So, after some deliberation, you’ve decided you want to be a doctor. You’ve done your research, knuckled down to get the grades, and even thought about where you’re going to work. But how much thought have you given to what type of doctor you’re going to be to advance your career?
Once you are qualified, you will pick a speciality that you will practice day in day out, so you’ll want to choose wisely. The good news though is that you shouldn’t be short of ideas. In this list, we will look at the many types of careers available in medicine and which one might be right for you.
*Note – Before you can study any of these specialisms, you would need to complete at least 5 years of medical school followed by 2 foundation years as a junior doctor in the UK, and complete 4 years of medical school in the US.
Based usually in public or privately owned clinics (as opposed to hospitals), General Practitioners (GPs) are generally the first port of call for most patients. “No two days are ever the same,” says Penny Wilson, a GP in Australia. “We have no idea what is going to walk through our door next and it could be anything”. GPs require an encyclopaedic knowledge of medicine, although good working hours help to ease the blow.
In the UK, you would undertake the GP Specialty Training Programme (GPSTP), a 3-year course made up of hospital placements and a GP Registrar placement. It is worth noting that following recent contract changes, salaries for GPs are slightly different to all other specialisms; during speciality training, salaries start at £30,000, with qualified GPs earning anything between £55,000 and £86,000 per year in the NHS. Alternatively, GPs can – and are increasingly being encouraged to – establish their own private practices, where they can earn more.
In the US, GPs are known as family physicians, and undergo a 3-year residency similar to the GPSTP after they complete medical school. Although salaries on average are good (around $225,000 per year), this is slightly lower than other specialities – one of the reasons attributed to the shortage of family physicians in the US.
Surgery is seen as one of the more glamorous specialities to go into, especially due to popular TV shows such as Scrubs and Grey’s Anatomy, but it is also one of the toughest. Aside from needing very steady hands and a strong stomach, you would be required to work quickly under pressure and have a flawless knowledge of human anatomy. You would also need to be a good communicator, as you would have to explain the process and consequences of very complex procedures to your patients.
It is also a very broad spectrum though, and this is reflected in the long training periods. In the UK, you would undertake 2 years of core surgical training in a hospital, before specialising again in a particular type of surgery, where further training can last up to 6 years. These include:
- Cardiothoracic surgery – Complex and serious surgery related to the heart, lungs and chest
- Neurosurgery – Complex and serious surgery related to the brain
- Oral and maxillofacial surgery – Related to the mouth and the facial structure
- Otolaryngology (ENT) – Related to ailments or conditions involving the ears, nose, throat and neck
- Paediatric surgery – Surgery involving children (usually in collaboration with the relevant specialist)
- Plastic surgery – Related to cosmetic surgery as well as reconstructive and superficial surgery, such as on burn victims
- Orthopaedic surgery – Related to the diagnosis and treatment of injuries, conditions or diseases involving bones, joints and the wider musculoskeletal system
- Urology – Related to the study and treatment of diseases and conditions involving the kidneys, bladder and urethral tract
- Vascular surgery – Related to diseases in your blood
- General surgery – Minor surgeries or anything not mentioned above
In the US, surgical residencies can last between 3-7 years depending on your chosen field, with average salaries slightly higher than other specialisms – a whopping $250,000 per year once qualified.
Depending on your location, this is probably the most dynamic – and one of the most stressful – healthcare professions in the world. Based usually in a busy A&E Department, you would have to work long shifts and deal with a large number of seriously sick patients: if you prefer the quiet life, this isn’t the job for you.
Whether alone or as part of a trauma team, your job would be to maximise the patient’s chances of survival, and as a result, you need to be comfortable thinking and acting quickly under enormous pressure. “There is constant variety and challenge,” says Jonathan Benger, a senior NHS consultant. “EM is diverse and mentally challenging, with exposure to a great deal of ‘real life”.
In the UK, EM training takes 6 years. Once experienced, there is the opportunity to work in the pre-hospital environment, such as with the air ambulance service, or in paediatric emergency medicine. Additionally, there is considerable scope to earn extra income through locum work, which pays especially well for EM doctors.
The US is well known for its high standard of EM residency training programmes, with courses lasting between 3-4 years; supplemental training programmes are delivered once you are qualified.
Paediatrics is an enormously challenging but rewarding profession. Working with children from birth to the age of 16, you would not only take on the diagnosis and treatment of various illnesses but also build relationships with parents and take on social welfare responsibilities. Working with children requires patience and a creative mind, and can also be emotionally draining when things do not go well. It is important to consider how you would deal personally with the impact of this.
In the UK it takes 8 years to qualify as a paediatrician, with the training pathway split into several stages. Due to the huge physiological differences between children and adults, your knowledge would be well valued and you would likely be asked to consult on a wide variety of cases. Further subspecialties include:
- Paediatric cardiology – Related to heart problems in children
- Paediatric endocrinology – Related to gland and hormone problems in children
- Paediatric oncology – Related to treating cancer in children
In the US, paediatric residencies typically last for 3 years, followed by further subspecialty training.
With the stigma around mental health gradually declining, research and treatment in this field is becoming more prominent year on year. As a result, there is plenty to explore in this fascinating profession. “There is no factory line, no standard procedure and no mindless protocol,” says psychiatrist Neel Burton. “Each patient is unique, and each patient has something unique to return to the psychiatrist”. If you are empathetic, good at listening and giving advice, then psychiatry might appeal to you.
You would undertake 3 years of core psychiatry training in the UK, then choose a sub-field that you would study over a further 3 years. These could include:
- General psychiatry – The study, diagnosis and treatment of mental disorders and behavioural problems
- Neuropsychiatry – Relating to clinical mental health issues in the brain, such as psychosis
- Geriatric psychiatry – Related to mental complications in elderly people, such as Alzheimer’s Disease
- Forensic psychiatry – Related to the correlation between psychology and criminal behaviour
In the US, you would complete a 4-year residency; the average salary of around $194,000 once qualified is one of the lower paid specialisms.
Pathology is the study of disease based on laboratory analysis of body tissues and fluids. Unlike the other specialities on this list, you would not have any contact with patients, although the impact of your findings would likely have a huge effect on their diagnosis and treatment – especially in cancer patients.
You would still need a strong stomach though; while the reality of the job is somewhat different to its portrayal on TV shows such as Silent Witness, forensic autopsies are still an important component of the role. If you are particularly interested in the biology and physiology of the human body, this field might be worth considering.
In the UK, pathologists train for 5 years. During this time you would be expected to choose and develop a specific area of interest such as in one of the following:
- Immunology – The study and treatment of the immune system and any related conditions
- Neuropathology – Related to the brain
- Cytopathology – The study of diseases at the cell level
- Cytogenetics – The study of chromosomes and associated conditions, such as Down’s Syndrome
- Autopsy – Thorough surgical examination of a corpse to try and determine the cause of death
Pathology residencies in the US typically last between 3-4 years, with supplemental rotations in various hospital departments. You would again be expected to pursue a specific area of interest.
Clinical radiologists use a variety of imaging techniques such as ultrasound, x-rays and CT scans to investigate and diagnose conditions and disease; if you enjoy working with technology, and have a very keen eye for detail, radiology could be a good fit. You will usually work as part of a wider team in the radiography department and provide expert guidance and advice to other doctors on your findings.
Radiologist speciality training in the UK takes between 5-6 years to complete, with the option to sub-specialise in either diagnostic or interventional radiology.
In the US, radiology residencies last 4 years, and are usually followed by a 1 or 2-year fellowship in a subspecialty such as breast imaging or nuclear medicine. Radiology salaries are generally on the higher end of the scale.
Anaesthetists are primarily concerned with the use of anaesthesia (a drug designed to numb the senses) during surgeries and extreme trauma cases, although they are also prominent in intensive care departments where patients require detailed monitoring, as well as in palliative care environments where they can dose and administer pain relief. If you are interested in how different types of drugs interact with the body and want to be hands-on with patients, you should consider anaesthetics.
You would undertake between 7-8 years of speciality training, with early emphasis on working independently.
In the US, anaesthetists are known as anesthesiologists and undergo a 4 year residency program. The average salary for a fully qualified anesthesiologist is $275,000.
Although it may be difficult to pronounce, ophthalmology relates to problems with the eyes. Therefore it stands to reason that if you are interested in how the eye works, this is the field for you. Ophthalmologists work in operating theatres, clinics and community care locations with patients of all ages; you would need to be dexterous with your hands and possess huge attention to detail.
You would undertake 7 years of specialist training, with frequent re-appraisals once qualified. It is worth noting that competition for consultancy posts is unusually high in the UK.
In the US, ophthalmology residencies are typically 3 years in length.
Obstetrics & Gynaecology
While these are technically two different professions (generally, obstetricians focus on the health of pregnant women and the unborn baby, whereas gynaecologists focus on anything related to the female reproductive system), they are intertwined and usually studied together. All of your patients would be female, and part of your responsibilities would be delivering babies. Once qualified as a consultant, you could choose to focus on one particular field, such as one of the following:
- Infertility – The study and treatment of causes of infertility in men and women
- Gynae-oncology – The study and treatment of cancer in the female reproductive organs
- Uro-gynaecology – The study and treatment of urology within the female urinary system
In the UK, specialist training lasts for 7 years.
In the US, residencies are 4 years long.
Oncologists are committed to the research, diagnosis and treatment of cancer. While oncology is generally a mixture of specialisms working together; an oncologist will typically manage the overall treatment of a patient and provide counselling as well as administering certain therapies. Many oncologists are attracted to the research-heavy nature of the job – if you are looking for a more academic role this could be a good fit.
Oncology training in the UK is typically 5 years and places considerably more emphasis on scientific activity than other specialities.
In the US, oncology residencies also last 5 years and are generally followed by a 2-3 year fellowship.
General Internal Medicine
There are several other types of medical fields that can be categorized under internal medicine, and you would likely practice these roles within a hospital inpatient setting:
- Cardiology – Related to the heart; subspecialties include stroke medicine, heart failure and intervention procedures, such as the insertion of a pacemaker
- Endocrinology – the study and treatment of conditions associated with the endocrine glands, such as diabetes and various thyroid conditions.
- Dermatology – conditions and diseases involving the skin
- Gastroenterology – the study, diagnosis and treatment of conditions and diseases involving the stomach and intestines
- Hepatology – A sub-specialty of gastroenterology focused on the liver
- Nephrology – conditions and diseases involving the kidneys
- Andrology – anything involving the male reproductive system
- Sexual health medicine – the study, diagnosis and treatment of sexually transmitted diseases
- Proctology – conditions and diseases in the anus, colon and rectum
- Rheumatology – conditions involving the rheumatic system such as arthritis
- Podiatry – Related primarily to feet
- Periodontology – Related to teeth supporting structures
The training periods for each of these specialities varies in both the UK and the US.
If you want to be a doctor but would prefer not to spend so much time with patients, there are other research and consultancy opportunities available. These include:
- Parasitology – The study of parasites and parasitic disease, and the effect this has on human populations
- Diagnostics – Studying the symptoms and medical reports of patients to diagnose a disease
- Epidemiology – Studying the causes and patterns of certain diseases in human populations or areas and how to prevent or eradicate them
In both the UK and the US you do not necessarily need to have a medical degree to pursue some of these fields, as the emphasis is on statistical understanding and awareness; a medical degree is accepted as a pre-requisite to get on the relevant post-graduate course.
If all this choice has given you cause for concern, don’t worry just yet – you don’t have to commit to a decision until after medical school. Some fields are very competitive though, and it is beneficial to have some idea of the direction you want to take early on, so that you can chase relevant placements during your foundation years in the UK and the last few years of medical school in the US.
** Note – In the UK, speciality salaries range from £28,000 to £46,000 depending on your chosen field and the length of the training period. Once you have completed all your training and are working as a consultant, salaries can be anything between £55,000 and £103,000 depending on location and experience; private consultants working outside the NHS can earn even more than this.
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