Choosing a Specialty

Now that I’ve been accepted to medical school a common question I often get is, “what type of doctor do you want to be?” Great question, the answer to which will very likely change as my knowledge of anatomy, pathology and disease transforms from something abstract and superficial to real knowledge. Choosing a specialty is one of the most important decisions a medical student will have to make. In just three years, we will begin the process of applying to residency programs, at which point you pretty much have to know what field of medicine you want to be involved in.

Hopefully, study of the various body systems in years 1 and 2 of medical school will help illuminate this for most students–piquing an interest in the brain or the kidneys or some other specialty. If that isn’t enough, medical students get plenty of help guiding them in this decision through exposure to various specialties via clinical rotations in years 3 and 4, mentors, specialty interest groups and shadowing opportunities.

I recently learned that the University of California Irvine Medical School administers the Myers-Briggs Personality Test to students during orientation to help match their personality and temperament with the residency best suited for them.

“…the Myers‐Briggs Type Indicator (MBTI) has become the most popular and widely used psychological test in the world. Based on Carl Jung’s theory of personality types, the MBTI was designed to analyze personality in a systematic, scientific manner. Where other questionnaires (type tests) only illustrate type, the MBTI precisely identifies a person’s personality type preferences. The test enables you to learn more about how you perceive and judge others, whether in an occupational or social situation. It identifies your strengths and weaknesses and shows whether you value autonomy or prefer interdependence.”

To learn more about the MBTI or to take the test for yourself, you can visit the following site.

In addition, the Student Doctor Network (SDN) has a free online test you can take that helps to match you with the specialty best suited for you: try it here

When I did the SDN test my top five results were: physical medicine and rehab (what?! no interest there), internal medicine oncology/hematology (right on), family medicine (boring), internal medicine-nephrology (hmm interesting!), emergency medicine.

It will be interesting to look back on this time and see how my interests have changed. To date, I’ve had the most exposure to Emergency Room physicians and so it’s no wonder the ED specialty ranks at the top of my list. In addition, here are where my current specialty interests lie:

1. Emergency Medicine

Why I like it: As an adrenaline junkie and someone who thrives on high pressure, high stress jobs, I really enjoy the fast-moving nature of this specialty. Every day is different. It allows you to see a huge spectrum of disease touching on pretty much every specialty (you don’t have to choose just one!). You get to perform really fun medical detective work- typically you have never met the patient and must form a diagnosis and treatment plan based on sound clinical judgement and skills of interpreting results/clinical presentation. You literally have someone’s life in your hands and can have the instant gratification of seeing that person get better. Shift work. No “on call.” Good work-life balance. Great for women.

What I don’t like about it: This is actually something I do like about it, but my body doesn’t. You are on your feet all day and it’s a physically demanding specialty. Although I personally enjoy this aspect, I am worried that because of my POTS, as much as I want to do it- I won’t be able to. It is currently very difficult for me to stand for 4 or more, let alone 12 hours, without feeling extremely fatigued. My heart is in a constant state of tachycardia and there are some as of yet unexplained physiological things going on that cause me to feel weak, sore and tired after this type of  excursion. I am working with my cardiologist to improve my physical stamina so my hope is that in four years I may not have this problem. I do have to be realistic however and it’s very likely I simply won’t improve much beyond where I am today.

2. Oncology

What I like about it: This is a very intellectually stimulating field which would allow me to have a dual role as a clinician and researcher. An interest in cancer is in my blood- both of my parents are cancer researchers focusing on novel drug development. As strange as it sounds, your patients are actually sick and you are able to help them. Often times in the ER patients come in with complaints but no real illness- some of them are just lonely. The field is constantly advancing and there is opportunity to play a role in that advancement.

What I don’t like about it: Exhausting all medical possibilities yet your patient still dies-often. Seeing patients suffer more because of the medicine you give them. Dealing with death that is slow and predictable.

3. Cardiology

What I like about it: I find the heart really fascinating and I have a keen interest in disease states of the cardiovascular system. Partly because of my own experience, I am drawn to cardiology and particularly further research on POTS and autonomic disorders. Same as for oncology, you get to establish long term relationships with your patient and create a continuum of care. Satisfaction of seeing someone improve by making positive changes in their lives to reduce disease state. You get to do procedures (stents, cath lab) and interesting diagnostic exams (echo-cardiograms, stress tests, etc.).

What I don’t like about it: So many of your patients are old. Nothing against old people, but I like a varied patient population. Seeing improvement in patients often requires real life-style changes from the patient and being frustrated when that doesn’t happen.

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4 Comments

Filed under Medical Specialty

4 responses to “Choosing a Specialty

  1. Very interesting post, I have been asked which specialty I’d like to go into. Pediatrics stands out to me. “Influenced by your love for babies?” asks one of my friends. I do love kids, and I suppose so far that’s my only reason. 😛

  2. Nimmie,
    Kids definitely make wonderful patients with plenty of laughs to lighten the moment. I think both cardiology and oncology would be interesting with a focus on pediatrics.

    • Oh you did reply to my comment! Haha.. just to let you know, people don’t get notified of your reply unless you hit reply directly to their comment. 🙂 I think the same about Peds, a subspecialty would be very interesting. But also very sad, cause pediatric cardiology includes many congenital disorders, and of course, pediatric oncology would be heartbreaking.

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