Strategies for Successfully Changing Specialty During Training

electing a medical specialty is a decision with far-reaching consequences made with limited information.Medical schools encourage student professional identity formation through curricular exposure to the breadth of specialties in expectation of success in the Match and lifelong career satisfaction.Despite these efforts, 1153 residents (0.7% of active residents) changed specialty in the 2022-2023 academic year for a variety of reasons, including erroneous assumptions about the nature of the specialty, skills misalignment, the consequences of a life in medicine, and changes in personal or professional priorities. 1 The authors themselves applied and interviewed in more than one specialty, changed specialty, and have worked with many residents, faculty, and even a department chair who changed specialties during residency training.Unfortunately, changing programs may derail training progress if not approached with deliberation, planning, and an understanding of contractual obligations and rights as a trainee and employee.We present a strategic approach to successfully changing specialty that can be used by a trainee navigating this process themselves, or by faculty mentoring a trainee.We present real-life examples to illuminate potential motivations, pitfalls, and positive outcomes (details changed to preserve anonymity).This approach can be divided into 3 phases: reflection, preparation, and action (summarized in the FIGURE).