Decision-Making III

Finally there are the intangibles. I always thought I'd be an internal medicine doctor, the kind of person who figures stuff out, who fields questions about diseases at a cocktail party, who needs nothing but his mind. Over time, the perseverance of that idea has waned, but how much should it count for? Shouldn't I be open to new paths? Furthermore, somehow as an undergraduate freshman, I set myself barreling towards anesthesia by taking a seminar taught by an anesthesiologist who would become one of my mentors. "Fate" - such a mysterious word - seems to play some role in my life decisions.

In the end, choosing a specialty should be based on an intersection between interests, values, skills, and personality. It's hard to tease out all the details, but these are distinct entities. The last few posts have focused mostly on interests. As for values, I'm unsure how to approach that; broadly, I value strong interpersonal interactions, a judicial use of tests, and primary care. That last value is tough; I don't have the interest, personality, or skills for primary care, so I'm not pursuing it yet I think it is the backbone of our health care system. The first two values I think I can get in both medicine and anesthesia; although medicine is more overtly about the patient-doctor relationship, I realized during my anesthesia rotation that building trust over a short period of time is a challenge and a reward. And all fields of medicine are struggling with the judicious use of tests and treatments.

For skills, part of that is unknown; I will learn what I need during residency. But thus far in my rotations, I think my background is sufficient for both medicine or anesthesia, and seeing what the residents and attendings do, I have confidence I can get there. I think my personality is that of an anesthesiologist; I pay attention to detail, I'm a stickler for organization, I like numbers, I like finishing one thing before starting another. I do like puzzles, which can fit internal medicine.

After mulling this over for days - or depending on how you look at it, years - I've come to the conclusion that there is no wrong decision. I will find something in either anesthesia or medicine that I like, that I'm good at, that I can contribute to patient care, and that I can make a lasting impact. And I think there's a reasonable amount of uncertainty in whatever decision I make; it'll be set, but not in stone. Regardless, I will try to keep the knowledge, skills, and experiences in all my rotations hoping that it will contribute to whatever path I choose to take. But I think I am satisfied now with my decision to pursue anesthesiology and perioperative medicine for residency (with a preliminary year in internal medicine), keeping my mind open for opportunities as they come.