600

This is the 600th blog since my first post September 1, 2006. I planned this one to be about the mid-point of my third year and serendipitously, it fell on election day. I honestly do not believe this, but my calendar tells me I have completed 3 out of my 6 blocks of required third year rotations. Inconceivable! I've spent half a year taking care of patients full time, immersing myself in the culture of medicine, learning, doing, and teaching. Yet I feel as underprepared as my first day (though I hope in actuality, I have gained something in the last six months). Though I feel like I know more, much of the growth is also in learning the practical aspects of medicine, how to work in a team, how to interact with patients, how to think and plan.

Third year rotations have this odd sensation that, during any particular day of a rotation, it feels like forever, but after the rotation, I can't believe how quickly it went by. It's a little scary to think that perhaps I've finished my last psychiatric mental status exam or evaluated my last acute stroke patient or scrubbed into my last surgery. Everything feels too premature and I'm a little sad about it. Only now do I realize how much more there is to learn, how much depth there exists in each field, and how fascinating these disciplines are.

A year from now (faster at this rate), I will be interviewing for residencies, paying my last year of tuition, with a firm idea of what specialty I would like to pursue, and as a result, what I would like to spend the rest of my life doing. That's simply mindboggling. Up to now, I've been putting off "real life," pursuing more and more school, majoring in philosophy, heartily avoiding real jobs. I want to do everything and yet I don't want to settle as a jack of all trades.

Have these six months solidified my confidence in medicine as a career? Yes and no. There are things I love about medicine and would never give up (the puzzle and pursuit of the answer, the science and physiology, the obscure and esoteric) but there are also things I frankly dread (dealing with paperwork, systems problems, devastating or fatal injuries). Now I've seen first-hand how hard and long the road is, and it's making a huge impact on me. Seeing what interns go through frightens me, and I wonder if this is the path I want to pursue. Is this a problem? I think that (except among surgeons), doubt is natural and not a problem. At least it helps me narrow down my specialty interests. What those are, I'll have to defer to another post.