There’s so much that goes into choosing a specialty. You already know that you have to pick based on the subject matter you enjoy, since you’ll spend a lot of time training in that particular area, and an even longer amount of time in practice.

However, there are other factors that you should consider to further hone down the list of possibilities. These include:

  • Do you want to work on a schedule, or are you okay with days that vary in length? Are you someone that wants to know exactly how long you’re going to be working, and be able to plan accordingly? Fields like emergency medicine and anesthesia that allow for shift work may be more for you.
  • Do you want to perform procedures? I know my husband (a surgeon) finds days that he doesn’t have a single procedure incredibly boring. I, on the other hand, perform plenty of procedures, but also know that I don’t miss procedures when I don’t have them. Also consider that procedures add an additional layer of uncertainty to your day.
  • Do you enjoy teamwork, or working independently? Some people really enjoy the camaraderie that they experience working on medical teams. Others are happier to see their patients and finish their own work, without the input of others.
  • Does how much money you make matter to you? You have to answer this question honestly for yourself. If you can make both the money that you want and practice what you love the best, that’s clearly the best situation. But if not, consider how much that salary weighs in.
  • Do you want to be primarily outpatient based or inpatient based? Some people love the intensity of inpatient based medicine, while others find it stressful. Obviously some fields see the inside of a hospital more frequently than others.
  • Is the potential to cut back or be flexible important for you? Let’s say you want to take a few months (or years) off at some point, or work part time or from home. Certain fields are more conducive to these arrangements than others.
  • What are other career goals that you have? If, for example, you enjoy public health, certain fields such as primary care and OB/GYN may allow you greater exposure to other projects you may be interested in.
  • What sort of patient interaction do you need to be happy? You probably don’t want to choose pathology if you went into medicine to develop relationships with patients. Other fields like radiology may have subspecialties where you get a lot of patient interaction, but you may not have longitudinal relationships with your patients.
  • Are you okay with being at work at 6 am (or earlier) everyday? Some people value their sleep more than others. Remember, you will likely still be doing this in your 50s. You have to be okay with it.
  • What will any given career path mean for family life? In most cases, it’s not always going to be only about what you want. Consider your family goals and if you’re already married, how your life will interface with that of your spouse.

Remember, when there is a will, there’s usually a way. But being upfront with yourself about your long term goals will allow you to identify deal breakers and save yourself some hurdles in the future.


Nisha Mehta, M.D.

Dr. Nisha Mehta is a physician and writer with interests in physician wellness, medical education, and health policy. Follow her on Twitter @nishamehtamd or on Facebook at


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