Imagine being given the opportunity to choose your clique in high school. Do you want to be a jock? All the attention and free sweat pants you can imagine. Is it worth the higher likelihood of being a washed out gym teacher who always talks about being “state champs” 40 years ago? Do you want to be a nerd? Can you put up with the social stigma and friends with questionable body odor for a shot at being the CEO of a Fortune 500 company? Imagine having that opportunity with only a week to decide your fate for the next four years. Oh, and if you get two weeks into the school year and suddenly get cold feet with your decision you have to repeat the 8th grade to get another shot. That’s how I would liken the decision of picking a specialty in medical school.
Saying you’re a physician is as vague as saying “I’m in business”. Surgeons, pediatricians, internists, and every doctor in between begin in the same medical school boat. Their journeys quickly diverge after graduation. There are currently 26 specialties and over 120 subspecialties. Undersea and hyperbaric medicine is a subspecialty. I don’t even know what that means. I’m imagining two guys in old timey scuba suits and one of them has a stethoscope and doctor’s bag. I doubt one could use a stethoscope in a scuba suit but this is my imagination and there are no rules. That being said, as a student in the Upstate how am I supposed to know that I wouldn’t enjoy practicing medicine under the sea. There is an entire world of choices and only a limited time to discover what you’re passionate about.
Senior year of college I found myself standing in front of two attending physicians in the emergency department of a local hospital. A gray-haired male physician sat spinning idly in his office chair while the female physician behind him typed harshly on an antiquated keyboard. The grey-haired physician stopped the chair with his sneakers and looked up at me.
“Come on. Tell me what you think of Obamacare.”
“Bill, quit harassing the poor kid!” The woman physician rubbed her temples as she stared intently into the electronic medical records.
Before I could answer the double doors of the department burst open and three figures stood in the doorway. A tattooed man in an orange jumpsuit stood defiantly, shackled head to toe, between two annoyed looking police officers.
“Man I told you. I fell in the shower!”
The tattooed man seemed to be trying to explain a large laceration on his forehead. The laceration had the clean edges of a wound made by a razor blade, shiv, maybe even a knife. Unless the showers were lined in barbed wire, my inclination was that this man’s story was better than he was letting on.
From that moment I was hooked. The patients were interesting and their stories were more so. Every problem under the sun came through those double doors and an immediate impact could be made. I was lucky to find my passion so early and so definitively but for many it’s much more difficult.
Choosing a specialty in medical school is a rite of passage. It determines the patients you will see, the procedures you do, and the lifestyle you live. More often than not it also determines the peers you surround yourself with, the stereotype you cast yourself as, and the professional values you hold. For some people they have dreamed of being one type of doctor and one type of doctor only. Some people wait for year three and just cross off rotations they hate. Others may have their “Ah-Ha” moment at any random time and place. Even with all the research and shadowing in the world eventually you have to make a leap of faith.
I’m reminded of a white water rafting trip I took in high school. Halfway down the rapids, we pulled to the side to “enjoy” a jump off a small cliff into the rapids at a spot that was “safe.”
“Aim for that spot right there. There are rocks to the left and on the far side. If you hit that spot right there you should miss the rocks and a current will shoot you into a clear lane in the rapids. Oh and don’t miss the rope at the end or well have to come rescue you.”
As I jumped, I immediately thought, “Did he say rocks to the left or right…Guess I’m about to find out. Oh well this is fun.”
That’s the great thing about medicine. In such a high stress career with so many critical decisions along the way, you never can be one hundred percent certain that you’re jumping off in the right direction. You can be certain it’ll be an exciting jump.
Copyright 2014 USC School of Medicine Greenville