N.P.
    Pharmacy – Pharm.D.
    Psychology – Psy.D.
    Veterinary Medicine – D.V.M.
    Physical Therapy – D.P.T.
    Chiropractic Medicine – D.C.

    These typically are cheaper alternatives to Med School and still make good money, while providing a doctorate in a specialized field.

  18. I am considering changing my future trajectory from Neuropsychology to Neurology. I am completing my bachelor's and will begin to search for medical schools. I just came across this youtube channel and I am glad I found it! I am specifically looking for information about neurology, but can't seem to find that on this channel or the websites. If anyone can point me in a better direction for that, it'd be much appreciated. Also, if there could be a video on this channel made about neurology, I think many of us could benefit from that. Thank you for all you do!

  19. I'm on the brink of graduating grade 12 and I have weird science and maths subjects that i chose bc i don't know what to do for the future. I alternate between wanting to do something to do with medicine and engineering. I like both too much and I keep tossing up between the two. Is there anything that goes into both?

  20. I really want to take general surgery but the problem is I am a bit clumsy. Should i continue pursuing general surgery or should i change specialties?

  21. I am now a doctor with 11 year of experience. I worked in anaes, medical, emergency, intensive care. I think in the end, you really need to work for a few months before you know if you like it or not. What you see in books or in work is totally different.
    I agree that all hot head medical fresh graduate is like I want to save the world. But after multiple complains, long workout, difficult colleague, nurse, boss, you realise that work is work, lack of satisfaction make you think that maybe free time, money is more important

  22. When you talk about surgery can you mention cardiothoracic as I try to watch your videos I've never heard you mention them, It would be nice to hear about it Thank you !!

  23. If you have the time, you should make some sort of spreadsheet that would rate qualities like Pay, Quality of Life, Outside work relationships, etc. on a scale of 1-5.

  24. I'm aiming for orthopedic but i am concerned about burnouts… Can anyone tell me about the burnout rate in orthopedic ! 😅

  25. derma…rhematology ….cardiology or oncology m confused …. i like all of these but wanna live a well balnced and happy life
    can anyone help

  26. Orthopedic surgeons work clinically a lot too, well at least pediatric ones… my orthopedic surgeon sees and treats people clinically a lot 🙂

  27. Listen, folks, this is all bullshit. If you want to make a ton of money and don't care about working around the clock, then choose orthopedic or plastic surgery. Good luck, though, because they happen to be the hardest specialties to match in. If you want the best lifestyle with the big bucks, then choose dermatology, opthalmology, and perhaps anesthesiology. I say perhaps anesthesiology because 1) as an anesthesiologist, you're going to be treated like crap by surgeons and even nurses (in other words, there's a reason why anesthesiologists have the highest suicide rates among physicians and unrivaled drug abuse problems) and 2) CRNAs (nurses who do anesthesia) are slowly but surely supplanting anesthesiologists because they're a hell of lot cheaper and insurance companies like cheap labor. Dermatology is great because you have much less hassle with insurance companies since a lot of your business is cash. Opthalmology is wonderful because there are incredibly few opthalmologic emergencies, so when you're on call, 99.999% of the time, you won't get called in. In addition, cataract surgery is quick and compensates you extremely well. So, both dermatology and opthalmology are essentially 9-5 jobs if not less with HUGE paychecks. Don't buy what they say about radiology (excluding interventional radiology). It's on death's door because of AI. Only fools would choose this specialty looking forward into the future. Gastroenterology is for the venture capitalists amongst physicians. Why? The return on investment for colonoscopies is unbeatable. However, you do have to get past the stench and the fact that you're sticking a camera up someone's asshole. But if you can weather the sideway looks of your colleagues, it's an excellent money making scheme. Finally, spine surgery. Why? 9-5 and big bucks. You can actually raise a family comfortably in terms of finances and lifestyle. All the other specialties lie on a spectrum with respect to bucks and lifestyle. Am I lying? Hell no. Listen, there's a reason that physicians burn out: they've gotten into specialties where they are literally being attacked by insurance companies and hospitals. The pressures are relentless because physicians have failed to organize or to file class action suits, so in way, they only have themselves to blame. So, be smart. If you can't get into these specialties for whatever reason (because they're extremely competitive and you don't have to guess as to why), then think long and hard about becoming a doctor. I suggest you start your own business or – if you have incredible talent – then focus on that. Most important: don't have any illusions about what medicine in the U.S. has become because the training is hard, the road is long and expensive, and you will otherwise (except for the specialties I mentioned above) be constantly shit on even when you're done with your training. God bless and Good luck!!!

  28. I know I'm young and still have time to decide on my future career, but since I was little I always wanted to be a doctor, cardiologist to be specific. I would do anything just to help people that have heart disease like what my dad died from..

  29. Wow!!! I have really learnt a lot from this video. I'm just a first year MD student. And my passion is to go to Orthopaedic surgery as a first choice and Cardiology as a second choice. I am really interested in surgeries.

  30. I’m only 13 and I’m watching this is very helpful for my career as I want to be a doctor Thx Med School Insider

  31. I’m really interested in the circulatory system and anything that has to do with blood and how our heart works and stuff, you think cardiology is good for me? Thanks for reading!

  32. Those numbers at 1:50 make sense to me. Im not in medical school yet, but Ive wanted to be a neurosurgeon since I was 5 years old

  33. I picked ophthalmology because it has a great balance of clinic, surgery, and a good work life balance. I haven't regretted it so far 🙂

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