I came to med school with several years of emergency medical service as a medic and from the military. I decided to completely forget about EM and take every class and course seriously. I even took 3rd year clinicals so seriously that each one I did I almost convinced myself that I could do that particular specialty. I even took a NHSC scholarship my 2nd year thinking I would do either primary care or rural EM. Then when the government broke the news to me this year that there would be no way to do EM without defaulting, I told them where they could go. I had come full circle and found myself back at the doorstep of EM. But in retrospect, except for the incredibly large check I had to pay to get out of my obligation, it was still worth going this route. I saw too many of my former EMS buddies fall on their faces in med school because all they thought about was "I don't need to worry about that...I'm doing EM". And they were right in many respects, except that they still needed to know that stuff to do well on boards and get some interviews. Several had to go the extra mile to get into an EM program and others flat out did not get in. One is literally in Iraq now as a GMO because he didn't match into EM in the military match a few years back. Its okay to be goal directed, but I would suggest that for your first 2 years at least you think very little about what specialty you want to enter and instead think about what test is on Friday. You can always worry about specialty later if you do well with grades and scores, but its hard to work backwards.