At what point should medical students select their specialty?

I changed my mind after two years of residency from one specialty to another. It is difficult for medical students to have a solid basis for long term career specialty selection. Realistically, as medical students, we spend 1-2 months "testing" various specialties. I would say that probably the most influential factor in a medical student's selection for a specialty is the clinical rotation and the attending at that time. If the attending is a mentor and role model that for whatever reason appeals to the student, then that student is more likely to enjoy the rotation and select that career. Good or bad, that is the reality. Do Attending physicians have any idea of the impact they have on shaping a career choice. I remember doing a urology rotation, for example, the surgical attending in the OR was so abusive, that I was compeletly turned off to that as a career choice. Right or wrong, that is how it happens, it is organic and often times subconscious, but it is an interesting variable that often times is overlooked. The career selection process needs to be re-focused and perhaps made a part of the education curricula.

Medical school debt may be greater than earning potential

Health care "reform" needs to more seriously address the issue of cost of a medical education and plot that against current wages for less lucrative specialties such as pediatrics and family practice. It seems that if every college or medical student calculated their potential earnings and plotted that against the cost of attending four years of undergraduate college and then four years of medical school, they would reconsider their selection as a physician. Here are some rough numbers. The average cost including living expenses for undergraduate schools and medical school is approximately $40,000-$50,000 per year. It is conceivable that all of that is borrowed so that upon graduation, a medical student has over $320,000 in debt. If the doctor wants to pay this off over 10 years, he or she will be paying, approximately $4000 per month or $48,000 per year interest and principal payments. This does not take into consideration the cost of those years in medical school of lost earning potential. This is disastrous for medical students, young doctors and the field of medicine. So, when health care reform begins to start chipping away at a doctor's income, and raising expenses for a doctor to operate their business, politicians need to be aware of the cost burdens on our young doctors. Alternatively, the way things are going, we may have no doctors to take care of our kids and our families.