Very interesting question from a med student reader the other day: How do I choose what specialty to go into? Her particular decision was worded differently, but the general idea of the query is the same: how can I possibly know what it’s going to be like to be this or that kind of doctor? It’s a great question.
After all, you have to choose during the third year of medical school because of the lengthy match process. (For those of you who don’t know what the match is, I’ll rant on that another day.) Plus, once you pick you’re going to spend the next 3-10 years training in that specialty. It really sucks when after all that you realize you chose wrong.
Some people just know. “I’ve wanted to be a pediatrician since I was 5, my mom is a pediatrician, my grandfather is a pediatrician, I was Doc McStuffins as a child, I loooooove kids…” Great. Awesome. Those people are lucky, and usually right. Others have it narrowed down to, at least, adults vs. kids, medicine vs. surgery, out-patient vs. in-patient, etc. Those people are less lucky, and sometimes right. For the rest of us, all we have to go on is what we see in the third year of medical school, when real clinical rotations get going. Remember, I was a nurse before I went to med school. I was a cardiac nurse. I wanted to become a cardiologist. I thought I knew exactly what I was getting into. I was so wrong. So, as someone who has chosen wrong more than once in her life, I herewith give you a list of things to consider so you don’t do what I did.
1. DO NOT LET A BAD ROTATION INFLUENCE YOU. I can’t emphasize this enough. For a medical student, the experience she has during clinical rotations has more to do with the residents and their treatment of her than anything else. For example, I had a horrible surgical rotation. The residents were stressed and thus either mean or dismissive of students, who are generally not useful and can be a significant added burden. No responsibility or accountability was given to the students, so I could disappear all day and show up for rounds in the evening and nobody would notice or care. I felt hesitant to ask to scrub in and nobody insisted that I do so. Med students in that rotation were not valued. And I could feel that. On the other hand, in medicine everyone was super nice and let me do stuff and ate lunch with me and generally tolerated my presence. So I went into medicine, which was a terrible decision. Please don’t take any of it personally or dismiss a specialty out of hand because some miserable resident was a jerk to you.
2. FIND THE BORING PART. What is it that the attending in each specialty does repeatedly? Because I guarantee you there is at least one thing that each doctor in every specialty does over and over every day. Happiness in a specialty is going to depend in part on how well you tolerate this repetition. Examples: Don’t become a pediatrician if you are bored to death treating ear infections. Even if you love kids. Don’t become a general surgeon if, after doing three appendectomies you’re ready to shoot yourself if you have to do another. Even if you love appendices. There’s a boring part, I guarantee it. Find it.
3. DON’T MAKE LIFESTYLE YOUR MAIN CRITERIA. This one is sort of counter to what people are aiming for these days, but I’ll tell you why I say it. It relates to #2. If you love the lifestyle of dermatology but can’t stand rashes, even the 9-5 office hours and lack of call will not redeem days filled with rashes. If you like that anesthesiologists get a lot of vacation time (we do) but can’t stand sitting in the OR all day, no amount of fabulous days at Disney World is going to make up for what you have to do when you’re not on vacation.
4. FORGET #1. PAY ATTENTION TO HOW YOU FEEL. By this I mean observe yourself in each rotation. Are you cold, hungry, and sleepy all the time? Not a good specialty for you, even if you think you would like it. You’re bored, don’t waste your time. Are you on call every other night and can’t wait to get back to it every day? Better choice. Does the work induce “flow”? That is, do you look up at the end of a day and go “That was fast!”? Good choice. Don’t find excuses for how you feel if you have your heart set on a specialty. Just because you thought you would like it doesn’t mean your body and mind aren’t telling you “no way”.
5. BEWARE OF THE NOVELTY FACTOR. You might think OB is awesome because you’ve never seen a baby born before. You might find cardiac surgery totally cool because you’ve never seen someone stick a hose in a ventricle. These things are awesome, but they better be awesome 15 years from now. Even if you love a specialty, residency will make you practice that specialty so much it won’t be fun anymore. You have to be able to sustain your passion through that.