Rounds to Residency

ANSWERS for Selecting Your Perfect Medical Specialty with Brent Lacey MD of the Scope of Practice

Dr. Brent Lacey guides us on the real questions and answers all medical students should ask when choosing a medical specialty


  • [7:03] Work-Life Balance
  • [9:04] Personality – Physician, Know Thyself
  • [12:10] Academic Material
  • [13:21] Clinical Procedures
  • [15:00] A Responsibility to Love Your Work
  • [24:01] Financial Compensation
  • [25:47] Further Resources

Students often wonder how to select a medical specialty. What will fit with their personality, their lifestyle, and be enjoyable? Well, today we are joined by Dr. Brent Lacey. He is a gastroenterologist and the founder of the Scope of Practice which helps physicians gain business knowledge and financial independence. Today we are going to investigate some of the questions every student should answer when considering their future specialty.

How to Select a Medical Specialty

As a medical student, Dr. Lacey asked residents how they chose a specialty and had many residents reply that it’s simply what they like to do. He found these kinds of answers unsatisfactory, and longed for a clearer roadmap and more concrete criteria for choosing a specialty. It is important to break down any justification for choosing a specialty into its component parts, to determine which criteria are valid versus less valid.

Dr. Lacey deems factors such as work-life balance and salary to be less important criteria in deciding on a specialty. A person has the agency to regulate these two factors regardless of their chosen specialty. In other words, these two criteria are person-dependent, rather than specialty-dependent. Rather, Dr. Lacey places an emphasis on three key specialty-dependent criteria: 1. affinity for performing the clinical procedures central to a specialty, 2. affinity for reading the academic content & papers of a specialty and 3. affinity to the personalities of people who tend to work within a given specialty.

Dr. Lacey says that a specialist should ‘love 99% of what they do, but not hate the remaining 1%.’ Citing how he overcame his initial aversion to treating patients with Irritable Bowel Syndrome (IBS) as his remaining 1% within gastroenterology, Dr. Lacey explains that physicians have a responsibility to themselves and to their patients to “bloom where they are planted.” Physicians should never settle for hating even 1% of their daily tasks as a specialist. If this is impossible, the specialty should be ruled out. To help students to tease out the 99% and 1% of a given specialty, Dr. Lacey recommends this strategy: as many people as possible within a specialty to tell you the best and worst thing about their specialty. Then, think about your own aptitude in navigating and appreciating the most challenging aspects of a specialty.

Students should use the various resources available to medical students who are trying to decide on a specialty, such as looking to one’s advisors, national medical societies and other books and materials. For resources on navigating being a physician in the real world, check out the Scope of Practice website. As Dr. Lacey stresses in today’s show, “if you want to be a leader, you’ve got to be a reader.”

Check out The Scope of Practice Podcast, Dr. Lacey’s curated Reading List, and these articles on Early Career and Young Professionals Resources and Choosing the Right Specialty!

Sign up for a Free Coaching session with Chase DiMarco, sponsored by Prospective Doctor! You can also join the Med Student Mentor FB Group to ask questions and receive guidance related to clinical rotations and clinical knowledge!


Chase DiMarco

Chase DiMarco is an MS, MBA-HA and MD/Ph.D-candidate. He is the founder of MedEd University, a free medical education resource, the host of the Medical Mnemonist & Rounds to Residency podcasts creator of several medical education platforms, and CEO of FindARotation clinical rotations service.

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