Finding the right physician specialty is a matter of knowing what you want to do, but it’s also about knowing where you are wanted. For medical students entering the final year of medical school, it’s getting to crunch time on specialty choice. Pursuing a medical or surgical specialty because of perceived prestige or competitiveness doesn’t make for a fulfilling career. It also might not make for a match.
“There are definitely enough spots for all U.S. allopathic and DO grads, so each student has a spot, but it may not be the spot a student has an eye on,” said Kimberly Lomis, MD, the AMA's vice president of undergraduate medical education innovations. “There’s a maldistribution of the students’ interest compared to workforce needs.”
FREIDA’s Specialty Guide—and corresponding series of videos offering expert insight on specialty choice—provides a clear, approachable overview of medical specialties and subspecialties and can help you choose a career path. It’s designed to simplify medical students’ specialty selection process, highlight major specialties, detail training information and provide access to related association information.
Dr. Lomis recently offered her expert insight on what medical students can do to make, what she dubbed, an “evidenced-based” physician specialty choice.
The Association of American Medical Colleges collects data on students who match in each specialty. The organization then makes that data publicly available, and it is a key resource for potential applicants.
For the time being, one baseline metric is a student’s score on Step 1 of the United States Medical Licensing Examination (USMLE)—the exam will be going pass-fail in 2022, changing the process.
Looking at pediatrics as an example, students from U.S. MD-granting medical schools who passed Step 1 but scored 216 or lower had a 76% chance of matching into that specialty between 2013–2018. That share climbed to 85% for U.S. MD medical students who scored over 235.
“Use the data that’s out there around the fields that you are interested in and look at your application on an evidence basis,” Dr. Lomis said. “Several specialties receive more talented applicants than spots available. In those fields, you will have very talented and qualified people not match. It’s not an issue of only marginal students who aren’t matching.”
If you are confused about the data and your applicant profile, ask your advisers.
“Listen to your advisers if you are interested in a field and they are telling you they don’t think it’s realistic. You should probably take that seriously,” Dr. Lomis said. “You’ll see students who press because they lock themselves into a vision of what they want to be and ignore counseling. There are many rewarding opportunities in medicine; students should be open to various versions of the future.”
There is more than one specialty for you. Speak to those around you and assess your strengths to get a firmer idea of which specialty will best draw on them.
There are other resources such as electives and away rotations—slated to return in the summer of 2021—that can also give applicants a view of their options.
“One of the things students can think through is being a little broader in their view of what a career in medicine can be—and try not to get sucked into this notion that there’s only one program or even one field for me to be happy,” Dr. Lomis said. “Medicine is a tremendously rewarding career with many different options.”