Career Musings

You may or may not have heard that I'm going to take (another) year "off" between my third and fourth year of medical school. Since I did a master's/MD, I will be doing a 6-year path through med school instead of the 4 years I was originally planning. Ouch. Instead of graduating at 26, I'll be 28. It turns out that on average, 1/3 of the rising MS4 students do this, and last year, almost 50% of the rising class decided to take a year away from their medical education. Most people did research. I am also going to do research. And career discernment, which isn't something you can put on your resume, but is super important in the crafting thereof.

At this point, I'm not really sure what I want to do with the rest of my life. I am feeling a bit behind and discouraged, largely because of my lackluster Step 1 score. I know there were extenuating circumstances, etc, but I've always been a good test-taker, so it's disappointing. I guess at our master's program, nobody ever really emphasized just how important Step 1 is in determining which career path you take -- I mean, people said, "Oh, yeah, it'll be fine," but it's really not. With my score, there are quite a few doors slamming shut. Some of them I really couldn't care less about (like radiology), but some are kind of sad (even OB/GYN and emergency medicine would be competitive for me). Of course, I for years thought about becoming a geriatrician. As far as I can tell, that path is still open to me. I also love developmental biology and genetics, so pediatrics is a natural fit. This year, I've gotten really interested in immune/rheum stuff as well, so I'm going to do research in that area to see if I want to do that clinically or whether it's only the lab work that's neat. Finally, neurology and rehab (especially spine stuff) is super interesting and expanding fast.

The other thing I've been thinking is -- it would be fine to have my Step 1 score if I were free to go anywhere and do anything. If I could literally apply to every single residency in a given specialty across the country and go to Idaho if I so chose. But obviously, that would mean that one of the best things that's ever happened to me (planning to marry B) wouldn't be happening, so I don't actually wish that. Instead, I really want to do my research and choose a specialty where my score isn't held against me too much, because I want to have a strong enough application to get in wherever B ends up also. Residency would be a long time to be apart.

Finally, I have to choose something that gets me up in the morning. Frankly, 3rd year rotations don't tell you a whole lot about what a career in a given field is like. They only give you a feel for the resident culture, which is 3-5 years of a 40+ year career (if you're lucky). You don't really get a nationwide, cross-sectional view of what it's like to be an OB versus a family doc versus a neurologist. I'm hoping to do some clinic days and shadowing during my months away, so that I do get a sense of what I'm getting myself into.

My current top 5:

1. Pediatrics
2. Child neuro
3. Rehab/spine
4. Adult neuro
5. Family or Int'l Med + geriatrics

Since applications happen in September and early applications (like Child Neuro) happen even earlier, I'm not ready to figure out what I want to do with my life and then create a good application for the 2011-2012 match year. The more I talk about the decision to take time off, the more I meet others who are doing the same thing. I'm excited. I think it will be a good move for the future, both career-wise and family-wise. And a little extra time to study for Step 2 is probably a good thing.

If you have thoughts about a gap year, pros/cons/worries/insights, please feel free to post them here!!