This decision is often bewildering. As a young person proceeding through healthcare education you face increasingly complex choices that touch on academic ability, financial debt and earning potential, social pressures, prestige and reputation, non-career interests and responsibilities, and personal passions. You likely have considerable freedom of choice, and with that freedom can come marked anxiety.
My short answer is, choose the field or specialty that most interests you. What do you dream about, think of in your off hours, or imagine yourself doing with pleasure and pride? This may well be your very best selection.
Those of you interested in the world’s most low-resource communities may be under the misconception that only primary care specialties are appropriate in such settings. While it is indeed true that the greatest needs in developing nations are in public health and primary care, there is also an important role for specialists. Physical therapists, ophthalmologists, midwives, orthopedists, pharmacists, plastic surgeons, and researchers, for example, all have unique talents to offer.
Teaching opportunities – generally better suited for more narrow specialists – are constantly expanding and offer influential positions from which to multiply your skills and impact. There also is a real possibility that at some point in your career you will practice among more affluent people. For all these reasons, I believe you will do best in pursuing a field or specialty in which you are genuinely interested.