Intended for healthcare professionals


Should I change specialty? I’m not happy

BMJ 2018; 363 doi: (Published 12 October 2018) Cite this as: BMJ 2018;363:k4304
  1. Abi Rimmer
  1. The BMJ

Three experts from Health Education England’s professional support unit talk to Abi Rimmer about what you can do if you think you may have chosen the wrong specialty

Take a step back

Kathleen Sullivan, senior coach, says, “It can be reassuring to know that it isn’t unusual to have doubts about a specialty choice—even fairly late in training. If you’re unsure about what to do next there are many sources of information and advice. The best place to start is with your education supervisor who can also advise who else you may be able to speak to.

“Contemplating switching specialty can leave you feeling worried about ‘getting it wrong’ again. Rather than rushing your decision, take a step back. Ask yourself, ‘which aspects of my professional and personal life have given me the greatest enjoyment, satisfaction, and fulfilment?’ With some probing, you can begin to get a clearer picture of why certain experiences feature more positively than others. Gradually, you can tease out what matters most to you and elicit your core values, skills, strengths, and interests.

“What will begin to emerge is a profile of the sort of doctor you want to be. Giving some thought to how your personality and what you may find stressful could impact your working life might also flag up useful criteria for further career exploration. These factors will come together to provide a foundation that will help you navigate possible directions for your career.

“There are also self awareness tools that are available in the career planning for foundation doctors’ module on the e-learning for healthcare website ( and the career planning materials of the Healthcareers website (”

Do your research

Jon Fairey, senior careers adviser, says, “Knowing what’s important to you and what you want out of your working and non-working life should help narrow down what options would be relevant to you. Further research might include a consideration of which specialities support your priorities. The Healthcareers website ( gives details of specialty working life, training, career pathways, and lifestyle expectations to support both your short and long term planning. You might also want to think about your particular aptitude for different medical careers. The Sci 59 is an online psychometric test that can help you choose a specialty and is available free to BMA members (

“When changing training pathways, it’s worth asking a few questions to help guide the process. For example, how long is the new training programme, is credit given for time spent in your current specialty, and how much competition is there for this specialty. It’s also worth considering how important further academic qualifications are to being successful in your new specialty and how working part time or taking time out impacts on the training programme. The Healthcareers, specialty training (, and royal college websites will host the most up-to-date information on training for each specialty. Talk to others who have been in a similar position because that can bring different insights. Talking to those within the specialties you are considering can also be helpful.”

Think long term

Katharine Hankins, head of careers, says, “Having completed an assessment of what’s important to you and what options may best match your career priorities, you may be faced with making a decision between a number of possibilities. You may feel that one option is right for you or you may prefer to use a more systematic approach to making your decision.

“There are a number of different ways to undertake this and you can find exercises to help you on the Healthcareers website. There are also career planning modules on the e-learning for healthcare website (

“What if these exercises don’t provide you with the definitive answer? How will you recognise the best option? You might find it helpful to revisit your reasons for changing and check how the new options match up to your current priorities. Which options will fulfil your potential? Are there any aspects that you may find challenging and, if so, what capacity do you have to manage this? What opportunities may unfold once you have completed training?

“Leaving something you have devoted a significant amount of time to can be a daunting prospect and it may help to have a longer careers discussion with someone you trust, such as your educational supervisor, careers advisor, or the training programme director of the specialty you’re interested in.”

BMJ Careers, in partnership with Health Education England, will be offering free careers advice at the BMJ Careers Fair on 19-20 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 19-20 October at the Business Design Centre in Islington, London.


  • Answers provided by the careers team from Health Education England’s professional support unit.

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