This question was originally posted on Quora.com and was answered by Amy Chai, MD, Internal Medicine, MS Epidemiology I actually didn’t know. But I did decide that even though I liked surgery, I did not like “getting up early.” I just did not think I could get up and be in the OR at 7am every day, like, forever. So I decided to go non surgical. That was the first part of the decision. The second part of the decision was that I was married and my husband was going for a highly selective sub specialty that had an early match. We could not match as a couple, so I would have ONE chance to get accepted in the match, knowing I could pretty much only rank one program. And as luck would have it, he was matched in a “top 10” program. So realistically, I would be decreasing my chances A LOT by trying to do something highly competitive and also get in to a top 10 program when I could only rank one program. How many people only rank their number 1 choice? Me. Anyway, I chose internal medicine and I was accepted at my top choice. In retrospect, I was way more competitive than I thought I was. I had very high board scores. I could have matched in a highly selective sub specialty as well. But I was attracted to IM because it had the reputation of being “The thinking man’s specialty.” Well, that was then. Now it is “The chump’s specialty, we don’t PAY you to think, you loser.” Source