Thoughts

I have been thinking lately about what specialty I want to go into. Fortunately, I still have about a year to decide. I am pretty sure I want to go into some type of surgery; I always assumed that I would want to specialize in some area. Two things have kind of surprised me on this outpatient medicine rotation. First, I have enjoyed being in the general internal medicine outpatient clinic a lot more than I thought I would. I like the fact that the doctors there have regular patients whom they get to know. I also like the fact that they see a wide variety of cases, in one day they can see anything from a toenail infection to congestive heart failure. The only thing that I would worry about is that after years I might get frustrated with only being able to do a certain amount before I would have to refer certain patients to specialists. This brings me to the second thing that has surprised me, I really have not particularly enjoyed the couple days I’ve spent in a specialist’s (nephrologist’s) clinic. (Note: everything I write here is based on three weeks of experience—no doubt many of these opinions will fluctuate over the next couple years, and I will probably look back on this someday and be amused at how naïve I was). One morning I wrote up almost the exact same note for five patients, two or three of them needed to have the same medication adjusted. I would be very concerned that I would get bored out of my skull if I had to see the same types of problems every day (again, this is based on three weeks of experience). But, there are possibly confounding factors here: for instance, the general internal medicine clinic is a very nice clinic, with very nice doctors, and I don’t have to deal with the computer system. The nephrology clinic was at the VA (not the nicest atmosphere), the doctors were nice but not gushing with warmth, and I had to deal with trying to figure out a complicated computer system as I was talking to the patients. It will be interesting to see if my opinion of surgery changes in September when I start that rotation.