I wouldn’t say that I have always known that I wanted to go into medicine. I remember consciously making that decision when I was 17 years old and realized that a lot of the problems I was seeing back home in my rural community — untreated chronic diseases, poorly managed dementia, lack of access to care — were just as present in communities that lived within walking distance of state-of-the-art hospitals. So maybe I haven’t always known, but it’s been nearly 6 years.
Now I’m in medical school. Before matriculation, I had no idea how fortunate I was to have a goal — an ambition, if you will — that was concrete and unwavering.
Now that I’m in medical school that ambition is moot point. Now, the question is what specialty I am interested in pursuing. They assure us that it’s okay to be undecided right now, and I think that’s certainly true. But we also have to start thinking of the future, like what kinds of research we want to get involved with. Our first chance to get involved in research is merely 6 months away — Summer 2019 — and deadlines for programs are already approaching.
I have no earthly idea what I want to do. Yes, I want to go into the primary care side of medicine. In that aspect, I am lucky; this “side” of medicine tends not to be competitive, and so I don’t need 5 publications under my belt to secure my spot in a residency program. But primary care is so vast. Do I want to do research in adolescent health? Queer health? Obesity and metabolism research? Social determinants of health? Refugee and immigrant access to healthcare?
I know that the research project I begin my first summer as a medical student will not dictate my future, but I can’t help but feel I am laying a foundation for myself and my future expertise. I have to ask myself questions like: what do I want to be known for in medicine? What kinds of questions do I want my colleagues to turn to me for answers to? What do I want to policy work in, or write for the New York Times about?
These are scary questions. Before, when I simply wanted to be a doctor, the possibilities were endless. I could be interested in psychiatry one day and then surgery the next. I could do research in soft science fields and take an education class, all to round out my understanding of communities I want to work with. I care, obviously, about working with medically underserved communities, given my background and general orientation towards life. But now I have to start deciding what that means. Am I going to work with queer folk? Adults with diabetes? In a rural setting doing a little bit of everything? In a public hospital working with pediatrics?
Does this mean specializing in family medicine? In internal medicine + pediatrics? Internal medicine with a specialty? Psychiatry?
Yes, I don’t need to know just yet. But I’ll need to know soon. For the first time, I have choices in front of me where picking one feels like losing another. I didn’t feel that way when I chose the MD over a PhD, a BSA in Bio & Psych over a BS in Biochem. With the exception of rent prices, I didn’t feel this way when I picked Columbia P&S over Baylor College of Medicine. I want to be a jack of all trades, but I’m afraid that means I will become a master of none.
I want to live by the beloved Mr. Roger’s philosophy: that you have to do the best good you can in your niche, and if everyone does that, it will be enough. So I have carve out my niche, instead of trying to stick a finger and toe in a dozen options.
And all of this is happening, of course, in a time of my life when I am also thinking about how I want to be seen in my personal life and what kinds of views I want the world to associate with me. I’m figuring out how to express myself and speak my opinions, how to maintain my hobbies and non-medical interest in causes like education, and navigate brand new relationships with friends and a new partner and mentors.
Honestly, I feel like a teenager again, except this time I’m at a loss when someone asks me “what do you want to do with your life?” I’m here, a small town girl in NYC attending her dream medical program, and I’m working to whatever “it” is that I want to do in life. I’ve just got to figure some parts out. Hopefully soon, before opportunities for this summer are filled.