How To Know If You Like a Medical Specialty

So you’ve finished medical school. Five long years of learning different subjects. Examining diverse facets of disease and its cure.

Then you became a medical intern. And went on to get hands-on exposure to stuff you’d learned from textbooks. That was a new experience.

And now you’re wondering…

Do I like this specialty enough to choose it for my career?

In other words, you may be asking:

“Should I be a surgeon?”

Or an obstetrician. Or paediatrician. Or anaesthesiologist.

Or… anything.

How to know if you’ll “like it”?

Let’s explore this…

WHAT ELSE DO YOU LIKE?

Think of other things that you like.

Food?

Okay. Let’s take food.

We all know what you mean when you say, “I like chicken biriyani” or “I like ice cream“.

The experience of eating a delicious, tasty meal is familiar. It delights your senses while it’s happening. And leaves you with a pleasantly comfortable satisfaction when it’s finished.

Or think of a movie.

We’re on the same page when you tell me, “I like this lovely film we watched last night“.

The sensation of pleasure from well-scripted storytelling is one most people have gone through. You enjoy the acting, songs and music, visual effects, ambience in the cinema house, and more.

So it’s natural to think in the same way about… everything you “like”.

Unfortunately, what determines if you’ll “like a medical specialty” isn’t quite the same as watching a movie or eating food.

No.

In fact, not at all.

The pleasurable sensations that accompany a meal or entertainment are FEELINGS which guide you to conclude that you “like” it.

What governs a choice of medical specialty, on the other hand, is much more than just feelings.

Yes, feelings do have a role in arriving at your decision.

But primarily, it is a LOGICAL/INTELLECTUAL exercisesupported by your feelings.

To pick a specialty or career based on how it makes you feel (especially for a very brief duration, such as a rotatory internship posting) can be a critical mistake.

One that could haunt you – for the rest of your professional life!

So if you can’t rely upon the time-tested, familiar concept of FEELINGS to decide a specialty, then…

How to know if you’ll “like it”? Or not?

Bear with me, because this is going to be a long-drawn explanation.

It’s long because it is important to know all of this – and there’s quite a lot that goes into it.

After all, this process will determine the kind of work you’ll do… for the next 20, or 30, maybe even 40 YEARS!

Questions To Help Know If You’ll LIKE It

We’ll explore the tricky question – by asking a whole bunch of other questions, to which you’ll seek answers.

Let’s group them under some heads, to make it easier to follow along:

  1. Downside: Hope for the best, but prepare for the worst‘ is great advice. So what if you saw all the downside of a particular specialty – and still like it?
  2. Challenge:If you’re not growing, you’re dying‘. A career path should allow for growth, and not throttle your ambitions and talents. Does your preferred specialty allow it?
  3. Reward: Humans are rather simple animals. We seek reward, and avoid punishment. Work fills much of our day. Will working in your specialty offer you adequate rewards?
  4. Aptitude: We tend to focus on things we know to do well. And often, when we’re good at it, we begin to like doing more of it. So being competent at tasks and skills in a specialty matters.

So let’s move on to what I’ll call ‘Core Questions‘ in each of these categories.

Answers to these Core Questions can lead you closer to knowing if you’ll like a specialty – or not.

DOWNSIDE

Here are some questions to ask yourself:

  1. Can I tolerate the worst bits – because the best ones are worth it?
  2. Do the less exciting parts at least seem tolerable?
  3. Will I get bored to death by the daily routine?
  4. Is there enough diversity or variation to keep me engaged and excited?
  5. Can I imagine myself doing this for the next 20 years?

Look, the opposite of ‘love’ isn’t ‘hate’… it’s INDIFFERENCE!

You simply stop caring.

The biggest downside from choosing ANY specialty is that the worst, most boring, least exciting parts of it – will drive you nuts!

When you first experience any field or branch, it’s natural to be fascinated by only the best parts.

But stuff grows old really, really fast.

I still vividly remember learning how to tie surgical knots.

For weeks, I struggled with it. And then, the late Dr.Thiyagarajan taught me during a posting in Casualty.

After hours of practice late into the night, I mastered not only the 3-finger technique, but soon could also tie knots using only one… as well as ‘square the knots’ effectively.

At that moment, I was THRILLED!

Years later, as a heart surgeon, every operation involves tying FIVE HUNDRED knots – or more.

I do it automatically, mechanically, without even thinking about it!

So an important element to get clear in your mind is this…

“Can I handle the most dull, boring, routine parts of a specialty – because there’s so much else in it to look forward to, and keep me hooked?

And be fully aware that what seem to be the most exciting, novel, fascinating bits today… may soon end up becoming that mundane routine!

SIDE NOTE: A Funny Syndrome!

Before moving on to the next category, a word about an interesting phenomenon.

You’ve surely seen it before.

A desire to hop and flit… from one choice to another.

  • Today, you’re fascinated by surgery.
  • Tomorrow, a brilliant diagnosis makes you enamored with radiology.
  • And the day after, you see a complex childbirth – and want to become an obstetrician.

In other words, the momentary thrill and excitement of a remarkable or dramatic achievement sways your career choice in a certain direction.

Nothing wrong about that… just as long as it doesn’t keep happening over and over!

This phenomenon isn’t rare, though.

It even has a scientific term for it.

SHINY NEW OBJECT Syndrome!

The important lesson is… to resist it.

It’s where these questions under the ‘Downside‘ category come in handy.

Because no matter how appealing or attractive a specialty seems in the short term, there are very few you’ll still ‘like’ after you’ve addressed the questions in the ‘Downside‘ category.

Now the next set of questions kicks in…

CHALLENGE

Here’s what to ask yourself:

  1. Is it intellectually challenging and stimulating?
  2. Will I have an opportunity to grow?
  3. Will it stretch my limits and force me to keep improving?
  4. Are things evolving? And do I have to keep adapting?

Your work will fill a significant portion of your life. And how much fun, challenge and fulfilment you find in it will determine the overall trajectory of your life itself.

If you’re stuck in a job with few challenges, that doesn’t test the limits of your potential, that won’t keep you on your toes, or inspire you to improve and get better… then sooner than later you’ll get bored with it.

A career which will motivate you to keep improving in an attempt to master your art or craft is the opposite.

You’ll never grow tired of it.

In the broader arc of your life, you want to look back at any point and see how far you’ve come since the beginning.

If, 10 or 15 years from now, you do this – only to discover you’re still pretty much where you began… it can be pretty disappointing.

A specialty that challenges you to give your best will never leave you with this tragic realization.

Because you will have changed as you practice it, and grown in expertise.

Never forget… If you stop growing, you start dying.

And it’s hard NOT to ‘like’ something that keeps you alive!

Okay…

Next, consider the practical advantages from picking a specialty.

REWARD

Here are some questions to ask:

  1. Can I be famous and popular in it?
  2. Will I make enough money?
  3. Does it take me towards my deeper purpose in life?
  4. Are the results likely to give me satisfaction?
  5. Does it align with my other priorities?

Work is an important aspect of your life.

But it is not your entire life.

It fits into a bigger, more complex whole. And your career choices have to be consistent with the rest of it.

Just because something looks like it might be a lot of fun today isn’t a good reason to pick it as your future choice… if it won’t bring you other things you want.

Or need.

And what you need may not be material – like money or possessions.

They may even be intangible.

  • Like respect in society. Fame and celebrity. Recognition by peers. Admiration of other people.
  • Like a deeper satisfaction that what you’re doing has meaning and value to others – and to yourself.
  • Like a sense of making a difference, by doing what you do.

All of these are good reasons to ‘like’ a specialty – even if this involves doing things that aren’t always (or even usually) fun or exciting!

The final category – and there’s a reason this comes at the end – is your unique suitability for the field of interest.

APTITUDE

Here are some questions to ask:

  1. Am I good at the job?
  2. Do I enjoy doing the various tasks in it?
  3. Have I got any skills, traits or strengths that make me better suited than others?
  4. Does it match/fit my personality?

Why does this matter?

Because it’s hard to remain excited about something you realize you aren’t really good at.

Sooner or later, you’ll run out of enthusiasm to carry on.

Or settle for a level of mediocrity in what you do.

If there are few other options available to you, then this is okay. But imagine if your unique skillset was a great match for something else and you’re stuck in the wrong place!

That’s why aptitude is even a factor to consider.

If you find yourself ‘good’ at doing some tasks, or handling certain situations, you tend to like the specialty.

By contrast, if you find yourself bungling jobs, or struggling to acquire some skills, you may not like it as much.

And yet, to decide purely on this basis can also be a mistake.

Because skills can be acquired, honed and developed over time.

With effort.

And practice.

As long as you have a deep INTEREST in doing so.

That’s why this is a non-critical element in deciding whether or not a field is right for you – even though it will deeply influence how much you ‘like’ it!

So What Have You Learned, Until Now?

  1. It isn’t easy to know whether or not you ‘like’ a medical specialty.
  2. This is significantly different from ‘liking’ food or films, because your FEELINGS about a specialty are only a small part of the whole.
  3. To really ‘like’ a medical specialty, it should be one that
  • will challenge you to grow
  • you can accept the downside
  • will adequately reward you
  • you have an aptitude for
  1. Before you can say that you ‘like’ a medical specialty, you should determine if it can offer ALL that you want from your professional life!
  2. To really ‘like’ a specialty, you cannot rely upon short-term gratification provided by feedback, mastery of a few skills, or even a warm glow you feel from working for a brief stint in the branch or field.

Okay, so what’s next?

Clearly, to decide if you ‘like a specialty’, you need more than just a couple of weeks’ exposure in it.

You need a lot of data.

And information.

Only then can you decide meaningfully.

And not rely upon a knee-jerk reaction which is driven by recent, transient, unreliable impulses or experiences.

Broadly, you need information in two areas.

  • KNOW YOUR FIELD
  • KNOW YOUR SKILLS

How To Know Your Field?

Well, you already do.

For 5 years, you have studied enough about the various fields and specialties to have information about some things.

  1. What diseases or conditions will you treat?

An oncologist treats cancer. A cardiologist deals with heart disease. An epidemiologist handles all kinds of conditions. A research scientist could dive into diverse areas.

  1. How will you treat them?

A surgeon will cut to heal. A physician will peddle pills. A healthcare administrator will make policy. A preventive medicine specialist will intervene to prevent illness.

  1. Who are your patients?

A gynaecologist will treat women. A paediatrician cares for kids. A geriatrician deals with the old and infirm. Each derives a different kind of meaning and fulfilment from their field.

  1. How will they be impacted by your specialty?

An emergency physician will very literally keep a patient alive. A palliative care expert will make one’s remaining years more comfortable. An anaesthesiologist keeps surgery pain-free. All benefit their patients – but in starkly different ways.

A few of these will appeal to you. Others will not.

The answers will help guide you towards a specialty you’ll ‘like’ – for the right reasons.

And then, there are questions that will make you pause and consider – to form your opinion based on facts that you already have:

  1. What is good about the way you’ll treat them?

A surgeon might feel a thrill from going right at the heart of the problem and cutting it out. A physician enjoys achieving the same result without blood and gore. A radiotherapist thinks getting there painlessly and remotely is the bees knees.

All specialties have their positive elements.

Something about it should appeal to you deeply – before you can reliably state that you ‘like’ a specialty.

  1. What’s not so good about it?

A surgeon cuts and sews. It’s painful. And invasive. If the same results can be delivered with less intrusion and pain, it would be better. So interventional cardiology may be a step ahead of cardiothoracic surgery.

Every specialty has things that aren’t so good.

  • Emergency neurosurgery may involve operating on trauma victims at all times of the day or night, wreaking havoc with your personal life.
  • Obstetricians deal with the tendency of little ones not to respect your sleep-awake cycle.

You should at least be aware of these things, and consider them as being a part of your life in this specialty – before taking a call on whether you ‘like’ the field or not.

And finally, there are some questions you’ve probably not asked yourself earlier – but already have enough information to address reasonably:

  1. Over the course of your career, what benefit will you deliver by practicing your specialty?

Imagine yourself as a practitioner in this field. Project into the future. Think of what you’ll have done – 5 years from today.

10 years.

Twenty.

Longer!

  • How will you have changed the world?
  • Helped your patients?
  • Improved yourself?
  • Grown in stature, position and reputation?
  1. What price will you pay in other areas of your life by picking this field?

You can’t make an omlette without breaking eggs.

Some medical specialties come with baked in ‘costs‘.

In terms of frustration and hardship you’ll suffer. In time spent away from other things and people. In degree and intensity of your commitment to patients.

And no, it’s not all the same.

A neonatologist in charge of 30-week premies lives in a kind of pressure-cooker environment that’s completely foreign to a consultant dermatologist.

There are many intrinsic dangers in specific fields.

Psychiatry puts you in close contact with the mentally unsound. Anaesthesiology gives you easy access to potent drugs with addictive potential. Surgery exposes you to physical danger in high-stress situations.

Will you really ‘like’ a field after you’ve considered these ‘costs’?

THE ART OF ASKING QUESTIONS

How to discover all this information?

One way is through experience. That might take too long.

Another is through somebody else’s experience.

Yes, by asking them questions, you can tap into their mind for help.

But before going down this path, you must be aware that there’s an art and method to asking questions that will bring you the right answers.

After all, you’ll only get what you ask for!

Here are the 2 biggest things to remember:

Know What To Ask – And What NOT To

Let’s say you’re interested in becoming a surgeon.

What should you ask someone, if you want help or guidance with your decision?

You could ask:

“Hey, ____________ . Should I become a surgeon?”

Or:

“I’m thinking about becoming a surgeon. What do you say?”

On the other hand, you could frame your question differently.

You could ask:

“Hey, ____________ . Why do you think General Surgery is a good specialty?”

Or even:

“What are the pros and cons of being a surgeon?”

At first glance, they all appear similar, as just different ways of asking the same thing.

To appreciate how they aren’t, you should slow down or pause for a moment – and think!

Yes, all of these questions call for an opinion.

But the first set of questions goes further – and requests a recommendation or suggestion.

In other words, you’re asking somebody to decide FOR YOU!

With the second set of questions, you’re asking for more information… to help you decide for yourself.

That’s an important reason to spend some time thinking about what you’ll ask a guide or mentor, a friend or parent, a colleague or senior.

If you word your question optimally, you’re more likely to get a rich source of valuable information… which will help you decide wisely and well.

But ask the wrong question, and what you’ll get back is worthless!

Know WHOM To Ask

When you’re seeking more information, it can seem tempting to look everywhere.

Or ask everyone.

That’s a mistake.

I’ve often said that if you’re seeking investment advice, you want to ask Warren Buffett – not the homeless guy on the street.

Buffett has returned a 23,000% return on his investment over 25 years. The homeless guy, no matter his other redeeming qualities, didn’t.

So picking the right person to ask for advice matters.

When you ask someone who lacks enough experience to guide you, you’ll end up with incomplete information. Or the wrong perspective.

When you ask someone who isn’t successful in a field, you’ll get a tinted view – as seen through the lens of failed dreams and hopes.

Try to ask people who have both experience and reasonable success in a field for advice – because they are the ones you seek to emulate.

You’re not setting out trying to fail!

The rest of the art of asking questions is stuff you’ll pick up as you go along.

As you talk to more people, you’ll learn that certain types of questions extract more helpful information than others.

Use those in future conversations, and you’ll quickly get to your goal.

THE SKILL OF ANALYZING ANSWERS

Ask the right questions, and you’ll get helpful information.

But there’s still one important step left…

Analyzing these answers.

Always remember something. You’re asking for opinions.

Most people will gladly give you one.

But there’s a problem.

It’s THEIR opinion.

And that may not always be in YOUR best interests!

Why not?

Because it will be colored by the other person’s background, experience, views and mindset.

Worse, they may not even be honest – and merely reflect what YOU expect them to say. (Many people do this, to appear popular or friendly!)

So as you think over the response you get, keep in mind the fact that you’re dealing with a set of biases.

There’s Recency bias.

If I ask you which is your favorite movie or book, you don’t immediately scroll back in your memory to every film you’ve watched since childhood!

No. You pick from the ones that spring to mind first.

And many of them will be recent.

We are all biased to recall (and assign higher value) to recent events and experiences.

So if you ask a PG resident trainee or a freshly qualified graduate about her specialty, you’ll get answers that are biased by their recent experiences (good, or bad).

Then there’s Confirmation bias.

If you ask somebody who has already made a decision ABOUT that choice, they will be strongly biased to confirm it.

So if you ask a PG trainee in a General Surgery program, you’re likely to get answers confirming that it is a good choice of specialty.

Obviously. Unless the guy is an idiot, he wouldn’t be in it if he thought otherwise!

There are all kinds of other biases baked into answers you’ll receive – to even your most intelligently framed questions.

But that doesn’t help when you’re looking for balanced information to help you decide.

That’s why you should be aware of bias – and CORRECT for it.

Analyzing the answers helps you do this.

You discount proportionately to the bias you assess, and weigh the information according to your analysis.

And see if it agrees with what similar others say or feel on the issue.

Only then should you factor in that information – to make your choice.

If it sounds as if all of this is complex and difficult, you’re right.

It is.

This is essentially a process of SELF DISCOVERY.

And sometimes you’ll find out stuff about yourself that isn’t what you expected.

Maybe better.

Or maybe worse.

Still, that’s why nobody else can do this for you.

Only you have the time, interest and motivation to explore yourself in such depth and detail.

But then, you’ll also be the one to reap the rich rewards that come from this exercise.

Finding what’s right for you is just one of them!

P.S. –

There’s one final (but important) point to highlight.

In all these factors to help decide if you ‘like’ a specialty, I’ve almost completely ignored FEELINGS.

That’s because if all these elements are not optimally present in the specialty choices you’ve short-listed, then no matter how you feel about it today, you’re making a mistake.

And the corollary is true.

When everything else is aligned with your life goals, but right now at this point in time, you simply don’t FEEL excited or thrilled about the specialty, maybe you shouldn’t dismiss it out of hand.

Because a sense of temporary discomfort, inconvenience and even moderate suffering in the course of working on a career or specialty that checks all of these boxes… is well worth the trade-off.

In other words, the price is worth the product.

And focusing on the cost alone may well get you a worthless item in exchange!

Published by DrSivasubramanian

Paediatric Heart Surgeon and Author - http://www.DrSivasubramanian.com

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