"What kind of doctor do you want to be?" "What field do you want to go into?" "What do you want to be when you grow up??"
From the first day of medical school, these are the most common questions a medical student will answer for the next four years. But the problem? These are HUGE questions!
As I sit on the other side of having made the choice of what specialty to go into, it is difficult to explain what all went into my decision. When I asked my husband for his perspective, he said you only need to ask yourself one question: "What do you want your life to look like?" While there are many more questions within this question, he is essentially right.
Here I have broken down this bigger question, into ten smaller questions I found helpful to ask in choosing a specialty. Not all questions are mutually exclusive, but all are important to consider.
In red, I explain general thoughts on considering this question. And in blue, I explain how I used the question to form my choice of which specialty to go into.
1. Would you rather know a little about a lot, or a lot about a little?
My senior resident asked me this question my third year of medical school, and while simple, I thought it was rather profound. Do you want to be the expert doctors turn to with their questions when they have done their best in a certain area (specialist), or do you want to be able to assist in most common medical situations? A neurosurgeon I worked with joked that when he was recently on a plane and they called overhead asking for help from medical personnel, he was about as useful as a plumber. That said, when any physician's patient develops a brain hemorrhage, he is who they are going to call to save the day.
I would personally rather know a little about a lot. I enjoy being able to answer most common medical questions, and am frustrated when there is a simple every day question I don't have an answer to. When there is a call overhead in the airplane, an accident on the side of the road, or a family member or friend with a concern....I want to be able to help in meaningful ways. I am okay with (and even enjoy!) having intelligent colleagues to turn to when I need help with bigger questions. In this sense, I lean towards primary care.
2. Acute or not acute?
Emergent or planned? Do you operate well under intense pressure? While there may be an initial thrill with work in the ICU, emergency room, or trauma surgery, twenty years in, will it still be enjoyable to you? Being asked to make life or death decisions in a few minutes....beyond how glorious this may sound to some....is this what you want to do with your life?
This one is hard, because I enjoy both. I operate well under pressure, and find fulfillment in successfully working a patient and their family through a crisis. But I also enjoy scenarios when there is plenty of time to dig through symptoms, past medical history and the patient's questions to come to the best solution for an individual, together. In some ways, this makes me doubt my choice of family medicine. The good news? There are some emergencies that show up in family practice office (particularly in rural areas), there is room for family practitioners to work in many ERs, and I can always do a fellowship later on if I decide I made the wrong choice.
3. Is academia/research important to you?
If you want to work in a large academic setting (teaching, doing cutting edge research, etc.), primary care is likely not the route for you. Of course, there are exceptions to everything, but this is an important point to consider.
I am really thankful for the experience to have done research in undergrad, but have no desire to maintain scientific research as a part of my career. I'm more a people person than a peer reviewed article kind of person. I do greatly enjoy teaching, however, and would like to find a way to teach in some capacity in the future.....likely working with a local secondary school, or having pre-med or medical students work with me.
4. Would you rather work in a clinic or a hospital, or both?
This can be a hard question to answer with out spending considerable time in both settings. But simply, the cultures of each are different, and as is the job you will be doing.
I love BOTH, and at this point in my career, am not willing to give up work in either. Most specialties have room to work in both (see patients in the clinic, and then round on patients hospitalized or do surgeries in the hospital), but this varies per specific job, and regional setup. With my career choice, I will spend the majority of my time in the clinic, but will deliver babies in the hospital, and depending on where I end up working/living, may see some of my patients when they are hospitalized.
5. Where do you want to live in the future? (And for training?) City, urban, rural? East coast, west coast, etc?
If you are set on living in a rural/small town environment, you are going to have a hard time going into certain specialties and sub-specialties, which in order to have enough patients to pull from, are located in cities....for example, you are not going to be able to find a job as a neurologist or vascular surgeon in a small town over an hour from the nearest city.
Similarly, some specialties look very different depending on where they are practiced. Family Medicine, perhaps, varies the most geographically. In a city ripe with specialists, a family practitioner is more likely to spend time referring patients, and less likely to have medically complicated patients, obstetrics patients, or pediatric patients. You are also more likely to have predictable and livable hours practicing family medicine in a city. Additionally, family medicine is viewed very differently in different regions of the nation; consider where you want to settle east coast, west coast, etc., longterm.
I am a small town girl, through and through! I do not enjoy living in a city, and even for training, try to minimize my time there. I also see my husband and I spending the rest of our lives in the northwest. So....I need to picture careers in rural northwest. For wanting to do full spectrum family medicine...this is perfect! Family medicine is well respected in the northwest, and many rural areas are in great need of family practitioners willing to do obstetrics.
6. What hours are you wanting/willing to work?
Do you (and when do you) want a family, and what do you want your role in that to look like? Do you prefer five shifts of 10 hours each, or three shifts of 14 hours each, or 24 hour shifts? Do you operate okay through "all nighters"? How much at home "call" can you tolerate?
While I do not care what hours I work right now....I'm okay with nights, long hours, home call, etc.....I know that this will not always be the case. I plan to have children sometime after residency, and want to have a practice that allows me to be a present mom. If my child has a sports game...I want to be there. If my husband and I decide it best that I stay at home until after 8am, and see the kids off to school....I eventually want to be in the position I can make this happen. While this will be difficult with obstetrics (I'll have to work on this piece), this is very possible with family medicine.
7. Look at the individuals in the field, and those going into the field....are these individuals you would be excited to work alongside, and would you be okay becoming a little more like them?
There are stereotypes for those who go into every field. While stereotypes do not always hold true, they are there for a reason. It is likely both the case that certain types of personalities lean towards certain specialties, as well as the fact that specialties change you. Make sure you can respect and be proud of the person you will be at the end of the path you are looking at.
Going into medical school with a Bachelors in Neuroscience, I thought that I would go into either neurology or neurosurgery. However, I spent significant time with a number of neurologists my first year of medical school, and found that I really could not relate to or look up to as mentors, any of the individuals I was working with. They seemed more obsessed with hospital politics and how to extend their paychecks, than they were relationships with their patients....and I realized I didn't want that to become my life. Perhaps it was just the one practice (I have met some marvelous neurologists since), but it was enough to speak loud and clear to me.
8. What are your natural talents?
Are you a good listener? Are you good with your hands? Do you work well under high amounts of pressure? Do you handle emotional strife particularly well?
Similarly, is there something you don't do well? Can't handle blood, vomit, children, patients with psychiatric illnesses, women in labor, etc? Do you have a medical/physical condition which limits you? These are important to know.
Talents: Proficient with fine motor movements (after some practice). Able to make a patient feel a meaningful "connection" in a short period of time. Able to explain something complex in simple and understandable terms. Able to effectively motivate and lead a team toward a common purpose.
Lack of talent: I don't do well with "pimping"....being put on the spot in intense questioning. My words freeze (terms are on the tip of my tongue, but I can't get my mind on it quick enough). While I think I might do well in a surgical career (my motor skills don't freeze), I do not think I would do well in a surgical residency with the well known "pimping". I also struggle with mild orthostatic hypotension....I get light headed standing in one position for a long period of time. While I have learned to take caffeine pills, wear compression stockings, and chug large amounts of water before going into a setting which will require me to stand extensively in one position (at an operating table or in the back of an exam room observing), I do not want to have to do these things on a daily basis for the rest of my career. I thought very seriously about going into general surgery, until I considered the impact of these, and others items.
9. What do you ENJOY doing?
What gives you life? Does completing a large project give joy to your soul? Laughing children? Overcoming a long fought battle? Telling stories with elderly individuals? Being a confidant? Longterm relationships? Predictability? Spontaneity? Spending a paycheck on luxurious things? What is it within the field that you can live for?
I am a people person! I thrive being with people (more small groups or one-on-one than large groups), and in being able to help people. I know I would do miserably locked away in a room for radiology, or something similar. I enjoy relationships with people of all ages, and both genders...and don't think that I could give up working with one gender or an age group. I like the babies, the mommas, the old men, and all the in between. This screams family medicine! I also love becoming deeply involved in my community, and choosing to practice medicine in a small community sets me up for almost any community leadership/involvement I could want.
I do NOT enjoy.....battling with parents over appropriate care for their children. I would consider going into pediatrics, except that parents who argue over what is the best care for their child take SO much energy out of me, I know I can only handle a couple a day. I need a few adults caring for themselves mixed in! :)
10. Why did you choose to go into medicine in the first place?
Was it to walk people through their greatest crises? Was it to build long term relationships? Was it to do life changing work abroad? Was it to do well financially? Was it to be the expert of the experts? Was it to change the health of a community?
I wanted to become a physician because I like people, and I like helping people. This can be accomplished in most fields, but I personally feel most fulfilled when it is done within the picture of a relationship built over time. Family Medicine also has great utilization overseas, where I know I will want to continue to work.
So there you have it! I am a soon to be Family Medicine physician! But, different individuals are made for different fields. No field is particularly better than others....but each field calls a bit of a different person to it.
I am simply blessed to have found a career I am ecstatic to belong to!
From the first day of medical school, these are the most common questions a medical student will answer for the next four years. But the problem? These are HUGE questions!
As I sit on the other side of having made the choice of what specialty to go into, it is difficult to explain what all went into my decision. When I asked my husband for his perspective, he said you only need to ask yourself one question: "What do you want your life to look like?" While there are many more questions within this question, he is essentially right.
Here I have broken down this bigger question, into ten smaller questions I found helpful to ask in choosing a specialty. Not all questions are mutually exclusive, but all are important to consider.
In red, I explain general thoughts on considering this question. And in blue, I explain how I used the question to form my choice of which specialty to go into.
1. Would you rather know a little about a lot, or a lot about a little?
My senior resident asked me this question my third year of medical school, and while simple, I thought it was rather profound. Do you want to be the expert doctors turn to with their questions when they have done their best in a certain area (specialist), or do you want to be able to assist in most common medical situations? A neurosurgeon I worked with joked that when he was recently on a plane and they called overhead asking for help from medical personnel, he was about as useful as a plumber. That said, when any physician's patient develops a brain hemorrhage, he is who they are going to call to save the day.
I would personally rather know a little about a lot. I enjoy being able to answer most common medical questions, and am frustrated when there is a simple every day question I don't have an answer to. When there is a call overhead in the airplane, an accident on the side of the road, or a family member or friend with a concern....I want to be able to help in meaningful ways. I am okay with (and even enjoy!) having intelligent colleagues to turn to when I need help with bigger questions. In this sense, I lean towards primary care.
2. Acute or not acute?
Emergent or planned? Do you operate well under intense pressure? While there may be an initial thrill with work in the ICU, emergency room, or trauma surgery, twenty years in, will it still be enjoyable to you? Being asked to make life or death decisions in a few minutes....beyond how glorious this may sound to some....is this what you want to do with your life?
This one is hard, because I enjoy both. I operate well under pressure, and find fulfillment in successfully working a patient and their family through a crisis. But I also enjoy scenarios when there is plenty of time to dig through symptoms, past medical history and the patient's questions to come to the best solution for an individual, together. In some ways, this makes me doubt my choice of family medicine. The good news? There are some emergencies that show up in family practice office (particularly in rural areas), there is room for family practitioners to work in many ERs, and I can always do a fellowship later on if I decide I made the wrong choice.
3. Is academia/research important to you?
If you want to work in a large academic setting (teaching, doing cutting edge research, etc.), primary care is likely not the route for you. Of course, there are exceptions to everything, but this is an important point to consider.
I am really thankful for the experience to have done research in undergrad, but have no desire to maintain scientific research as a part of my career. I'm more a people person than a peer reviewed article kind of person. I do greatly enjoy teaching, however, and would like to find a way to teach in some capacity in the future.....likely working with a local secondary school, or having pre-med or medical students work with me.
4. Would you rather work in a clinic or a hospital, or both?
This can be a hard question to answer with out spending considerable time in both settings. But simply, the cultures of each are different, and as is the job you will be doing.
I love BOTH, and at this point in my career, am not willing to give up work in either. Most specialties have room to work in both (see patients in the clinic, and then round on patients hospitalized or do surgeries in the hospital), but this varies per specific job, and regional setup. With my career choice, I will spend the majority of my time in the clinic, but will deliver babies in the hospital, and depending on where I end up working/living, may see some of my patients when they are hospitalized.
5. Where do you want to live in the future? (And for training?) City, urban, rural? East coast, west coast, etc?
If you are set on living in a rural/small town environment, you are going to have a hard time going into certain specialties and sub-specialties, which in order to have enough patients to pull from, are located in cities....for example, you are not going to be able to find a job as a neurologist or vascular surgeon in a small town over an hour from the nearest city.
Similarly, some specialties look very different depending on where they are practiced. Family Medicine, perhaps, varies the most geographically. In a city ripe with specialists, a family practitioner is more likely to spend time referring patients, and less likely to have medically complicated patients, obstetrics patients, or pediatric patients. You are also more likely to have predictable and livable hours practicing family medicine in a city. Additionally, family medicine is viewed very differently in different regions of the nation; consider where you want to settle east coast, west coast, etc., longterm.
I am a small town girl, through and through! I do not enjoy living in a city, and even for training, try to minimize my time there. I also see my husband and I spending the rest of our lives in the northwest. So....I need to picture careers in rural northwest. For wanting to do full spectrum family medicine...this is perfect! Family medicine is well respected in the northwest, and many rural areas are in great need of family practitioners willing to do obstetrics.
6. What hours are you wanting/willing to work?
Do you (and when do you) want a family, and what do you want your role in that to look like? Do you prefer five shifts of 10 hours each, or three shifts of 14 hours each, or 24 hour shifts? Do you operate okay through "all nighters"? How much at home "call" can you tolerate?
While I do not care what hours I work right now....I'm okay with nights, long hours, home call, etc.....I know that this will not always be the case. I plan to have children sometime after residency, and want to have a practice that allows me to be a present mom. If my child has a sports game...I want to be there. If my husband and I decide it best that I stay at home until after 8am, and see the kids off to school....I eventually want to be in the position I can make this happen. While this will be difficult with obstetrics (I'll have to work on this piece), this is very possible with family medicine.
7. Look at the individuals in the field, and those going into the field....are these individuals you would be excited to work alongside, and would you be okay becoming a little more like them?
There are stereotypes for those who go into every field. While stereotypes do not always hold true, they are there for a reason. It is likely both the case that certain types of personalities lean towards certain specialties, as well as the fact that specialties change you. Make sure you can respect and be proud of the person you will be at the end of the path you are looking at.
Going into medical school with a Bachelors in Neuroscience, I thought that I would go into either neurology or neurosurgery. However, I spent significant time with a number of neurologists my first year of medical school, and found that I really could not relate to or look up to as mentors, any of the individuals I was working with. They seemed more obsessed with hospital politics and how to extend their paychecks, than they were relationships with their patients....and I realized I didn't want that to become my life. Perhaps it was just the one practice (I have met some marvelous neurologists since), but it was enough to speak loud and clear to me.
8. What are your natural talents?
Are you a good listener? Are you good with your hands? Do you work well under high amounts of pressure? Do you handle emotional strife particularly well?
Similarly, is there something you don't do well? Can't handle blood, vomit, children, patients with psychiatric illnesses, women in labor, etc? Do you have a medical/physical condition which limits you? These are important to know.
Talents: Proficient with fine motor movements (after some practice). Able to make a patient feel a meaningful "connection" in a short period of time. Able to explain something complex in simple and understandable terms. Able to effectively motivate and lead a team toward a common purpose.
Lack of talent: I don't do well with "pimping"....being put on the spot in intense questioning. My words freeze (terms are on the tip of my tongue, but I can't get my mind on it quick enough). While I think I might do well in a surgical career (my motor skills don't freeze), I do not think I would do well in a surgical residency with the well known "pimping". I also struggle with mild orthostatic hypotension....I get light headed standing in one position for a long period of time. While I have learned to take caffeine pills, wear compression stockings, and chug large amounts of water before going into a setting which will require me to stand extensively in one position (at an operating table or in the back of an exam room observing), I do not want to have to do these things on a daily basis for the rest of my career. I thought very seriously about going into general surgery, until I considered the impact of these, and others items.
9. What do you ENJOY doing?
What gives you life? Does completing a large project give joy to your soul? Laughing children? Overcoming a long fought battle? Telling stories with elderly individuals? Being a confidant? Longterm relationships? Predictability? Spontaneity? Spending a paycheck on luxurious things? What is it within the field that you can live for?
I am a people person! I thrive being with people (more small groups or one-on-one than large groups), and in being able to help people. I know I would do miserably locked away in a room for radiology, or something similar. I enjoy relationships with people of all ages, and both genders...and don't think that I could give up working with one gender or an age group. I like the babies, the mommas, the old men, and all the in between. This screams family medicine! I also love becoming deeply involved in my community, and choosing to practice medicine in a small community sets me up for almost any community leadership/involvement I could want.
I do NOT enjoy.....battling with parents over appropriate care for their children. I would consider going into pediatrics, except that parents who argue over what is the best care for their child take SO much energy out of me, I know I can only handle a couple a day. I need a few adults caring for themselves mixed in! :)
10. Why did you choose to go into medicine in the first place?
Was it to walk people through their greatest crises? Was it to build long term relationships? Was it to do life changing work abroad? Was it to do well financially? Was it to be the expert of the experts? Was it to change the health of a community?
I wanted to become a physician because I like people, and I like helping people. This can be accomplished in most fields, but I personally feel most fulfilled when it is done within the picture of a relationship built over time. Family Medicine also has great utilization overseas, where I know I will want to continue to work.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~
So there you have it! I am a soon to be Family Medicine physician! But, different individuals are made for different fields. No field is particularly better than others....but each field calls a bit of a different person to it.
I am simply blessed to have found a career I am ecstatic to belong to!
