Five Career Questions to Ask Yourself as a Medical Student

Most medical students select a specialty based on their enjoyment of the clinical work for that field — the assessments, treatments, and procedures, or the disease states commonly treated. But these aspects are only a small part of what contributes to our overall well-being and sense of gratification at work.

Moreover, your medical specialty is only one of many elements that shapes your career in medicine.

It’s so important to consider a range of factors when selecting a specialty and planning out your career path. These factors include the variety of practice settings available, the typical work hours and schedule, the scope of job prospects, and whether the compensation aligns with the lifestyle you want. These components can significantly impact your career satisfaction.

Unfortunately, the settings for med school clinical rotations are usually limited. They may not fully expose you to the less conventional employers or practice environments available. These less conventional options can be part of your full-time job, but can also be used for side work as a consultant, moonlighter, freelancer, or in other arrangements to supplement your income and achieve your professional goals throughout your career.

I urge you to ask yourself more than just “What specialty will I pursue?” during medical school. There are numerous other questions to consider that will prepare you for a career that you love. Below are five career questions that I recommend asking yourself throughout your medical student years – and as you move into your professional life.

1. Which suits me best — employee or owner?

The choice between being an employee and an owner is one that plays a big role in shaping your medical career. Making a thoughtful decision about whether to take an employed position, start your own practice, or join a practice as a partner requires reflecting on whether you prefer working for yourself or someone else — and why.

A few years ago, there was a significant shift from the majority of physicians being in private practice to the majority opting for employed positions. This change has been driven, in part, by healthcare regulations and financial pressures. Despite this, the option to start or join a private practice remains viable.

Innovative business models and practice niches exist. Many of them address the common challenges such as reliance on health insurance payments. And many of them can make private practice a sustainable choice.

if you like strictly practicing medicine without the additional responsibilities of business management, an employed position might suit you best.

On the other hand, if you’re someone who enjoys making all the decisions — not just clinical decisions, but also marketing, financial, and business strategy decisions — private practice may be a good fit. Some specialties are more conducive to private or group practices, while others offer more employment opportunities.

There are flexible options too, such as working as an independent contractor. In many cases, this allows you to choose when and where you work without the full responsibility of running a business. Locum tenens positions are a great example of this, though there are other types of independent physician opportunities across various medical fields. In my own area of clinical focus — correctional medicine — it’s common for doctors to work independently, taking part-time roles at multiple facilities. Many appreciate having certain benefits of employment without all its restrictions.

2. What is my ideal work setting?

Picture a doctor’s workplace.

What most likely came to mind is a traditional hospital or outpatient medical office with a waiting room and exam rooms.

But the reality is broader. There are many different environments where you can practice medicine. Each has a different atmosphere. A different feel. A different flow. As a result, each has the potential for a different impact on your job satisfaction.

Here are just some of the diverse options for work settings for you to consider: rehab centers, detox centers, urgent care clinics, standalone ERs, nursing homes, prisons, dialysis centers, patients’ homes, student health centers, professional sporting events, medical vans and other mobile units, and cruise ships.

Thanks to telemedicine, there’s also the option of your own home doubling as your practice setting. For many of us, our house is synonymous with comfort and convenience — even if we’re working while we’re in it.

For doctors interested in jobs outside of direct patient care, the range of work settings for nonclinical jobs expands your options even further.

We are affected by our environment. Differences between various work settings can dramatically change your perception of the work that you’re engaged in. This can affect how you go about your daily tasks, your interactions, and how much you enjoy your work.

So, take some time to consider the typical work environments and patient care settings of your chosen specialty or sub-specialty. Where are all the places where physicians might practice that specialty, both the common and the uncommon ones?

3. What is my ideal mix of predictability and excitement?

Here is an aspect of career planning that is often overlooked by medical students:  finding the right balance between routine tasks and dynamic challenges in your work.

I like to describe this balance as an interplay between tediousness and stimulation, or between planned tasks and unexpected challenges.

This is a major influencer of job satisfaction and stress level.

In medicine and many other professions, there is too much idolization of “exciting” jobs. There’s a prevailing (yet misguided) notion that more excitement makes for a better, more successful career.

When I interview doctors about their careers, I often ask about a typical workday. Nearly all of them say “There’s no typical day!” or “Every day is different!” But I know that is not true for many of them. While this response can make for a more sensational and dramatic interview, the reality is that most jobs have a routine — even jobs in medicine!

Many doctors are actually better suited for predictable, routine tasks. Unexpected events, uncertainty, and being forced to make major decisions on the fly can be highly stressful. Sure, there are some physicians that thrive in these scenarios, like surgeons who remain unfazed by mid-procedure complications, or ER doctors who love anticipating what’s going to walk through the door next. However, those same surgeons and emergency physicians have high burnout rates.

Try to be honest with yourself about what you truly want from your day-to-day work. While the shocking, rare diagnoses and life-saving moments are undoubtedly exciting, ask yourself if you want that level of excitement constantly. Or, could it eventually become overwhelming?

Jobs with more routine tasks have a lot of appealing elements. They offer their own kind of excitement. For instance, I have worked extensively in utilization management, reviewing requests for medical services and determining the medical necessity of those requests. This requires reading through medical charts — one after the other. Yes, it is repetitive; however, I find comfort in the predictability of knowing what to expect in my workday. Additionally, each case presents its own intriguing features and involves critical thinking. It is never boring.

When planning your career and choosing a specialty, don’t overlook work dynamics. And don’t be tricked into thinking that “exciting” is always better.

4. How do autonomy and flexibility influence my well-being?

Autonomy and flexibility shape your professional life. They also can shape your overall well-being. You need to understand how having (or lacking) control over your schedule and your work environment affects your stress, happiness, and job satisfaction.

The impact of autonomy and flexibility comes in two primary forms:

First, within a single job, the degree of autonomy and flexibility can vary a lot. For example, a primary care physician in a busy outpatient practice may have little control over their schedule due to patient appointments and a centralized scheduling system. On the other hand, a Medical Director or staff physician at a hospice program might have considerable flexibility. They can decide when to see patients, how and when to do their chart reviews, and how much time to spend with each patient.

The other impact comes from the sum of all your professional obligations. Many physicians juggle multiple roles and obligations. Some have a full-time position and one or more side gigs, for example. In many situations, they have ample control over how these roles fit into their schedule and how the roles fit into their overall career or financial goals.

In contrast, physicians employed by government entities or large academic institutions may face restrictions on outside work. They may need permission for moonlighting, consulting, or even doing an interview for a news article. While this can limit autonomy, many physicians in government or academic roles perfer the structured path for advancement, job security, and benefits.

You can find varying degrees of autonomy and flexibility in any specialty and any career trajectory. But you have the ability to choose your employer or practice based on your preferences for these factors. When you think about your future work life, consider how these will influence your sense of balance.

Your career satisfaction is not just about the type of clinical work you do. It’s about how you do it.

5. Is medicine my profession, my passion, or both?

This question is last, but definitely not least. This one can really impact your medical career.

Here is the take-home point:  you need to discern whether medicine is something you see purely as a job, or if it extends into a passion. By passion, I mean something you’re enthusiastic about even beyond your regular work hours. If you find joy in the science and practice of medicine, you might really love pursuing professional medical activities outside of your primary job.

As you think about this question, set aside the bureaucracy and stressors that exist in conventional physician settings. Without those, do you have genuine enthusiasm about the medical field?

Do you enjoy the intellectual challenge of diagnosing and treating patients? How about educating others about medical topics?

If your answers are “yes,” you should explore medicine not just as your daily job but as a lucrative pursuit that will include consulting work and additional professional pursuits throughout your working years. These extra roles can offer flexibility, a healthy challenge, and even fun. Plus, they can contribute significantly to your financial independence.

As you choose a specialty, consider options that align with whether medicine is a passion for you. Some specialties naturally lend themselves to certain consulting and side gig opportunities. An oncologist, for example, will find it easier to get consulting gigs with pharmaceutical companies than a family physician.

Also, think of your career not just as a single job but as a blend of multiple roles, either sequentially or concurrently. You can pivot and transition between different roles, especially if your passions lie in diverse areas within or outside of medicine.

Start laying the groundwork for “passion opportunities” early in your training. Build a network and learn about various options like independent medical examinations, legal consulting, disability reviews, medical writing, and educational content development. Engaging in these activities can turn your “free time” into a productive, fulfilling extension of your professional life — but only if you want it to.

Learn more about all the career paths you can take with a medical degree

Your career in medicine is molded by far more than just the specialty you choose. Don’t overlook the many factors that influence your career satisfaction. How much you enjoy your work affects your overall happiness, your income, and your risk of burnout.

Be proactive in exploring the options that med school doesn’t teach you about.

My new book 50 Unconventional Clinical Careers for Physicians delves into the diverse career options that are available to us as medical doctors. It can help you find the path that aligns best with your personal and professional goals and interests. My hope is that it will equip you with the knowledge to curate a more satisfying and rewarding career in medicine.