Intended for healthcare professionals


How should I choose my specialty?

BMJ 2017; 359 doi: (Published 19 October 2017) Cite this as: BMJ 2017;359:j4731


For those feeling under pressure to make a decision about what specialty to follow after the foundation programme, advisers working with Health Education England offer guidance

“Give yourself time to think”

Gilly Freedman, an independent career coach working across London and the south east of England with the Careers Support Unit for Health Education England, says, “It’s worth giving time and reflection to your decision as it will have a big impact on your career and your life. Self assessment is crucial in this process. An introduction to career planning can be found on the Health Careers website ( This can help you to identify your key values and interests as well as those skills that you are good at and would like to use more—helping you get greater clarity. These areas will form the basis of a personal summary and give you a list of weighted career priorities, against which you can match specialties that you have enjoyed.

“For those specialties that interest you and you haven’t yet experienced, there are plenty of ways to get information. Face to face networking with educational supervisors, programme directors, former peers, or lecturers is an excellent way of getting the ‘inside story,’ along with shadowing, tasters, and attending conferences and events.

“The Specialty Training website ( has information on person specs, competition rates, training pathways, and application deadlines. While doing a systematic analysis of options, don’t ignore your intuition—research shows that both are valid for decision making. Also think back to when you have made successful career or personal decisions in the past and look at what you can draw from these examples.”

“Reflect on what you’ve enjoyed”

Lisa Stone, a freelance careers adviser working across London and the south east of England with the Careers Support Unit for Health Education England, says, “A good starting point would be to reflect on what you have really enjoyed during medical school and your training. Consider the environment—for example, do you like working in a community setting, or do you prefer a hospital? What other aspects have you enjoyed: variety, patient continuity, being a generalist or an expert?

“Next, think about the options that will match some of these aspects. Websites such as have detailed information on roles available. Bear in mind the lifestyle you would like to lead. How flexible is the specialty? Are there chances of going part time, if that’s what you want? If the specialty is competitive, then are you prepared to move where the roles are? Talking to people in those roles is key to discovering more about them.

“Then it’s worth making a list of three or four of the specialties you are considering. To make a decision, you can try making a pros and cons list, or listening to your gut feeling. Talking over your thoughts with a friend or a trained careers consultant can help.

“Remember dedicating yourself to a training programme doesn’t mean that you have to sign up to it for life. You can swap specialties, you can also take some time out to do something different, such as a clinical fellowship, further study, or a gap year.”

“Ask trainees about their experiences”

Clare Kennedy, national specialty recruitment manager for medical and dental recruitment and selection at Health Education England, says, “There is a wealth of information available that could help to inform your decision. Consider carefully the likely levels of competition and be prepared to be flexible in your career choices; not all applicants will get a place in their first choice specialty or region. While competition ratios can’t tell you what will happen with this year’s recruitment, it will give you an indication of historical trends.

“Person specifications will tell you what the eligibility requirements are for each specialty. Once you have a shortlist, speak to trainees who are already undertaking the post. Ask them what their expectations were and whether the training programme has met their expectations

“There is nothing to stop you applying for a different specialty at a later date, providing you still meet the eligibility criteria. Many core competences are common across specialty curriculums. When moving from one training programme to another, competences gained in core, specialty, or general practice training should not have to be repeated, if already achieved.

“The Academy of Medical Royal Colleges has developed the accreditation of transferable competences framework to assist trainee doctors in transferring competences to another training programme. If you decide to change career path you could potentially transfer competences and reduce the length of your new training programme by a maximum of two years. Please note, accreditation is not available for all specialties.”

Free career advice sessions at the BMJ Careers Fair

BMJ Careers, in partnership with Health Education England, will be offering free careers advice at the BMJ Careers Fair on 20-21 October.

These sessions constitute 15 minutes of one-to-one career advice with a fully qualified adviser. This will give you the chance to talk and be listened to by a skilled and impartial professional.

BMJ Careers Fair takes place on 20-21 October at the Business Design Centre in Islington, London.

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