How to choose a medical specialization?

The decision about specialization is usually made in a few weeks, based on six years of studies and several months of internship, and its consequences extend to the next three decades of work. This is a very uncomfortable asymmetry. In the SMK form, you do not choose the field itself, but up to fifteen combinations of field, voivodeship and training mode, and each of them means a different daily rhythm, a different number of shifts and a different city. In addition, there is the LEK result, which either opens all variants or deletes a dozen or so of them even before the first stage, and the education system, which is currently being rebuilt. This decision can be broken down into factors that can be checked before they turn into a signed contract.

What does choosing a specialization really involve?

Formally, a field is chosen. Practically, you choose a variant, i.e. a set of three things at once: field, voivodeship and training mode. For each variant, no more than three training units can be indicated in the preferred order, and the application includes fifteen whole variants.

This construction has a specific consequence that is easy to miss when completing the application for the first time. Fifteen variants are not fifteen domains. If someone enters the same specialization in fifteen voivodeships, they will create a relocation plan, not a professional plan. If, on the contrary, he enters fifteen different fields in one city, he may end up in a department he never considered. A sensible application is usually two or three areas that you really want to work in, spread across several locations and both modes.

The order on the ranking list is determined by the score, based on the LEK result, and additional points are awarded for, among others, publications, the degree of doctor of medical sciences and completed courses. The LEK itself is a test consisting of 200 questions with five answers, in which a positive result means at least 56 percent of the possible points. However, the pass threshold and the threshold sufficient to enter a selected field are two different values, sometimes differing by thirty or so percentage points.

Recruitment takes place twice a year. In the spring 2026 procedure, applications were accepted from February 1 to 28, and 4,039 residential and 8,221 non-residential places were available. In the autumn 2026 procedure, applications are submitted from September 1 to September 30, and the ranking lists after the first stage are to be published by November 7. After the first stage of the spring recruitment, 3,274 people were qualified out of 4,367 formally correct applications, and after two stages, 2,868 doctors confirmed their acceptance of the place, including 1,927 in the residency mode.

There is a third stage that is worth knowing about in advance, not after the fact. The Minister of Health may launch it when there are vacant residency places, but it covers only priority areas and only those doctors who have indicated at least one priority variant in the residency mode. Anyone who has not entered a single such item will simply not be admitted to this stage, even if they missed a fraction of a point in the second stage.

Does the division into surgery and conservative treatment still make sense?

This division is convenient because it immediately cuts the list in half. The problem is that it describes a stereotype of the department rather than the real scope of activities that will be performed in the next thirty years.

Procedurality is a gradient rather than a switch. A cardiologist may spend his entire career in a clinic or in a cath lab. The gastroenterologist spends a significant part of the week using the endoscope. The anesthesiologist inserts central and arterial lines, performs blocks and conduction anesthesia, although he never stands on the operator's side. The hematologist does a bone marrow biopsy. The dermatologist cuts it out, freezes it and sews it up. On the other hand, after completing ophthalmology or gynecology, it is possible to work without an operating room, if life works out that way. The question "do I like working with my hands" is better than "do I go for treatment" because it leads to a much broader list of answers.

What really differentiates these paths is the length of the path to independence. In surgical fields, the learning curve is long and knowledge cannot be gained by reading. You need to be admitted to the table, and this depends on the center and how many residents are standing in line in front of you. In conservative areas, independence comes faster, but the therapeutic effect may be spread over years and is more difficult to see.

The second factor is the risk of claims, which is clearly higher in surgical areas and has had a real impact on the decisions of young doctors in recent years. The President of the Supreme Medical Council said directly that the more difficult and responsible a specialization is, the worse it is paid and the more difficult the conditions for its performance, which can be seen, for example, in general surgery, where for years there has been a lack of candidates despite staff shortages.

The third thing is more prosaic. A narrow procedure such as cardiac surgery or plastic surgery means there are few centers in the country. If you want to change your employer after five years, you can choose from three cities instead of thirty. For someone with a family anchored in one place, this is a stronger argument than all the others combined.

How much does it really cost to choose a priority field?

The Ministry of Health has indicated 23 priority areas, commonly called deficit areas. These are the areas where there is a shortage of doctors and the current staff is aging. The list includes anesthesiology and intensive care, general surgery, internal diseases, geriatrics, emergency medicine, family medicine, neurology, clinical oncology, pathology, pediatrics and psychiatry.

There are four incentives and only one of them is really big. Higher basic salary, more training places, full co-financing of compulsory courses by CMKP and participation in an additional stage of recruitment. The specific amounts as of September 2026 are as follows.

Over the course of five years of training, the difference in basic salary alone amounts to approximately PLN 63,000 gross. It's money, but not enough to outweigh decades of work in a field you hate.

Moreover, the system itself provides proof that the bonus does not work as planned. The director of CMKP said that even a higher-paid residency in a priority field does not encourage doctors to choose it, and places in some of these fields remain unfilled. In his opinion, earnings in the chosen field are only the third or fourth criterion for young doctors, and the first priority is simply the desire to do what they want to do. The recruitment results confirm this: geriatrics and oncology fields were once again not among the most frequently chosen, despite the aging population and the growing number of cancer cases.

For whom does the priority list not matter? For someone who has a clearly defined narrow field and a sufficient LEK result. The subsidy will not compensate for five years spent not where you wanted to. However, the list can be really useful for people hesitating between two fields of similar attractiveness, because then it tips the scale without any costs.

Which fields are really hard to access?

Here it is worth separating popularity from availability, because they are not the same. A field may have a thousand applicants and eight hundred places, and another field may have forty applicants and one place.

CMKP data presented in February 2024 showed the scale of the phenomenon best. In dermatology and venereology, an average of 76.38 people applied for one of the forty places. Next were endocrinology with a candidate score of 65.39, plastic surgery with 61.82, orthodontics with 41.05, dental surgery with 32.69, gastroenterology with 25.07 and maxillofacial surgery with 24.23. This is the level of competition at which a LEK result of less than ninety percent practically decides the matter.

The other end of the list looks completely different. Two people from all over Poland wanted to train in neuropathology. Thirteen doctors chose clinical toxicology, seventeen medical microbiology, twenty-seven sexology, and thirty-eight forensic medicine. These fields are not worse, they are just narrow, not very visible in studies and rarely shown during internships.

The current data is similar. In the first stage of spring recruitment 2026, the most frequently chosen fields were family medicine (250 indications), radiology and imaging diagnostics (237) and cardiology (228). Radiology and dermatology have held the top spots for years, and in one of the earlier proceedings, the total number of applicants for these two fields exceeded the total number of residency positions.

The practical conclusion is that the LEK result must be compared with the list earlier, and not after the ranking is announced. If you fall within the range that has historically not been sufficient for your dream field, you have three real moves: indicate it as the first option anyway, and fill the rest of the application with achievable fields; approach the LEK again and proceed to the next procedure; or enter the non-residential mode, where there are twice as many places. The fourth option, i.e. entering only hard-to-reach fields and hoping for a miracle, usually ends with a year break.

How long does the training last and what does the basic module open?

The duration of specializations varies twice, and even more for some paths. Four years are enough for family medicine and ophthalmology, four and a half for radiology, five for internal medicine or neurology, six for most surgical areas, and eight years to earn a degree in pediatric urology or gynecological oncology.

However, the number of years itself is less important than the design of the program. Some fields have a uniform module, i.e. training in one thing from the first day. Some have a basic module followed by a specialized module, and it is this second structure that provides something that is not visible when signing the contract: branching.

The core module in internal medicine lasts two years and is a common entry point for allergology, angiology, diabetology, endocrinology, gastroenterology, geriatrics, hematology, cardiology, nephrology, clinical oncology, rheumatology and several other fields. Pediatrics works similarly, except that its basic module lasts three years and leads, among others, to neonatology, pediatric cardiology and pediatric gastroenterology.

This is a real option for people who are undecided. Instead of choosing a narrow field blindly, you can enter the basic module, spend two or three years seeing from the inside a dozen or so subspecialties in your own department, and only then narrow down the field. The cost is time, because internal medicine lasts five years, not four. The advantage is that the decision is made with real knowledge, and not with impressions from two weeks of sixth-year classes.

Residency or non-residency mode?

Everyone automatically thinks about residency, because it is a full-time position financed from the state budget. However, the numbers show that this is not the dominant path in terms of number of seats. In the spring 2026 recruitment, there were 8,221 non-residential positions, which is more than twice as many as resident positions.

The non-residency mode covers various situations: doctors who already have one specialist title, people employed full-time in a given unit, training as part of expanding activities or as a volunteer. The remuneration then does not come from the budget allocated for residencies, but results from the contract with the employer, which can be both a disadvantage and an advantage, depending on how much a specific hospital pays.

However, there is one difference that few people talk about before submitting the application, and which is very important in the event of a wrong choice. The resident may, without giving a reason, re-apply for residency in another field only once, and a change to the basic or uniform module is possible no later than within the first twelve months of training, and within the same basic module only after its completion. The second mode of change requires a decision from an occupational medicine doctor on contraindications to continue the current specialization. Physicians training outside of residency are not subject to these restrictions.

It is similar with changing the medium. A resident may move to another accredited unit if it has a vacancy and if one year has passed since qualifying, and this requires the consent of the director of the unit, and in the case of moving to another voivodeship, also the approval of the local voivodeship consultant. The year requirement does not apply to non-residency.

What does the upcoming education reform change?

This part is important for everyone who will submit an application in 2027 and later, because the system on the basis of which they are planning a decision today may look different in a moment.

On June 8, 2026, the Ministry of Health submitted a draft amendment to the Act on the medical and dental professions for public consultation. The most famous provision is the shortening of the postgraduate internship of doctors from thirteen to six months, and of dentists from twelve to six months. According to the ministry, the internship program partially duplicates the effects of the sixth year of studies, especially after the change in education standards effective from the 2024/2025 academic year. If the bill passed the entire legislative path, a shortened internship would apply to people starting in October 2027.

The second change directly affects the scoring in the qualifying procedure. The project eliminates the public LEK and LDEK question database, from which approximately 70 percent of the test currently comes. The Ministry argues that with the pass rate exceeding 90 percent, the exam no longer differentiates candidates because only 60 out of 200 questions verify actual knowledge. In addition, there is the proposal of a State Competency Examination and a Specialized Verification Examination, as well as a mandatory practical part of the exam at the end of the training and an exam after the basic module.

The project also provides for the allocation of residencies in accordance with the health needs of regions and the possibility of obtaining a second residency for doctors who have completed specialization in internal diseases, surgery or pediatrics.

Objections to some of these solutions were raised by the Supreme Medical Council, the Residents' Agreement, student organizations and some medical universities. As of September 2026: it is still a project, not applicable law. So the practical advice is caution. Don't plan your path based on announcements, but if you graduate in 2027 or later, check the state of legislative work before submitting your application, because the scoring rules may look different than today.

How to check a branch before signing a contract?

The choice of center is sometimes more important than the choice of field, and this statement sounds exaggerated only until you end up in a department with a terrible atmosphere. Over the next few years, you will spend about two hundred hours a month there and it is the environment, not the name of your specialization, that will determine whether you will develop.

Questions to ask the residents on the unit, not the manager, go something like this. How many shifts are there per resident per month and are departures after duty respected? Is there a specialist available at night to consult the case? Do external internships take place without any quarrels, or does it always turn out that your presence at the home department is irreplaceable. How many residents per bed and per specialization manager? Is it allowed to perform procedures, and this applies not only to the operating room, but also to echocardiography, endoscopy and biopsy? Does the hospital subsidize residency?

This last point forms a clear pattern. Clinical hospitals rarely pay extra because there are only a few people waiting for a place, but they offer access to the latest guidelines, a scientific path and gradual introduction to independence. District hospitals more often offer subsidies and additional shifts, and independence comes much faster there, sometimes faster than would be comfortable. Choosing between them depends on whether you prefer to be fifth in line at the table or get your own patients in the second week.

If you are still not sure, the personalized postgraduate internship allows you to choose departments in up to three fields and in up to three different entities. Volunteering for a few weeks at the department you're considering also makes sense, although it may sound unattractive. A few weeks of observation costs less than a year of residency in the place from which you will have to move.

How does specialization translate into everyday work and work attire?

It looks like a detail until you count the hours. With five or six shifts a month and a normal job, you spend over two hundred hours in uniform, which is more than in any other clothing. The nature of this uniform results directly from the chosen field and it is worth thinking about it in advance, because it is one of the few elements of your future work over which you have full influence.

In the operating theater, the matter is simple and least dependent on you. Hospital clothes are required and you change into them on site, so the surgeon, anesthesiologist or gynecologist needs their own set mainly for rounds, to the clinic and for travel between departments. It's completely different in a medical ward, in an emergency department, in a primary care hospital or in a private office, where you work in your own clothes throughout your shift and you have to wear them for twelve or twenty-four hours.

That's when things that look like little things in the store start to count. Pocket capacity, because the phone, stethoscope, diagnostic flashlight and notebook must fit somewhere and not fall out when bending over the bed. Zipper your pockets if you run. ID holder so that it does not hang around the neck during the examination. The breathability of the material, because it can be twenty-six degrees in the office. Adjustment at the waist, because the weight rarely remains the same after a year of duty. Leg length, because the standard size does not suit either short or tall people.

The medka.eu store is a convenient point of reference because it is a Polish design brand medical clothing and sews locally, and its assortment covers just this range of professional situations. There you will find medical sweatshirts and trousers for women and men, women's medical sets i men's medical suits, medical tunics, medical dresses and cosmetics, women's medical aprons and men's, medical T-shirts, socks, medical footwear and separate collections for physiotherapists and dental staff. The practical details show that they were designed by people who know the realities of change: the trousers are available in two leg lengths and have additional adjustments at the waist, some of the sweatshirts have magnetic pocket fasteners and an ID holder, and the materials are selected for frequent washing and moisture management. Prices start from PLN 189.90 for a sweatshirt and PLN 209.90 for trousers, a tunic costs PLN 239.90, a dress costs PLN 319.90, an apron costs PLN 339.90 and medical shoes cost PLN 259.90.

Several solutions are important for people at the beginning of the path. After verification of their status, students receive a permanent 15 percent discount, so the internship set is cheaper. Bulk orders work, which makes sense when your entire squad wants one color. There is also embroidery, thanks to which you can put your name and field on the sweatshirt, which may be more practical in a large department than an ID badge turned backwards. Delivery over PLN 450 is free, and the return period is 60 days, which is of real importance when purchasing online without trying on.

However, there is a situation in which buying your own sets before the first day of work does not make sense, and it is better to say it directly. Some hospitals issue and wash their own uniforms, and some departments have imposed colors distinguishing professional groups or simply do not allow private clothing. Before you complete your wardrobe for the entire year, ask about the rules in a specific department. A reasonable start is one or two sets for the first weeks and buying the rest when you know what you actually wear and in what color. With five or six shifts a month and washing at sixty degrees, two sets usually turn out to be too few, but this is a conclusion from the second month of work, not from the day of purchase.

Before you apply

When you put all these elements together, one thing becomes clear: choosing a specialization rarely turns out to be one decision. More often, it is a sequence of smaller decisions spread over several months: whether you want to work with your hands or manage patients for years, how many shifts you will endure in the fifth year rather than the first, whether you are willing to move four hundred kilometers beyond the narrow field and whether the center that accepts you intends to teach you anything.

However, a few things can be summarized in simple rules. Compare the LEK result with the historical competition before you arrange the order of the variants, because this is the only part of the puzzle on which you no longer have any influence after the ranking is announced. Don't fill out the application with only high-end fields and don't fill it with only emergency options. If you're hesitating between several courses, a core module in internal medicine or pediatrics buys you two or three years of real-world observation rather than guesswork. Ask the residents about the center, not the management. And if after all the considerations you still don't know, working in primary care, night and holiday health care or in the emergency department for a year is not wasted time, but the cheapest available way to learn about medicine from a side that is not seen during studies.

A final note concerns the scale of the error. The specialization can be changed, the center can be changed, and the system also allows a second specialization after the first title. This is not an irreversible decision and treating it as a verdict does more harm than good. However, it costs time, and no one returns this.

Frequently asked questions

Below are short answers to the most frequently asked questions on this topic. They concern formalities, deadlines and situations in which something goes differently than planned. The article is for information purposes and does not replace consultations with the voivodeship office or CMKP.

Do you need to have a specialization to work as a doctor?

NO. After a postgraduate internship and passing the LEK, you can work, among others, in primary health care, night and holiday health care, in a regional blood donation center or in clinical trials. Without the specialist title, however, work in most hospital departments, some procedures reserved for specialists and positions such as head or consultant are not possible.

Can I change my specialization after starting my residency?

Yes, but with restrictions. The resident may, without giving a reason, re-apply in another field only once, and a change to the basic or uniform module is possible within the first twelve months of training, and within the same basic module only after its completion. A separate path is a change based on an occupational medicine doctor's decision on contraindications. In non-residential mode, these limits do not apply.

Is it possible to transfer to another hospital during specialization training?

Yes, if the target accredited unit has a vacancy and one year has passed since qualification. The consent of the director of the unit is required, and when moving to another voivodeship, also the approval of the local voivodeship consultant. The one-year requirement does not apply to non-residency training physicians. It is worth confirming the details of the procedure at the voivodeship office.

Can the LEK be taken again if the result is not sufficient for the selected field?

Yes. A person who passed the LEK with an unsatisfactory result may take the exam on another date. The first application is free of charge, and for the second and subsequent applications an examination fee is charged, the upper limit of which is linked by the Act to the average monthly salary in the enterprise sector.

What happens if the doctor does not qualify for any of the indicated variants?

There remains another procedure, i.e. a maximum break of six months, because recruitment takes place in spring and autumn. This time can be used to work in primary care, in the emergency department or in night and holiday health care, to retake LEK and to gain points for publications and courses. If residency positions are unfilled in a given session, the Minister of Health may announce an additional stage, covering only priority areas.

How much does it cost to join PES and what happens if you fail the exam?

The State Specialization Examination takes place in two sessions a year, and applications are accepted until December 31 for the spring session and until July 31 for the autumn session. The third and subsequent applications are subject to a fee of PLN 700. Failure to pass the exam does not invalidate the training, but requires its extension for a period agreed with the head of the specialization.

How many doctors in Poland are currently undergoing specialization training?

At the end of 2025, over 31.4 thousand doctors were practicing specialization, which is almost eight thousand more than ten years earlier. The Ministry of Health points out that Poland already has almost four doctors per thousand inhabitants, which is why the ministry's subsequent activities focus on the quality of education and the distribution of staff in regions rather than on increasing the number of graduates.