Blog Archives

The Ins and Outs of Choosing a Specialty: The Generalist vs. The Early Committer

For many third-year med students, this is a challenging time of year. Preparing an ERAS can be daunting, but it’s even worse if you don’t know what specialty you want to practice. Here’s a short piece I wrote with my colleague David Presser MD MPH called “Choosing a Specialty: The Generalist vs. The Early Committer.” And here’s a complementary, but non-medical, New York Times article called “You Don’t Want a Child Prodigy” that’s a great follow up to our piece. 

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How Race and Gender Affect Medical Specialty

The AAMC published an interesting piece recently showcasing the results of their Physician Specialty Data Report on the interplay of race, gender, and specialty. 

It’s worth combing through the data yourself, but here are a few takeaways:

Doctors from underrepresented groups are more concentrated in primary care fields. These specialties are extremely needed and noble, but since primary care is less well remunerated than surgical specialties, it’s worth thinking about the disproportionate density of minority physicians.

Women make up the majority of medical school students for the fourth year in a row.  

Women represent a significant minority in surgical specialties like orthopedic surgery (5.9%), thoracic surgery (8.3%) and neurosurgery (9.6%). Ouch.

Focusing on another demographic, the doctor workforce has grown older. Over 46% of active U.S. doctors are 55+. That number was ~38% in 2007. 

For more details, read the report here.

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How Do I Strategically Apply in Two Fields?

Occasionally I help residency applicants who are applying in two specialties. This tactic can be strategic in specific scenarios, but it also makes the process more complicated. Here are some quick clarifications to help:

1) Different personal statements can be assigned to different programs. This means you can assign your ob/gyn essay to ob/gyn programs and your internal medicine essay to internal medicine residencies. Of course, in this case, you need to have two versions of your statement in the first place, and you need to ensure you assign correctly. 

2) Different letters of recommendation can be assigned to different residency programs as well. (A maximum of four letters may be assigned to each program.) You’ll either need to have letter writers for different fields, letter writers who will craft two types of letters, generic letters (less compelling), or a mix of these approaches.

3) You will have only one MyEras application. It will go to all of your programs. Note that if you list your membership in multiple ob/gyn organizations, for example, that will be viewed by your internal medicine readers as well – and might make them question your commitment to IM.

Contact me for help.

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What to Do in the Summer after Your First Year of Medical School

A super nice client of mine who is currently a first-year medical student recently emailed me to ask my suggestions for what he should do this upcoming summer. The summer after the first year of medical school is – unless you take a gap year – the last free one you will have for a while, so it’s important to use it wisely. Of course, it’s hard to plan with COVID, but generally, the advice I give is that if someone plans to go into a highly competitive specialty like dermatology or neurosurgery, research is probably the best bet. Those specialties require a significant early commitment to the field and a lot of investigative experience/ publications. 

For less competitive fields, research is still an option, but other opportunities should be considered. If you know you’re not going into a highly competitive field, you have a bit more flexibility. After my first year of medical school, I participated in Harvard’s Urban Health Project and spent my time shadowing a physician in an underserved clinic.

Of course, I would not recommend spending the summer at Club Med :), but I would try to make sure you are happy over the summer – near family or friends – no matter what specialty you are seeking.

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Emergency Medicine: A Career That’s Currently Taking a Lot of Hits

Having been in the field of emergency medicine since I started my residency in 1996, I can tell you that the discipline has had its ups and downs. Currently, the specialty is facing a lot of challenges: COVID has driven some physicians out (to utilization review, administration, research) and has adversely affected others emotionally. Additionally, there’s a tremendous dearth of positions currently for emergency physicians. I’ve had friends and colleagues lose promised hours or their jobs entirely in the last 18 months. 

Here’s a short piece on the job scarcity issue. Those choosing a specialty must consider the atmosphere of the job market (while recognizing it might improve in a few years).

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About Dr. Michelle Finkel

Dr. Michelle Finkel

Dr. Finkel is a graduate of Stanford University and Harvard Medical School. On completing her residency at Harvard, she was asked to
stay on as faculty at Harvard Medical School and spent five years teaching at the world-renowned Massachusetts General Hospital.
She was appointed to the Assistant Residency Director position for the Harvard Affiliated
Emergency Medicine Residency where she reviewed countless applications, personal statements and resumes. Read more

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