The Art of Choosing a Medical Specialty

Form the moment you apply to a Caribbean medical university, you will be bombarded by thoughts, and unsolicited nosy inquiries, about which specialty to choose. The proliferation of specialties, not to mention subspecialties, makes sure that no two physicians practice the same type of medicine even within the same specialty. Wrapped up in the throes of this diversity, medical students often find it a tough nut to crack to commit to a single specialty. Some choose to try on myriad skins, envisaging their lives within personal roles and hypothetical careers, some resort to a process of elimination to distill down their choices, bidding adieu to specialties that do not meet their predetermined criteria, while others do their due diligence to make an informed choice. Seeing the befuddlement of students when it comes to making this career-defining choice, we have decided to drill all the doctors-in-training with this comprehensive guide to help them make the right decision.

Skillset

Despite the façade that you put up in front of others, you need to introspect and diligently scrutinize yourself. What exactly are you good at?

For instance, if you are not a “people person,” one could say that a predominately clinic setting was not made for you. However, having an aversion to the clinic setting doesn’t entail that you won’t enjoy doing clinic at all. Depending on your role, your attending, the patient population, and so on, a clinic could be an entirely diversified experience that would keep you on your toes. A person who isn’t entirely into breast clinic, ophthalmology clinic, or primary care clinic, could develop a fancy for gynecology clinic or ENT per say, during the clinical rotations.

Similarly, all those who are clumsy of hands should steer clear of procedural or surgical specialties. While generally, third or fourth-year students have had plenty of chances to hone in on their skillset during residency, you still need to do some soul searching if you find that you are significantly less coordinated than your peers. The residency match would be a long shot for you.

Ability to Perform Well Under Pressure

With medicine being such a taxing profession in itself, it can be rather hard to predict what specialty will test your grit the most. Stress can be the product of myriad factors, such as supervising your staff, putting in protracted hours without a respite, or operating your own practice. However, there exist some areas of medicine which put you in direct contact with patients suffering from debilitating life-threatening conditions or those clutching at straws, drawing their final breaths. With so much at stake, you may find yourself constantly on edge. If you have a knack for maintaining your cool under pressure, working in the emergency room or in critical care may be a great career choice for you. On the other hand, if you are looking for a low-key forte, consider dermatology or ophthalmology.

Types of patients encountered

All medical professionals have to interact with patients in one way or another, even pathologists working in the laboratory. After all, what’s a medical practice without patients? When it comes to deciding on a specialty, most aspiring doctors overlook the importance of factoring in the different types of patients they will likely encounter over the course of their careers. Take a stock of the typical patient in the specialty you have developed a penchant for. It’s important to ascertain that you will be able to thrive both professionally and emotionally in that particular patient-doctor relationship.

For instance, Emergency medicine physicians have to contend with hordes of angry and exasperated patients who have been waiting for hours on end, in addition to answering the constant apprehensive solicitations of their attendants. Pediatricians have their own demons in the form of concerned, over-demanding parents, and dealing with sick children.  Oncologists have to bear the trauma of treating mortally-sick people who keep getting worse, despite being administered aggressive treatments. Obstetricians get the worst end of the bargain perhaps, always apprehensive of the possibility of being slapped with a malpractice suit, in the events of a minor birth defect. To put it in a nutshell, you need to gauge your level of perseverance and patience, before deciding how much you can bite off!

In addition, your level of comfort with patient contact can distill down your choices. For instance, if you are a social animal and aspire to nurture long-term relationships with patients, myriad fields running the gamut from family practice to psychiatry provide ample opportunities to spend time with your patients. On the other hand, introverts may do well to remain with a more low-key field, such as pathology, ophthalmology, dermatology, or radiology. If you are not scared of getting your hands dirty, consider a career in surgery, obstetrics-gynecology, or emergency medicine. Some specialties, such as orthopedic surgery and urology, only entail doctors to perform focused physicals. Fields, such as anesthesiology and emergency medicine keep your interactions with patients short and to the point, but it’s really gratifying to know how many people you help out each day.

Expected salary

While “holier than thou” medical professionals may demonize this aspect, remember that you are choosing a career for life. If you aspire to a certain lifestyle, it is important that you are able to afford it. For instance, if you are weighed in by loans, you might want to earn more to lead that lifestyle, as compared to a free bird. It’s important to know beforehand what you are getting into so that you don’t harbor resentments for your patients or your career down the road. However, their highly volatile nature means that medical reimbursements are finicky and subject to constant change during your career. Also, be mindful of the fact that salaries can vary depending on your niche and patient population. So the other side of the coin says that while taking your expected salary into consideration is important, it shouldn’t be a sole deciding factor.

Personality

Your choice of medical specialty should align with who you are as a person: your task-management skills, limitations, aptitudes, ambitions, interests, abilities, likes and dislikes, social disposition, and personality. Are you into solving complex problems and thinking about details, or are you a hands-on practical person? How do you fare with complex/busy situations and uncertainty? Would you like things to go more orderly with not much room for surprises?

Most medical specialties entail a heady mixture of attributes due to the variable and varied nature of a physician’s job. Most foundation schools and local education and training boards offer learning style and personality testing through their careers department so that students can have a better idea of their fit with a medical specialty.