What do I want to specialize in?


Picking a specialty is a big decision, but don’t let the sheer enormity of this decision overwhelm you. Instead of being a “laser beam” or a “waffler,” try to stay in the middle of these two approaches. Pick around 5 specialties to focus on and go from there. The real work at this point in your journey is to begin to define your internal understanding of yourself – this is the time to start thinking about what type of doctor YOU want to be. Narrow down the specialties to a manageable number for you to explore, and you can make your final decision later.


One of the first questions that you will come across when you start medical school is the big question of “What do I want to specialize in?” You know that you don’t quite have to make up your mind yet, but people will be asking, “So…what kind of doctor are you planning to be?” This is a thinly veiled question about what medical specialty/sub-specialty you plan to pursue for your medical career.

While this decision is indeed an important one, many students place too much emphasis on this decision and don’t take the time to properly explore their true professional values and aspirations. Ultimately, many students end up substituting this decision for that inner process. Don’t let this happen to you! Slow down and think this through… Let’s talk about how best to do just that.


Medical specialties and you…

Medical specialties often have their own cultures and skillsets. You should align yourself with a culture and skillset the best that you can. However, what may be even more important than picking the “right” specialty is figuring out how to work with that specialty to contribute to patients according to YOUR values and talents. In that respect, there are many specialties that can suit your purpose.

Medicine/healthcare is an immense field. In the beginning, you will see the clinical care aspect, which is at the heart of the profession. However, whatever talent you have, you will find that the profession can accommodate you, IF you take the time to discover it and “lean in” to it. So basically, the question of “So…what kind of doctor are you planning to be?” is actually more of a question of what specialty you plan to pursue. You have to think about the answer to the question “What kind of doctor WILL I be?


Two types of decisions…

Let’s go back to an earlier decision that you made not that long ago: which college to go to? At the time, this was a HUGE decision. When you were first trying to make this decision, you probably thought it was going to make or break you and your future, right? Now let’s think about something…  What if you had gone to a DIFFERENT college on your short list?  Would you, still be YOU? For the most part… yes. It turns out that this seemingly “major decision” wasn’t quite as major as initially thought…

The key take-away is that we will have MANY decisions to make in our lives. Some of these decisions are:

  • What residency to apply for?
  • Where to work?
  • Whom to marry? (If you’re into that)
  • How many kids to have—if any?

While these decisions are important, there are decisions behind these which are even more important to consider. The most important decisions are the ones you make about yourself; I’ll call these the “inner” decisions.

  • Whom should you marry? That’s an external decision.
  • What kind of spouse will you be? That’s an internal decision.
  • What school will you go to? That’s an external decision.
  • What will I do while in school? That’s an internal decision.

Think about all the meaningful things that you did while in college. While the outer contexts would be different, what you would do in college would generally be the same regardless of the school you attended. The most important thing is to decide what YOU want to do and take action.


“lasers” and “waffles”…

Let’s now explore this question of specialty at a more practical level. What you may notice among your classmates is that there is a group of students who know EXACTLY what they want to be from the first day of medical school…  Let’s refer to these guys as the “laser beams.” There’s another group of students who want to explore all their options; they’re not quite sure of their exact path yet… Let’s call them the “wafflers.” I used to be a “waffler,” and I remember that the “laser beams” made me very uncomfortable… It felt like I was always behind in going to my “87 student interest groups” in order to explore all my options, many of which seemed equally good. Which approach is better?

There are good and bad aspects to both approaches… Many of the “laser beams” regret not taking the time to explore. After all, as a first-year medical student, how do you know all there is to know to make a good choice? The truth is that you DON’T know… The “wafflers” are seeing more through their exploration, but often feel overwhelmed by choices because they are open to just about anything and everything.

You may consider finding a point in the middle of these two approaches. Perhaps it would make sense to pick 5 to 8 specialties to explore. Outside of those 5 to 8 specialties, resist the temptation to get involved. Do some homework beforehand to help narrow down the set of options to explore. The AMA and AAMC have excellent resources to help you with this process. You may even want to talk to or shadow some attending faculty members to help you better understand their particular specialties.

You won’t need to decide on your specialty at this early stage. The main thing you need to do at this point is to begin to define your internal understanding of YOURSELF, and to narrow down the options of specialties to a manageable number to explore.