When should I decide on a specialty?

Unless you come into medical school with a specific specialty in mind, you should really approach every third year medical student rotation with a very open mind. If you have any interest in a very competitive specialty in your first and second years (think ophthalmology, urology, neurosurgery, etc), try and reach out to people in those fields early. A lot of those specialties require specific research and it's helpful to start that earlier rather than later. Otherwise, enjoy your third year -- take notes about what you like and don't like for rotations, see if you jive with the people, try to hone in on what the bread and butter is and if you can see yourself doing that for 20-30 years. It can be really difficult. IF you have any specialties you really like but aren't 100% sure about, do a sub-i in that field as early as possible. A sub-i will help you narrow it down and confirm one way or another. Learn from my mistake where I avoided the sub-i until it was too late. Biggest bottom line advice -- talk to as many people as possible! Residents, attendings, etc. These opinions will be invaluable for figuring out if the specialty fit is right for your professional and life goals. At some point you will have to take a leap. Worst case scenario and you choose the "wrong" specialty, that's also ok - people switch all the time and figure it out. It's all part of the process.

The truth is that there is no "right" time. An early decision (prior to starting med school or in the first year or two) tends to make things easier in the sense that you can get started on connecting with people in the field, research (especially for competitive specialties), and exploring potential future employment options. However, based on what I've seen, most students make a decision at some point after starting their clinical rotations. Others, like myself, wait until it's time to start applying for away rotations to make a final decision. It's worth noting that deciding on a speciality is a fluid process, meaning that it often changes with time. Students are commonly set on one specialty when they start medical school only to find themselves pursuing something completely different by the end. It's very normal to feel unsure because your experience as a medical student provides a glimpse into the various specialties, but doesn't always give you the full picture. Not everyone has a "Eureka" moment during a clinical encounter that solidifies their specialty choice. What's most important is making a well informed decision to help ensure you're fulfilled by whatever specialty you pursue. Residency is challenging regardless, but less so when you enjoy what you're doing.