For those of you avidly following the specialties toolbar, you’ll notice some drastic changes over the last few weeks.
Over the last six or seven months I’ve learned a lot about what’s important to me, and why. I care a lot about participating in decisive interventions that make large differences in my patient’s lives. I want strong human relationships with my patients. I want to have a family, and children, and to spend time with them. I want to solve challenging and meaningful problems that require my full commitment and involvement. I don’t mind working long hours on nights and weekends. I want to be a thinker and, ultimately, a doer.
In short, I want something that can’t exist: a 48 hour day, to do surgery, to have longitudinal relationships, to have a family and work extremely hard.
There are only a few specialties that promise this sort of impossibility: surgical fields (general surgery, ENT, urology, neurosurgery), medical and pediatric fields (cardiology: electrophysiology and interventional, critical care).
Of those, the surgical caseload is potentially far more interesting and varied (multiple approaches, multiple different procedures) than the medical interventions. However, the question that I am desperately trying to answer is whether the cognitive style of surgery is sufficiently interesting and varied to keep my attention over decades of practice. I don’t just want to be a technician – doing the same procedure over and over again.
Right now, I’m strongly leaning toward general surgery (leading to pediatric surgery or surgical oncology) vs. neurosurgery (tumors or vascular), with medicine (cardiology-interventional or EP or critical care) coming in third. I haven’t yet done my inpatient medicine rotation, so I’m hamstrung by that lack of experience. I also haven’t done neurosurgery yet, but I have a two week elective coming up soon as well.
We have to choose something so that we can start planning our fourth year. Have to start applying for away rotations, since we want to end up in other cities and at other hospitals. Right now I’m planning on surgery – but could change my mind any day now …