School of Medicine

Wayne State University School of Medicine

Choosing a Specialty

There are over 125 specialties and fellowships and 9000 accredited programs in the US. The number of medical students is growing two times faster than residency positions, so being competitive and making the right decisions for the right reasons is imperative. The earlier you begin thinking about specialty choice, the more you can maximize the opportunities that medical school provides. The Careers in Medicine website goes into detail about important aspects of each specialty, including residency and training requirements, the nature of the work, lifestyle considerations, match statistics, competitiveness data, workforce statistics and salary data.

 It is helpful to explore 2 or 3 specialties each semester in Year 1 and Year 2. If you are unable to narrow your specialty choice down to 2-3 specialties by the end of your MS2 year, don't fret. Make sure you've done a good self-assessment and you understand your innate likes, dislikes and abilities. As you begin your clinical rotations, record your reflections. Be open, flexible and honest with yourself. It's important to challenge preconceived ideas and determine your competitiveness. You need to employ a critical eye. For each specialty you are considering, you want to understand the work the physicians do as well as the attached lifestyle. Consider using elective time during your MS3 and beginning of your MS4 year if you are still are uncertain about your specialty choice.  As you move through your Year 3 clerkships, regularly consult with faculty in specialties of interest so that you can solidify your decision.

Consider the training path and length of time to complete residency and any potential fellowships. Most residencies are between 3-5 years with further sub-specialization an additional 1-2 years. Advanced specialties require you to complete a preliminary year of training, usually in internal medicine or general surgery. Changing specialties with the current model is almost an impossibility due to limited government funding, so making the right choice is critical.

If you are still unsure, consider completing the Specialty Indecision Scale and other assessments found on the Careers in Medicine website.  Examine your options from multiple angles and perspectives including data, intuition, and emotion, all of which play a role in decision making. The old idea that “Knowledge is Power” applies here; the more you know about a field, the more informed your decision and the more likely you'll be successful and satisfied in your career.