Medical students are commonly advised to “find their fit” as they strive to make a specialty decision. But what does “fit” mean? Does it mean you have a specialty “soulmate,” one perfect specialty that will make you happy? Not quite.
Unpacking “fit”
The term fit comes from vocational psychology’s theory of person-environment fit1 (previously, Parsons’ trait and factor theory), which shares similar or equivalent concepts with other theories (e.g., person-organization fit, person-job fit) prominently recognized across academic fields (e.g., industrial and organizational psychology, public administration). As such, it is widely recognized across fields that individuals who fit their field, work setting/environment, and other related factors are happier and more satisfied and, thus, more engaged, productive, and/or high performing. In this context, fit is multifaceted and complex.
Matching interests and skills
Matching interests and skills to the content of the specialty is probably the most common understanding of fit. This aspect of fit often begins with an interest in or affinity for the content of the basic science underpinning the specialty; for example, one would expect a surgeon to enjoy learning about human anatomy and a psychiatrist to have an interest in psychological theory.
Matching skills to the specialty is another important aspect of fit. For example, to be a competent surgeon, one must have well-developed psychomotor skills, including the ability for well-coordinated physical movements and precise manipulations. While some skills can be learned through repeated practice, others may require a natural ability.
Matching personality or fitting in with co-workers and other members of the health care team, or feeling a sense of comradery with one’s colleagues, is annually cited by students as the strongest influence on their specialty choice.2
While determining your fit with people in the specialty who have similar skills, values, and interests is an important consideration, there is some inherent danger in matching oneself to those already practicing in a specialty, as it can lead to stereotyping and exclusion of those who don’t “look like” the typical practitioner in that specialty.
If you don’t find people in a specialty who look like you, does it mean you don’t fit there? Or are there opportunities for you to change the “look” of a specialty? While it’s important to get along with the people one works with, fitting your skills and abilities with the work of the specialty should take precedence over fitting with the people who are “typically” practicing in the specialty.
The Medical Specialty Preference Inventory (MSPI) can indicate fit by helping you identify your interests in medicine and recommend specialties that reflect those interests. The Physician Skills Inventory (PSI) is another self-assessment that can help you determine fit by identifying your strengths and weaknesses in three major transferable skill areas found to be critical for all physicians. These results can be used to consider how well your specialty interests match your current skills, and, if needed, develop a plan to improve your skill.
Bear in mind, these assessments are not Harry Potter’s "Hogwarts sorting hat"; they will not and cannot provide you with a definitive answer about your specialty choice. Rather, they serve as an "indicator" of a group of specialties that you might find satisfying and therefore are recommended to explore further. In fact, you may find that any of the specialties identified through these assessments will provide you with a satisfying career, given the presence of other aspects of fit.
Integrating work and life
Fit also means integrating work with other priorities such as family, friends, hobbies, and civic engagement. Whether your only role right now is that of a medical student, or you are managing multiple roles such as partner, parent, or caregiver, it may be difficult to project how your priorities will change during your medical career. So, look to role models who are at various stages of life and career, as they can articulate and demonstrate how to manage the integration of work and life effectively.
By conducting informational interviews with practicing physicians, you’ll find that many specialties can be made to fit one’s lifestyle desires, given the right circumstances and decisions such as practice setting.
You’ll also learn that no one’s career trajectory is linear. Your medical career can flex as your priorities change and your life roles increase or decrease in significance, and new unexpected opportunities arise. For this reason, it’ll be important to revisit your priorities with every life transition, then adjust your course accordingly.
Making meaning
Finally, fit means seeking opportunities that are personally meaningful and rewarding, based on your values, interests, and beliefs. This is an aspect of fit that can be more difficult to grasp and is too often overlooked.
In its simplest form, this could mean “actively mastering what you passively suffer,” such as a childhood cancer survivor who becomes a pediatric oncologist. However, enacting your values in the practice of medicine and using your specialty choice to advance your life story is not necessarily tied to what specialty you practice but how you practice medicine within a given specialty.
The Physician Values in Practice Scale (PVIPS) helps you clarify what is important to you in your medical career. Reflecting on what you admire most about those you choose as role models, both within and outside of medicine, will aid you in identifying the characteristics you wish to emulate in your own career. Role models can also provide you with examples of how to incorporate your values in the practice of medicine to create a meaningful career.
Putting it all together
These different aspects of fit are not mutually exclusive. Your task is to find common themes and patterns in the information you learn about yourself, and the career options you identify as potential pathways to career satisfaction. This is an active process that requires research, observation, and reflection. Once you’ve adopted this approach, instead of a specialty “soulmate”, you’ll have found a method for assessing every present and future career decision based on your own personal definition of fit. Careers in Medicine along with your advising team are valuable resources as you begin the process.