Need advice about choosing specialty
Hey! I'm about to start my second year of medical school in Ontario, and I'm feeling pretty anxious about residency and choosing a specialty.
I'm looking for advice from physicians or residents who have been through this before.
I don't come from a medicine background and I'm the first person in my family to pursue anything in healthcare. Before medical school, I genuinely didn't realize how early you had to start thinking about specialization, or that the decision would likely shape the rest of your career.
I've always known that I value a positive team environment, being surrounded by kind and respectful colleagues, and having a lifestyle that I'll still enjoy when I'm 50. Going into medical school, family medicine seemed like the obvious fit because it was really the only model of a physician I knew.
Then I started shadowing. Someone I was close with previously (not any longer) introduced me to psychiatry. I never considered it before but decided to give it a chance and I ended up becoming really interested because it seemed to fit me surprisingly well. I did a lot of qualitative research in undergrad, and I've realized that's just how my brain likes to think. Every psychiatry team I've shadowed has been incredibly supportive and welcoming, and the research I've been involved in has been some of the most fulfilling and least stressful work I've done. I especially loved consultation-liaison psychiatry.
The funny thing is, I never imagined myself in psychiatry before medical school. Honestly, I didn't even know the difference between a psychiatrist and a psychologist until recently. But looking back, I spend a ridiculous amount of my free time watching psychological analyses of TV show characters, so maybe I've always been interested without realizing it. I also wonder if I've had some internal resistance because of the stigma around psychiatry. It's never been a field I really allowed myself to seriously consider until now.I also don't want to feel like I am only pursuing a specialty because someone I used to be close with introduced me to it.
At the same time, I've noticed that I haven't really given other specialties a fair chance. Aside from psychiatry, I only shadowed orthopedics and ophthalmology during first year. Part of that was simply not having enough time between studying, research, and extracurriculars.
But I also wonder if I'm subconsciously avoiding exploring more competitive specialties because I don't think I want to do what it takes to match into them. I came into medical school with the goal of protecting my own well-being and not making medicine my entire identity.
The part I'm struggling with is this: whenever I talk to classmates or upper years pursuing ophthalmology, dermatology, anesthesia, or other competitive specialties, I get this nagging feeling that if I don't at least try for one of those, I'm somehow wasting this opportunity. I'm in a stage of life where I'm single, don't have children, and have relatively few responsibilities. Part of me wonders whether this is the one time in my life where I could chase something highly competitive if I wanted to.
What confuses me is that psychiatry genuinely feels like the best fit. If I ignored prestige and competitiveness completely, I think it's where I'd naturally end up.
But I'm not completely at peace with that decision. I worry that I'm settling too early because people say psychiatry has a good lifestyle and is less competitive, rather than because I've fully explored what's out there.
I had an upper-year tell me they were applying to ophthalmology knowing they might not match, and that if it didn't work out they'd happily do internal medicine instead. It made me wonder whether I should also just pursue a competitive specialty, not because I necessarily want it more, but so that years from now I can tell myself I really explored my options and won't have any regrets. This is what actually prompted me to shadow ophthalmology and despite not liking fast paced stuff, I've noticed I've kind of been pushing myself to seek out opthomology opportunities.
On the other hand, I know that pursuing a competitive specialty would probably change my entire medical school experience. It would mean more pressure, more research, more networking, more stress, and sacrificing some of the balance that I specifically came into medicine wanting to protect.
I guess my question is: how do you know whether you're choosing a specialty because it's genuinely the right fit, versus because you're unconsciously limiting yourself versus because you've been influenced by what other people are doing? How do you balance wanting to keep doors open with not spending four years chasing something that doesn't actually align with the life you want?
I'd really appreciate hearing from anyone who's gone through something similar!