At some point during residency, the future internist has to make a decision about what happens once residency is complete. Generally that means choosing a specialty or deciding on some specific career track if specialty has already been decided. This can be a confusing time for residents who haven’t given it much thought.
There are so many specialties just within internal medicine that it would be impossible to do them justice in this post. So perhaps a better way to tackle the subject is to address strategies that might make the specialty decision a bit easier.
First and foremost, a resident willing to ask questions and solicit advice is way ahead of the game. There is a lot of wisdom in counseling, and there’s more wisdom available to those who seek multiple counselors. Above and beyond seeking counsel, there are two easy exercises residents can engage in to help provide a bit of clarity.
1. Block Analysis
As you already know, residency is split into a series of blocks designed to give clinicians as much exposure as possible to every area of internal medicine. The blocks serve as both educational opportunities and practical, day-to-day experience. Residents can make the specialty decision a bit easier by analyzing each block at its conclusion.
A block analysis exercise looks at every aspect of a particular block and how it might affect one’s career path. What things did you most appreciate about that particular block? What things did you find most challenging? Is there anything about your experience that would cause you to question pursuing that form of practice as your specialty?
Note that block analysis should be approached from both the mental and emotional perspectives. You are more than just a thought machine or a bag of emotions. You are both. The point of block analysis is to figure out how you might respond mentally and emotionally over the course of a career in that particular field.
2. Career Visualization
The second exercise is known as career visualization. It involves combining past experience with your expectations of the future in an attempt to visualize what life will be like 10, 15, or 20 years down the road. Practice career visualization at the conclusion of each block.
Let’s say you are leaning toward emergency medicine. Try to remember your worst day in residency up to that point. Combine your memories of that day with what you know about extremely busy emergency rooms, then mix it all together with images of working in an environment that is more hectic and fast-paced than anything you’ve ever experienced.
If you can imagine yourself still wanting to get up and go to work every day despite your visualization, emergency medicine may be a good fit. If you imagine yourself being miserable 10 years from now, emergency medicine may not be your thing.
You Can Always Change Course
Even after a lot of counseling and practicing both exercises, you may find yourself in a career that is not what you expected it to be. That’s okay. The beauty of internal medicine is that you are not locked in. You can always change course at some point down the road.
Maybe you will decide to try emergency medicine. You will enjoy it well enough, but you’ll eventually decide you like the idea of becoming a hospitalist. Great. Start looking for hospitalist work whenever you’re ready. You didn’t have to remain in emergency medicine just because you started there. And if you decide to return to the ED after a few years as a hospitalist, that’s fine too.