Decision time

How do you know which specialty is right for you? And what if you change your mind? FYi editor Dr Anne Parfitt-Rogers investigates

  • Date: 27 February 2015

BY the time you reach the end of medical school, you may have already set your heart on cardiology or be busy boning up on orthopaedics. But if you haven’t yet decided which path to follow, don’t worry. You will be able to look at each specialty with an open mind – and there are practical ways of exploring which one is right for you.

A good first step is to join a society – this may confirm what you’ve always felt or help you realise that particular field is not for you. If there are no existing societies in your preferred field, why not start one? Invite local speakers to inspire your members and enhance your CV in the process. Thinking outside the box, you are also likely to have the opportunity to gain experience in less obviously medical clubs such as the Red Cross or Amnesty International.

Clinical options projects, electives and special study modules are also useful ways of gaining experience over and above clinical rotations. You may also get a poster presentation or paper out of the time spent. Attend careers fairs, read interviews based around a particular specialty and see what fires you up with passion. Even if you don’t know what you want to do, start thinking about your five or 10-year vision, including your work and home aspirations.

Don’t forget to think practically. While you may have dreamt of being a radiologist after seeing the expertise of those with ‘X-ray vision’, it may not be the specialty for you if you appreciate patient contact and are not keen on dark rooms.

Make a list of your positive attributes and dislikes, and see what matches up with that. You may find psychometric testing such as Sci59 useful, however bear in mind that the people working in each specialty will have varied personalities and the results should only be used as a guide. Using a SWOT analysis (compiling a list of strengths, weaknesses, opportunities and threats) may also be a good model.

Selecting a path is a huge consideration and a recent BMJ article “Are trainees being rushed into choosing a specialty?” wonders whether trainees are being forced to make career choices too early.

The article cites a National Institute for Career Education and Counselling (NICEC) questionnaire which was sent to 930 doctors. Forty-seven per cent of respondents felt they had been “forced” into a particular specialty, two-thirds knew “little” about many specialties, and 55 per cent wanted more “in-depth” career information.

One way of accessing more in-depth information is to get involved in taster weeks which let you sample one or more specialties, often ones not covered in your foundation jobs. These can provide invaluable experience without the pressure of ward round tasks and endless discharge documents. Research suggests doctors are more likely to choose a specialty they had worked in themselves.

Senior colleagues are another useful source of advice and can often influence decisions, with doctors perhaps being drawn towards a particular consultant or registrar. They can help you gain inside information and separate your feelings about a person from the truth of the specialty.

Successful applications

Adding value to your CV is helpful to increase your chances of success during the application time. Audits look good, particularly if presented as a poster or in a journal, while some journals (such as InnovAiT) offer trainees the chance to participate in digital projects such as creating podcasts. Writing book reviews can also help you get published without requiring a research project. Make sure you’re aware of the requirements and dates for specialty applications and request study leave in plenty of time. If competition ratios are particularly stiff, consider less desirable locations or applying to more than one specialty.

Changing your mind

Even after you have been accepted into a specialty, it’s not too late to change your mind. Some people find after their first year, things are not as they expected. They can then re-apply for a concurrent programme; in the course of a career, one year is not a long time. Even after this time, it is not unheard of for doctors to change from, for instance, surgery to general practice for career or lifestyle reasons.

Flexible working is also becoming increasingly attractive. In the NICEC study, 30 per cent of respondents were intending to pursue flexible working at some stage in their careers, compared with six per cent who already had tried this option. Growth in this area may widen access to some specialties which traditionally had long, less sociable hours such as surgery or emergency medicine.


• A booklet for budding physicians including a worked SWOT analysis -

• Log in to take the medical quiz based on the book How to Choose a Medical Specialty (Anita Taylor) -

• The BMA website has a list of Royal College websites and addresses -

• A light-hearted algorithm for selecting a specialty -

• Interpreting the Sci59 psychometric test -


Dr Anne Parfitt-Rogers is an F1 doctor and editor of FYi

This page was correct at the time of publication. Any guidance is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.

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