The residency journey is just getting started

Every career has that one question that is notoriously hated by all. For nurses, that question is, “So, why didn’t you want to be a doctor?” For teachers, it’s questions about the age-old adage, “Those who can’t do, teach.” For medical students, that question is, “So, do you know what you want to do?”

It’s not that people who ask medical students about their career plans are ill-intentioned or nosy; in fact, the question seems like natural small talk to non-medical folk.  The truth is, it’s an extremely overwhelming and personal decision. Medical students are exposed to only a few week of core specialties within the 3rd year — internal medicine, pediatrics, family medicine, surgery, obstetrics and gynecology, and psychiatry — with little or no exposure (depending on curriculum) to the many other career options. And while the final decision is somewhat negotiable, medical school and residency is, quite frankly, a long and expensive haul that does make a do-over all that appealing.

While the input and approval of friends and family may be respected and appreciated, the answer to the question becomes much more difficult when a resident or attending physician is doing the asking. It’s not so easy to tell the person who grades you that you want nothing to do with his or her own profession. On the other hand, its the good and bad experiences that you have with your attending, residents, and other team members that can really make or break your career choice.

At least, that’s what happened to me.

I came to medical school convinced that I would go into rural family medicine. I had worked in my father’s internal medicine practice during summers and vacations, and adored his patients and the family atmosphere. I also loved working with children, and carried an interest in women’s health. I figured I could be a great addition to his practice one day.

When 3rd year rolled around, my thoughts became more jumbled. Internal medicine was my first rotation. It took some time to adjust to the ins-and-outs of 3rd year clerkships, but I enjoyed the rotation. I was immediately drawn to the art of bedside rounding and teaching rounds, and knew immediately that teaching could be a way to integrate my communications background into my medical career. I did a stint in the stroke unit, which I found incredibly challenging and exciting.  I was surprised to realize that I didn’t actually love pediatrics. I had fun and learned a lot, but I found managing childhood illness less exciting than managing the care of adults with multiple commodities. I had similar thoughts about obstetrics and gynecology; I also didn’t love the time I spent in operating room during the rotation.

The “make-it-or-break-it” moment actually happened during my family medicine rotation. During the clerkship, I was able to experience both inpatient and outpatient family medicine. While I enjoyed the outpatient portion of the rotation, I found myself thinking about the patients on the wards. I missed the pace of inpatient medicine, and missed morning teaching rounds. I realized that I loved the challenge of working with and caring for sick patients, and watching their health improve from day-to-day. I also loved the beauty of the physical exam. During my time on inpatient services, I could actually see and appreciate the physical findings I had previously only read about.

And the rest is history…

… sort of. My journey is really only just getting started. I have no idea whether I want to go into hospital medicine, pursue a fellowship in one of the internal medicine sub specialties, or work in a critical care unit. I know that teaching is definitely in my future, and have decided to look into residencies at university hospitals to help me achieve this goal. But, most importantly,  after nearly 3 years of medical school under my belt, I am happy to announce that I am officially ready to start applying for residency.

Allison A. Greco is a medical student who blogs at MD2B.

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