Ashley's Bio

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I've been asked at least 20 times this week about which specialty I have chosen as my new career. "Career? What career?" I think, "I'm not ready." I was under the impression that third year was the time to learn clinical medicine and experience each specialty. Boy was I wrong. Third year is about DECISIONS. I have found that some people at my school want to know what your plans are and they want to know NOW! I'll admit I have become pretty bad myself. On seeing a classmate I haven't seen in weeks, "Hey, I hear you're going to be a pediatric neurodermatopathoendocrinologist!" The truth is that as third years, things start to get exciting around this time of year. The fourth years have matched. Our fourth year schedules are due. The departments at our school are free to start planning for the next crop. And we have some very important decisions to make, whether we like it or not. So this journal entry is all about advice.

Well, here's my experience. Hmm…let's see. Does the number of review books you own for a course equal your desire for that? Let's see, I have 4 for OB, 4 for medicine, and 3 for peds. No, that won't work. Hmm...maybe I should get out my yearbook and see which department "looks" the most like me? Nope. Hey, what about my friend, the resident, that wants me to do her specialty? And wait, do I want to stay here or move out of state? What will my husband and family think of all of this?

As silly as it sounds, this is how many of us arrive at our decisions. I will challenge you to fully experience your third year rotations by keeping your eyes open, and asking a lot of questions. Watch your residents, but mainly watch your attendings. Do these doctors regret their choices? Do they still love their work? Are they always headed for the door or do they stick around to visit with patients? Do they round on 10 or 40 patients each morning? How is the lifestyle of their specialty? How about you? Do you love waking up each morning to see your pediatric patients? Do you dread scrubbing in? Do you get along with the personalities you meet? Would you leave your kids in the middle of the night to see that post-op patient? You will also hear that the third year rotations can be vastly different from the actual job you would do after residency. An example is internal medicine. As a third year you do mainly inpatient care. In private practice you may see only outpatients for preventive care, respiratory infections, etc. As for fields such as OB/Gyn & Emergency medicine, what if you can't get insurance after residency? All things to consider.

A good friend of mine gave me a great tip this week. She told me that she took time on a psychiatry rotation (a slower paced rotation at our school) to sit back and reflect on all she had seen during her third year. The answer came to her and it was pediatrics. Another friend advised me to make a list of positives and negatives of each field I was considering. Lastly, 2 more friends of mine staged an "intervention" to try to talk me out of one specialty I am considering.

That was a lot of information to take in, but the best advice I can offer is:

1. Books are invaluable: Iserson's Getting Into A Residency, Anita Taylor's How to Choose a Medical Specialty, The Pfizer Guide: Medical Career Opportunities. These are amazing resources, especially Iserson's book. I recommend getting it immediately.

2. Work that web! www.scutwork.com, the frieda website, www.studentdoctor.net and of course, MomMD. So much of what I know about residency came from online. There are amazing resources available.

3. Try not to get so caught up in the match. Try to follow your heart and your head.

4. Consider a "lighter" specialty plus hobbies. An example: If you enjoy surgery or working with your hands, but don't want to commit to a surgical field, take up a hobby. Use your hands with art, sewing, or gardening in your free time.

5. Work out an algorithm if you have to. Cut or no cut? Kids or adults? Long progress notes and rounds or short notes & rounds? Identify early on what style of medicine is most congruent with your personality. Are you a very thorough person? A patient person?

6. When you are on a difficult rotation ask yourself if you can honestly keep up that pace for 3-5 years and be the wife/mother/friend/daughter/volunteer you want to be.

7. How important is medicine to you? Is it worth a few sacrifices or a ton?

8. And lastly, don't listen to other people (including me). Only you know what you're capable of & what you are willing to do.

So, where does that leave me? In a good place. Have I decided yet? No, but I have narrowed it down. I consider myself lucky to be in this situation. I am a third year medical student. I go to school every day trying to help people and learn as much as I can. I have a future full of opportunities. I have an amazing support system of family and friends to help me along the way. Now is that so bad? I don't think so.

Good luck as you decide what you want to be when you grow up!

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*Some names have been changed.