This past weekend, I had the honor and privilege of keynoting at the Alberta Medical Students Conference and Retreat, a conference I had attended myself as a medical student. I spent part of the talk discussing questions I thought were important in deciding on a medical specialty. I share it here, for those who might find it helpful in choosing their own specialty. I concluded the talk with advice and challenges on tackling clinical practice, and will share that in a separate post. Please feel free to share with those who may benefit from this.

“For the next part of the talk, I want to focus on you, and share some thoughts on choosing your future career path. While many of you may be 110% set on your future career path, there are many more of you who are unsure of what path to pursue. Realizing this, I have put together some questions for you to keep in mind as you advance through your respective careers.

How many of you have heard, “first decide on medicine versus surgery?” You can forget about that right now. That is an oversimplification, and I want introduce you to some other questions you might consider along the way.

1. Do you like high-acuity or low-acuity situations? There are most certainly low-stress surgical specialties, and high acuity medical specialties, and vice-versa.

2. Do you like diagnosing or treating? If you are a diagnostician at heart, maybe primary care or emergency medicine is for you. Often times, by the time the patient has gotten to the specialist, the diagnosis is very clear, and the main challenge lies in treatment.

3. Do you want to be a part of primary care or secondary care? Do you like the thought of being a manager of a myriad of conditions, a gatekeeper to the specialists and a protector of resources? It may sound dramatic, but practically speaking, if that sounds appealing, you should consider a career in family medicine or pediatrics.

4. Do you like procedures? Beyond surgery (obviously), there are non-surgical specialties that certainly encompass a higher proportion of procedures. Interventional radiology and cardiology certainly fall into this category, as do emergency, ICU, anaesthesia and certain dermatologists and family physicians.

5. How much do you love/hate research, and how does that factor into your career choice? Certainly, the most competitive specialties, from ophtho to derm, will require you to pursue competitive research projects. Most surgical specialties have annual research and residency-long publication requirements. Certain specialties, because of the job situation, will require you to obtain an advanced degree to remain competitive. Neurosurgery and cardiac surgery are examples of these.

6. Where do you ultimately want to end up, geographically and institutionally? Does it matter? How does the job situation for your chosen field tie into this? If you are small-town folk and heart and only wanting to practice in rural Inuvik…maybe cardiac surgery isn’t conducive to this.

7. Speaking of where you want to practice…Do you like clinic? The OR? Hospital practice? Community practice? Some mix of all of the above? If you hate clinic, maybe rethink your choice of psychiatry. If you love community practice, maybe neurosurgery isn’t for you.

8. What are your personal, family and lifelong goals? How do these tie into your chosen profession? There are doctors who are also authors, photographers, pilots, athletes, entrepreneurs, researchers, community volunteers and, of course, parents. How much you can dedicate to each of your commitments will depend heavily on your work-life balance (or lackthereof).

9. What is the job situation like? And how much does that matter to you? If you have to do years of sub-specialization and advanced degrees to be competitive for your field, will you be happy with that? If you opt instead for a shorter residency with better job prospects, will you be happy?

10. What are the people like? It might sound cliche, but it’s true: each field attracts its own brand of crazy. I encourage you to pay attention as you rotate through your clinical years. What kind of people does each specialty tend to attract, and how do you fit into this? On that note, what are you like? Are you an introvert or an extrovert? Believe it or not, it does matter, and will play a role into your overall happiness.

I want you to think about those questions as you progress through your respective careers, because I believe they will be valuable in your decision-making.”