Thursday, June 23, 2011


Medicine is an unique (and I often think foolish!) career choice. One odd feature of physician training is the clearly defined chapters and transitions every 3-5 years. In many careers, you get promotions or may even change jobs, but usually when your responsibilities change, they change gradually. Even with job changes, you need to learn the ins and outs of your new environs but your work (usually) involves similar content, similar skills.

In medicine, job changes are pre-scheduled, abrupt, and dramatic. There is no 'easing' into new roles. With each change you start knowing virtually nothing about what you are supposed to do. The structure of your new role, the body of knowledge you need to have at your command- we start from a place of ignorance but are supposed to know what we are doing. I guess what I'm saying is, the learning curve in medicine is STEEP.

Me and Bonnie
First there's medical school. The first 2 years of medical school involve being in class from 8-5, 5 days a week with a one hour lunch break and then studying before and after (or both) class. Once your body and mind adapts to SITTING all day every day and trying to pay attention, this isn't so hard. Expectations are clear: memorize stuff and regurgitate it on tests. Simple.

3rd year of medical school is the first shock to the system. Every 2-4 weeks you have a new supervisor, new co-workers, new responsibilities and new knowledge to master. Surgery, Pediatrics, Medicine, Psychiatry, Obstetrics/Gynecology, Family Medicine-- the list goes on and on, w/ surprisingly little overlap b/t fields. For most of us showing up every few weeks to a completely NEW job w/ NEW people and NEW rules is intensely stressful. I was pretty miserable through most of 3rd year and only got through it due to my two dear friends and colleagues, Bonnie and Deepa. Love those girls!
Deeps and I

After medical school graduation, we start intern year (the first year of our residency). Again, our responsibilities and colleagues change every month. Plus now we are actually doctors (not just students) and we are calling the shots (with various degrees of supervision, of course). Prior to starting our residency programs, we've each spend a maximum of 4-6 months working in our fields. So we have A LOT to learn.

Me w/ co-residents Sara and Laura
The only semi-gradual transition in medicine is from intern to senior resident. One day we are interns (June 30th), and literally the next day (July 1st), we are residents. So not gradual temporally. But, as intern year progresses most of us assume more and more responsibility and certainly acquire more knowledge. This, for me, this was a super easy transition and the 2nd and 3rd year of residency were the most comfortable years of medical training thus far. Still hard, still too much work and not enough sleeping or weekends, but I didn't go to work everyday with a sense of fear and dread (except MICU call days).

The 3rd year women at Senior Dinner (photo courtesy of Michael Joyce)
Three years of residency then end abruptly. We celebrated the end of our Medicine residency this year w/ a Senior Dinner at The Allerton's Tip-Top-Tap in downtown Chicago. It was a great night! So much fun to have all the residents in the same place at the same time, most of us stress free with the next day off of work, eating, dancing, celebrating, laughing at our goofy senior video. I had a blast!

Next up, a real job! I wish. While most of our college educated peers have been in the "real world" working for 7 years (and even our grad school educated peers have been working for at least 3 years), we continue training on a trainee's salary for another 3 or so years. This is called fellowship.

That's where I am now. About to start Hematology/Oncology fellowship on July 1st. A new job, new responsibilities, new content to master once again. This time, I've had 5 months of work in my field, which is not much. What do I know about Heme/Onc? Not much. Just because I WANT to know about it, doesn't mean I DO know anything!  So here I am again at the low end of the learning curve. And this time, there is no 'intern' year in which everyone knows you are new and expects you to need guidance. As far as I can tell, fellows are just thrown into the deep end w/o a life vest. Awesome.

But, just like with every other new position, in a few months being a fellow will be comfortable and less stressful. I look forward to that time!

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