One of the first major challenges of applying to residency is making yourself presentable, to tailor your experiences to the career you want to achieve. The last year of school is generally reserved as the time to pursue electives in the various disciplines.
In general, every school has certain requirements that must be achieved, such as having at least one elective in medical, surgical, and primary care specialties. Beyond that however, you have the flexibility to choose whatever you want to do.
At some point in the natural order of things, you begin to realize that the journey to medicine is not as straightforward. There was once upon a time when being a doctor meant knowing everything about everything. In this day and age, that has become an impossibility.
With that in mind, you reach the crossroads for a second time: what should I do with my life?
There are many ways to conceptualize the thinking process but it always boils down to three simple questions you should ask yourself:
For example, someone who enjoys working with his hands, is comfortable not knowing the full picture and likes a wide but shallower pool might be better suited for emergency medicine.
These three questions are fundamental to understanding where your values and interests lie. As your education progresses, take a moment to reflect. You might be surprised how often and how dramatically things change.
The most crucial time to consider these questions is in the clinical year. Consider how your newfound experiences change or reinforce your choices.
This becomes important when choosing your fourth year electives.
Making the Match
Part 1: Knowing Yourself
Part 2: Choosing Electives
Part 3: Understanding CaRMS
Part 4: References
Part 5: Research and preparation
Part 6: Creating a schedule
Part 7: Travel planning
Part 8: Interviewing
Part 9: Ranking
That is a very tough but excellent question. For the four years of medical school, I have sacrificed many things.
One sacrifice was time to explore. When people ask about applying to medical school, I never dissuade them from waiting, taking a year off, or worrying about being too old. Being a little late to the game never hurt anyone. In the time I have been in school, I have not taken the opportunity to travel or pursue my interests outside of medicine to the extent I would have hoped. A sizeable part of my twenties, a time typically dominated with a youthful exploration of the world feels cut short. While I am sure there will be a chance to do some of this in the future, it will never match the freedom of flexibility of these years allotted to medicine. In some ways, these “not-so-distant” opportunities always feels just out of reach.
Another sacrifice was family and friendships. I cannot tell you how many times I have had to send my regrets for a gathering with friends or family because of studies, exams, or a long/night shift. The impact of medicine can bleed into the home when your friends lose touch and your family support is strained in these circumstances. It can sometimes be very isolating.
Last but not least, I have sacrificed my health. It is not by nature that we were intended to work sleeplessly through the night, to eat irregularly by day, and to stress constantly. With the right practice and mindset, we can avoid some of these factors but we never really escape them entirely.
Everyone makes sacrifices and I have made mine for a higher calling. It is a passion for the practice that drives me forward. I truly believe that the rewards of this challenging yet fulfilling career are worth the time and dedication I have put into it. Having said that, every choice comes with a price and that should never be overlooked.
On March 27, 1897, whilst eating some soup, [J.W.] aspirated a bone. This accident was followed by attacks of violent cough and dyspnoea, which, however, became gradually less… On direct laryngeal examination by mean of Kristein’s spatula, the patient being seated with his head strongly deflected to the left, I saw in the right principal bronchus a white mass. On the following day I introduced, under cocaine anaesthesia, a straight tube of 9 millimeters diameter and of 25 centimeters length through the larynx and the trachea until I came near the foreign body. The curvature of the trachea was thus removed, and the foreign body could be seen distinctly. I had great difficulty in catching hold of the foreign body, using a pair of slender forceps which had specially and quickly been made. The difficulties were great, as at that time…I was still without the necessary practice which enables one to look easily, and even more to operate, through long tubes. Eventually I succeeded in catching the bone and in extracting it. The patient was able to return home the following day.
Gustav Killian, 1902.
Direct endoscopy of the upper air-passages and oesopghagus; its diagnostic and therapeutic value in the search for and removal of foreign bodies. J Laryngol Rhinol Otol 17:461, 1902.