Like most students who tell their family or friends that they are studying medicine, I get the typical “What do you want to be?” or “What would you like to specialize in?” questions and I have a prepared (abridged) spiel “I would like to be a blah”, or “I like …. area”. However, if I am honest and put forth that I don’t really know yet, I often get shot a look that makes me feel like I am unprepared or not serious about my career aspirations. I am.
After going though a science degree, tailoring it to be as close to “premed” as possible, and boosting my CV with research, tutoring and nursing experience - all hoping to be the best doctor I can be, as well as gain any competitive edge (I am in a med student tsunami after all!) - I am very serious. Yet, one and a half years in to med, I have less of an idea about the end destination than ever. Due to the self-directed nature of medical education and the vast amount of information, but relative time shortage, one of the skills you must learn early on in your studies is to identify what you don’t know. The further I go along, the more I realise how much I am yet to learn. Thus at this early stage – before I have really experienced what working in an area might be like – I’m uncertain about what area I would like to specialise in.
At the moment, I am leaning towards Critical/Intensive care and Anaesthetics. I love physiology and these disciplines are the few where you get to see dramatic and immediate changes in a patients vitals and chemistry; where accurate and rapid decisions can make a huge difference to the patients outcome; and where adrenaline is plenty! I also love the relationship dynamics between patients - when (and if) they are recovering - and their families (I appreciate the human side of it). Of the many strong memories from my elective in ICU/Anaesthetics last year, I have two that to me confirm my love for this sort of discipline. One evening I manually ventilated a post-surgical, sedated patient who had developed CO2 narcosis while the RMO was periodically testing ABGs for the CO2 to drop from about 80-90! She was ‘better’ in the wards a few days later (I am not sure if she was ever discharged though). The other experience was being part of a daily meeting with a patient’s family for a week until their uncle/brother/father passed on, helping them come to terms with this unexpected tragedy – the grief and facing their own mortality.
It will be interesting for me to see what direction I will think of heading in after (and throughout) my upcoming clinical years, and whether I ever end up in that specialty at all.
For those who have chosen a path. I would be very interested about what made you finally choose that path? Was it hard to decide, or was there never any doubt?
Any stories/ memories/ moments that made the choice easier?
Hi Robert,
Thanks for the insight into your medical career so far. I think many people who have chosen a path will have different stories to tell, and hopefully we will get to hear some here. My personal experience was of a gradual realisation more than anything. I happened to do a BMedSci (compulsory at Melbourne Uni at the time) in oncology because it interested me from a basic science point of view. That was in my third year of medicine. My supervisor was by chance a radiation oncologist and the seed was planted. I didn't put too much thought into specialty training as a student, but for my elective I travelled to London and I had clinical oncology (their closest approximation to radiation oncology) and neurology as my preferred specialties. I ended up doing clinical oncology, and got my first insight into the day to day activities in radiation oncology which were fascinating.
After residency I took a year off to travel, work differently (locum, volunteer) and ponder my choices. Again I spent some more time in a radiation oncology centre to see the job from the perspective of someone who has been in the workforce (all my other exposure had been as a student). At that point, the choice became pretty obvious.
I think an important part of choosing your specialty, quite separate from having an interest in a particular field, is getting to know yourself and your personality, which has a huge impact on the environment in which you would like to work. I learnt a lot about this as an intern and resident, when I noticed that even if I was doing something that was very interesting, a high pressure/long hours environment exposed to very intense colleagues detracted a lot from my enjoyment of work. When working in a pleasant environment, I was able to enjoy some activities which I might previously have thought were not all that stimulating. During that time I learnt about the importance of balancing what you are doing AND who you are doing it with AND in what work environment when choosing a specialty.
J.