“Go with your own interests.”
Years ago many recommended surgery. Not bad advice, but it really does not make any difference. If you are a brain surgeon, you will likely work at a training center in a large city to train other doctors. If you are an internist, like me, you will also be able to use your skills in a wider area. I do wish I knew a little more about surgery. But, truth is, even though I greatly enjoyed my surgery rotations, I really do not like to even sew up cuts, so I teach others how to do it, and supervise. They like it, I don’t.
God made you who you are with your particular interests. Even before the beginning of time, he had made that decision.
Answer from David, an physician internist who has served for five year in Honduras and coordinates the medical aspects of several community development groups.
“To be a good doctor, enter the field you enjoy most.”
You should probably enter that field which you enjoy the most and in which you will be a good doctor. This includes specialties like pathology, radiology, etc.
If you know what part of the world in which you wish to serve, then find out what specialty is most likely to gain you a visa.
If you have no special personal preferences and you don’t know where you might serve, then family medicine is the most likely to be useful.
Answer from Cynthia Hale, who served as an MD with the United Mission to Nepal.
“I recommend general surgery.”
The best specialist for the mission hospital and the one still most needed is the general surgeon. Orthopedics, plastic surgery, and obstetrics are still very needed. Every specialty can be used by God for the furthering of his kingdom. I’m glad that God prepared me with an extensive general surgical residency.
Answer from Harold Adolph, an MD who served in three Ethiopian hospitals over thirty years.
“It depends, but get surgical training.”
It depends on your own interests and on the type of work in which you will be involved. If you are contemplating ever being in a hospital that has an operating room, and ever being alone there, even for an afternoon, get surgical training. You may be called on to do bowel resections, repair a lung, care for a machete wound of the brain, put a rod in a femur, take out a bladder stone, or do an emergency C-section on a moment’s notice!
If you are part of a large team or in a hospital with no operating room then you can forego surgery. Get training in pediatrics, infectious diseases, community health, etc.
Answer from Donn, an MD who retired from ABWE (Association of Baptists for World Evangelism) after twenty-six years in Bangladesh.
“Prepare to train others.”
The future of medical missions is in teaching and training, rather than fixed-base mission hospitals. Mission hospitals will still be very useful as an outreach in the area of evangelism, as well reaching the poor, but the most long-term good and sustainability lies in training nationals to do medicine with a Christian perspective.
The surgical program under the Pan African Academy of Christian Surgeons is a good example, as are the many Christian Family Practice Training Programs overseas, like In His Image International.
Answer from Jim Smith, an MD who was a Peace Corps physician in Kenya and has served for more than twenty years with the Medical Education International council of CMDA.
“Keep an open mind and pray.”
I would encourage students to keep an open mind and a prayerful approach. When I went to medical school with plans of being a missionary, I had not traveled out of the country, and had little idea of the direction of current missions. I pictured a mission hospital in a developing country where I would need to be able to do everything, so naturally I chose family medicine. As I began to talk to people more and more I realized that there are getting to be fewer hospitals like that (many hospitals have been nationalized or were too expensive to run). Some countries train mostly general practice doctors and want specialists to come in and help or to train national physicians in specialties.
On the other hand, some countries are starting to see the benefit of better trained generalist and are wanting to develop an FP-type system. There is no way to really know what is going to be needed in any one location by the time you are ready to go.
By God’s grace, I love family medicine. I can’t see myself in a better specialty because it matches my personality. I never even knew how much I would love it until almost mid-residency. I had always just seen medicine as a tool to get to missions. As I matured, I realized that God has given us each talents and desires and personalities that are each suited to different tasks and that performing those tasks is not the drudgery of the means to an end.
God does not fragment our life into spiritual tasks and earthly tasks. He redeemed us wholly, to be all that he created us to be. It is the fellowship of a simple walk in the garden. Medicine is part of my spiritual act of worship: to be the best doctor I can be in the place he put me.
It turns out he did direct me to a place where I get to do “complete” family medicine in a developing country. I sought his kingdom and righteousness; he gave me the desires of my heart (even though I didn’t know what they were at the time).
Keep open. Let God lead you naturally. Unless he gives you very clear direction otherwise, choose the specialty most suited to your interests, talents, personality, family needs, etc. Then find a way to use it in service to him. There are all kinds of needs all over the world.
Answer from Scott, family physician who has served for two years in a hundred-bed hospital in Papua New Guinea.