Choosing a field of medicine is likely the most important decision a medical student will make during their career. The vast majority of residents complete their residencies and practice in the field in which they’ve trained. Switching residencies, or completing two unrelated residencies consecutively, is feasible but difficult. The bulk of your clinical years in medical school will be spent performing required clerkships, including surgery, pediatrics, internal medicine, psychiatry and obstetrics/gynecology. There are 140 ACGME specialties and subspecialties (aamc.org). How can a student reliably choose the appropriate field when s/he is given so little elective time prior to residency applications, which are due in early fourth year of medical school? The best way to truly know you’ve made the right choice is to explore as many fields as possible during medical school. To maximize your education and exposure to different fields of medicine, you need to have a plan.
Get experience during your non-clinical years: Take advantage of your first two years of medical school. Yes, your priority in the first and second years is to learn basic medical subjects and pass your exams. But you shouldn’t wait to “get your feet wet” first during your clinical rotations. If you have a free afternoon, spend it shadowing a physician in a field you may be interested in. For example, the first week after an exam, you’re probably not studying intently. Find a specialty clinic to spend time in, even if just for a few hours. Another opportunity is the summer between first and second year. If you are doing a research project that summer, consider devoting one morning each week to explore different fields of medicine. If something piques your interest, you can set up something more concrete at a later date, such a two-week or four-week elective.
Ask lots of questions: When you spend an afternoon “shadowing” in a department, don’t just be a shadow! Be proactive and ask lots of questions. Keep in mind that when a student does an official elective, one’s actions and conversations are more meaningful because a grade will be assigned at the completion of the rotation. When you shadow a physician (attending or resident), the environment is a lot less formal; they have agreed to spend time with you and are likely open to questions such as “Why did you choose this field?” and “What is your typical day like?” Take advantage of the opportunity to gather information in this informal setting. If you become interested in the specialty you’ve learned about, ask when would be a good time to return and learn more about the field.
Use tools at your disposal: Find out if your medical school has a mentor database or other program to search for mentors. These resources are excellent because the physicians volunteer to mentor students and are genuinely interested in sharing their ideas, support, and experience with you. (Why else would they sign up to be a mentor?) When you contact a potential mentor, be honest about your intentions. If you know nothing about the field and are still in the information-gathering stage, say so.
For example, you may consider e-mailing:
“Hi Dr. Addams,
I’m a 1st year medical student and I got your e-mail from the mentor database. I’m interested in learning about anesthesiology. My third year rotations seem so far away, and I’d love to get some exposure to the field earlier on. Is there a good time I can come by to clinic?”
Don’t be afraid to reconsider and look for new mentors if you change your mind. Mentors are there to help you and will not be insulted if you move onto a field you are more interested in.
Participate in student interest groups: Participating in student interest groups are a great way to learn about a specialty, especially one you may not have any firsthand exposure to. The groups often invite an attending to give a general background lecture about the field, and the attending will frequently stay afterwards for questions. This is another situation where a physician has volunteered to spend time teaching students, so take advantage! Ask questions and, if you’re interested, set up a time to meet up at a later date. Another opportunity: if there’s no interest group in the field you’re interested in, consider starting the interest group and inviting physicians to speak. It’s a great way to network and learn about the specialty at the same time.
Check out the graduating seniors: When Match Day comes around, most schools circulate this list for everyone to view. If you don’t have access to it, you can ask the school’s administrative office for the list. Check out the match list and see if anyone has matched into a field you are interested in. Then, contact the individual and ask to speak with them about their choice and application process. You may worry you are bothering them, but the truth is that many students are happy to share their tips with you–especially when they’ve successfully matched into their chosen field! In addition to getting information about the field in general, you’ll learn about the residency application process. And, you’ll be making contacts with a future resident who you may meet again in the future when you’re on away rotations and interviews. There’s no such thing as too much networking.
Choosing your path in medicine is a stressful and exciting process. The possibilities are nearly endless, so don’t get bogged down. Make a plan–the earlier the better. Then follow your instincts and take advantage of opportunities for learning and networking as they arise. The truth is that all of your experiences in medical school will help you take care of your patients, no matter what specialty you eventually choose. So take control of your education: you are the one who will be practicing this medicine for years to come.
Dr. Miriam “Mimi” Knoll, MD is a radiation oncology resident at Mt. Sinai Medical Center in New York. She grew up in Brooklyn, NY and graduated from NYU Medical School in 2011. She has three children with her husband, Abe, who is a radiology resident. Her interests include medical education, oncology, social media in medicine, and work-life balance. She can be found on Twitter @MKnoll_MD.