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Whether you're a medical student, a recent board passer, or even a veteran GP who is now looking for a change of pace, the prospect of choosing a particular field of specialization to pursue can be quite daunting. There are just so many to choose from, and it weighs heavily on you when you consider that it will define your practice for the rest of your life. Not to mention the hardship and sacrifice you need to endure for a few years as you go through residency training.
I will try to make this as objective as possible, so as not to steer the reader towards any particular area of specialization.
Given that this blog can be seen by everyone, let's start of with the basics.
Throughout history, the role of the physician has been continuously evolving. The exponential growth in scientific knowledge has created a need to subdivide the practice of medicine into many different fields, each with its own unique approaches to the identification and treatment of illness. Pretty soon, it became humanly impossible to contain all that accumulated (and still currently growing) fund of knowledge under just one title.
By my own estimate, there are about a dozen "basic" specialties that one can apply for residency (here in the Philippines). Almost all of these specialties allow you to pursue further training in subspecialty fellowships available both here and abroad. Not included are the other special trainings that you can apply for outside of the formal fellowship programs. I shall only touch on the latter briefly, since I am not really familiar with what's available.
Given this intimidating and confusing plethora of choices, its easy to feel very lost and confused. Remember, the most important thing here is that you should be prepared to give yourself wholeheartedly to the specialization that you ultimately choose. It won't be easy by any conceivable measure as you are expected to go through the crucible of residency and emerge as a properly-trained specialist. I shall be discussing residency training in a separate entry, as this one is all about making the choice. In the event that you realize that the specialty is not for you, there is no shame in turning in your resignation. However, it would be much appreciated if you would decide earlier, preferably when the final selection of residents is not yet done, in consideration of the schedule of the remaining residents.
I once had a conversation with a relative who happened to be a physician, and he was able to break it down quite elegantly by lumping the choices together into clusters, after which you choose your path from there. After a bit of refinement, here is what I was able to put together:
You can lump the different specialties into 5 large groups, based on what you will be expected to deal with:
1) Adult
2) Kids
3) Pregnant
4) Cutting
5) Diagnostics
I am also adding a 6th Miscellaneous category to accommodate certain specialties that cannot be shoehorned into any of the 5 aforementioned groupings. More on this later.
Lets go over them one by one:
1) Adult - basically refers to Internal Medicine and its vast multitude of subspecialties which are based on the different organ systems.
2) Kids - obviously talking about Pediatrics, as well as its own umbrella of subspecs.
3) Pregnant- the specialty of Obstetrics and Gynecology gets its own category, since the attendance to childbirth is a unique discipline in itself
4) Cutting - refers to all the specialties that involve surgery (excluding OB-Gyn). This would include General Sugery and its various disciplines (Urology, Orthopedics, Thoracic and Cardiovascular, etc), Otorhinolaryngology (ENT-HNS), and Opthalmology.
5) Diagnostics - this would encompass Radiology and Pathology, as well as their respective subspecialties
6) Miscellaneous - Included here are those that do not clearly belong to any one particular category. These are:
- Family Medicine (technically trained to be all-around, if I understand it correctly)
- Nuclear Medicine (the practice of medicine involving the use of radioactive materials defies classification)
- Dermatology (I wanted to put this together with IM, but remembered that they can serve both adult and pedia)
- Anesthesiology (was tempted to lump this together with the cutting specialties since they all share the OR, but thought better of it because they are technically "Internal Medicine in the OR", as what some of our Anesthesia colleagues might say)
The next step would be to choose a particular category, and get things started from there. This advice seems to be catered to those going into IM and Pedia, where they have 3 years to figure stuff out while they choose which subspec they will be going after. Its a bit trickier for the surgeons, as there are certain "straight programs" available where the trainee does not have to undergo the General Surgery residency program before getting started on the subspec.
There you have it, a simplified overview for choosing a specialty. Hope it helps! 😁
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