There are a lot of fields in medicine to choose from. How do you find the right place for you? It’s quite the task to figure out where you belong in the medical field, as complex and varied as it is. Even when you find a specialty that lights your fire– one that makes your hair stand on end and that makes all your neurons fire in the best way– how do you know if you really belong there? It’s a pretty high-stakes decision, choosing the right career. No pressure… pick the right career, or else.

Despite women comprising more than half of medical school students, there are still many fields that seem to repel women. So if you’re interested in urology for instance, how do you keep from being repelled for the wrong reasons? 

Women are clustering in to pediatrics, OBGYN, and other *relatively* lower-paying specialties: think endocrinology. If you are truly driven to be in one of these specialties, then you’re following your true north, and the work itself can be part of the benefits package. But what if you choose in part because… well, it seems easier to work with some other female colleagues around? Or because some attending physicians ‘advise’ you to choose something ‘easier’ than the field you really like?

What are the consequences of picking the wrong career?

1. The gender pay gap no one talks about. 

I’ve noticed that no one talks about the gender pay gap- the huge, yawning gap that arises from women clustering in certain specialties. Take a look at this study. It says as women enter a field in increasing numbers, there is a tipping point at which it loses its alpha allure, men stop entering the field, and pay FALLS. This article made my head hurt. But it also reaffirmed the virtue of pursing the right field based on the work, not the demographics. If you choose a ‘woman-friendly’ field, beware of the pay cut that often comes along with it.

I talked about this article with Bonnie Koo on her podcast, WealthyMomMD. Check it out: 

The right career can help you duck burnout

2. Epidemic rates of burnout

The other reason I’m interested in career choice is because I think it behooves you to pick what fuels you most. Medicine is demanding, so you might as well choose the field that puts you in a time warp. The one where you forget that clocks exist, and you emerge from a case or interaction as if from a spell. That’s what happened to me recently, as I attended to a trauma patient who needed angiography of multiple body parts. He was a one-man code “triage,” and the surgeons and I masterminded minute to minute, in order to figure out what needed to be done next, as his blood pressure floated from the nineties to the seventies systolic. 

When administration makes a decision that makes my eyes roll, what keeps me going is knowing I’m doing some real good in my work. Knowing I’m using my skills and talents at the highest level to help patients is fulfilling, despite the difficulties in our current medical environment. Being the only one in the hospital who can help in a specific way, using my specific skillset, makes me feel like a critical part of the team. And no one can devalue that. 

This is what helps keep burnout at bay. It’s what makes going in at 10 pm for an emergency a duty, not a burden. 

I’m worried burnout, especially in women, though multifactorial, can come from settling. Settling on a career based on extrinsic, rather than intrinsic factors. That’s why the message of my book is to choose the field that fits you best, and ignites you the most. Settling seems a recipe for disengagement and burnout. 

Can you afford to pick the wrong career? 

3. Maybe, but it’ll cost you dearly. 

If you don’t like your job, it’ll cost in career satisfaction. That is a major bummer after all that time spent in school and training, not to mention those student loans!

If you need to change course and apply for a new residency, that’s okay. Lots of successful people have done it. It’s worth a year or three up front, if that pivot lands you where you truly belong. 

If you have an idea of the area of medicine you’d like to practice in, and you grow out of it or realize it’s not quite what you thought, it’s okay. 

If you think, “Why do a fellowship when it’ll cost me a year of attending salary?” I’d say the investment is worth it if fellowship gets you where you want to be. To do a fellowship, you’ll earn maybe $70k, maybe more with moonlighting, if that’s an option. You could be earning $200-300k as an attending though, so you’re “losing” $140k or more, right? NO! 

Not if that fellowship brings your earning potential higher! If fellowship garners you an extra $50k per year (say, on average, even if this is oversimplified), then over a 20 year career, that’s a million dollars in gross earnings. In these decisions, keep the long view in mind, or it’ll cost you!

That’s why I wrote Save Lives, Enjoy Your Own. To help guide you toward the right decision. It will help you sift through your talents to realize how much exploring you need to do. The book will prompt you to spill your guts (my journaling exercises) so you can dig beneath the surface, below other people’s expectations of you, to what you really desire in your career.

Career longevity in the right career

A key component of making a living and building the life you want will be career longevity. If you don’t love what you do, it won’t be long before everything else becomes more important… your partner’s career, your kids… and what will be left of your career? It’ll become low priority. It’ll get what’s left over. 

If you practice something you truly enjoy and can grow into, you’ll be poised for a career that’s as long as you want (and you need) it to be. If you keep working, especially as a primary breadwinner, your family can enjoy the financial security that comes from your ongoing ability to earn. 

Boredom in the wrong career

Getting bored is a thing, even in medicine. And if you stop feeling stimulated and engaged by your work, it can become a slog. So word to the wise, from someone who is entering her seventh year as an attending, go for a specialty that feels like a bit of a reach. Take a leap of faith into something that intimidates and stretches you a bit. Because that big, beautiful brain of yours might get bored of something if it loses its challenge. I’ve seen it in others.

Was I intimidated by all there was to learn in interventional radiology? Heck yeah, I was. There were the procedures, the equipment, radiation physics, not to mention the male-dominated side conversations I couldn’t relate to. Sometimes, it seemed like too much to learn. Still, I knew it was the right career for me, despite the added challenges I saw. It’s not always easy choosing the right career, but it sure is worth it. I did it, and you can too.

Let me know what you think by leaving a comment below.

‘Till next time!