“I’ve always known that I wanted to be a __________” and other self-fulfilling prophecies

This is a post about thinking (read: freaking out) about choosing a medical specialty.

Before starting: yes, I am fully aware that no one needs to choose a medical specialty during first or second year. And yes, I know that many older students/residents will write this off as simply gunner or fanciful or both.

But I can’t help but think that the majority of first year students do spend time thinking about this topic, and moreover could benefit immensely if they happen to guess correctly their medical specialty of interest, or at least, the ballpark of medical specialties they would enjoy.

The benefits are self-evident:

1. we have more time to think about specialties, shadow, meet more people, ask more overly direct questions to physicians during lunch talks before slinking off into the background (the book “The Ultimate Guide to Choosing a Medical Specialty” is very good too);

2. we have more time to prepare our extracurricular portfolios (even though people will swear again and again that “it doesn’t matter” and “they just want to see leadership/involvement/work ethic,” obviously the people interviewing you will be more interested in any work or research you’ve done in their field);

3. we get procrastinate studying renal physiology by agonizing over personality tests online that TELL YOU YOUR FUTURE! (here and here).

The medical specialty selectors (I’m partial to the SDN one for the ease of use) may in fact be very insightful, although their methodology is vague (“I have a 70% match with surgeons? Does that mean I will be 30% unhappy???” Cue me exploding in a pouf of bad statistics and pessimism).

As I was taking these specialty selector tests though, I wondered how reliable the tests were because of my own biases of not only who I think I am, but who I think I should be. I’m particularly attentive to this because, although I’ve recently decided that I am definitely going into surgery, I had always previously thought that I would choose something in internal medicine. It was probably only because surgery was foreign and seemed like too much work and because I only knew what family doctors did while I was growing up. So I thought that I too would be an internist and even did cardiology research during undergrad (not that I regret it – I worked with stem cells, which are awesome, and had a super supportive PI who helped me publish).

Only at the end of college, after shadowing in more and more specialties and randomly shadowing a urologist (whom I shadowed only because he cornered me and insisted that he had the best job) did I think about “my personality.” I realize that the fact that the field of medicine is not homogeneous in personality types dramatically impacts my choices. In fact, doctors love to perpetuate these stereotypes within specialties.

So now, as I was taking the SDN medical school selector last night, I wondered if I was being truly honest in my answers. Would I have answered these question the same in my sophomore year of college when I thought that I wanted to be an internist? Or would I have thought myself a warmer, more caring, more attentive, more involved physician because that’s what I think internists should be?

And now, when I answer these questions as a student committed to working in an ENT research lab, do I highlight and emphasize preferentially the aspects of me that I think fit surgery?

I think there is a real possibility for bias, and yet I think that it is only natural: why are all orthopods stereotyped to be the same (like in Dr. Au’s famous cartoon)? Probably because 1) they aren’t all the same BUT 2) people like to be around others who are at least somewhat similar and if it is true that the average orthopedic surgeon is x,y, and z, perhaps this inspires the next generation who relates to those qualities to choose that specialty. And maybe, the more we hang around our colleagues and teachers whom we admire, who are also x, y and z, we tend to adopt even more their values and attributes.

So I should now add another caveat to choosing a medical specialty this early to join those who criticize people like me who want to think about this early: maybe committing too early eventually makes it hard for us to recognize our love of a disparate field later on and replaces our freedom to choose our specialty with a self-fulfilling prophecy.

On the other hand, C has always been more optimistic and cheered me up as I was struggling last semester to decide which kind of lab I should join (which would, you know, impact everything about my future career duh). He sent me this very reassuring article in the NYT by Cal Newport that ends with this advice: “Passion is not something you follow. It’s something that will follow you as you put in the hard work to become valuable to the world.”

Here’s to many, many years of hard work ahead.



Just for fun!

SDN Med Specialty Selector Results

C: 1. Nuclear medicine. 2. Medical genetics. 3. Thoracic surgery. 4. General surgery. 5. Diagnostic radiology. 6. Plastic surgery.

T: 1. Gen surg. 2. Anesthesiology. 3. Plastic surgery. 4. Otolaryngology. 5. Ophthalmology. 6. OB-Gyn. 7. Colerectal surgery. I wonder if anyone has ever said that she’s always wanted to be a colon and rectum surgeon as a first year…


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