Five mistakes students make when choosing a specialty (and how to avoid them)

Medical students or interns - choosing a residency is one of the most consequential decisions in your career.

And exactly because of that, it's easy to fall into mistakes.

In this video I go through 5 common mistakes in choosing a residency, and what you can do differently to choose more wisely - both professionally and personally.

Hi, I'm Dr. Elisheva, and on "Medicine Without Filters" I talk to you honestly about the path through medicine, from school through residency, and tell you about the real life of being a doctor.

Let's go.

## Mistake 1 - Choosing only based on what interests you

When I was a student on my internal medicine rotation - I thought it was the most interesting thing in the world, content-wise. I told myself, wow, this is real medicine, this is Dr. House.

But in the end, what's more important than that is the character of the specialty itself - what the workday looks like and whether it suits you.

You might be surprised to hear that the actual subject matter, or the organ/system you're treating, is much less essential than you thought - and now you understand why there are proctologists in the world.

So ask yourself the right questions:

- What's most satisfying to you - manual work, mental/diagnostic work, communication with patients? - High-pressure situations - do they energize you, or wear you out? - Do you like short, focused contact with patients, or long-term relationships with trust built over time? Or do you not want direct patient contact at all (that's okay, you're allowed to say that)? - Is it important to you to see immediate results from your actions, or do you enjoy improvement and progress over a longer period? - What kind of patients do you like - in terms of age group, gender, level of medical complexity, and level of consciousness? Do you like sleeping kids, like me? - And what work environment is good for you? Working in a team, a hospital environment, an operating room, or more individual work like in a clinic?

Most important - don't take this process lightly. Answer these questions honestly. Not what you think you're supposed to want or what you'd want to be, but what you actually feel. And I recommend not doing this only theoretically - try to pay attention to how you feel during your rotations as a student or intern, when you're exposed to all these different situations. Just ask yourself: what gives me energy, and what drains me?

I'll say honestly: I love manual work, I hate sitting in a clinic, I love immediate results from my work, I love building trust and a good but short relationship because I don't have patience for long-term relationships, emergencies fill me with energy and focus, and I love that my patients are asleep most of the time. And that's okay.

## Mistake 2 - Looking only at what residents do day-to-day

Let me give an example - if you look at residents in OB-GYN you'll get the illusion that it's a specialty where you do everything, which is why it also attracts a lot of doctors. There's a pure medicine side but also a surgical side, there's clinic and there's hospital and there's action. But notice that as attendings - people choose to focus on one of these areas. They no longer "do everything." And that's true for almost every specialty - in the end we focus on one thing, and the work also looks very different from the work as a resident.

In the hospital, on rotations as students and interns, we tend to be in more contact with residents and to look at them. But it's very important to also talk to attendings who have already chosen a path, and ones who aren't in the hospital at all, in order to understand if the specialty really suits you. And in that context, I'll soon publish a series of interviews with attendings from various fields in medicine so you can hear and understand what each specialty looks like and decide for yourselves - so subscribe so you don't miss them.

## Mistake 3 - Underestimating the residency years

When you're deliberating about going into a specialty with a particularly grueling, no-life residency, there's a tendency to hear oversimplifications like "the specialty is for life, residency is just a few years." But that's not entirely true.

And no, I'm not contradicting what I said earlier - to understand the professional character of the field it's a mistake to look only at residents.

But when we're deliberating about "sacrificing" a few years of our life on a residency that's hard from the personal side, you have to remember that 4–5 years and sometimes more - that's not such a short time.

It's also often the years you're building a family and have small children at home, and these years matter. So it's perfectly fine to make the decision to specialize in a field with a tough residency, but don't underestimate that period and the long-term impact it has on your life.

## Mistake 4 - Choosing based on "extreme cases"

In every specialty there are super-interesting edge cases - the crazy surgery, the complex patient who can't be diagnosed - and as students we have a tendency to be exposed to them especially for the "teasing" effect, and that can create a bias in our own minds. But remember - at least 90% of the time you'll deal with what's called the bread and butter of the specialty.

The blood-pressure-control patient in clinic, the appendix in the OR, things that aren't particularly complex, that repeat, with no drama.

I'm not telling you this to depress you about what being a doctor means - quite the opposite. Choose the specialty where you're excited even by these "boring," simple cases.

I'm a pediatric anesthesiologist, and when I put an 800-gram preemie under, it's especially challenging and exciting. But I also get excited about putting a healthy child under for a tonsillectomy and knowing I'm creating a positive experience for that child and allowing them to safely undergo the surgery they need.

So look at the bulk of the "regular" work of the doctors around you - make an effort to be exposed to that too - and ask yourselves: if the specialty were only this, would you still enjoy it?

## Mistake 5 - Choosing for the wrong reasons - and too early!

And here I'm talking about reasons that maybe shouldn't be completely ignored, but should be relatively low priority.

Choosing by prestige, by what's expected of you, by your parents' profession… and it's also often a decision made too early. A medical student at the start of the path who already chose a specialty without ever having heard of all the options and without being able to mature into the decision.

I'm of course not saying that's necessarily going to be the wrong decision if you decided early, but in many cases it'll prevent you from opening your eyes and being open to other options - and you're also allowed to change your mind and go into family medicine even after announcing to everyone for 5 years that you'll be a neurosurgeon. Trust me, no one cares.

And even after you've started a residency, it's okay to regret it, to discover it's not for you, and to switch to another specialty. It's not shameful and it's not a sign of failure - quite the opposite.

I hope this video helped you. Don't forget to subscribe so you don't miss the upcoming videos. If you have more questions, write to me below and I'll answer.

See you in the next video.