Source: Surviving Grays
I have been contemplating writing this post for quite a while. The single biggest decision you make during your medical education is when you choose a medical specialty. Other choices will affect you for a few years tops, your choice of specialty will affect you for the rest of your career. This is some heady stuff! Thankfully I have readers like MedSchoolMoore to get me off my ass and tackle this subject. She recently asked:
Hello Survivor! Since two of my older sisters became Surgeons. They assume that I will follow their footsteps for some reason.But the problem is that i don’t like the concept of holding guts,babies,bladder etc. I’m almost done with med school and the rotations didn’t help me at all. I need to find a profession in Medicine quick. Can you help me?
Thanks for asking, the Survivor is here for you! Let’s break it down!
1. Separate Perception from Reality
An internet classic from “A Cartoon Guide to Becoming a Doctor“
Original version available here
Although meant to be comical, this flowchart really gets down to how we perceive some of the more popular specialties. Inevitably we are drawn to a specialty by how it is perceived, your job is to determine how much of this perception is fact. How do you do this? Read. Ask Questions. But most importantly shadow / rotate. But Survivor, I don’t have time! Are you flipping serious? This is the rest of your life we are talking about. Make the time early on during medical school to explore all the areas you are interested in and determine the facts.
2. It Is Okay to Consider Money and Lifestyle
There is a certain amount of antiquated bullshit one must deal with when entering the medical profession. Historically it has been a veritable sin to mention money or lifestyle issues when considering your future career*.Our generation has begun to buck this trend. Let’s face it, pay is unlikely to significantly increase anytime soon. More and more of us are looking for specialties that provide an equal balance between financial reward and personal freedom. You must decide where you fall on this spectrum.
3. Don’t Let Others Decide For You
As is evident from MedSchoolMoore’s question above, students often feel a lot of pressure to choose a certain specialty. These outside forces can come from parents, peers and revered attendings. The only people who should have serious input into this decision are you and your significant other. YOU are the one who is going to have to make this decision and YOU are the one that is going to have to live with it for the rest of your life. It is important to listen to the input of others, especially those closest to you but remember, YOU make the final decision.
4. Keep an Open Mind
An attending once told me that an acceptance letter to medical school was like a key to a door. Behind that door was vast opportunity. The various fields in medicine are so varied that there truly is something for everyone. It is okay to have an idea of what field you want to pursue when entering medical school but promise me that you will keep an open mind. Consider all specialties with equal thought. If you change you mind, great! You have found the specialty for you. If you stay the course with your original pick, great! You have proven to yourself that this is where you belong. It’s a win, win people!
5. Don’t Go Into Surgery
I’m sure many at you just had a “whaaat?” moment knowing that I am a surgical intern. If you read the above statement and said, “yeah you’re probably right, surgery is just too much” than don’t go into surgery. If you read it and said, “fuck you Survivor DO surgery is the greatest specialty ever and I cannot dream of doing anything else” then surgery may be for you. My point is this. Choosing surgery as a career should be essentially a process of elimination. If you have considered every other possible specialty and still can’t see yourself doing anything but surgery then go for it (it is the best specialty after all). If you have even the littlest amount of doubt, then run now, the last thing we need is another unhappy surgeon.
Here’s the take home point. I am pretty laid back and most of the time will encourage you to be as well. There is just not enough time to deal with life with a sphincter tone consistently tight enough to crack open a walnut. However, when you choose a medical specialty you must take it seriously. IT IS OKAY to have doubts. IT IS OKAY to take a long time to decide. Do it right, the right decision will lead to a happy and prosperous career.
*I recently overheard a conversation between two of my elder attendings. One was relaying that he had had such difficulty changing is grandchild’s diaper (he had never been home to do it when his own children were growing up).