Choosing a Medical Specialty

By Hannah Brown in Career development on Monday, June 15, 2009 @ 10:38

One of the hardest decisions you’ll make in your career, and indubitably the one that will have the most impact on your life.  But how do you choose if you haven’t felt some innate calling to a particular specialty?  Everyone you know - at med school, hospitals, home, will have advice and recommendations, and juniors are increasingly expected to commit earlier in their training, often with limited practical experience in the area. 

Think back to medical school – what did you enjoy most and get the most satisfaction from?  Where are your weaknesses, what did you display a real aptitude for, and can you imagine feeling passionate about it for the next forty years?  What do you like doing most, and what would you like to do less of?

There are all sorts of personality questionnaires and psychometric testing available, but take them with a pinch of salt.  Think more about the questions they’re asking you, rather than the end result.  The University of Virginia has an online personality test that will determine which specialties you are best suited to: www.med-ed.virginia.edu/specialties

What do you want from your career? Consider the impact of your career on your home life – many people choose a specialty based on the lifestyle associated with it.  Maybe you want to undertake research, or just need to be thoroughly intellectually challenged – all these things needs to be taken into account.

Make a shortlist.  List the pros and cons of each specialty.  Include things like length of training, career prospects etc.

Do your research.  Visit the websites of the Royal Colleges and learn as much as you can about the training syllabus.  Most importantly, talk to established specialists in the areas you’re interested in – find out what they like most about the job, and what they can’t stand.  Are they still passionate about it?  Do they love their job?  What kind of work/life balance do they have?  Look at the competition ratios and person specifications for the roles you’re interested in at http://www.mmc.nhs.uk/.  If you’re flexible you might even consider re-locating if posts are undersubscribed in a particular area. 

Once you’ve decided what you want to be a cardiologist, for example, you will need to demonstrate your commitment to cardiology, especially as it’s such a competitive specialty.  Look for taster courses or ‘access to’ courses that you can attend.  Talk to senior specialists and see what advice they have.  They might let you shadow them or attend clinics so you can get a feel for the area.  Use your rotations to write papers in your chosen specialty and get them peer referenced - everything that you can do demonstrate 'commitment to the specialty' will get you noticed when it's time for applications and interviews.  Many F1s are even starting preparing for their membership exams.  Given the Royal College of Physicians' recent change to their regulations it's possible to complete MRCP by the end of F2 if you passed MRCP 1 in September the year after graduating, and then attempted Part 2 and PACES in the following year.  A little drastic, maybe, but even just demonstrating that you're thinking ahead shows real aptitude and commitment.

Have a back up plan.  Not everyone can get their first choice specialty.  Competition can be intense for desirable specialties, and even the best laid plans can fall by the wayside.  Most importantly, be able to rationalise your second choice if you’re asked at interview ‘so why do you want to be a…?’