Dress Shopping

In high school, I loved to shop for dresses. Prom, homecoming, winter formal, Sadie's....my mom and I would head out to Macy's or Jessica McClintock to pick out something really special. Often this would happen before I even had a date to these dances. The date was negotiable; the dress was not. We'd spend the day checking out the racks of dresses and even though the styles and materials changed over the years, the dresses always fell into the same categories:

Category 1: The dress looked great on the rack, but not on me

Category 2: The dress was neither attractive on the rack or on me

Category 3: The dress looked good, my mom liked it, but I wasn't in love with it

Category 4: The dress didn't stand out on the rack, but looked fantastic on me

Sometimes I walked in thinking I knew what I wanted, and left with something completely different that I loved. Other times I left with what I thought I was looking for. Each time, it was a fun adventure.

It's the end of my third year of medical school. I'm starting to ask for letters of recommendation for residency, set up "audition" rotations, and look at programs. I'm setting up all these things like I know what I'm doing, but I don't. I have to figure it out soon, though. It's almost time to pick a specialty. Rotations are set up so students can "try out" all the different disciplines of medicine, and see what they want to do. And strangely enough, it reminds me of dress shopping.

I knew some disciplines were not for me. They were a category 2 dress, a specialty that I knew wouldn't fit and it didn't. I never had aspirations to be a general surgeon, and I would have rather done just about anything than stand next to the OR table for a seven hour abdominal surgery. Radiology is a wonderful diagnostic tool, but the darkroom put me to sleep. Neurology was painstakingly meticulous and gave me a headache.

Category 3: I did wonderfully in family medicine. The attending physicians and patients loved me, and I scored the highest score in my class on the family medicine board exam. The high score actually created some anxiety, because I wondered if I was so clearly dispositioned to this specialty, shouldn't I go into it? I did like it, but I didn't love it.

Category 1: Internal medicine was like one of those dresses that looks fab on the rack and then adds fifteen pounds to your hips. You had high hopes for it, but then can't peel it off fast enough. I was sure this was going to be my specialty; a springboard for internal subspecialties like oncology and gastroenterology. Instead, addressing multiple chronic (and often preventable) diseases in medically complex patients became a draining task, bringing me a sense of weariness instead of the reward of knowing I helped someone. It is an important specialty, one of the backbones of medicine, but I was ready to unzip it and move on.

Category 4: Pediatrics and ob/gyn were time-consuming specialties that I thought I might enjoy, but would certainly not pick as a career. Crying kids held little appeal to me, and I was not particularly interested in women's health. But trying them on was like slipping into a great dress- curves in all the right places without being too tight, a gorgeous color and on sale. I felt like I easily molded into the role of obstetrician, into a kind pediatrician talking with a scared mom. It wasn't a tense stretch, it was just a gentle extension of my own personality, of my own strengths and skills.

So I'm left with two dresses that fit well, a scenario that often happened in the shopping trips with my mom. Sometimes we bought both, if I had occasion to wear them; perhaps perinatology, a mix of obstetrics and newborn care, would be a good choice. Other times we put them on hold and went out for lunch, returning to buy the one that stuck the most in my head. That's another option- just finish up my rotations now, and return to my thoughts in August, assessing which specialty has persisted out of all the disciplines.

I'm don't know yet. I'm still out to lunch. Hopefully it will be become clear soon, or maybe there is nothing to become clear. Either specialty fit well, and I could be a good doctor either way. I need to let go of the idea that there is only one "right" choice. I'm just not sure yet.

For now, I think I'll order dessert.