Choosing Your Specialty? Answer These 5 Questions

So you have hit that point in PA school, Medical School or nursing where you finally have some control and someone says “so what do you want to go in to?”.

How do you answer that?

Now for nurses and PA’s, you are a bit more lucky in that you could decide surgery and then 5 years later decide to change. For doctors, there is not such an easy path to change since we are bound by what our residency training covers.

No matter your title, here are 5 questions you should be asking yourself before you decide on a specialty.

1.     Do you like to cut? No… better question: Could you EVER live without surgery in your life?

It seems like I am being dramatic but this is true. Surgery is a tough lifestyle. That said, things are changing and it is getting easier than it used to be to have a normal life and be a surgeon but the truth is it isn’t going to be easy. The best advice I was ever given was that second question. If you can live without surgery, it’s not for you.

Another trap to be wary of is someone you respect like a seasoned attending praising your skills. It is addictive to hear from such a skilled master that they think your skills are strong but remember this just because you are good at something does NOT mean that you have to do it for the rest of your life. Find something you LOVE not something that you are just good at. It seems silly but trust me on this one, it is very easy to get caught up in this one.

2.     Do you want high acuity or medium to low acuity?

Again, no wrong answer but decide if you like seeing sick patients all day who are crashing on you, or would you prefer to help manage a chronic disease to make a positive change in someone’s life. There are no “right answers” today, these are all just points to consider. It is just a fact of life that someone in the ICU is seeing more “sick” patients than someone also practicing internal medicine at an outpatient clinic.

3.     Do you want to follow up on your patients?

It is SO KEY to figure out your opinion on this. Do you like to see the same patient throughout the years watching them grow and keeping them healthy or would you rather see new faces (mostly) every day for the rest of your career. Emergency Medicine and Family Medicine are two great contrasting specialties for this.

4.     Do you like shift work?

When you’re on you’re on but when you’re off you’re off! That’s the beauty. No call, no thinking about the patients when you’re home, you just come in, work hard and go home (mostly) clear of responsibility. Sounds nice right? Well it’s not all rainbows. You also have the issues of sleep wake disorder from changing your schedule all the time. Oh and you can’t really forget about your patients because you are so worried about them while you are at work. That said, it is nice not to have to answer phone calls or worse, actually go into the hospital in the middle of the night.

5.     What lifestyle do you want?

Don’t be ashamed to ask yourself this. Give yourself permission to think about what you actually want. You are not less of a healthcare provider because you want more time to yourself and no call just the same as you are not less of a parent for spending long hours in the OR and having someone help take care of the kids. Do you want to do neurosurgery where you almost certainly must live near a large academic hospital to work or would you rather do internal medicine and have the flexibility to work in the rural Midwest. Again, THERE IS NO RIGHT ANSWER but there is a right answer for you.

Give yourself the time you need to answer these five questions. Chat about them with your friends and family. If you truly reflect on these, I believe you will be much happier in the long run.

Why did you choose to practice in the area you did? Comment below


-Adam Goodcoff


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