Choosing a Specialty…and Matching

This is a big week for 4^th year medical students. If you are on social media and follow any of them, you probably saw several really excited posts on yesterday about them matching.

What is the match? Glad you asked! The match is the system that places medical students into residency programs. Throughout medical school, students go through the process of deciding which specialty career they want to pursue; they apply and interview to different programs; they rank their top programs; and the programs rank the students they interview. Then on the Monday of the Match Week (yesterday), students get an email telling them that they matched with a program in their specialty of choice. [Unfortunately, some students also get emails saying they did not match and have to “scramble” all week to find an open position.] On Friday of this week the students who did match will find out at which program they’ll spend the next several years training. So in this season where students are already excited that they’re about to be “real doctors,” now they can also be excited that they will soon have a “real job” that pays them money instead of them having to pay for their education.

Now, yes, some people attempt to match into multiple specialties or some people go back after they’ve been practicing for a while and do another residency in a different specialty…it happens. But the idea is that you decide on a specialty as a medical student and you match into it and have a long, happy career practicing in that specialty.

Sometimes when I’m talking to pre-med students, I ask them if they know what specialty they want to enter. I don’t ask because I expect an answer that I’ll hold them to forever, but I am always surprised when pre-med students do have a confident answer to this question. Sometimes the “confidence” in that answer is because they have a relative in that specialty, sometimes it’s because they’ve done a lot of shadowing in that specialty, but most often, it comes from what they think the specialty is like from TV shows!

You don’t have to decide right away

Please realize that you don’t have to know as a pre-med student what specialty you want to go in to later. And if someone (like me) asks you, it’s completely okay to say you don’t know! That’s why you go to medical school…to go through each rotation and decide what you want to do. As a medical school upperclassman, you’ll go through pediatrics, surgery, family medicine, psychiatry, internal medicine, OB/gynecology, etc and you get a feel for them all. You’ll know which ones you love and which ones you hope you never have to do again. Even if you do think you know what you want to do, you can always change your mind later! No one really expects you to be 100% sure of what you want to do for the rest of your life when you complete your medical school application.

Keep an open mind

As a medical student, I tried to go into every clinical rotation as if that was the job I was going to have for the rest of my life. In addition to the clinical aspect of learning, I asked my attendings questioned about why they chose the specialty, how it fit their personality, what they considered pros and cons, etc. If you keep an open mind going into each rotation (and each clinical opportunity you have as a pre-med student) it will make making a decision later much easier for you! Orrrr you’ll be like me and you’ll genuinely like all (most) of the rotations so you’ll decide that family medicine is the best specialty because you get to do a little bit of all the other specialties on a daily basis!

Medical school program tracks

Now, I said above that no one expects you to know what you want to do forever when you’re applying to medical school, but some schools do have specific tracks that you can apply to (like a primary care track) and they do want you to have a general idea because they’re accepting you into their medical school based on your “interest” in that track and the increased likelihood that you’ll enter that field. When you apply to such a program, you’re telling them that you have a genuine interest in whatever that track is. So in the example of primary care, you’re not legally bound to match and practice in primary care but your application, interview, and medical school training are going to be related to primary care. All that to say, if you feel strongly about applying to a medical school as part of a track or specific curriculum, you need to be able to back up that interest. If you’re not really interested, but trying to slide your way into medical school by saying you are, trust me, it’s going to show in your application and/or interview.

Shadow broadly

Getting medical exposure as a pre-med student is so important for your application. One: you’ve got to have some type of medical exposure to be considered a strong candidate. But, also: shadowing and getting medical exposure are great introductions to the various specialties. Shadowing hours, as we all know, are hard to come by—take them however you can get them and in whatever fields you can get them! If you go to church with a gastroenterologist and they offer you a chance to come shadow in their clinic, whether you like guts and butts and not- say yes! You need the hours, the patient interaction experience, and the relationship with that physician. If you feel strongly about a certain specialty, yes you should definitely seek it out, but you should also get some exposure to other specialties as well. Sometimes, as you’ll learn when you’re in medical school and trying to decide for the match, knowing what you don’t want to do is just as important as knowing what you do want to do!

Do you know anyone who matched this year? It’s a great feeling to know that you have a job, even though early in the week you don’t know for sure where exactly that job will be! I’m really excited for Friday for my 4^th year medical school mentees!

Do you think you have an idea of what you want to do? If so, that’s great. If not, that’s great too! You’ve got time! Keep an open mind and get as much exposure as possible. First, let’s get to medical school. Then, let’s get through the match!