When to decide on your future specialty

The most difficult thing during studying medicine is not preparing for exams. The real challenge is to decide for a specialty.

Photo courtesy of istockphoto.com

Photo courtesy of istockphoto.com

 If you do this right, it can really help your career.
There are few students who know from the start, often because they want to inherit their parent’s clinic. (No problem there, I just didn’t have that luck) But for the rest of us: The first question is: WHEN should you decide?
Should you decide early and focus your interests on your future field? Or should we stay open-minded, to get a broad overview of medicine and to become an all-rounder? Most curricula and exam requirements are broad enough to ensure you won’t become a “one-topic-expert”.

But let’s look at the reality, that always helps:

The medical knowledge that has to be mastered grows fast and doubles constantly. As a consequence you don’t stop specializing after you are a general orthopedic surgeon but rather subspecialize in extremities or even joints. Heart surgeons subspecialize in heart valves. (Mrs Tricupid and Mr Shoulder…)

Even a field like nephrology (that’s one organ!) provides different areas. Transplant, Dialysis, Intensive Care, Interventional Nephrology, Autoimmune. I only know one good allrounder in nephrology, and he is definitely out of my league. So sooner or later in most cases you will have to (sub-)specialise, if you want to compete.

All important leadership books teach you that you have to focus. Apple focuses on 3-4 products. Southwest Airlines only uses one type of aircraft. Starbucks focuses on coffee, nothing more. “If you do one thing and do it well, you can build a reputation that almost guarantess success in the long term.” (Al Ries, “Focus“)

 In my opinion you should attempt to do the same and decide for a field as early as possible.

An early decision on what you want to learn gives you certain advantages:

  • You have more time to make the necessary connections to your future boss.
  • You learn differently as a student compared to as a resident. You’re allowed to make mistakes and ask stupid questions. As a resident you have to do the basic work, while the student gets to watch interesting stuff.
  • While studying for exams and tests, you can decide whether you just want to pass the test or really dig into the information to profit for your future career.
  • You can choose to do the practicals and clerkships in fields that will help you in your future careers:
  • You want to be a dermatologist and you have to do a surgery rotation: Try to get into plastic surgery.
My next blog post will be on how to make the right decision for a specialty. Stay tuned.
Question: When did you decide for your field of STUDY? Leave a comment below!