Whether you’re a first or fourth year medical student, choosing your preferred specialty is a major decision, but how do you determine what to practice? Learn how to choose a specialty with tips from an advisor who understands your mindset.
Surendra Varma, MD, has worked as the executive associate dean for graduate medical education and resident affairs at Texas Tech University since 2007. Each year, he advises 40 to 50 medical students about their residency program applications.
When it comes to specialty choice, Dr. Varma said he’s noticed an interesting trend: Most students want to choose a specialty they genuinely enjoy, but often lack exposure to a variety of disciplines to make an informed decision.
“Unless they have a parent who’s a physician or they attended some kind of medical service trip, the majority of students entering school aren’t exposed to many specialties outside of the popular ones like pediatrics or primary care,” he said.
The Association of American Medical Colleges (AAMC) 2015 Report on Residents found 56 percent of medical students change their preferred residency specialty over the course of medical school. This data is based on comparisons between the specialties students selected on the AAMC’s Matriculating Student Questionnaire, which students are invited to complete during the summer before their first year of medical school, and the specialties they later chose on the AAMC Graduation Questionnaire during their final year of medical school.
Dr. Varma said he understands why students often change specialties between each questionnaire, noting that it may be more productive for students to initially select their specialties after they matriculate and gain exposure to their options.
So how can you learn more about specialties and find the best fit for you? Make sure you don’t overlook these important factors when determining what to practice:
Assess your skills—not just the amount of money you wish to make
While the lifestyle and revenue associated with a particular specialty are important, students should also consider the skills required for the field. Avoid pursing a practice simply because of its prestige or earning power.
For instance, “many people want to go into orthopedics or surgery, but what if you don’t have the skills to successfully perform a surgery?” Dr. Varma asked, noting that Texas Tech University offers a simulation center for students who wish to test their skills in a medical setting.
Find out if your school provides similar resources, so you can take inventory of your strengths and weaknesses and choose a specialty that truly fits your talents.
Gain clinical experience in your preferred specialty
Shadow an attending physician in your field as much as you can. “The best way to do this is through an externship,” Dr. Varma said.
However, if you can’t work one into your schedule, join specialty clubs at your school and take advantage of free talks and lectures to gain exposure to different disciplines. “Most schools have a club for every specialty and people do more than just have lunch,” Dr. Varma said. “Physicians will come to club meetings and talk about their work and the lifestyle of their practice.”
Research the culture and availability of your specialty
The popularity of specialties can shift based on each generation of medical students, which will impact job availability.
Data from the AAMC suggests that factors like gender may also impact specialty choice, so take the time to consult practicing physicians and advisors about the culture of different disciplines. This will help you develop a holistic view of the practice environment you may work in.
Choose a backup specialty
This one is hard for many students to accept, but it’s important, Dr. Varma said. While gaining exposure to your preferred specialty, it’s helpful to also identify a backup specialty you’d be happy practicing, especially if your primary choice is in a competitive field.
“We usually tell students to apply to 20 or 25 programs and use interviews to gauge whether or not they’ll match in a certain specialty,” he said. “In competitive fields like orthopedic surgery and urology, students may even want to apply to 40 or 50 programs.”
Make your residency program application as authentic as possible
It’s counterproductive to research a specialty that uniquely fits you, only to submit an application that sounds similar to your colleagues.
Besides focusing on your overall competitiveness in your class, choose credible physicians who can write honest letters of recommendation about your potential to excel in your chosen field, Dr. Varma said.
Also, don’t forget: The personal statement is a chance to show who you really are and why you’re the best fit for a specialty. “Please, don’t submit a cookie cutter essay about why you want to work in surgery,” he said. “Go from the heart.”
The residency application process is all business. Those who read your essay are not looking for novel styling, mysterious openings, or poetic phrasing; instead, they are looking for a clear statement of why you want to pursue a career in that particular specialty.
Like the AMCAS personal statement, residency personal statements are open ended in that there's no specific prompt. However, your residency matching application essay will need to be even more focused than the one that you submitted to medical school. Keep in mind that you are ultimately applying for a job, and your residency essay should reflect a strong level of professionalism.
One of the biggest mistakes that we see in residency essays is organizing them like med school application essays. Some applicants even try to use their med school essay as the basis for their residency essay. On the surface, this makes sense. Obviously, your medical school application essay was successful, so you want to repeat that success in the residency matching process.
However, we definitely recommend starting your residency essay from scratch. The selectors really only want to know about your life after you began medical school, so you'll need to draw upon those experiences to create an effective essay. Also, there is a strong trend within residency matching for shorter and shorter essays. No specialty is looking for an essay of longer than one page and one paragraph, but limiting the essay to fewer than 700 words is a good guideline.
Additionally, we've learned that creative essays don't perform particularly well in the matching process. Residency selectors are looking for very specific things within the essay, and they want to know how you'll fit in to their program. It's called 'matching' for a reason, and you'll need to show the selectors that you have a place with them as a resident.
Here are the main content areas that we suggest covering in your residency essay:
Why have you chosen this specialty?
In the first part of your residency statement, you should discuss what in particular has interested you about the specialty you've chosen, and how you've built experience in that field. If you're planning on devoting your life to internal medicine, radiology, or any other focused branch of medicine, you must have a clear reason for doing so. Thus, make sure that the reader comes away from this section understanding what has led you to this profession.
Why do you think you will excel in this specialty?
Not every med school student will have equal interest in, let alone talent for, every specialty. What about you makes this specialty the right match for your personality and goals? Help the selectors see that you have what it takes to thrive in the specialty. A meticulous person can feel right at home doing gross and checks in pathology. Excellent manual dexterity can ensure success as a surgeon. Persistence in solving complex puzzles can serve you well as an internist. In this part of the essay, make connections between general talents and your chosen specialty.
What are you seeking in a residency?
Next, write about how you intend to further that experience during your residency and what specifically you're seeking in a residency. Don't talk about specific locations, though, as you'll likely send this essay to a large number of facilities. You've got a solid base of experience already, but during your residency you're going to become an expert. What will you contribute? You may want to write about things like teamwork, continuous learning, and passion for patient care.
How do you see your career in this field progressing?
Finally, look past your residency to give the reader an idea of what you plan to do with your accrued knowledge once you have completed your residency. Show the residency selectors how you will use the knowledge and skills that you gained in the residency for the benefit of patients. Do you envision yourself pursuing research? Working in a university? Being a provider in underserved regions? Tell them your vision for your career as a physician.
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