Choosing a medical specialty

It’s that time of year, 4th year medical students (like me – kind of) are choosing their future careers and starting to interview all over the country in their residency programs of choice. I’ve been notably quiet – subsumed in work, study and applications – but I am catching up on writing about the clerkships I’ve done in the meantime (Pediatrics, Psych, OB/Gyn and Family Medicine). But since I’m applying for residency now (MD/PhDs have an abbreviated 4th year) I figured now would be a good time to tell people about what this is like, and in the coming months what cities I’m going to be in from time to time.

Choosing a medical specialty is a big decision. I’ve necessarily made up my mind, am very confident I’ve made the right choice and encourage you to take bets on my choice – it will be fun to see what people think. But the decision making process is famously difficult and many different strategies have been devised to help the indecisive (not me). Perhaps most famous is this chart first published in the BMJ by then-resident Boris Veysman:

If you’re very patient you can answer 130 redundant questions at this site offered by UVA to help you make up your mind, or read one of the books on the subject.

Then there is the famous Goo index, which I think may be quite useful. Basically, chose your specialty based on which types of bodily fluid you can stand being in contact with every day for the rest of your life. If you have a low tolerance for any goo, psychiatry or neurology might be up your alley. If you can take any fluid being sprayed at you at high velocity, surgery may be an excellent specialty for you.

Then there is the general opinion among the goo-heavy specialties that you should avoid the goo you dislike the most. For instance, if snot is bothersome, avoid pulmonary specialties and pediatrics. If it’s urine, maybe you shouldn’t go into urology (or if you don’t want to stare at genitalia all day). If you don’t mind blood but don’t like any of the stinky stuff, maybe neurosurgery is the right match. It’s all about balancing your goo exposure.

If you don’t want to get divorced during residency, maybe read this paper. The surprising result? Psychiatry is the worst at a 50% cumulative divorce rate followed by surgery at 33%, and most other medical specialties between 22-30%. I guess psychiatrists drive their spouses nuts when they bring their work home.

There is the Myers-Briggs guide to specialties which is only useful if you’re the type of person that likes astrology or other advice based on vague, general descriptions of people coached in psuedoscientific drivel. There is a lot of study of personality traits specific to different specialties, a review of the subject concludes that for the most part medical students tend to be too homogeneous for the blunt-instrument personality tests to distinguish something so specific as an ideal career choice and there is more variation of personalities within a given field than between fields.

So, using these highly-scientific and time-tested methodologies, which kind of medicine would you like to practice? Which do you think I chose?