Preparations necessary to make an informed decision: As a first year or second year medical student you might choose to work in a medical or non-medical area or work in a research lab during the summer. You should also spend some time doing serious self-assessment: clarify thoughts you have had in your first year by talking with family, friends and physicians of various ages and specialties. Read about health care issues in newspapers and magazines and become a student member of a professional or specialty organization that offers student memberships and you will receive their journals. Listen to what family and friends are saying about your future career plans in medicine. Explore various specialty areas by establishing relationships with at least two mentors, who will take a professional interest in you. Take advantage of any opportunities to meet with them and share in their family and community life. Actively participate in the Mentor/Advisor Program. Pay attention to your grades and prepare well for Step 1 of the United Stated Medical Licensing examination, because some residency programs and specialities place great emphasis on scores in their consideration of applicants. Seek out faculty in your area of specialty interest about clerkships or electives at other schools or internationally.
During your third year of medical school, you should faithfully make notations, both positive and negative, about each clerkship you have completed. When an attending offers to write you a letter of recommendation, be sure to periodically visit with them so that will remember you when you are ready to request the letter. Attend any programs offered on specialty choice and residency planning, i.e. Residency Review Seminar for third year medical students and the annual Residency Fair are two great sources of information. Prepare your curriculum vitae for residency applications. Schedule electives, particularly in the specialty area you have chosen, at your earliest opportunity and arrange electives at other schools at least twelve weeks in advance in order to secure the dates that you wish to attend. Begin the preparation of your personal statement for residency applications by jotting down ideas or even preparing a first rough draft of why you have selected a particular specialty and your future plans. Speak with current fourth year medical students who have matched in the specialty you are considering, to obtain advice on the application process, residency program selection, electives to take and interviewing. By early summer you should write to residency programs to obtain information especially if you are interested in Ophthamology, Otolaryngology or Neurosurgery. Continue to pay attention to your grades and prepare well for Step 2 of the United Stated Medical Licensing examination, because some residency programs and specialities place great emphasis on scores in their consideration of applicants.
Resources On Choosing A Medical Specialty: Taylor AD. How to Choose a Medical Specialty, 2nd Edition. Philadelphia: W.B. Saunders Company, 1993 Iserson K. How To Get the Residency of Your Choice, 3rd Edition. Columbia, SC: Camden House, 1991 Miller LT, Donowitz LG. Medical Student's Guide to Successful Residency Matching. Baltimore: Williams and Wilkins, annual edition Glaxo Pathway Evaluation Program, Research Triangle, NC: Glaxo, Inc. AMA Directory of Graduate Medical Education Programs, annual publication Annual Board Review Issue. Resident and Staff Physician, May issue Annual Medical Education Issue. JAMA, September issue.
Characteristics of Generalists versus Subspecialists: Generalists like working with people; like variety in work activities; have a high tolerance for undiagnosed problems with multiple symptoms; and, want to be involved in patients' lives on a continuing basis.
Subspecialists like taking care of people; prefer a narrow scope of professional expertise; and, their satisfaction comes from action-oriented curative activities.
Characteristics of Types of Care: Primary Care: Focus of care is broad; the population served is small; types of problems are common; the type of care is continuous; the dominant practice base is community; the technology necessary is basic; and, the approach is as an integrationist.
Secondary Care: Focus of care is intermediate as is the population served; types of problems are uncommon; the type of care is episodic; the dominant practice base is the hospital; the technology necessary is complex; and, the approach is as a consultant.
Tertiary Care: Focus of care is narrow; the population served is large; types of problems are complex/rare; the type of care is discontinuous; the dominant practice base is a medical center; the technology necessary is innovative; and, the approach is by referral.
Ask Yourself These Questions: What was the reason for my interest in becoming a physician? What did I see myself doing in my medical career when I applied to medical school? What are my family members, friends and instructors telling me to do in medicine? What would be my ideal practice setting? What do I want from my career and how will I know when I achieve my goal? How do I define success? What can I offer to a specialty? What can I offer to the community where I will live? What goals, other than career goals, have I set for myself for the next five years? For the next ten years?
Answers to the questions above can be useful as you review all of the specialty choices that are available; as you prepare your personal statement and complete applications; and, in preparation for residency interviews.
Note: Excerpts taken from a presentation by Anita D. Taylor, M.A.Ed at the AAMC Annual Meeting in 1996.
All physicians must have residency training in a particular medical specialty, and many practicing physicians go on to specialize in a particular area of medicine. The most frequently entered specialties, as derived from National Resident Matching Program (NRMP) data, are listed below. You can click on the Specialty to view more detailed information.
Emergency medicine is the specialty that focuses on the recognition, evaluation, and care of patients who are acutely ill or injured. It is a high-pressure, fast-paced and diverse specialty that requires a broad base of medical knowledge and a variety of well-honed clinical and technical skills. The emphasis is on pre-hospital care and the acute care aspects of the other specialties. Emergency physicians treat all age groups in a myriad of conditions with varying degrees of severity. Emergency medicine training also encompasses clinical areas such as disaster medicine and mass gatherings.
Family medicine physicians are trained to prevent, diagnose and treat a wide variety of ailments in patients of all ages. Although the scope and practice of family medicine is broad, it is a precise discipline, integrating a unique blend of biomedical, behavioral and social sciences. Family medicine focuses on care within the context of the family on a continuing basis. Family physicians employ a diverse range of cognitive and procedural skills and coordinate care with other specialists when necessary. They receive training in surgery, psychiatry, internal medicine, obstetrics and gynecology, pediatrics and geriatrics.
Internal medicine is a broad-based specialty encompassing the body's major organ systems. The general internist is a physician who provides care in the office and the hospital, managing both common and complex problems in adolescents, adults and the elderly. Internists diagnose and treat a spectrum of acute and chronic illnesses, promote health and help prevent disease. They are trained in the essentials of primary care which involves an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Obstetrics and Gynecology is a diversified specialty concerned with the delivery of medical and surgical care to women. Relationships with patients are long-term and are often maintained through the postmenopausal stage of a patient's life. This field combines two specialties: obstetrics, which focuses on the care of women before, during and after childbirth, and gynecology, which involves the diagnosis and treatment of disorders of the female reproductive system. Obstetrician/gynecologists often serve as consultants to other physicians, but in many cases the obstetrician/gynecologist is a primary care physician with whom patients have regular contact and obtain medical advice and counseling.
Orthopedic Surgery is the medical and surgical specialty that includes the study and prevention of musculoskeletal diseases, disorders and injuries and their treatment by medical, surgical and physical methods.
Pediatrics is the specialty primarily concerned with the physical, emotional and social health of children from birth to young adulthood. The field encompasses preventive health as well as diagnosis and treatment of both acute and chronic diseases.
Psychiatrists specialize in the prevention, diagnosis and treatment of psychiatric disorders including mental, emotional and behavioral disorders and in the common medical and neurological disorders that relate to the practice of psychiatry.
General surgeons are trained to manage a broad spectrum of diseases and injuries almost any area of the body which requires surgery. These physicians are involved in diagnosis, preoperative, operative and postoperative care. They are usually responsible for the comprehensive management of trauma and critical patients. Although its scope is broad, general surgery usually involves the abdomen, breasts, peripheral vasculature, skin and neck. General surgeons today in the United States only rarely perform complex neurologic, orthopaedic, thoracic or urologic procedures.