From My Story to Your Path: A Personal Reflection on Choosing a Medical Specialty

Introduction

Choosing a medical specialty is one of the biggest and most intimidating decisions you’ll make in your career. For some, the choice feels like love at first sight during a rotation. For others, it’s a slow process of elimination. In my case, my closest friends actually called my specialty before I did. They knew me in some ways better than I knew myself, and they were right.  I ended up in anesthesiology, and I’ve been passionate about that decision ever since.

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This post is my story and the lessons I learned along the way. It’s not a universal formula, because there isn’t one. Each of us brings different priorities, personalities, and experiences into this decision. My hope is that by sharing what shaped my path, you might find ideas, reflections, or reassurance to help guide yours.

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1. Know Yourself First

Before chasing prestige or trends, ask yourself: Who am I in a clinical setting?

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It is important to throw yourself into each rotation with an open mind. You’re there to learn the medicine, but take the time and space you need to notice how you feel. Do you feel at home? Comfortable? Energized? Or do you feel anxious, out of place, or drained? These reactions are signposts pointing you toward or away from your eventual specialty.

Questions to ask yourself

• Do I thrive in high-pressure, rapid-decision environments, or do I prefer a slower pace with more time to reflect?
  
• Do I value long-term patient relationships, or am I more energized by brief, intense encounters?
  
• Am I more detail-oriented and precise, or do I prefer big-picture problem-solving?
  
• Do I enjoy hands-on procedures and interventions, or do I gravitate toward cognitive/diagnostic work?
  
• Do technology, imaging, and data interest me, or do I prefer direct patient conversations and counseling?
  
• Do I prefer variety and unpredictability, or do I feel more comfortable with structure and routine?
  
• Do I want to work as part of a large, interdependent team, or do I prefer greater autonomy?
  
• Am I comfortable with nights, call, and unpredictable schedules, or do I need more control over my hours?
  
• How important are income, job stability, and geographic flexibility to my long-term happiness?
  
• Do I want to develop deep expertise in a narrow field, or maintain broad knowledge across many conditions?
  

For me, I realized I wasn’t well-suited for a specialty that required meticulous daily clinic notes or long-term follow-up. I enjoyed acute medicine. I preferred fast, focused, and impactful work. That insight immediately ruled out some specialties and steered me toward others.

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Remember, these questions are just the beginning. They’re not meant to provide all the answers, but to spark curiosity and encourage you to dig deeper. The more honest you are with yourself, the more clearly you’ll see where you belong.

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2. Learn From What Doesn’t Fit

In my case, some decisions became clear not by finding the “right” specialty, but by recognizing what didn’t work and why.

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• Clinic settings: I carry a lot of time-stress. Being late in clinic made me anxious, and we were always running behind.
  
• Documentation: As a recovering perfectionist who had overcome a speech impediment, dictating notes was absolute torture- it slowed me down and added to the stress of jam-packed days.
  
• Lifestyle: I loved OBGYN, but the lifestyle wasn’t for me. Watching attendings sleep in lounge chairs with the lights on and SportsCenter on repeat left an impression, and not the good kind.
  
• Culture: I loved surgical specialties and found the work fascinating, but the entrenched “good old boys” culture left a bad taste and wasn’t a good fit for me.

That was my story. For someone else, those same environments might be energizing. Each of us has different pain points, strengths, and personal history that shape which paths feel sustainable and which don’t. Knowing what you don’t want can be just as powerful as knowing what you do.

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3. Find Your Non-Negotiables

When I finally looked at what I did want, my list was clear:

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• Procedural work that was immediately impactful.
  
• A team culture where personalities meshed, and I felt at home.
  
• A field I could truly turn off when I left the hospital.
  
• Solid earning potential to pay off debt and live comfortably.

Anesthesiology checked every box.

4. Don’t Ignore Lifestyle

Prioritizing lifestyle isn’t selfish; it’s realistic. You’ll spend decades in your specialty, and your quality of life will matter just as much as your passion for the work. I wanted to be fully present when I was at work and truly off when I wasn’t. Anesthesia provided me with that balance more than any other field I considered.

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Equally important, lifestyle affects how long you can thrive in your career. Burnout is common, but it’s not inevitable if you choose a specialty that fits you. The real goal is to pick a path you can see yourself enjoying not just next year, but 20 or 30 years from now. Fit is everything.

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So put on your “future hat” and ask: Can I see myself doing this into my 60s and still feeling fulfilled?  A specialty that allows you to grow and sustain joy in your work is one that will support you for a lifetime. Think long-term, and give yourself permission to prioritize balance.  It’s what will keep you both present for your patients and whole as a person.

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5. Money Matters, But It’s Not Everything

When I was in school, there were no accurate, accessible numbers about what different specialties earned. That’s one of the reasons I later created Marit Health – to make compensation and time-off data transparent for both active clinicians, as well as students and residents charting their careers.

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This information is not about chasing the highest salary. It’s about having a clear understanding of what your work will provide financially and how that aligns with your life goals. Compensation and time-off should be one of many data points in your decision. If they were the only factors, I would have chosen a different specialty. But money is still a factor, and it should be, especially when you have six figures of student debt waiting for you when you finish training. 

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6. Keep an Open Mind During Rotations

Your preconceived ideas about a specialty can crumble or solidify when you actually experience it. 

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When I started my anesthesia rotation, I was curious. By the time I finished, I knew I had found my place. The mix of physiology, teamwork, and procedural skill felt natural. I liked the attendings. I liked the residents. I liked the pace. I liked that my work had an immediate impact on patient outcomes.

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But more than anything, it felt like home. These were my people. We aligned in beliefs and purpose, and it just clicked in a way that’s hard to put into words. That kind of connection can take you by surprise, but it can only happen if you approach each rotation with openness. Had I gone in with a fixed perception or a closed mindset, I might have missed it - and with it, the chance to discover my true match.

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7. Expect Trade-Offs

There is no perfect specialty.  Every choice involves giving up something, whether it’s income, lifestyle, scope, or environment. The goal isn’t perfection; it’s alignment with your core values and long-term goals.

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Medicine is a lifelong career, and it’s easier to navigate its challenges when your specialty fits your strengths, personality, and the life you want to build. The key is deciding which compromises you’re willing to accept, and which ones would slowly erode your satisfaction over time. Maybe you can live with irregular hours if the work energizes you, or perhaps you’re comfortable with a lower salary if it gives you the freedom and balance you value most.

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Knowing your non-negotiables, while being realistic about the rest, will help you choose a specialty you can sustain for the long haul.

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Closing Thoughts

Choosing a specialty is deeply personal. For me, anesthesiology fits my personality, skills, and lifestyle goals better than anything else. Your path might look completely different, and that’s exactly how it should be. The best choice is the one that feels like yours.

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And if you’re still unsure, remember: go into every rotation with curiosity, pay attention to how you feel, and let that guide you. The right fit is out there. You just have to notice it when it shows up.

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If you’re already in practice, how did you choose your specialty? What lessons or advice would you share with those still deciding? Share your story, and we’ll feature it in a future post to help the next generation of clinicians find their fit.