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Choosing a Specialty

Ben_3Ben Bryner -- If there's one thing I enjoy about medical school, it's talking to people about what specialty they're going into and why. Most students change their minds a few times during medical school. I was one of the lucky ones who knew exactly what I wanted to go into (surgery) after rotating there as a third-year, but for most people in my class it was not so obvious. It’s a hard decision; you’re making a choice that will affect almost every aspect of the rest of your life. At many schools, if you’re interested in a field that doesn’t have a required third-year rotation, it’s hard to get a lot of exposure to the field before your fourth year, when decision time comes up quickly. And if it turns out that you don’t like that one, it isn’t always easy to switch gears at a later stage in the game (but it’s certainly possible). To address this difficult situation, there have been a lot of different tools proposed to help you decide on a specialty beyond clerkship and elective experiences.

You might have already seen this graphic, which reflects the growing trend in medicine to reduce decision-making to following an algorithm. An even simpler method is the Goo Tolerance Index, which simply ranks the specialties by their exposure to “goo,” so all the student has to do is identify his or her desired level of goo exposure and pick from a short list. Both of these are pretty easy to use. Oddly, they both leave out OB/GYN (which would probably fit under the “crazy” and “high-goo” categories, respectively).

If you want to take a more comprehensive approach, you can take the Medical Specialty Aptitude Test online. It will ask you a series of questions (130!) and at the end will list the specialties you should consider. I didn’t get through all of them because it kept asking me the same questions over and over, but you might have better luck. Similar kinds of things are available at the AAMC’s Careers in Medicine site, but you need a password from your med school. And of course there are a few books on the subject.

But there’s no substitute for rotating on those services. Hearing about the field from others, shadowing, getting involved in interest groups, etc. are all somewhat helpful, but they can give you a very different picture of the field than your rotations. Of course, rotations are far from perfect tools for evaluating specialties. Since you’re mostly spending time with residents, you may get a pretty good idea of what the residents are doing, but not necessarily what it’s like to be a practicing physician in that specialty. And despite the fact that residency can be quite long and seems so imposing during medical school, it’s a lot shorter than your career. So it’s worthwhile to really try to get a feel for what the attendings’ workdays are like.

There are a lot of good choices out there, so good luck.

June 29, 2008 in Ben Bryner | Permalink



This post made my day. I'm doing 4th year rotations right now as a pharmacy student and I've realized on my dream rotation this month that the job I thought I wanted to do for a living is not what I want to do. You are totally correct about rotations - I've shadowed people at this job and talked to others who have this job, but I didn't realize what it was actually like until I actually started doing it for the last 4 weeks.

I love that algorithm that you posted and the Goo Tolerance Index. Those made my day a lot better. Keep doing what you do. You're awesome at it!


Posted by: Brian | Jul 2, 2008 10:11:03 AM

l've done a test and did expect to have surgery in lot's of at the top but not to have ccm even recommended at all was a lil' bit surprisingly as well as disappointing...but still l want let a test decide for me :D
anyway, about the hole thing, people usually come to medicine not having real but fictional vision of medicine itself, therefore change their future careers on the way as they see medicine for what the hole thing really is. that's why there's so many switches in specialty desires....

Posted by: | Jul 2, 2008 12:45:09 PM

That algorithm you posted and the Goo Tolerance Index is Great! :)))
Ben, I LOVE your blogs!

Posted by: | Jul 3, 2008 12:40:54 AM

neurosurgery is the best!

Posted by: | Jul 3, 2008 4:24:04 AM

i m already working in Surgical department and doind my training in this speciality as a second year resident.even though i i read ur comments n ideas and visit the sites u proposed and find them interesying and worth considering.

Posted by: sumair | Jul 8, 2008 3:38:13 AM

It is really an amazing time that pass on us in rounds,me as a freeshly graduated dental surgon
who already made her decision to specialize in pediatric dentistry still I'm trying to be 100%
sure of what I want,I'm an intern right now seeing all cases but trying to

basically concentrate on what really I want & we will see..
Time & patients can affect our final decision..

Thank you so much Ben it was an interesting talk

Posted by: Dr.Maryam | Jul 31, 2008 1:21:44 AM

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