I’ve done it, you’ve done it, we’ve all done it. Lying down in bed at night right before you’re about to go to sleep, imagining your life after 15 years when you are an independent, practicing physician. We all know what it’s going to take to get there – working your butt off, passion for the field, etcetera etcetera. However, given the people of science that we are, it might be worthwhile to look at it from a more objective lens. In other words, here’s the question that I want to try to answer – what are the factors that contribute to the decision you make when choosing a specialty? Inside the OR vs. Outside the OR vs. Somewhere in the Middle I would encourage you to reference an earlier article I wrote where I described the process that every first year medical student should consider going through, trying to shadow in as many specialties as possible in order to figure out between medicine and surgery. In my opinion, this is the most important decision that you need to make while you are still in infancy for the long road ahead. If you like being in the OR and nothing else, then you should do something in surgery. If you can live without the OR, but still want to do something procedural, then you should look into something along the lines of critical care medicine, interventional radiology, interventional cardiology, or something like that. And if you never want to see the inside of an OR and never want to cut open your patient’s skin, then explore the many different medical subspecialties. Team/Attending on Rotations I can recount so many instances where currently practicing physicians have told me about how a particular mentor, attending physician, or even resident influenced their outlook about a specialty. Sometimes, it’s about seeing how happily someone practices in a particular field that can affect you and make you want to follow in their footsteps. Then, it doesn’t matter whether it’s dermatology or neurosurgery, you just have to do it. Life Outside the Hospital Think back to when you applied to medical school. The thought probably crossed your mind – “I want to be the most badass doctor there is!” And this is what keeps your motivation fueled as you go through the grueling process of medical school applications, the first two years of medical school, your USMLE Step 1 exam, and eventually starting rotations. However, once you start working and practicing medicine in the flesh (aging gracefully along the way), you start to realize the importance of a life outside the hospital in order to maintain your sanity (unless of course you are a megalomaniac, or a neurosurgeon, which are pretty much synonymous). Furthermore, this is the time when you are likely to be in your late 20s and 30s, finding a significant other and starting a family, which of course has a significant influence on your career choices. Type of Future Career This is perhaps one of the most difficult yet most crucial factor. Sure, every one of us would like to do it all – clinical practice, groundbreaking research, teaching young physicians, and volunteering internationally. However, given that there are unfortunately only 24 hours in a day, we can only do so much. However, at the same time, the constantly changing landscape of medicine and the degree of flexibility that can be exercised has transformed what was once thought about some specialties that put constraints on what one could do. For instance, a career in vascular surgery was once considered a gruesome specialty that most likely required a complete dedication just to care for your patients. However, in today’s day and age, vascular surgery is one of the most sought after fields with high-power research, clinical education, and much more. Nevertheless, if you choose to do something like neurosurgery, it might be worth taking a hard look at yourself in the mirror before overcommitting if you would like to lead an active life outside the hospital. Source
