Stop, World, I'm Getting Off!

My parents think me all kinds of crazy for refusing to go straight into fellowship next year.

Who can blame them? I am (as they are) not getting any younger. Common sense dictates that the sooner I continue my training, the sooner I can get started on establishing a practice... ergo, the sooner I will achieve financial independence.

My parents do not put much store in detours.

To be honest, I have never been much of a detour person myself.

I think I've already mentioned somewhere that I am a pathologic planner. Having made the decision to pursue medicine as a career in 2nd year college, I have had a definite plan for myself since I started on this career path almost 8 years ago. I've had hiccups of discontent every now and then, when I've felt overwhelmed or frustrated, but I think it's safe to say that I never really seriously faltered in my pursuit of that elusive MD.

Before I started residency, I toyed around with the idea of taking a year off to take a break from the hospital, spend time to pursue other interests, maybe figure out what I really wanted to do with my degree. But the impetus that is also known as Common Sense (and also known as opinionated parents) prompted me to ignore the urge to dilly-dally and go straight into a training program. Voices of reason in my head applauded the decision -- after all, I had already made the choice of making Internal Medicine my life's work, so there was no point in putting it off. At the time, I had no plans of going abroad, so there were no exams to study for that would need so much time away from the hospital. I was fresh from internship, and figured the transition to residency would be less difficult. Besides that, it was a safe choice, and it would mean I didn't really have to think about the hard questions for at least 3 more years.

Looking back now, I realize it might have been wiser for me to have heeded the urge to take that year off.

I can't say I regret what I've learned and experienced during residency - despite the myriad frustrations, there were good days. Friends made along the way, the people I got to help, the feeling that in some way I have been able to make a small difference in my patients' lives - I don't think I would have gotten that from anywhere else. What I do regret is convincing myself I had to go through all the steps of my career choice without taking a break in between. There are a lot of things I can imagine myself doing. I've always wanted to write, to travel, to get some training in singing - things that are just not possible when you're tied to a hospital, going on 24 hour duty every three days, and spending all the time in between those duties on 7-5 days still in the hospital.

Would taking that break have changed things in terms of whether I would've wanted to continue on the straight and narrow path towards becoming a doctor? I don't know. I do think it would be crazy to switch careers at this point in my training... but I have decided to take that year off to reassess where it is I want to go. Maybe all this year will be in the end is just a delaying the inevitable, but I don't want to force myself into a definite niche when I have absolutely no idea at this point what it is I really want to do next.

I have been so immersed in my medical career that I can't imagine what life is away from the hospital. Despite the many frustrations in our work as lowly, under-paid, unappreciated residents, it is work that is not without its rewards, and I will miss it. That is what makes the idea of going straight into fellowship so very appealing - it's the safer choice, it's choosing the familiar, it's staying on the well-beaten path.

I have, however, for better or for worse, made the decision to get off that well-beaten path for a while.

I'm wracked in guilt, I feel like a potential parasite and to be honest, the thought of having nothing certain to look forward to (and no definite source of income) this coming year already keeps me up at nights. But I've refused to take the path of least resistance in order to take a step back and reevaluate where I am and where I want to be (the facts that I am 30, very single, and broke notwithstanding).

At this point, if someone were to ask me where I see myself ten years from now, I'd tell them, "Hell, I don't know." That's in how much of a flux I am in. For a doctor who's about to finish residency to say that is a really big deal. In the medical world world, I've already specialized and ideally at this point should be able to tell you straight out what I want to subspecialize in.

Which is why I refuse to rush to the next step. I know that you can never really be sure in the end, and every decision is a leap of faith, but I don't want to jump into another definite phase in my training with the spectre of "I don't know" hanging over my head. I don't want to wake up two years from now, unhappily stuck with a subspecialty I don't want to pursue after all.

I'm trying to break myself out of the mindset that it's too late in my life as a doctor to make a different choice. It's a really tough, especially when I feel that I've already invested so much in my medical career at this point. I think that refusing to go on to fellowship has been more a leap of faith for me than continuing with my training would have been.

So if you're like me, a doctor in flux, take that well-deserved sabbatical and find yourself. I dare you to yell, "Stop, world, I'm getting off!" Let's be terrified together.