Day 149: Brief musing on specialties

Today's inane image of the day:

This was the sky's "Good Morning" today -- this photo was taken from a study room in O'Dowd [I highly recommend these rooms early in the morning... so peaceful to watch the sun rise].

For our PRISM session next week, each of us is required to complete the 150 question MSPI-R assessment on the Careers in Medicine website. Not surprisingly, the speciality it said I was most compatible with was OB/GYN. Huh, you ask? Haven't you been raving about interest in anesthesiology, radiation oncology and cancer genetics? Why did you know you would get OB/GYN [beside the fact that the survey asked predictable questions]?

Well, first and foremost, I really enjoy working with the female population [which is probably why I was so involved in the Society of Women Engineers and now the American Medical Women's Association]. Women indeed have different needs and I find it fascinating how distinct males and females react to problems or emotional expression. I love the connection and the firsthand understanding. And babies are absolutely magical.

But, I don't know if I really want to dedicate the rest of my life to women's reproductive health. Maybe after my clerkship I'll change my mind. Or maybe it'll push me more toward breast cancers. Or maybe I'll be back here exactly where I started [hopefully not that last one!].

Bah! It stresses me out not to have a more concrete idea of where I want to and hope to be after medical school.

Day 75: Seeing patients

Today's inane image of the day:

We've started delving into the lower limbs in Anatomy... 

The last two days have been rather exciting -- yesterday we all had our first real patient encounter and today we had the opportunity to hear from a 3-person patient panel about their experience with testing positive for the BRCA1/2 mutation. Although the material is continuing to pile on, and we have an exam a week from Monday [eeeeek!], medicine is starting to feel more real. It's starting to be tangible; I have touched my first patient and have heard the heart-wrenching stories of 3 women who had their worlds turned upside down by this seemingly tiny alteration in their genome. It's incredible.

I still feel very insecure about what I want to do in medicine. Sure, it's early and I have time to decide. But like many others in my position, I'm frightened that the moment of clarity that I need just won't come. Today, I felt a spark with heme/onc -- the presentation was emotional, but very raw and human. Cancer is such a pervasive and fickle thing -- sadly, it has touched us all in one way or another. But we've come so far in the last couple of decades. We have treatments to keep malignant cells at bay. We have preventative screening measures to halt a tumor or malignancy in its infancy. We can do something now.

Some part of me is terrified that medical training will turn me into an unfeeling, cold-hearted physician. It takes a lot to finally reach the ranks of attending status, and I don't want to lose that emotional connection with my patients. I want to feel something when I see, speak or touch my patients. In the end, they are humans with stories to tell and loved ones. Sometimes, I just want to hear everyone's story.

Today's medical school fact of the day: "The greater saphenous vein is the longest vein in the body and it arises from the medial side of the dorsal venous arch." -- Dr. Bee's "Bare Bones" text

Day 15: Where to go, where to go

Today's inane image of the day:

We use this fun device for most of our classes -- it's a part of the "active learning" part of our curriculum. For the most part, I think it does do its job of making sure we understand the material.

Just to keep you coming back, I've been promised guest posts from some of my inaugural-classmates... assuming I can squeeze one out of someone!

I've been meaning to write an entry about this for a while, but I've found other things to be easier to discuss and thus left it for a special day. Apparently, the day has come: let's talk about specialties. Yes, yes, yes, I'm barely in my third week of my M1 year and I'm already concerned about what I want to be doing after four years?

Well, first off, it isn't that absurd to be thinking about it now -- especially if I wanted to go into dermatology, ophthalmology or something along those lines [I don't]. Nevertheless, the thought of having to select a single thing to do for the rest of my life is quite daunting and has been weighing down the back of my mind since I received my first medical school acceptance letter. See, the moment we started medical school, our clock has been counting down to the day that we take the UMSLE Step 1. Not to say that this test will make or break us, but a high score on it will inevitably open more doors than one that is just barely passing. Even though I cannot predict my performance on this test [actually, I'm a terrible test-taker, so I'm just hoping that the right thoughts will pop into my head at the right time...], I can think about what fields of medicine intrigue me the most and set myself up early for success in the match.

Although I hate to admit it, one huge factor in deciding on a speciality is the lifestyle. True, I went through medical school so that I could practice medicine, and I fully intend on practicing full-time, but I also fully intend on living a fulfilling life [have you ever seen 'ful-' used so many times in the span of 11ish words?!]. I have to face the facts: I am female, and I intend to have children. I also plan on being there for my children during many of their important milestones. Plus, a good number of men look at the lifestyle factor as well, so I know it's not just a gender-thing.

I want patient contact, but I don't think I could do the sustained, long-term relationship. I have been very seriously considering radiology [there are reasons I feel that I could forego patient contact for it], but there are a lot of factors that go into whether or not I am serious about that. After reading Dr. Michelle Au's blog from Day 1, I have very seriously been looking into anesthesiology. Another route I was considering was trying to figure out a way to fit in a pediatric subspecialty [pediatric anesthesiology?] because kids always just brighten my day [yes, I do realize the capacity that I would be interacting with them -- but really, the thought of helping a child just feels like you're doing so much more because they have a whole life ahead of them].

I'm still keeping my options open because I have yet to start clerkships or the real medicine part... but with my sights somewhat narrowed, I feel better about having a goal to work toward. One thing I've learned about myself is that I need to set goals in order to achieve, and by setting this target of scoring at least in the median range of students who successfully matched into anesthesiology, I am giving myself something to work toward. I realize that things could [and probably will] deviate from my plans, but I've grown much more comfortable with accepting and embracing change.