Sunday, January 9, 2011

The Power of Choice

When I was a kid, I knew I could be whatever I wanted to be when I grew up.  It was a wonderful feeling.  My first big dream was to be a singer.  As a little girl I would perform from my "stage" in the living room and belt out my favorite songs (ah, Dolly Parton) and show off how I could sing my A-B-C's in vibrato (like the opera), which I considered to be very advanced.

As the years passed, my world of possibilities became more limited.  By the time I was a teenager I could feel the pressure to make the right decision for my life's purpose and direction. 

I came to the conclusion that I had two choices:
1) lawyer
2) doctor

For some reason I thought those were the "best" jobs out there.  Even though I knew very little about what either of them would actually entail, let alone what the various other options might be.  After more thought, some very enjoyable science classes, and an inspiring health class, I decided I would be a doctor. 

What had started as a wide open meadow of limitless possibilities, had now evolved into a well defined path leading toward a distinct goal.

This is NOT a story about ending up in the wrong place.
Today I am completely in love with what I do for a living.  Working with kids and their families, learning new things on a daily basis, watching technology advance with the field, and teaching.  It is an honor and a privilege to be a part of these patients lives.

It's about finding my voice again.
What I also love is my ability to define what, where, and when I do my work.  Without this power, the joy is much harder to come by.

Getting here was hard.
Medical training in the US is founded on many years of tradition.  The field enjoys a very special place in the working world, where the expectation of one's commitment are set extremely high, and since there is no other way to earn your MD to practice in this country, this is the path every candidate must take.

After graduating high school, I spent 14 years following a training path, working grueling hours along the way.  This involved moving around the country, studying like mad for exams, giving presentations, and spending countless days/nights/weekends/holidays in hospitals, clinics, and at home tied to my pager.  It's what every doc goes through.  It's tradition, what is expected.

Stepping off the beaten path.
The really interesting part is what happens after training.  What choices are presented to us, and what we believe we SHOULD do next.  It's very similar to what I felt as a teen, that I had only a couple of choices if I wanted to do the right thing.  I see it over and over in my colleagues who struggle with wanting something different, something as of yet undefined, because all they see is the narrow path laid out before them.

It's still a wide and gorgeous meadow out there!
I know, because I made it here.  I have the power to decide when and where and how much I want to work, and what a great feeling that is!  This may seem obvious to someone on the outside looking in, but for me it was so liberating to realize that I had choices again.  The choices made me feel powerful, in control, and yes, very happy!

Open up your options.
You are the only one who can put limitations on what you do.  It may feel like you don't have options, but you do.
I love learning about jobs I've never heard of before.  Established ones like industrial designer, or new ones like social media expert.  There's so much out there it's hard to imagine how anyone can decide what's best for them without trying out a few first.

I really love those stories about people finding their true calling in a surprising way.  There's been lots of them lately with the recession; folks who were fired from an unfulfilling job who were then free to find their dream job.  Others find their calling later lin life, such as the late great Julia Child.

It is true that if you have a passion, and follow it, you can find a way to make a living doing it.  It's not just a childlike expectation, it's what happens everyday to those who are wise enough to find the power of their own choices.

Thoughts for my fellow and future MDs out there:
- First know that there are many many many other jobs in health care that puts you directly in front of patients in every possible setting:  for example nurse practitioners and physician assistants work in clinics, hospitals, and surgical rooms alongside physicians doing very much the same type of work.  You spend a fraction of the time in training and work much more reasonable hours.
-  In college you can major in anything and still go to medical school, as long as you take the pre-requisite classes.
- You can take time off for other pursuits in between training steps and not be at any disadvantage (ie after college, or after med school).  Many places see it as a bonus if this life-experience you gained makes you more well rounded.
- Your school or residency or fellowship program may have the option of non-traditional schedule for your training.  For example, you might take time off (many months) and make up for it.  Or you might prefer to stretch out your training but work half the time.
- Fellowship is not necessary to have a great and successful career.  Do it only if you are truly inspired by that subspecialty field, not because you feel you need more training.
- In fellowship, know that you don't have to work in a lab in order to do great scholarly work.  There's clinical research, advocacy programs, and teaching/curriculum development to consider as well.
- Jobs are very flexible.  We are lucky that there is a steady demand for doctors.  This allows for great flexibility in what type of work you want to do.  Don't just sign up for whatever job offers come your way.  Think first what you want (location, patient population, clinical setting, research demands, hours, call), then go after exactly that.  Don't settle for the next logical step in your path, define it yourself.
- Locum tenens and moonlighting work is super easy to find and buys you time to find your dream job.
- Know that you can use your MD in many ways besides clinical.  You may prefer to do research, work for pharmaceutical company, do consulting work, public health, politics, education, etc...

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