When I figure out what I want to do when I grow up…
Sometimes, I just wanna crawl back into the womb, and be all like, “Mommy, feed me!” Not that fetuses feed, but you get my drift… (I hope.) I also love that in this photo, “Doctor” is 7th on the list, and under LAWYER of all things. I’d much rather be a ballerina than a doctor if we are being honest here, but that ship has come and gone long ago. Plus, I just don’t have the legs for it.
Anyway, so the past 6 months or so have been kind of a whirl-wind immersion into “doctoring.” I’m a little over halfway through the 3rd year LIC model (longitudinal integrated curriculum) so by now I have a fairly good idea about all of the specialties and what they involve. Theoretically, I should have SOME clue about what I want to do, but I’m still wavering. Thankfully, I have discovered what I do NOT want to do (and that’s how all the experts say to pick your specialty, right?) So here goes…
I do NOT want to do:
1) Psychiatry: I love my psych preceptor, but I don’t get hardly any inpatient psych during this rotation unfortunately. We did a few consults at the local hospital (which was a 20-bed joint in the middle of freakin’ NO-where) and a bunch of tele-psych conferences with the local jail, and I even did one consult at the jail myself (with a convicted murderer which was fairly intimidating), but as much as I try to love it, I come home every day drained and exhausted. Listening to people with serious mental health issues all day requires a very VERY special person. I find myself wanting to pray with every patient, not give them more meds! That’s another thing – outpatient psych is 99% medication visits. My preceptor does very little therapy because they have counselors at the psych clinic I rotated through who took care of that. Sorry Lucy, but I think you and I both should find a different specialty.
2) Surgery: Ok, I love the OR. No really, I do. (This is coming from the person who used to pass out at the sight of a needle.) I have two surgical preceptors, an orthopedic surgeon and a general surgeon. I usually go to the OR 1-2 times per week, and do 1/2 day of clinic. My orthopod is a fabulous teacher, I love rounding with him and seeing consults and he usually lets me close most of his cases. (For the non-medical – that means he finishes the majority of the case, closes the deepest layer of tissue, then hands me the needle and is like, go for it.) I get a majority of my suturing experience with him. However, he only really teaches me stuff about ortho. My gen surgeon is a fairly crabby, unhappy person who really really REALLY enjoys pimping and watching me sweat when I don’t know an answer. He rarely lets me do anything too complicated (basically – I am a human retractor for the most part, except when he lets me staple). However, although the pimping is painful, I learn a TON from him – he’s seriously like a genius. And I think he is starting to like me more now that I’m not intimidated by him anymore. So between the two of them, I think I have a fairly good surgical rotation. The only thing is… I could never see myself doing the same thing day in and day out, over and over again, for the rest of my life. My ortho is basically a knees and hips guy – I’ve scrubbed into probably fifty total knees and hips, with the occasional fracture or dislocation thrown in. I could do it in my sleep. I honestly almost did fall asleep during some of those cases – so bored was I! The gen surgery is more interesting – we do everything from gallbladders, colon resections and amputations, to carotid endarterectomies and fistulas. He also does a lot of breast biopsies and colonoscopies. But still… I think I’d get bored after a while, because for the majority of the time it’s gallbladders, hernias and colonoscopies. I’m pretty sure my grandma could do a hernia repair. So anyway, I learned that I am ok with blood (Praise you JESUS!) and I do like procedures, but anything past half an hour long and I want to slit my wrists.
Not to mention that all my classmates who want to do surgery are like this:
well, let’s just say… I’m no gunner.
3) Internal Medicine: Ok, my internal medicine rotation is somewhat disappointing. My preceptor started utilizing the hospitalist program right before I started, so I had no inpatient internal medicine except for two 1-week “bursts” in the hospital. I loved those. But the clinic is just like my family med clinic. Don’t get me wrong, the preceptor is great, I love his staff, and we have a fabulous and fun time, but I don’t feel like I am really getting the “flavor” of internal medicine. The bursts were definitely fun – I spent two different weeks assigned to 2 teams with an attending, a resident, an intern, sometimes a pharmacist, and me. They gave me a 4-5 patients to follow during the week (I totally could have handled more, but oh well.) We did ER admissions too which was fun. The experience was great, but I think that chasing around labs all day every day on chronically ill patients would get rather frustrating after a while. I liked being in the hospital, but I think that might also get tiring (i.e. I wouldn’t want to be a hospitalist.) And I definitely am not really interested in being super specialized and never getting to do any procedures, so I think internal medicine was out for me fairly early on. Plus, I do want to see kids (at least some kids – more on that later.)
Ok, maybe that’s slightly unfair – but internists do seem to order an absurd amount of tests. Maybe it was just my experience…
4) Pediatrics: Ok, by FAR my least favorite rotation. I hate hate hate outpatient peds! UGH. Not to mention my preceptor can be really annoying. He is one of those people who is jolly and happy in the room, but complains about every single patient the second he walks out of the room. And it is so incredibly boring. A typical day is 5 well child visits, a few “cold-like symptoms” visits, more well child checks, a kid with abdominal pain that turned out to be gas or constipation, more well visits, and maybe some kids who needed ADHD medicine thrown in at the end. And every parent thinks their child is DYING. I do very little inpatient peds which is really frustrating, (the lack in inpatient medicine is one of the serious problems with the LIC model, and I think there may be some changes in store for next year’s class). I do round sometimes with my preceptor in the hospital nursery, and once in a great while, he will send me to pre-round on an interesting case that he had admitted the day before, but other than that, it is outpatient, outpatient, and more outpatient. He is a brilliant teacher though – and a grueling pimper. Every single time I am with him, he picks a topic and endlessly questiosn me about it. He also makes me write up a full H+P on every patient I see (which meant I see only a few patients per day because I have to go write up the whole thing, by hand, and present it to him). However, I am getting very good at my H+Ps. Anyway, bottom line: I like kids, I want to see some kids, but I could never see kids full-time!
Yeah. Peace out, pediatrics!
5) Anesthesiology: Oops, almost forgot about this rotation. We had a 1-week rotation in anesthesiology, and I thought it was fabulous! They just kind of stuck us in pre-op (2 students per week) and said, “have at it!” The anesthesiologists that were working were more than happy to have a student to teach, because they never have students, and all the nurses in pre-op were wonderful and so nice. The nurse anesthetists were a little more grumpy because of their insane work hours, but I found one nurse anesthetist who we referred to as “The Colonel” who kind of adopted me and showed me everything he knew. I got to do a bunch of intubations, started tons of IVs, pushed meds and everything in between. By the end of the week, the Colonel let me have complete charge of an entire case – I intubated, drew up and administered all the meds, kept an eye on everything, and then extubated when it was over. It was so much fun! However, getting to do short procedures was the fun part. Learning about all the meds and airways and stuff like that… not so much. And their hours are horrible! So although it was a great rotation, I have to say, I don’t think I could do that full-time.
Nerd moment: A sweet view of the vocal cords through a Glidescope – which is by far the best way to do an intubation. Just gotta stick your tube through those two cords and you are golden!
Ok, so I need to go do some studying, so I’ll leave it here. Stay tuned next time for the specialties that I AM interested in doing. Can you take a guess as to what’s left?