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A guide to medical specialties

Read our detailed guide and explore the different types of medical specialties you can choose from as a medical student.

What is a medical specialty?

A medical specialty refers to a branch of medical practice defined by the type of patient cared for, the diseases addressed, the skills required or specific approach of the practitioner. A doctor chooses a medical specialty after they complete medical school. Typically, to become a practicing doctor in a specialty of medicine, the doctor is required to complete a multiple-year residency in that specialty, take an additional exam testing their ability to specialize in that field, and then register with the governing regulatory body for that specialty.

For example, OB-GYNs (obstetrician/gynecologist) are medical doctors who have completed their specialized training in the female reproductive system. After they graduate from medical school, OB-GYNs need to complete a 4-year residency specializing in obstetrics and gynecology. At the end of their residency, doctors need to pass an exam with the American Board of Obstetrics and Gynecology to assess their skills, knowledge, and ability to treat a variety of conditions related to the female reproductive system.

In comparison, if a doctor decides to specialize in pediatrics, they will have to complete a 4-year residency specializing in pediatric medicine and become board certification with the American Board of Pediatrics by passing a specialization exam.

Choosing the right field of specialty will significantly influence your career path, determining how many years of additional training you need, the type of medicine you will be practicing, how much patient contact you will get, and what your potential salary could be. For example, if you enjoy high-stress environment in a field that requires highly skilled doctors, and you are intrigued by a high salary, it might be worth considering neurosurgery. However, if you want a less stressful working environment, a typical 9 to 5 job, and to complete your residency as soon as possible, you might want to consider family medicine.

How to choose a medical specialty?

As a doctor, one of the most important decisions you will make in your career is which specialty you choose. Your specialty will determine how much time you will spend with patients, the type of patients you work with, how much you can potentially earn, and the type of training that you will be required to undertake, and for how long.

The first decision you will have to make when choosing a field of medicine to specialize in is whether you want it to be surgical or non-surgical, or perhaps a mix of both. Next, you need to pick your scientific/clinical interest areas — what organ system, type of patient or diseases do you find the most exciting?

You will also need to decide how much patient contact you would prefer. Would you like to work with patients every day and all day or be more comfortable in a research lab or operating theatre? You will need to consider how important your work-life balance will be for you and your family. Do you need to work a traditional 9 to 5 job, or is it okay to work nights, weekends, and regularly on call? Finally, you need to think about how important earning potential is to you. Did you become a doctor to earn a lot of money or to help people who cannot necessarily afford large medical fees?

Try your best to answer all these questions and talk to your medical school professors about which specialty best suits your needs and interests. This is obviously a stressful decision, so you must take it seriously.  While it might seem simple to pursue only the highest-paid specialties, you also need to consider whether it is worth the years of additional training required, the daily stress endured, and whether that field will be compatible with your family life.

An overview of medical specialties 

There are two broad categories of specialty for practicing medical doctors: indirect patient care and direct patient care. Indirect patient care includes radiology and pathology, whereas direct patient care includes virtually everything else. Direct patient care can be further broken down into three categories: surgical, medical, or mixed. Surgical specialties include fields such as plastic surgery, vascular surgery, and orthopedics. Medical specialties include fields such as psychiatry, radiation, oncology, pediatrics, and family medicine.  Fields that incorporate both surgical and medical mixture include OB-GYNs, urology, anesthesia, and dermatology.

What are the highest paying medical specialties? 

In the USA, salaries based on medical specialty can vary drastically. For example, according to the University of Stanford Medical School , the median salary for a neurosurgeon is $548,000 compared to the median salary of $198,000 for a family medical practitioner. It is important to note that neurosurgeons need to complete six years of residency training, while family medical practitioners must complete three years of residency. In general, the more training required to specialize in any field of medicine, the higher your potential salary will be.

According to Stanford[AB2] , the five highest medical specialties in the USA are neurosurgery, orthopedic surgery, radiology, radiation oncology, and plastic surgery. Although these are generally the highest-paying specialties of medicine, salary is also highly dependent on where you are practicing medicine, how many years of training you have, and how much experience you have working in that specialty.

Although the salaries might be enticing for the medical specialties, salary should not be your only motivating factor in deciding your specialty. In addition to significantly more years of training required, the highest paying medical specialties are the ones with the most responsibility, skill required, and stress expected in the role.

What are the most competitive medical specialties?

It is important to note that residency programs for certain specialties are particularly competitive and much harder to get into than others. These specialties include neurosurgery, plastic surgery, orthopedics, dermatology, emergency medicine, and radiation oncology, all of which are also some of the top paying specialties.

The most competitive specialty residency program in 2021 was dermatology, which had 239 applicants for only 31 positions. This was followed by emergency medicine, which had 111 applicants applying for 30 positions.

Some of the least competitive specialty residency programs in 2021 include internal medicine, pediatrics, pathology, family medicine, and general surgery.

Although family medicine has historically been the least competitive field of specialty, it has risen in demand since 2008. Efforts to reform the American healthcare system, such as through the Affordable Care Act, have been highly influential in changing the growing need for family medicine practitioners.

Why is choosing the right medical specialty program important?

Choosing the right medical specialty is probably the most important decision when training as a medical doctor. No matter what stage of your career you are at, whether you have just starting to think about medical school or are starting to apply for residency programs, your specialty will have a major influence over your work-life balance, your earning potential, how much time you spend with patients, and how stressful your typical workday will be.

If you are just at the beginning of thinking about becoming a doctor and deciding your specialty, try checking out MUA’s MD program to help you get started on the right path. If you think about your medical specialty now, your medical school professors can help you pick the right field and prepare for it.

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