You don’t have to love your specialty. Here’s why.


It’s that time of year where upcoming fourth-year students are frantically preparing applications for their chosen specialties.   Statements like “I LOVE psoriasis,” and “’I’m fascinated by the colon,” are heard from eager, smiling, seemingly-passionate faces when asking preceptors for a “strong letter of recommendation.’”

But what about you? You know, the one whose specialty decision-making process feels more like being tossed into an M.C. Escher lithograph than the instant, undeniable attraction between Kim and Kanye.

Relax. It’s going to be OK.  And, you’re not alone.

I decided on my specialty, internal medicine, while pulled over in a McDonald’s parking lot with my mom through a mess of tears, tachycardia, and a sudden feeling of impending diarrhea.  Up until that moment I had felt confused from all of the advice: “Choose surgery if you can’t live without the OR”; “You’ll be bored in family medicine” (this one was ridiculous by the way: family docs are some of the coolest and most fantastic people I’ve ever worked with!); and, “No one would want to go to a female urologist.”

I liked almost every specialty, but there wasn’t just one that rose above all others like it seemed to for many of my classmates.  I did enjoy the OR, but there wasn’t a single female surgeon I worked with whose life I wanted.  And that’s where clarity found me.  The physicians whose lives I most wanted to emulate were internists and family docs, and all of them: educators.

I counsel a lot of undecided students to enter internal medicine and here’s why: It allows you to delay your decision-making by years.  Professionally-acceptable procrastination, people!  You can do primary care, work in global health, be a hospitalist, work in education, be an academic researcher, act as an expert witness in medicolegal cases, or serve as a PI for industry research.

It doesn’t stop there: You can treat the enigmas of medicine as an infectious disease specialist, do all the caths you want as a cardiologist, travel around the world as you work on a cruise ship, act as a medical school dean, answer your uncle’s health questions, run a rural ICU, be an administrator, or even act as a non-clinician, all, both, none, and even more.

Internal medicine is the “pluripotent stem cell” of specialties.  That being said, let’s face it: Tweaking diabetic drugs is boring, but the opportunity to craft a career that suits your interests, personality, and lifestyle at the different phases of your life is priceless.

Here’s the meat of the message: Regardless of specialty, being a doctor is one of the best professions in the world. I don’t love my specialty, but I like it well enough.

I do, however, love the life my specialty allows me to have and the intimate and gratifying role that I play in the lives of others — patients and learners alike.  Professional mentors are important, but it is important to seek those mentors whose lives you appreciate, not just their job.  Internal medicine works for me, but I know tons of physicians in other specialties that are equally satisfied with the package.  Work is a part of you, but it’s not you.

Know yourself, and envision your 5-, 10-, and 20-years-from-now self: the one nursing a newborn, teaching your son to drive, caring for your ill parent, or wanting to train for a sprint triathlon or to climb K2.  And believe me, the passion will probably follow; it simply isn’t something you have or don’t have, but can be cultivated as you grow and develop as a person.

So next time you ask yourself, “What type of doctor do I want to be?” consider this answer: a great one, and a good human.  For at least 99 percent of you, that is the real truth.  The other 1 percent should probably look into getting that MBA.  Good luck and welcome to the club!

Laurel Fick is an internal medicine physician.

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