The Big Decision

Okay, it may not seem like a big decision to most people who have just got on and done it. You know, finish school and find a job that you will be doing for the rest of your life, as in forever. Unless you decide to quit and get another job. But basically, most people pick something and stick with something in that general direction until they retire, no?


What do I know? All I seem to talk to most of the time are med students. Or teachers, but those come in two flavours: some knew from birth they wanted to teach; others never did figure out what they wanted to do so they figured they'd be teachers.

And so.

Surgery. Emergency. Family. Or even obstetrics. Radiology has its advantages. Internal medicine... no, I'm kidding, although infectious disease really appeals to me.

I very much envy the people who came into med school saying 'I want to be a neurosurgeon/anaesthesiologist/pathologist," who have come all this way, happily arranged electives, and are currently researching schools which have the best programmes for whichever was their calling.

My choices haven't changed much since the beginning, but my reasons have.

Obstetrics is so much fun. Exhausting because you just can't predict when the next patient will go into labour and so your days are looooooong and your nights disturbed. And there are babies! And they go home with mommy when they start to poop! But seriously, it's amazing to be involved with births, be it mum's first or fourteenth.

Family medicine is the most versatile of the degrees, with the added bonus of being a two-year plus fellowship residency as opposed to the others which are all five years plus fellowship. But you can do anything. If you can handle the clinics.

Emergency. Oooh. Set aside the romance factor that you see on ER (although there are quite a few hot emerg docs....), it's got the energy, the unpredictabiity. You need everything you ever learned in medical school, down to the smallest differential. You need the guts to act on your own, as well as the ability to work with a team. And the best part is, with rare exception, ER docs don't do call. They do their shift, they go home. Wow.

And well, surgery. I liked the idea of surgery because it was the thing that worked when everything else failed. It's the only cure for most cancers. But I kept getting warned away by people who were in surgery residencies who are unhappy and exhausted.

But then I did my surgery rotation. I was exhausted. I was overwhelmed by the arrogance of some surgeons, disgusted by the stunted personalities and by the rigid hierarchies the residents felt the need to enforce. I was stunned by the treatment of the senior residents by the staff under the guise of teaching them to practise clean and careful medicine.

And you know what? I loved it anyway. I had a great team that worked beautifully together under a young and vibrant staff surgeon. I learned that my immediate-gratification type personality was ideally suited to surgery, as was my hands-on attitude, and my memory based on doing. Most importantly I found that surgery would take me where I wanted to go: war zones, hurricane aftermath, crisis relief.

(And hot surgeons? Oh, baby!)

I have three electives planned and a fourth in-process, all surgical. I have so much to learn. So wish me luck.