Continuing with the theme from before, I should mention that there are tests out there that are supposed to help guide medical students to various specialties. It should be well noted that they should be taken as a suggestion only– as many don’t include some specialties (like anesthesia, as I saw on a few I participated), and can make you myopic in regards to a career. I stopped using them after I kept matching with surgery because they lacked anesthesia related fields.
Yet despite the suggestive nature of these skill exams many students let these guide them, forcing their minds into a predetermined notion of needing to like a rotation because they’ve tested highly on that area consistently. While this may help make a month or two pass blissfully, it will not let 4-5 years pass quickly if you didn’t recognize warnings with your rose colored glasses. Nor will it assuage concerns that rise during residency and afterwards about the choice of specialty. It would be quite sad to spend so much time and money to only hate what you're doing.
Fortunately the 4th year of medical school usually allow some experimentation through 4 or more months of electives and can help shape your thought process. But it also comes at a time when you begin to get worried that you’ll miss the ERAS deadline, won't receive interview offers because you waited too long, or won’t be able to get letters of recommendation since the letter writer already committed to multiple students.
You may also never consider an elective in a specialty that fits you more fully since you never received any exposure. Right off the top of my head I feel that Pathology and Radiology are often those fields where rotations may not be required and are never considered. How can you make a clear decision when you've received little to no information other than bias?
For the stated expectations of medical schools and the LCME many schools meet their agendas. However, this too often leaves students pondering their future and entering residencies they find deplorable within a couple years. They are then forced to decide to continue on or to reenter the match, hoping for a better fit, and losing time. It should be taken with a great deal of warning that the 3rd year is not the ultimate year of decision making. The entire 4 years of medical school needs to be more focused on exposing students to more than the core requirements and students themselves should not enter school with one field already decided upon – as this often changes.