Richard F. Mitchell, MD,
For many clinicians, the path of medicine is a comfortable one—well-worn, made by many feet before your own. From college to residency and beyond, the courses to take, exams to pass, and applications to fill out have been laid out for us in a nice, orderly path. There is some room for brief excursions off the path, but the route to our prescribed life of clinic medicine, hospital medicine, specialty care like sports med, OB, or geriatrics, or some combination thereof is a well-marked trail with lighted signs to guide us all the way.
Until the day you decide to teach. I recall talking to our program director on the first day I had administrative time and asked, “What should I do?” His response: “I don’t care.”
Kathryn Freeman, MD
This past spring, I consciously moved away from learning clinical skills and spent time at two conferences: the National Medical Legal Partnership Conference, and the Family Medicine Advocacy Summit. There, instead of learning about medicine, I learned about stories.
When I reflect on what I learned in medical school, it was all about taking a patient story and converting it into a formal presentation. We spend years training our residents to boil down a patient’s history into discrete facts in a defined structure, using medical terminology to convey a message that only other physicians can understand. But that only allows us to communicate with each other, not with the world around us, or with the people, partners, groups, and leaders who have the potential to make a larger impact our patients’ health.
Medical students, especially those with little exposure to careers in medicine, have great difficulty imagining a career in medicine other than what they see and experience through their rotations.
Antoinette Moore, 4th-Year Medical Student
And shortly after rotations, they are asked to make choices that place their careers on certain trajectories. And while the scope of someone’s ideal practice will grow and change, the choice of specialty defines us in a way that is undeniably powerful and far reaching into our professional careers.
As I wrap up my third year of medical school, what has become apparent to me is that there are two often unnoticed—and often under-promoted—qualities that influence whether a student chooses one specialty over another.
These two qualities are physical and metaphysical. Physical describes the more brick and mortar/billable procedure/patient population aspects students are exposed to during rotations, such as “Is the preceptorship in a small town or a large urban setting?” and “Does this rotation expose students to a wide variety of patient presentations, procedures, and demographics?” The metaphysical is a bit harder to quantify but importantly demonstrates how happy employees are with their chosen line of work. It speaks to the culture of the rotation environment, which, to the student, serves as a representation of the profession as a whole.