Wednesday, October 10, 2012

Let the great debate begin

Alright so there would be no great debate had my first rotation not thrown a complete kink into my life plan - but I guess that is the purpose of rotations, to show us possibilities our minds could not ever imagine. Needless to say, that is what they have done with mine. Even though it seems so far away right now, the time when residency applications open up and I need to make a decision as to how I want to spend the rest of my life is closing in on me very fast. Anyone who knows me, knows that I have always said from the beginning that there was no way in God's green earth you would ever find me wanting to go into surgery. Yet here I sit, complete with 2 full rotations and 3/4 of the way through my third one more confused than I ever have been. I started out in orthopedic surgery after being transferred from my ENT subspecialty due to a scheduling conflict. Then the surprise of my life came - I loved, and I mean LOVED, my ortho surgery rotation. I could see myself doing this as a living. I could see myself working as an orthopedic surgeon specializing in sports medicine. Talk about a reality check. Next came my general surgery rotation which I merely existed through. I can definitely say I can cross this off my list of possible futures. I loved the patient part but was not thrilled with the surgery part. One possibility off the list. Then my general internal medicine which only served to confuse matters for me. I have been considering either a general hospitalist or an intensivist as possibilities for my future. So when I was assigned to an inpatient internal medicine rotation I was thrilled. Well, I found myself in a situation where I did not get to do much, where I wrote notes but they did not "count" nor were they reviewed so I never knew if I was thinking right or on the right track. So while I was okay with it, it did not thrill me and I did not enjoy it as much as I thought I would. So it left me wondering if I would want to do this - and given the fact that I did not get a good feel for what the experience would be like, is it fair to make a judgement on whether to pass or not to pass at this point in my journey and close that door? Then my rotation in Hematology-oncology. Four weeks of pure grief and sadness...four weeks of death and people who are facing death. It was the hardest and most emotionally draining four weeks of my life. I had been briefly considering this as an option at one point in time and I can safely say that I can climate this from any future possibility of career. Then when I was least expecting it comes another curveball. As part of our preparation for Step 2 we had to run through a practice PE (physical exam) portion with 4 patients. One of my patients was resenting to an ER type situation with acute abdominal pain. ER or urgent care has been in the fore from of my option consideration for a very long time. When I reviewed my patient feedback on my interpersonal skills, there were comments from my ER patient that I displayed "very real empathy" and that I was "detective-like" in my questioning. And the comment at the bottom of the page stuck out to me like a sore thumb: "I definitely felt like I came to the right place.". That one sentence literally took my breath away and again had me thinking ER. But I keep coming back to Ortho surgery with a fellowship in Sports medicine. I want something where I will be able to use my OMM skills and this seems like such a perfect fit. The question is can I handle the 5 years of an Ortho surgery residency with people who have personalities that are so dramatically different than mine?? I really do not know. I am leaning toward doing a semi-audition rotation early next year in July in Ortho surgery to see if I really like it and to see if I would thrive in that environment then following that with an ER rotation to have a back to back comparison on which one I like better. I do not know if this will serve to place things into focus better or if it will only serve to confuse matters more. If only I had not fallen in love with Orthopedic surgery - so now this debate over what I want to do with my life begins. And I only have until Juneish to figure it out *eek*.