Finding Your Future Career

First off, huge thanks to Amanda for letting me share my thoughts with you guys on this lovely blog! My name is Joyce and I'm a dermatology resident in New York City. I run a skincare and beauty blog at where I mostly write about skin and medicine (with occasional travel and fashion thrown in!), but I also have a Path to MD series dedicated to premeds navigating the long journey of becoming a physician. I remember being in those shoes not long ago and I felt so lost ... so often. I hope that some of you may find reading about my experiences and advice useful!

This post is going to center around how to choose your future specialty, a topic near and dear to my heart because it defined my fourth year of medical school. In fact, the very first post of my revamped Tea with MD blog was written about this subject. It was March 18, 2013, and I had just attended Stanford's Match Day ceremony. I felt so nervous and lost about what field I was going to apply in the next year, so I talked it out in a blogpost. Little did I know at that time that I was going to do a complete 180, just a few months later, switching into dermatology, and having the most stressful year of my life applying. If you're curious about that story, you can read more here. Now that it is all behind me and I'm more than halfway done with dermatology residency, here are some of the things that I personally think will help you out when making the huge decision of what you want to do with your life.

Link to this funny cartoon of 12 medical specialty stereotypes:

1. Personal interest. This goes without saying but sometimes when you're a type A medical student who is used to always striving for the best, you get blinders on and you don't take a step back to see whether or not you actually ENJOY what you're doing. Do you like the day to day tasks that come with a certain specialty? Do you feel intellectually stimulated by the research done in this field? Do you enjoy studying the topics of your field? (Because trust me you will be studying A LOT for the rest of your life...:P) I find myself actually being excited to go to lecture and grand rounds to learn more about the skin. I even sign up for voluntary conferences and workshops on the weekends because I want to learn more and do more in dermatology and I genuinely enjoy the subject matter. I surprise myself sometimes! Don't trick yourself into doing a field for prestige or money because you will be the one suffering and questioning your choice years down the line.

2. Mentorship. One thing I've stressed over and over again is how important it is to have a good mentor in medical school. Find someone who is living the life you want to live when you are his or her age, and see if you can imagine yourself in that medical field. A mentor can help you explore a field through shadowing, doing research, helping you write letters of recommendation, or even making phone calls or writing emails on your behalf. If you find someone you really click with, explore that field and see if you like it for yourself.

3. Relationship with Patients. In medical school do you prefer short interactions with patients like in the emergency room or do you prefer following patients long term in outpatient clinic? Different fields have very different relationships with patients, whether it's seeing them everyday for a month as an internist in the hospital or following a patient's psoriasis for years in the clinic setting. Do you like seeing adults or kids? Also, what type of patients do you want to see? Do you want to treat sick patients (hematology/oncology, radiation oncology, etc.) or relatively healthy ones (ob/gyn, general pediatrics, dermatology)? One is not better than the other - it's a matter of personal preference. In medical school I felt drawn to the relationship pediatric oncologists have with their patients and patients' families, but at the end of the day after doing rotations, I realized that I have a hard time separating work and personal life. The sad cases I saw in the hospital really affected me and I couldn't turn it off after I went home at the end of the day. So that wasn't a good fit for me personally. Explore what relationship you enjoy with your patients during rotations, and go from there.

4. Lifestyle. For some reason "lifestyle" seems to be the dirty word you're not supposed to mention when deciding on career path, but I think it SHOULD be one of the factors that you think about. Wanting to have good work-life balance is not a shameful thing. If having a family and kids is your top priority, think about whether you can balance that with a field that requires you to be in the hospital 11 hours a day. The other thing I tell medical students is imagine what lifestyle you want when you're in your 30's, 40's, 50's, and beyond. It may be exhilarating to stay up several nights in a row in the OR in your 20's, but think about whether you can sustain that and stay happy in your later years too. If you can, then go for it! I have so much respect for people who feel passionate about their fields. Sometimes it's hard to imagine what you want in life decades later, so that goes back to point #2 about mentorship. Find someone you identify with and see what his or her life looks decades later. Is that something you want for yourself? 

5. Hands on experience. The initial branching point for many is procedural vs. not. Do you like working with your hands and doing procedures? Do you enjoy being in the operating room? If you enjoy doing surgery, aside from going into a surgical field, you can also consider subspecialties within more medical fields such as interventional cardiology, GI, interventional radiology, or even Mohs surgery within dermatology. Shadow different physicians and get a sense of what their day to day responsibilities are.

This is in no ways a complete list of everything you should consider, but it's a good place to start. For me personally, going through rotations was the best way to find out what I loved and didn't love. I didn't love my surgery rotation or being in the OR, and I knew I wanted to take care of people who were not chronically very ill. Some of my favorite rotations were in internal medicine, ophthalmology, dermatology, and reproductive endocrinology and infertility. I enjoyed the ob part of my ob/gyn rotation but didn't love the gyn or the gyn surgery parts, so that took out reproductive endocrinology & infertility as an option. I enjoyed internal medicine because I was the sub-I and I had a chance to make my own plans; however I was not a fan of spending more time with a computer than my patients. I loved ophtho and was almost going to apply in it but I realized when I finally shadowed in the OR that I was not a huge fan of microsurgery and the microscope gave me a headache. I fell in love with dermatology when I did the rotation during the end of my third year; it combined medicine with office procedures and I found the science very interesting (more on why I chose derm here). Now that I'm halfway through derm residency I find myself liking the field more every single day and feeling thankful that I had made this decision even though it was a hard one to make.

So good luck to you, wherever you are in your stage of training. We are really lucky to be able to be doctors, even with all the tough days. I hope this was helpful and don't forget to check out some of my other posts on getting into residency and choosing a residency program!

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