How To Choose a Medical Specialty: The Ultimate Guide

There are multiple factors to consider when choosing a medical specialty. We’ve broken down all the medical specialties available to 4th year medical students below to compare lifestyle, salary, and more.

For those that remain undecided, read here for the 10 best medical specialties for work-life balance.

The Ultimate Guide to Choosing a Medical Specialty

Fourth year medical students are eligible to apply for residency positions in the following specialties. Read here for more information on choosing a residency program.

For even more, the AAMC has compiled a comprehensive list of specialty profiles with extensive data on residency program competitiveness as well as average salaries and other lifestyle information.

When choosing a specialty it’s important to note there may be multiple training pathways to the same specialty or subspecialty. For example, students interested in interventional radiology have the option to apply for a fellowship in interventional radiology following a residency program in diagnostic radiology, or to apply for one of a small number of integrated diagnostic/interventional radiology residency programs.

Medical Specialties

Anesthesiology is a 4-year residency program. Upon completion of residency and board certification, physicians have the option to pursue fellowship training in one of 9 subspecialty options including adult cardiac anesthesiology, neurocritical care, pediatric anesthesiology, clinical informatics, obstetric anesthesiology, pediatric cardiac anesthesiology, critical care medicine, pain medicine, or regional anesthesiology and acute pain medicine.

Those interested in anesthesiology can find more information through the American Board of Anesthesiology.

Child neurology is a subspecialty that physicians can pursue following general neurology residency, but there are also a number of 3-year child neurology residency programs that allow residents to pursue the specialty immediately upon graduating from medical school.

Those interested in child neurology can find more information through the American Board of Psychiatry and Neurology.

Dermatology is a 3-year residency program. Upon completion of residency and board certification, physicians have the option to pursue fellowship training in one of 3 subspecialty options including dermatopathology, micrographic dermatologic surgery, and pediatric dermatology.

Those interested in dermatology can find more information through the American Board of Dermatology.

Emergency Medicine is a 3-year residency program. Upon completion of residency and board certification, physicians have the option to pursue fellowship training in one of 8 subspecialty options including pediatric emergency medicine, medical toxicology, sports medicine, emergency medical services, pain medicine, undersea and hyperbaric medicine, critical care medicine, and anesthesiology critical care medicine.

Those interested in emergency medicine can find more information through the American Board of Emergency Medicine.

Family Medicine is a 3-year residency program. Upon completion of residency and board certification, physicians have the option to pursue fellowship training in one of 4 subspecialty options including adolescent medicine, sports medicine, geriatric medicine, and pain medicine.

Those interested in family medicine can find more information through the American Board of Family Medicine.

Internal Medicine is a 3-year residency program. Upon completion of residency and board certification, physicians have the option to pursue fellowship training in one of 16 subspecialty options including adolescent medicine, cardiovascular medicine, endocrinology, hematology, neurocritical care, rheumatology, gastroenterology, hematology oncology, medical oncology, pulmonary disease, sports medicine, critical care medicine, geriatric medicine, infectious disease, nephrology, or pulmonary critical care.

Even further sub-specialization is available for physicians in cardiovascular medicine and gastroenterology. Those interested in internal medicine can find more information through the American Board of Internal Medicine.

Interventional radiology is available as a subspecialty after completing residency in diagnostic radiology, but there are also a number of integrated interventional radiology residency programs that allow residents to pursue the specialty immediately upon graduating from medical school.

Upon completion of residency and board certification, physicians have the option to pursue fellowship training in one of 5 subspecialty options including hospice and palliative medicine, pain medicine, neuroradiology, pediatric radiology, and nuclear radiology.

Those interested in interventional radiology can find more information through the American Board of Radiology.

Neurodevelopmental disabilities is a subspecialty that physicians can pursue following general neurology residency, but there are also a number of 6-year neurodevelopmental disabilities residency programs that combine training in both pediatrics and neurology and allow residents to pursue the specialty immediately upon graduating from medical school.

Those interested in neurodevelopmental disabilities can find more information through the American Board of Psychiatry and Neurology.

Neurosurgery is a 6-year residency program. Upon completion of residency and board certification, physicians have the option to pursue fellowship training in one of 2 subspecialty options including endovascular surgical neurology or neurocritical care.

Those interested in neurosurgery can find more information through the American Board of Neurological Surgery.

Neurology is a 3-year residency program. Upon completion of residency and board certification, physicians have the option to pursue fellowship training in one of 9 subspecialty options including brain injury medicine, epilepsy, neuromuscular medicine, child neurology, neurocritical care, pain medicine, clinical neurophysiology, neurodevelopmental disabilities, or vascular neurology.

Those interested in neurology can find more information through the American Board of Psychiatry and Neurology.

Nuclear medicine is a 3-year residency available after completion of a preliminary PGY-1 program (read more about different residency program positions here).

Those interested in nuclear medicine can find more information through the American Board of Nuclear Medicine.

Obstetrics and gynecology is a 4-year residency program. Upon completion of residency and board certification, physicians have the option to pursue fellowship training in one of 6 subspecialty options including complex family planning, gynecologic oncology, critical care medicine, female pelvic medicine and reconstructive surgery, maternal-fetal medicine, or reproductive endocrinology.

Those interested in obstetrics and gynecology can find more information through the American Board of Obstetrics and Gynecology.

Orthopedic surgery is a 5-year residency program. Upon completion of residency and board certification, physicians have the option to pursue fellowship training in one of 8 subspecialty options including adult reconstructive orthopedic surgery, musculoskeletal oncology, orthopedic trauma, foot and ankle surgery, orthopedic sports medicine, pediatric orthopedic surgery, hand surgery, or orthopedic spine surgery.

Those interested in orthopedic surgery can find more information through the American Board of Orthopedic Surgery.

Osteo-neuromusculoskeletal medicine is a 2-year residency program available to osteopathic medicine graduates after completion of general medicine rotating internship.

Those interested in osteo-neuromusculoskeletal medicine can find more information through the American Osteopathic Board of Neuromusculoskeletal Medicine.

Ophthalmology is a 3-year residency program. Upon completion of residency and board certification, physicians have the option to pursue fellowship training in one of 5 subspecialty options including neuro-ophthalmology, pediatric ophthalmology, ophthalmic pathology, uveitis and ocular immunology, or ophthalmic plastic and reconstructive surgery.

Those interested in ophthalmology can find more information through the American Board of Ophthalmology.

Otolaryngology is a 5-year residency program that includes training in ear, nose, and throat (ENT) disease as well as head and neck surgery. Upon completion of residency and board certification, physicians have the option to pursue fellowship training in one of 3 subspecialty options including complex pediatric otolaryngology, neuro-otology, or plastic surgery within the head and neck.

Those interested in otolaryngology can find more information through the American Board of Otolaryngology and Head and Neck Surgery.

Pathology is a 3 to 4-year residency program. Upon completion of residency and board certification, physicians have the option to pursue fellowship training in one of 12 subspecialty options including blood banking, cytopathology, hematopathology, forensic pathology, neuropathology, chemical pathology, dermatopathology, molecular genetic pathology, medical microbiology, pediatric pathology, clinical informatics, or selective pathology.

Those interested in pathology can find more information through the American Board of Pathology.

Pediatrics is a 3-year residency program. Upon completion of residency and board certification, physicians have the option to pursue fellowship training in one of 17 subspecialty options including adolescent medicine, medical toxicology, pediatric critical care medicine, pediatric gastroenterology, pediatric infectious disease, pediatric rheumatology, child abuse pediatrics, neonatal-perinatal medicine, pediatric emergency medicine, pediatric hematology-oncology, pediatric nephrology, pediatric sports medicine, developmental and behavioral pediatrics, pediatric cardiology, pediatric endocrinology, pediatric hospital medicine, or pediatric pulmonology.

Those interested in pediatrics can find more information through the American Board of Pediatrics.

Physical medicine and rehabilitation is a 3-year residency program. Upon completion of residency and board certification, physicians have the option to pursue fellowship training in one of 6 subspecialty options including brain injury medicine, neuromuscular medicine, pain medicine, pediatric rehabilitation, spinal cord injury, or sports medicine.

Those interested in physical medicine and rehabilitation can find more information through the American Board of Physical Medicine and Rehabilitation.

Plastic surgery is a 6-year residency program that includes clinical education in general and plastic surgery together in a single program (“Integrated Pathway”). It is also possible to enter a plastic surgery fellowship upon completion of a general surgery residency (“Independent Pathway”).

Upon completion of plastic surgery training and board certification, physicians have the option to pursue further fellowship training in one of 3 subspecialty options including craniofacial surgery, hand surgery, or plastic surgery within the head and neck.

Those interested in plastic surgery can find more information through the American Board of Plastic Surgery.

Psychiatry is a 6-year residency program. Upon completion of residency and board certification, physicians have the option to pursue fellowship training in one of 6 subspecialty options including addiction psychiatry, forensic psychiatry, psychosomatic medicine, brain injury medicine, child and adolescent psychiatry, or geriatric psychiatry.

Those interested in psychiatry can find more information through the American Board of Psychiatry and Neurology.

Radiation oncology is a 4-year residency program. It is also possible to enter a fellowship in radiation oncology following residency training in diagnostic radiology.

Those interested in radiation oncology can find more information through the American Board of Radiology.

Diagnostic radiology is a 4-year residency program. Upon completion of residency and board certification, physicians have the option to pursue fellowship training in one of 12 subspecialty options including abdominal imaging, endovascular surgical neuroradiology, musculoskeletal radiology, pain medicine, cardiothoracic radiology, interventional radiology, neuroradiology, pediatric radiology, clinical informatics, medical physics, nuclear radiology, or radiation oncology.

Those interested in radiology can find more information through the American Board of Radiology.

General surgery is a 5-year residency program. Upon completion of residency and board certification, physicians have the option to pursue fellowship training in one of 6 subspecialty options including complex general surgical oncology, hand surgery, pediatric surgery, critical care, vascular surgery, plastic surgery, or cardiothoracic surgery.

Those interested in general surgery can find more information through the American Board of Surgery.

Thoracic surgery is a 7-year residency program that combines general and thoracic surgery training. It is also possible to enter a fellowship in cardiothoracic surgery following residency training in general surgery. After completion of thoracic/cardiothoracic surgery training, physicians have the option to pursue further fellowship training in congenital cardiac surgery.

Those interested in thoracic surgery can find more information through the American Board of Thoracic Surgery.

Urology is a 5-year residency program. Upon completion of residency and board certification, physicians have the option to pursue fellowship training in one of 2 subspecialty options including female pelvic medicine and reconstructive surgery or pediatric urology.

Those interested in urology can find more information through the American Board of Urology.

Vascular surgery is a 5-year residency program. It is also possible to enter a fellowship in vascular surgery following residency training in general surgery.

Those interested in vascular surgery can find more information through the American Board of Surgery.

Final Thoughts

Choosing a medical specialty is one of the most important decisions for young doctors, and there are several important factors to consider. Fourth year medical students should try to enroll in elective rotations in specialties or subspecialties they think they may be interested in, or meet with physicians in this specialty at their university hospital to learn more about salary and lifestyle.

Read more about specialty and subspecialty options on the AAMC website.