Recently I have been a big fan of asking questions promptly. It was my 2018 resolution that died a quick and abrupt death: "Never leave a question in your head! Find someone who might have an answer and ask them." I'd give it another go in 2021.
When the new chair of medicine kindly offered his phone number and said, "If you have any questions, you can reach out to me." I took it as divine intervention. I asked him what his decades of experience taught him about choosing a career. Thank god I asked. He had pretty slick advice to offer.
"Knowing what you want to get into starts with knowing who you are." I know, I was thinking the same: Seriously! That's what I get for summoning my most proactive-least hesitant self, squeezing every ounce of courage, and wearing the tie I bought for my USMLE step II CS exam. But then he said something sharp and quantitative. Exactly the way I like to keep things. He said there are two aspects to choosing a residency and a career.
What do you like to think? Have you noticed that you can drain yourself of all energy just by thinking about some things? And have you also noticed that you could feel more vitalized after you flow in the stream of thoughts about specific topics? What, within reason, of course, are the things you enjoy thinking about? For example, a career in hematology and oncology would only make sense if you enjoyed topics like signal transduction, second messengers, immunology, neoplasm, anemia, and VTEs. Finding what you love thinking about is an aspect of choosing a future career that does not take a lot of guesswork. As you will see quickly, the other part is a different story.
As a resident in IM, I reach my ward at 7 AM. Review my patients while drinking my coffee. I generally focus on new labs and overnight events. Then I take a pre-round to make sure my patients are doing fine. After a while, my attending comes to the ward. I update her with the findings, and we round together. We make plans for the patients: "Let us change this antibiotic," "how about doing an anemia workup?", Let us talk with the social worker for him, "I think we can discharge her." The attending leaves, and I follow up on the plan. I leave at 5ish. That is what my day looks like, mostly. Before I started my IM residency, I would read that paragraph and still needed to fully comprehend what a day in an IM resident's life looks like.
That is the guesswork part of choosing a career. I would only know their day-to-day business if I became a hematologist and an oncologist. I have reached out to many, and they have been kind enough to explain to me their daily routine. But I know that an observation is a product of physical reality and the lens we use to look at it. That means I would never understand what it is like to be a hemeonc fellow or an attending until I become one. Sure, observerships and electives can help, and of course, I will try and get some, but now I know some guesswork is involved.
The only way I know to work with that is "Knowing what you want to get into starts with knowing who you are." It wasn't a piece of vague and abstract advice, after all. The suggestion was meant to solve a fundamental problem in choosing a career: How do you work with the inevitable guesswork involved in deciding what you want to get into? Know yourself! What are your fundamental strengths and weaknesses? What conversations do you love to have? What does a fulfilling day look like to you? All of these questions will guide you into defining a day you will want to live over and over again.
And that, my friend, is how you choose your career.