After three weeks post-Surgery and three weeks of glorious Winter Break, I think I've recovered enough to blog. In case you missed my last set of posts, I put up some quick photos of the full lunar eclipse that occurred on December 20 (starting with "Live blogging the lunar eclipse"). Other than that, the past two months of Surgery have been a blur of days walking to work before the sun rises and nights walking home after the sun had set. Sitting down to eat dinner with my friends in Phi Rho Sigma for the first time in weeks after finishing my last day of Surgery was an indescribable experience. I could feel my face light up; my change in attitude was palpable.
Winter Break has also been a much needed respite from the daily grind of M3 year. There were lunches and movies to be had with old friends from high school. A trip to Reno with my family involved skiing, bowling, and poker. Then there were epic times with the Stanford Band, first witnessing Stanford Women's Basketball upset No.1 UConn, then traveling to Miami to play at the Orange Bowl and bask in the Cardinal's 40-12 rout of Virginia Tech. Some photos, links, and posts from all of Winter Break can be found on my Facebook profile:
http://www.facebook.com/dukelukeli
[A sample of Winter Break awesomeness]
But enough about Winter Break. In just a few more days, I will returning to Michigan for the last four months of M3 year. Up next: a month of Neurology, a month of Family Medicine, and two months of Pediatrics. Although there are still about six months until residency applications start, this is about the time for me to start thinking about my future specialty, especially since I will need to arrange for M4 away rotations in the next few weeks. At the beginning of M3 year, residents and attendings would often ask my classmates and me what we think we'll be specializing in, but always with the qualifying remark, "It's OK to not have an idea this early on." Now that we are three-fourths of the way done with third year, many of us are starting to get an idea of what direction we want to go in terms of our interests. (Rest assured, though, that there are still folks at this stage of the game who have no idea, and that's OK as well.)
Which brings me to the focus of this post. Out of all of the rotations I've had so far (Internal Medicine, Ob/Gyn, Psychiatry, and Surgery), my favorite has been Psychiatry. The pathology I saw was fascinating. What's more, I loved the pace of Psychiatry. In a healthcare system that is often filled with 15-minute or 30-minute outpatient appointments, it was a huge relief for me to be able to interview patients without have to constantly look at the clock. The interdisciplinary atmosphere of Psychiatry was also a huge plus for me; social workers were essential partners in coordinating non-medically related aspects of patient care, and inpatient Psychiatry nurses were in the best position to help monitor patient treatment progress. Psychiatry was also the first time I directly experienced continuity of care; during the 6-week rotation, every student was assigned to a weekly outpatient clinic, which allowed me to see a few patients two or three times and develop a comforting familiarity with them.
However, going into M3 year, my inclination was initially toward Family Medicine. I liked the idea of continuity of care, I liked how I would be on the front-lines of primary care, and I liked what I heard in terms of procedures that Family Med docs were able to do in the office (e.g. colonoscopies, mole removals). What I'm beginning to realize at this point in my education is, regardless of what specialty I end up going into, eventually I will have to say, "I am OK with not knowing something." My favorite part of Surgery, for example, was actually getting to stitch up skin at the end of a case, but chances are I will end up with little opportunity to do so in my future career. And unless I become a Family Med doc that does obstetrics, I may never be able to deliver a baby again (my favorite part of Ob/Gyn).
Granted, one could argue that I came to that decision point of "not knowing something" when I went into medicine. After all, I will never be able to understand quantum physics, the law, or even calculus as in depth as some of my friends. Yet, my whole concept of being a doctor before medical school was wearing a stethoscope, listening to people's hearts and lungs, moving limbs around, etc., which is why I'm hesitant to commit 100% to Psychiatry. Don't get me wrong, there would probably be times during a career in Psychiatry when I might have to test someone's reflexes or perform some other aspect of the physical exam, but it wouldn't be a routine part of my practice.
For those reasons, I'm leaving Family Med on the table as a possible specialty, especially since I've heard that Family Med docs manage many basic psychiatric conditions. In the end, I will have to see if I can reconcile my preconceived notion of a physician with my interest in Psychiatry. What helps reassure me during this process is the knowledge that regardless of what field I choose, I will be able to help others in a meaningful way.