When do people actually decide on a specialty?

The honest answer is that your deadline is whichever program you are aiming at, and they are years apart. RACGP takes applications from doctors who will hold general registration by commencement, so an intern can and should apply ¹. RACS states application is not linked to postgraduate year but that the earliest point you can apply is PGY3, and the rotation prerequisites push most specialties to a first realistic application in PGY4 ². RANZCO's 2026 intake averaged 5.2 years since medical degree and a mean age of 30.7, with 23 of 38 entrants holding a Masters ³. So "when should I decide" has a three-to-five-year spread depending on the door.

What the sub reports is later than the anxiety suggests. The recurring story is not a med-school epiphany but a term that ruled something out: people describe deciding in their first clinical year, in PGY1 on a rotation they hated, or at PGY3 once they had confirmed what they could not tolerate ⁴. Several describe starting one program, leaving it, and starting another ⁴.

The trap is the paradox the sub names itself: you are told not to stress about it, while the CV scoring that will judge you rewards starting early ⁵. Both are true. The resolution is that the early work — audit, a publication or two, courses, references from bosses who know you — is portable across most programs. The unportable stuff is specialty-specific rotation time, and that is what you should hold off on committing until you have worked in the thing.

Counter-argument. Deciding late is cheap in GP, ED and psychiatry and expensive in surgery and ophthalmology, where the prerequisite terms and the seniority of the successful cohort mean a PGY5 starting from scratch is years behind ²³.