At some point during your journey as a health practitioner, you’ll face the choice between general medicine or going down a different route into a specialty field.
While your options are vast, the choice isn’t always simple. The specialty you choose has a profound impact on your future career and daily responsibilities. If you find yourself going back and forth about your decision of which specialty to focus on, you’re not alone. A study from the American Medical Association revealed just 1 in 4 medical school graduates pursued the same specialty they picked before starting medical school.
So how do you choose which medical specialty to go into? Let’s look at the difference between a general practitioner and a specialist, and then explore tips for choosing a medical specialty that makes sense for you.
General Practitioner vs. Specialist
General practitioners and specialists undergo the same initial medical schooling. Their life trajectories afterward, however, look a bit different.
Specialists tend to take a longer education period compared to general practitioners. And the more specific and complex the specialty, the longer you’ll go through residencies, fellowships, or other .
If you become a general practitioner, you’ll typically be first in line in treating patients. Also called primary care physicians, general practitioners work in hospitals, physician offices, and health clinics where they treat common medical conditions, perform routine exams, offer preventative care, and serve as a gatekeeper for overall health. When an ailment moves beyond the scope of common diagnoses or treatment, a general practitioner may refer patients to a specialist.
Specialists handle care and treatment for more specialized health conditions. They have in-depth knowledge and advanced training in a particular branch of medicine. If a general practitioner suspects a patient has an underlying health problem, for example, he or she may refer the patient to a cardiologist who specializes in heart health.
#1: Decide What Level of Competition You’re Comfortable With
Getting into any residency is challenging, but some specialties are notoriously more competitive to get into than others. Knowing which specialty programs are hardest to gain acceptance into may sway your decision on which specialty is right for you. After all, if you don’t get into the residency program you hoped for, you may have to determine a plan B specialty.
According to Medschool Insiders, the most competitive specialties are:
- Plastic Surgery
- Dermatology
- Neurosurgery
- ENT
- Orthopedic Surgery
- Interventional Radiology
- Radiation Oncology
- Vascular Surgery
- General Surgery
- Med/Peds
#2: Length of Residency
The length of medical training is what stands between a med school student and a practicing physician.
While primary care usually requires the least amount of training, specialists tend to undergo the longest post-medical school residency programs. Residency lengths vary depending on specialty but can range anywhere from three to seven years. Residency examples on the lower end of the spectrum include internal medicine, pediatrics, or prevention medicine, while longer residency examples include neurology, interventional radiology, and plastic surgery.
While some students pursue fields they’re passionate about regardless of residency duration, others might consider the impact extra years of schooling has on other life goals and aspirations. As you choose your specialty, think about whether or not the length of residency is important in your decision-making process.
#3: Surgical vs. Non-Surgical and Direct vs. Indirect Care
Start by envisioning your preferences for day-to-day responsibilities as a doctor. What does your dream job look like? Are you in and out of surgeries throughout the day, or are you spending most of your time in a room conversing with patients?
According to the American College of Surgeons, examples of specialties that are procedure/surgery-based include (5):
- cardiothoracic surgery
- colon and rectal surgery
- general surgery
- gynecology and obstetrics
- gynecologic oncology
- neurological surgery
- ophthalmic surgery
- oral and maxillofacial surgery
- orthopedic surgery
- otorhinolaryngology
- pediatric surgery
- plastic and maxillofacial surgery
- urology
- vascular surgery
Examples of common, less procedural-based specialties include internal medicine, pediatrics, family medicine, psychiatry, and dozens more (6).
As you envision your ideal role as a physician, also consider whether you’d like plenty of face time with patients or if you’d prefer to offer behind-the-scenes care. Options like radiology or pathology allow you to support patients without direct, in-person appointments. While pediatrics, family medicine, or psychiatry will allow you plenty of time to engage with patients and their families.
#4: What Does Your Life Look Like Outside of Work?
Consider how your job will impact the life you’ll have outside of work, and vice versa. Most doctors work between at least 40 and 60 hours per week, while around a quarter of physicians are putting in between 60 and 80 hours per week—or more.
Choosing a medical specialty can feel like an overwhelming decision. Keeping these tips in mind can help you narrow down your choices and select a specialty that will set you up with a successful, fulfilling life as a future physician.
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