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Specialties: choice and competition

The rapid advances in technological and chemical developments have resulted in a wide array of specialties and sub-specialties and the range of specialty options looks set to expand even further. Whilst on the one hand it is good to have a choice, on the other it can make it more difficult to choose which to select as your preferred career. So, what factors need to be considered before deciding upon a specialty and where to find more information?

Factors to consider

  • Is it really you? It can be very easy to be influenced by someone working within a particular specialty. Their enthusiasm and commitment can be inspiring but this does not automatically mean that this is the ‘right’ specialty for you as well. When choosing your specialty area, it should be the case that the more you find out and research the specialty, the more interested you become in it. For some it may even become an all-consuming interest. It may be stating the obvious but if you are really interested and committed to your specialty you will be more motivated and therefore more likely to succeed. This will then result in increased levels of confidence and your genuine interest will communicate itself to patients, which of course in turn results in better rapport, diagnosis and treatment. This will also carry you through those ‘bad days at the office’, when nothing seems to be going as it should.
  • Skills and Aptitudes. You may be fascinated by keyhole surgery but are in possession of a set of metaphorical two left feet. Hand/ eye co-ordination just isn’t your forte. So don’t do it! Statistically people with a high level of self-awareness, a knowledge and understanding of where their strengths and weaknesses lie are more likely to perform well in their chosen career. Assess your own skills and natural aptitudes and then look at how these link into the different specialties. Whatever else you do, don’t try to fit your personal qualities, skills and aptitudes around the specialty; the specialty should be the closest possible match to you. If you are not sure of your skills and aptitudes there are a number of tools which can help you to identify these, ranging from psychometric tests such as Morrisby, Sci59 and career interest inventories.
  • Needs/values. This is a very personal area and you alone can answer this. What is important to you in your work? Identifying your personal ‘drivers’ is important: if you know what motivates you, you will choose appropriately and be happier in your role. This means a healthier life for you and those closest to you. If one of your needs is to have an active family life, this is possible but look at the specialty area closely. Does it offer you that opportunity now or later? How long are you prepared to wait? Location may be a significant factor for you - if so, acknowledge this and build it into your career decisions. If money or status are the key needs and values for you, then assess the potential and the competition. Some people feel strongly about ethical or moral issues and may not therefore be suited to a career in a particular specialty. These are all very personal choices, so be guided by your own conscience.

Where to find the information?

Information on the various specialties can be found through a variety of sources which include the following:

  • Websites. There is a good range of accurate information available through websites such as National Medical Careers, NHS Employers, MMC, BMJ and the websites of the Royal Colleges.
  • Deaneries. Many of the deaneries provide useful information via their recruitment sections of the website. Always look at the additional information before submitting your application!
  • Printed material. This includes DVD’s, booklets and books devoted to specific specialties. However, it is advisable to check whether the publication is endorsed by the appropriate Royal College.
  • Clinicians. The resource which is there in front of you every day! People who are passionate about their work will be very willing to spend time telling you about it and many will be very honest about the pros and cons. If you are interested in a specialty, don’t be afraid to approach the clinician directly or, if you don’t know anyone in that field, ask your Educational Supervisor to recommend someone you can approach. It is very rare for someone with a genuine enquiry to be refused the opportunity: quite the opposite.

The competition!

Competition for training places does vary between specialties and it would be naïve not to research the level of competition in your specialty and location. Where to check this out?

  • The MMC website is the best place to start. Updated with the statistical information supplied by Deaneries, it is possible to analyse the number of applications by specialty, level and Deanery (or Unit of Application as this is sometimes referred to). Furthermore, this can be broken down into first and second choices, shortlisted applications and placed. You will need to allow some quiet time to analyse the data when you first encounter it. Be aware though that due to the volume of data, the competition tables may reflect information which relates to the situation two years ago.
  • Also look at the information from the Royal Colleges and Associations. Some may be predicting growth areas, others may only offer a small number of specialty training places each year but have high interest, others may be perceived as less ‘glamorous’ and therefore attract fewer applicants. Again it is worth keeping an open mind about some specialties and perhaps exploring other options as future financial restrictions may have a greater impact on some specialties than others.