Passion, money, prestige, or lifestyle?

Some students start medical school knowing exactly which specialty they want to enter. But most don’t decide on a specialty until their 3rd or 4th year. While I was in medical school at Georgetown, one of my professors broke down what to consider when choosing a specialty during one of our lectures. He stated, “When making a career decision, one should think about 4 things: Passion, money, prestige, and lifestyle.” For example, if one chooses to become a Neurosurgeon, which is an extremely competitive field to match into, you will have prestige and respect because of its difficulty, and make tons of money ($500k to over 1 million/year) but sacrifice family time and lifestyle. You will make lots of money, but will be working so much that you may not be able to enjoy it. You’re likely to miss several baseball and basketball games for your kids and miss many dinners with your family. Conversely, one who decides to go into Pediatrics will sacrifice compensation (they are some of the lower paid physicians averaging around $125k-$150k/year), but for lifestyle, you will have more flexibility with your time and more stable working hours. However, the perception of career prestige may not be considered as high as some other specialties.

For me, lifestyle and passion were the two most important factors that influenced my specialty choice. I did not make a decision until the end of my 3rd year of medical school. Initially, I was interested in Emergency Medicine and then Urology. I finally decided upon Orthopedic Surgery because I loved working with my hands and I fell in love with the complex bone surgeries the moment I stepped foot in the operating room.

The other day, one of my coworkers asked me, “If you won the lottery, would you still continue to train as an Orthopedic Surgeon?” To be honest, it did cross my mind what I would do if I did win, but it dawned on me that I absolutely love what I do and wouldn’t trade it for anything in the world. My point is that you should choose a specialty that allows you to wake up each morning and love going to work. I currently work with three Orthopaedic surgeons who are over 70 years old, the oldest being 81. When choosing your specialty, ask yourself, “Will I still enjoy this at 70?” Or, “Will I still love to work in this field after 40 years of practice?” If the answer is yes, then that specialty may be for you. Don’t choose a specialty just because it makes lots of money, has a short residency, or because you can work shift hours. You may regret it years later. Instead, ask yourself “What’s most important to me and where does my passion lie?”

Editor’s note: For data about specialty choice, see the AAMC’s Graduation Questionnaire. To learn more about choosing a specialty according to your interests and values, please visit the AAMC’s Careers in Medicine website.