Choosing a specialty is one of the most challenging aspects of medical school. While it’s not an irreversible decision and many people do change their specialties after matching, the process in doing so can be complicated and is best avoided. Nevertheless, if you realize that your path through medical school is leading you to a different area in medicine than the one you had initially been considering, these tips can help you sort through the logistics of making the switch and readying your application.

How to Change Your Specialty in Med School

1. Use your electives

If you are considering a different path in medicine from the one you had been pursuing, electives are a great opportunity to explore different medical specialties. Furthermore, if you are applying into a specialty that did not represent a core rotation during your clerkship year, it can be exceedingly challenging to successfully match without having done an elective.

Quite simply, it’s difficult to develop a compelling reason why you want to pursue a career in an area in which you have had no experience.

Finally, you want to have as much information as possible if you make the decision to change your residency trajectory and electives are a great way to do so.

2. Prepare your residency application

Much of your residency application will be the same regardless of the specialty into which you are applying. Specifically, you can still list the same activities in which you were involved during your first and second year, even if they were more germane to a different area in medicine.

For example, if you were thinking about applying into ophthalmology as a first year and participated in community vision screenings, you are still encouraged to include that engagement on your application even though you have now found your calling in anesthesiology.

Of course, some components are closely tailored to the area into which you are applying and these should be revised accordingly. This starts with the personal statement, which should on some level explain what your path through medical school has been and where it is taking you including how you decided on your specialty.

Here also, it is important to have done rotations and/or electives in the new specialty to have experiences from which you can draw in crafting this story. Again, it is fine if you were not always planning on going into the area of medicine in which you are now interested; one of the useful aspects of the personal statement is that it affords a freeform space to communicate to admissions committees how you came to where you are now.

The letters of recommendation you will include with your application are an additional consideration. All of the letters do not have to, and probably should not, come strictly from attendings in your area of interest, but you should definitely include at a minimum one; for instance, if you are applying into dermatology, one or two letters from internal medicine attendings and two or three letters from dermatology attendings would represent a well-rounded mix of perspectives on your attributes and performance.

By completing rotations in your new specialty and working with attendings in the process, you can demonstrate your skills and allow these individuals to speak to your strengths and support your application, even if this area of medicine was not always the path on which you had been.

Finally, if you are still unsure of your calling but committed to applying in the upcoming cycle, applying into more than one specialty is an option. However, this really should be considered a last resort because it can make the application process taxing and expensive.

The application interface allows you to upload as many personal statements and letters of recommendation as you would like and then select which combinations you would like to send to each residency program. For example, if you are dual-applying to neurology and internal medicine, you may send two internal medicine letters to all programs, two additional neurology letters to all neurology programs, and two additional internal medicine letters to all internal medicine programs.

3. Consider taking a year off

If this timeline still seems too daunting or you are worried your reconsideration may be impulsive, it is perfectly acceptable to take an additional year to think more about your decision. The option of spending an additional year as a medical student may not be palatable or possible for many, but the experience can be a rewarding one. The process of changing your residency after matching is complicated and can be avoided by taking the time you need to feel comfortable with your choice.

It’s of course important to use the year productively. First, additional electives in the specialty or specialties that you are considering can provide more insight and assist in your decision making. Doing so will assist tremendously in preparing your application by expanding the experiences you can draw from in crafting your personal statement and during interviews; you will also be in a better place to articulate why you are interested in the specialty into which you are applying. You will also interact with more attendings who may be willing to comment on your performance as a medical student in a letter of recommendation.

Many students who take an additional year engage in one or multiple research projects. If you are deciding between different areas in medicine, this pursuit can serve a dual purpose of exposing you to the academic side of different specialties and strengthening your application when you do apply. Reaching out to faculty members and identifying members early on in your year out is crucial to maximize your productivity and even attain funding in some cases.

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