Messly exists to help doctors make better careers choices. One of the biggest questions we help junior doctors and medical students with is how deciding which specialty to choose. After deciding to study medicine, this can be of the most daunting decisions that young doctors face.
Last year, we interviewed some amazing senior doctors from a range of specialties – asking them questions around their training, the highs, and lows of their specialties and tips on what makes for a great doctor in their field.
To kick off the New Year, we have rounded up the best bits of advice from our specialty interviews so far. If you missed them can check them out on our Blog page.
1) When’s the right time to decide?
The first question we asked our interviewees was when/ how did you decide what type of doctor to be?
Stella Vig was our only interviewee who had a definite idea of what they wanted to do in medicine before starting clinical practice. At the age of 5 she vowed to become an ophthalmic surgeon after seeing her grand aunty’s loss of sight. At medical school this was tweaked slightly when she realised that she didn’t enjoy working with eyes, but the desire to do surgery remained.
Helgi Johannsson (Anaesthetics) and Simon Carley (Emergency Medicine) both decided on their career choices at the end of their SHO years, after trying other specialities to understand what they felt suited them back. For Helgi, his dislike of clinics and ward rounds made him look for a change, and the idea of being an anaesthetist as a student came back to him. Simon had a similar epiphany and decided to become an emergency doctor when he found surgery too specialised. The ICU Reg (ICU) also changed his mind after first training as a medic. “I discovered a geeky interest in physiology and a taste for looking after really sick people without getting too stressed.” He found that ICU allowed him to focus more on the individual patient, and found this more satisfying than “‘firefighting’ massive numbers of patients”. Dr Ahmed Rashid (General Practice) originally wanted to be a cardiologist but realised after completing a masters that he wanted to work more in prevention and public health. He eventually decided to combine general practice with an academic clinical fellowship. This allowed him to combine his clinical work with research.
For Kier Shiels (Paediatrics) there was an element of luck. He was on an FY2 plastics placement that happened to involve a lot of exposure to paediatrics. He discovered there that “working with children was so much more fun than adult medicine” and had paediatrics lined up as his next rotation.
Clearly, everyone’s personal experience of a specialty differs. But the key message here is to keep an open mind in training and get as much experience in different fields as you can. If you don’t manage to get a rotation in a specialty you’re interested in, then organising a placement or shadowing experience can really help improve your chances of discovering whether it’s for you (as well as boosting your application to it!).
2) What personality traits are best suited to each specialty?
Alongside experience, many junior doctors rely on age-old stereotypes to guide their decision as to which specialty they’re best suited to. Many of our interviewees were vehemently against such out-dated ideas, so we gave them the opportunity to tell us which personality traits were useful for their specialty. Most of the answers were very similar:
Anaesthetics: Good situational awareness, communication skills, insight, and good manual dexterity.
Paediatrics: Communication skills, building trust with patients and parents, listening. As Dr Kier said “picking up the nuances of the way parents are speaking, identifying their concerns, putting them, and their children at ease. It’s by far the most important bit of my work.”
Emergency medicine: You need to be able to talk to anyone about anything at any time. You need to be interested in patient stories and in solving puzzles. You absolutely need to be able to manage uncertainty and risk. Finally, in general terms you need to be the sort of person who can lead or work within a team to ‘make things happen’.
Surgery: The old myth is that surgeons are male and have no communication skills. You need resilience and people skills alongside the pure technical skills to be an excellent surgeon.
General practice: Kindness, friendliness, good listening skills, the ability to be reflective.
ICU: Staying calm under pressure, decision making, reflecting on your decisions, flexibility, team work.
3) What’s your advice for junior doctors?
The last question we asked our interviewees was what advice they would give to junior doctors in their specialties. The general advice given was:
- Find a mentor to help you get experience and complete application forms.
- Think about where you want to train and live. Choose teams and locations that reflect your own aspirations.
- Try different specialties- you might be surprised!
- Keep your options open, aim to get a wide variety of experiences through your training and be prepared to be flexible.
- Just do it! At some point you just have to make the decision and go with it.
We also received some more specific insights for particular specialties.
Dr Helgi Johannsson, Anaesthetics: Enjoy the privilege of treating people during a really critical time for them when they feel at their most vulnerable.
Dr Kier Shields, Paediatrics: Doctors who haven’t done a full rotation in paediatrics will not be discriminated against. Don’t worry about having a child health related audit in your portfolio. Don’t worry about having a child health reflection in your portfolio. Skills are interdisciplinary: if you’re asked for evidence that you will be a good paediatrician, it is completely appropriate to talk about experiences involving carers, adults with learning difficulties, sporting injuries, needle-phobic patients etc.
Dr Simon Carley, Emergency Medicine: Get online and join other EM trainees around the world using #FOAMed to be the best doctors they can be.
Dr Stella Vig, Surgery: Core Surgical Training is an 18-month interview process into higher training of many different types and not just in surgical specialties. The paper portfolios are important, so start developing them as early as you can and know them inside out and upside down!
Dr Ahmed Rashid, General Practice: GPs are everywhere! General practice allows you to pursue other career interests including commissioning, leadership, research, charity work, occupational medicine, sports medicine, travel medicine, writing and lots more.
The ICU Reg: If you want one of the few general specialties left, the ability to see people improve in front of your eyes, plenty of procedures, and to be the one everyone’s always pleased to see at cardiac arrests/in A&E, then ICU is the one for you!