Chasing Dreams

“So where do you see yourself in ten years?” asked my supervising resident pointedly. It was a Friday afternoon and we were sitting across from each other at The Barton Bean, the main coffee shop in the Hamilton General Hospital. Exhausted from a busy afternoon clinical shift, we were happy to cap off our working day with steaming lattes. Since our conversation thus far had been fairly light, this question struck me by surprise.

Medicine offers over fifty different specialties and sub-specialties, ranging from heart surgery to nuclear medicine. Before graduating, McMaster medical students complete five foundations in the study of the body and disease, followed by an 18-month “clerkship” period that, in my case, starts this November. As clerks, the students work full time in the hospital, rotating through various specialties to narrow down their own area of interest.

Then comes the “CaRMS” process, the bane of every med student’s existence, whereby they compete with one another for limited specialty spots. They have to fly all over the country, interviewing at different hospitals and clinics with the hope of being accepted into their first choice. Some specialties like plastic surgery and dermatology are highly competitive, while others (like psychiatry) generally accept all their applicants.

As a high school student, I was sure that I wanted to be a surgeon of some sort. The challenging and stimulating environment of the operating room as well as the opportunity to directly fix problems appealed to me. But as I’ve progressed through my first year at medical school, my interests have shifted to neuroscience. The brain – the hardware of the mind and soul – is by far the most complex, indecipherable and fascinating organ of the body.

A career in neurology, the study of the brain and nervous system, would obviously be the most logical career path. And yet, in my experience, the real clinical work of a neurologist consists mostly of treating a narrow set of conditions over and over again; migraines, seizures and strokes. It also requires the completion of the internal medicine residency, probably one of the toughest available. This residency involves several difficult years of stress and sleeplessness borne out of regular 28-hour shifts. Then come additional years of training specifically in neurology.

When I try to envision my future, I'm not sure I would want to continue training in the hospital past the age of 30. By then, I’d like to be settled in a beautiful red-brick house somewhere in Toronto with a big, overly-friendly dog, a loving spouse and maybe even a kid or two. For me, the true substance of life is family and friendship, adventure and exploration. I'd want to be sure that whatever career path I chose allowed me enough flexibility to cherish these aspects of life. 

Lately I’ve begun to consider family medicine as a possibility. Its flexibility and broad scope of practice appeal to me. I could imagine myself running a busy clinical practice, as well as doing some teaching, writing and travelling. Undoubtedly, I have many tough decisions ahead … But if I make these decisions based on true values and interests, then I think I’ll be just fine.