As a medical student pondering your future as a physician, there are many key considerations in choosing a medical specialty to pursue. The most obvious move—particularly considering the $100,000-plus loan debts most medical students accumulate—may be to go straight to a list of the highest-paid medical specialties and proceed from there.
Yet a physician’s day-to-day existence is shaped by factors that extend well beyond compensation.
The AMA offers tools to aid you with your medical specialty choice, including the Choosing a Medical Specialty resource guide (member login required). For specialty-specific insight, the AMA’s "Shadow Me" Specialty Series offers perspective from physicians in fields such as infectious disease, adolescent medicine, physical medicine and rehabilitation, radiology and orthopedic surgery, among others.
These four questions can help you narrow down your medical specialty choice.
Procedures or patient interaction?
On the surface, this question comes down to surgery versus office-based care. Some specialties, such as obstetrics and gynecology, may offer a mix of both.
“In medical school, I knew that I wanted to engage deeply with my patients every day, help them lead happy and productive lives, and have fun too,” said Caroline Barangan, MD, a pediatrician who focuses on adolescent medicine. “So, I chose a field that isn’t all about medical procedures and crises. Because of this, I knew that my salary would support a comfortable lifestyle but not an extravagant one.”
How do you want to interact with patients?
Primary care specialties such as internal medicine, family medicine or pediatrics offer the opportunity to form lasting relationships with patients while others, such as radiology, feature limited patient interaction and more time working on the technical aspects of medicine.
“I have had many of my patients in my practice for 15–20 years, so I get to form such long-lasting, meaningful relationships with them,” said Susan Thompson Hingle, MD, an internist. “I truly get to know my patients as people, and I am forever grateful for that.”
What kind of work-life balance do you want?
Some people are at their best when the pressure is on and the hours are long. Working in that kind of medical specialty is not for everyone. A recent survey found that the specialties with the highest levels of burnout were those in which the stakes were the highest.
“Work-life balance is important for all human beings,” said Amit Pandya, MD, a dermatologist. “Because the amount of work for a doctor can be overwhelming, it’s important to put limits on the amount of income one desires and work one has to perform on a daily basis. Although I work hard, I take time off every day for myself to pursue time with family and friends, exercise or hobbies that help bring balance into my life.”
Who do you want to treat?
Circumstances and demographics are going to change depending on the type of medicine you practice. Use your clinical training to map out the types of patient populations you enjoy working with and the scenarios in which you might thrive.
“Internal medicine patients tend to be older and sicker, with multiple medical problems and often significant social and psychologic challenges as well,” Dr. Hinkle said. “However, internists—me included—enjoy the complexity this provides. It is so rewarding to work through not only the acute issue at hand, but how that interdigitates with their chronic issues and how to best provide patient centered care.”