#doc-resilient

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Okay, headspace, but you clearly haven’t heard of medicine and medical education...

Jokes aside, this concept is something I struggle with. I like to think I’m doing better. 

I have to remind myself that I can contain multitudes. I am worthy as everyone human is of being more than one thing. It’s all one life. I’ve got this one life.  

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dx: fix that rx

approximately 80% of the discharge summaries i wrote on my hospitalist elective - diagnosing people with polypharmacy in all but those words, d/cing the meds i can without stepping on toes, and begging them to get that shit checked out with their PCP before it becomes non-life sustaining

yeeeeahhhh, med reccs are a hill i will always die on

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owe really?

me to me: you owe everyone EVERYTHING

me to absolutely everyone else: [emphatically] you DON'T owe anyone ANYTHING!!!

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it’s actually pretty funny how much of medical school you spend telling everyone you’re not a doctor and how much of residency is telling people you are a doctor. (although the latter is tiring and i sometimes just end up letting it go.)

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What helped to you choose internal med? Cause im between internal and peds atm, obvs it’ll change as i get through m3, but the gauging the scope of the practices is hard. I like peds for how broad the practice is, despite the narrow age range, But internal med, ideally i’d want to be a hospitalist, it has a lot of different paths to follow but idk if i want to be a “care coordinator” you know? In terms of happiness/longevity, are you pleased with where youre at?

Ooo, first off. Hey community, please chime in! How did #MedBlr decide what they were gonna #Med in?

HI FRIEND! Love the question! I am probably the worst person to ask but isn’t the worst person to ask also kind of the best person to ask? (That made sense in my head.)

But really, thank you so much for asking because this is a perfect opportunity for reflection as I prepare for the future.

So let’s break it down.

((record scratch))

About Me (AKA Physician, Know Thyself)

Step 1 (sorry, not that Step 1): what is important to you? When I say “know thyself,” this profession is full of introspection and discovering things about yourself and medicine, so of course it will change and evolve. It still helps however to sit down and pick a few important interests /dealbreakers about yourself.

If you’re into this, do it with me now! Here’s an example list about myself so you get where I am coming from when I made my choice.

I am passionate about / it is important to me that I am this type of physician:

- Public Health / Policy - Big Picture- Hands On- People And Their Stories- Interdisciplinary- Broad Knowledge / Capable in Many Situations- Passions Outside Medicine

Choosing Internal Medicine (AKA The Match Forcing Me to Say Goodbye to My Other Love, Family Med)

Some people meet their specialty and just know. Choosing my specialty involved using what was important to narrow it down. The interesting thing about The List is that you and I can have the same list but come to a different decision. Your experiences and how these things translate to you will vary.

Going through clinical years I was like, yo! I like it all - yes, even surgery. The name of the game became ruling out. I ruled out surgery because to be a surgeon, I personally would’ve wanted that to be a calling level interest. As for pediatrics, honestly I feel like I didn’t have the strongest exposure so that might have played a factor but I essentially wasn’t ready to give up treating adults though I truly did like (and felt mentally and socially capable of) treating kids. (In retrospect, I do think I would have really enjoyed pediatrics so totally keep exploring it, friend!)

I eventually narrowed it down to Internal Medicine or Family Medicine and was willing to rank by program and let the Match decide. To me, IM or FM was going to give me that big picture and broad knowledge that I craved. I felt it would allow me to have other passions and veer off the beaten path to less traditional physician roles, too. I wasn’t tied to needing to specialize [IM subspecialties] but knew I’d consider it if I matched IM. That’s what ended up happening and I said a bittersweet goodbye to bebes and preggos.

Exploring Hospital Medicine (AKA Where I Am Now AKA Love is a Battlefield)

Why hospitalist? Going through internal medicine residency, I did not end up finding my One True Specialty. There were aspects of all of them that I liked but not one that I immediately wanted to do the rest of my life. Turns out I didn’t change much in terms of The List/ What Was Important To Me, either. I do not mind outpatient primary care and can see still myself choosing it and having a patient panel. However, I chose hospital medicine. I am still a newbie to it (despite growing up around it in my residency) and am still job hunting/learning more about the pros and cons. From what I understood, I felt hospital medicine would allow me a broad range of experiences and interactions, particularly acuity. It would allow me to build on my residency training and keep those skills sharp while allowing me a flexible schedule to pursue further interests (medicine and non-medicine.)

You mention the term “care coordinator.” You are absolutely right, internal medicine (and our family medicine brethren) doctors can be all those super fun terms - gatekeepers, care coordinators, order monkeys, assistant to the assistant managers, etc. Like all of our medical community, we face all the frustrations and broken pieces. It’s just I feel like hospital medicine and primary care faces it head-on. We are one of the frontlines of everything the system holds - politics, bureaucracy, overburdened, etc. If our other counterparts have shelters (”shift work”, “Let the primary handle”, etc.), I feel like we have less of it. It is so easy and even a protective mechanism to get jaded.

Instead of this being a con, this is actually a reason I want to go into it. Outside of medicine, I actually *am* interested in seeing how this system is broken and brainstorming solutions to ease it. I am interested in understanding the politics (some can’t stomach meetings, I can). I also feel like I am good at self-reflection and keeping an eye on getting jaded (hopefully, if not I have friends and family for that.) So yeah, I’m trying to hack it from the inside, essentially.

That being said, I am still interested in fellowships in the future (Infectious Disease? Endocrine? Something Else?) and I think hospitalist will be a good transition as I build a strong foundation prior to applying to fellowship.

Okay, Talky McTalkerson, So Are You Sustainably Happy?

To me, my happiness/longevity (which I’m calling Sustainably Happy) is having  freedom. By freedom, I mean the freedom to mold my career, the freedom to grow and learn as a physician, the freedom to change my life completely if I want/need to, and the freedom to be a multifaceted human of which a physician is a fundamental part but just a part. I believe, where I am now, a state school undergraduate grad, an American IMG, t-minus 5+ months left of my internal medicine residency at an unopposed community hospital, trying to be a better physician and person, currently looking for hospitalist jobs and also soul searching of what the future should look like… I believe in longevity, and I think I’m happy enough (it’s a mindset and active practice y’all), and can only see myself getting happier.

Thank you to all who read this. I hope it was at least a little bit helpful.

Cheers,

Doc Resilient

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Is this a date or a stroke alert?

When you’re trying to make plans and your medically corrupted autocorrect has its own ideas of what makes a good date 😂

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🎶All I want for Christmas is 🎶

this CBC to result.

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When you’re monitoring urine output and you get a celebratory text when your patient diuresces