<p>How and when do you decide what specialty in medicine you will pursuit?</p>
<p>You don't have to declare until it is time to apply for residency programs during final year of med school. Many students think they know just what they want to do when they enter med school, only to find a field they like better after a clinical rotation or an elective. </p>
<p>And if you are still unsure, you can take a rotating/general internship for a year. </p>
<p>And it is not unheard of to start a residency in one area, and then transfer/start over in another. I have seen many ER residents switch to general surgery, a few surgery residents switch to ER, etc.</p>
<p>yeah, pretty much what sunny said.</p>
<p>I think a good way to start thinking about what direction to go is to think in very broad general dichotomies and sectioning off specialties that don't fit. Do you want to work mainly with children or adults? Do you want to do more diagnostic evaluations or more procedures? Do you want to really get to know your patients and work with them for a long time, or would you rather help someone and then move on? </p>
<p>And it's okay not to know the answers to such questions, but thinking about them can give you an idea, and can at least help you pick out which things you feel are the most important and which things don't really matter to you. </p>
<p>For example, I know that I want to work with kids, and I want to be more procedurally based. And while I do want the ability to develop close relationships with patients and see them grow and progress, I'm more willing to accept trade offs in that category than I am in the other categories.</p>
<p>During 3rd and 4th years of medical school, you will do "rotations" in the hospital, where you get experience in lots of different departments. This should help you narrow it down.</p>
<p>The answer involves explaining the match process.</p>
<p>1.) You find out in March of your fourth year in medical school what kind of residency you will be placed into, as well as specifically what program.</p>
<p>2.) This may still be very broad. For example, those going into Internal Medicine may end up as Intensivists, Cardiologists, Pulmonologists, Nephrologists, etc. - in which case they won't figure out their career path for another three years. General surgery residents can go into transplant, pediatric, cardiothoracic, or trauma - and they don't find out for another FIVE years.</p>
<p>3.) You can, of course, change your mind, as mentioned by SF above.</p>
<p>4.) Matching involves three steps: you put down what residencies you'd like to attend and in what order, and they put down which medical students they'd like and in what order. Then, a computer sits down and decides how to match everybody best based on a surprisingly simple (relatively speaking) algorithm.</p>
<p>5.) Because many medical students only apply to residency programs in a certain field, they know as soon as they turn in their list what kind of residency they're going to go into, unless they get completely unmatched. For example, if I only apply to residencies in pediatrics, then I know I'm going to end up with a residency in pediatrics.</p>
<p>6.) Generally you'll be expected to start deciding early in your fourth year of medical school. To settle too firmly as a first or second year medical student is substantially inappropriate, as it limits your mindset. Settling down as a premedical undergraduate, or, worse yet, a high school student, is wildly off-base.</p>
<p>7.) One admissions officer explained to me that very few medical schools ever bother asking, because answers from incoming medical students were not worthwhile. Things change too much. If I remember correctly - and my head is quite fuzzy on this point, so please don't quote me exactly - "About half of you have some idea what kind of specialty you're going to go into. Of those half, about 1/9 of you are right."</p>