Today Dr. Karen Zier gave us a talk on research opportunities we may have for next summer, which is essentially the only intended period of time that we will have "off" from class between now and when we graduate in 2009. Her talk wasn't enlightening, exactly; instead, all it managed to do was make me more nervous about my plans for this year and my medical career. The point to my post a few weeks ago on choosing a specialty (see here) was to address this very topic. In that post, I somewhat flippantly took a look at all the fields of medicine in an attempt narrow down my medical interests by exclusion of fields I am definitely not interested in. The problem is that while there are some fields I am fairly sure I would never want to pursue (i.e. colorectal surgery), I really don't know anything about most of the fields of medicine, and therefore I can't determine my level of interest either way with any type of certainty. The conundrum that I am faced with (and that all medical students face, for that matter) is that while this coming summer is a great opportunity for me to do something interesting and important for my medical career, I really won't be getting any real exposure to medicine and patient care (outside of EHHOP and the other weekend clinics) until my third or even fourth years in school. By that point I will be expected to have singled myself out from every other applicant to the limited residency programs around the country, which means that I have to get started on that now. It doesn't seem worth it, though, to just get involved in geriatrics research for research's sake, especially when my ultimate goal might be a pulmonology residency. In fact, in my mind that may even seem detrimental on my record.Dr. Zier said that many students who are not competitive enough take a year for "scholarly absence" between their second and third years (this notion, unfortunately, was corroborated by a fourth year I spoke to who is taking a year off to do ENT research so he can apply to the best residency programs). I would really rather not have to follow in that plan just to be placed in a good residency program, because the prospect of not graduating from medical school until 2010 sounds incredibly scary.
On the one hand, I really do not feel like I need to stress because residency seems like such a far off endeavor. On the other hand, however, I feel like I am already inexcusably behind for not having already shadowed a vascular surgeon, or not having published six articles on a new radiographic imagine technique I invented. I know that my primary interests seem to fit with global and community medicine, especially as they have to do with infectious disease, internal medicine, ophthalmology, immunology, or pulmonology. I also understand that I cannot spend the rest of my life traipsing around the world from clinic to clinic trying to treat all the poor people in the world-- I am going to want, sometime in the near future, a single place to settle down, financial stability and job security in a healthy and expanding medical field. I know that even a few years ago I had sworn off ever seeing patients (my plans were to go directly into research or public health administration after medical school without doing a residency program), but, at least at this moment, I envision a component of my career always involving patient care. I can see myself following in the footsteps of someone like Paul Farmer, who seems to actually be making a difference while still being a doctor and practicing medicine. The problem is that people like him are few and far between, and there is no clear path one can follow to get there (in fact, it seems that those types of doctors tend to reject being boxed into a certain mold, and come from many different aspects of medicine).
At this point I really can't see myself going into a surgical specialty. Really, though, most of these specialties are no more than just words to me, and I don't have any idea of what they really consist of. This is why I have been so adamant to volunteer at EHHOP, and I have started sending some emails to people about possible shadowing opportunities. I know that in the long run I will get a chance to experience all of these specialties, but I hate the feeling that I am falling behind and will not be competitive enough the do the things I want to do when the time comes. For example, Brigham and Women's Hospital in Boston is one of few hospitals that has a residency program in Global Health. I don't know if the program is really something that would interest me in the long run, but the thought of applying to BWH seems like such a long shot that I need to really start getting my act together now to even have a shot.
By the way, today is Halloween, so trick or treat!
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