Vascular Surgeon Dr. Eric Fishman Shares Advice on How to Choose the Right Medical Specialty

Choosing a specialty is one of the most important decisions that medical students must make. And it is one that is all the more daunting, because of the breadth of options available such as surgery, emergency medicine, psychiatry, orthopedics, dermatology, pediatrics, neurology — and the list goes on.

“The bad news is that there is no definitive, standardized formula or method to ensure that medical students make the perfect choice,” commented vascular surgeon Dr. Eric Fishman. “What may be coveted for one aspiring physician may be undesirable to another.”

And to make things even more complex, people change over time. For example, a student who is very excited about the prospect of specializing in emergency medicine — which is a growing sentiment during the COVID-10 pandemic — may realize, after a few years of residency or later on in practice, that their personality is much more aligned with the dynamics of being a family practitioner. Or, the opposite may be the case: a family medicine practitioner may pine for the opportunity to work in the “controlled chaos” of an emergency room environment. The point is, again, that there is no GPS that accurately points the way forward.

“However, the good news is that there are some fundamental questions that students can reflect on, and which may help them generate interesting and often profound insights into who they are, what they want to do with the careers, and why,” commented Dr. Eric Fishman, who practices in Purchase, NY and is affiliated with multiple hospitals in the area including New York-Presbyterian/Lawrence Hospital, White Plains Hospital Center, Greenwich Hospital, and Saint Joseph’s Medical Center, respectively.

The three key questions that Dr. Eric Fishman recommends include:

Am I energized at the prospect of significant patient interaction?

Commented Dr. Eric Fishman, who is experienced in peripheral vascular disease, carotid disease, aortic surgery, endovascular surgery, and aortic disease: ‘It is too simplistic and frankly unrealistic to say that extroverts should focus on specialties like family medicine and introverts should focus on specialties like radiology. People have complex and sophisticated personalities — nobody is entirely extroverted or entirely introverted. However, it can be helpful to really think deeply about whether it is going to be enjoyable and rewarding to work significantly with patients, or if it is more compelling and comfortable to focus on research, and working independently or with peers.”

How long am I willing (or can I afford) to spend in residency?

“All medical students will spend at least five years in residency. However, those specialize in vascular surgery should prepare to spend seven to nine years in residency” claims Dr. Fishman. Medical students have to really think long and hard about both the time and financial commitment they — and in many cases, their family members — need to make in order to pursue a specialization that requires additional years of residency. Some people may need to settle for their second or third choice, if it means that they are more likely to endure the long road to becoming a fully licensed physician. It can be particularly daunting to start building one’s career when similarly-aged siblings, other family members and friends are already a decade into their career path. While some of them may be eyeing early retirement, newly-minted physicians are just getting started.”

What do I truly value the most?

Commented Dr. Eric Fishman, who received his medical degree from Icahn School of Medicine at Mount Sinai: “This seems like a very simple and easy-to-answer question, but it is deceptively difficult. Some medical students are heavily influenced by compensation potential. Yes, money must be considered — especially since many medical students are saddled with hundreds of thousands of dollars in debt. And obviously one wants to head into an area where demand will be strong. But what really and truly matters is what one values the most — because that, more than anything else, is going to determine whether the choice of specialty is rewarding or regrettable.”