Dr Saul Hymes, pictured here, writes:
There are times that medical school and residency feel like a sheltered island. When you start medical school, what field you will eventually choose for a residency seems an eternity away, but by 3rd or certainly 4th year, most of you will have chosen one.
And while that decision might have initially been a difficult one, the next steps seem automatically laid out: ERAS
, The Match
, starting residency. One step follows the next without very much need for serious decision-making. Sure, you choose where to apply, what geographic area you want to be in, and weigh other factors, but ultimately a computer decides, right? It's not like the real world where you actually get to play a major role in choosing a job. And while immersed in residency itself, the world of "What To Do After Residency" still seems far away indeed. For those who choose fellowship over practicing right out of residency, this process repeats itself, with further isolation and restriction of choice by another Match. Throughout all of this, who you are as an individual and how you act hardly seem to matter.Of course, most of the paragraph above is a gross oversimplification.
We obviously have choice in our career paths, choices in where we apply, and even some influence over where we match. But it is different from the regular job market. The Match, and its computer-based assignment of slots in training programs, appears to remove human decision, choice, and influence from the process. Yes, we interview, and yes we are more than the collection of numbers on our applications, but ask anyone who has gone through a traditional job application process --where you compare multiple offers on factors like salary, benefits, job environment-- and it is absolutely different. However, as I discovered when going through my own training path, there is much more of a human element than I at least had ever realized, a human element that can truly determine your future career.
When I sat down early in the second year of residency with my program director and he asked me, “so what do you want to do when you grow up?” I thought I had some idea. I was thinking about pediatric hematology-oncology, pediatric infectious diseases, and general pediatrics, and I was pretty sure I would need more time to decide. By late fall/early winter, I had decided on pediatric infectious disease (peds ID), but it was too late in the application cycle for me to apply that year. Before I move on, I should note that this was before peds ID had a Match
. But while some of the details of my experience differ from what happens now, hopefully you’ll agree that the human element still applies.
So there I was in the middle of my second year of residency, going along biding my time until the start of the next application cycle, when I received a very fateful email...[stay tuned for Part II]
ABOUT OUR GUEST POST CONTRIBUTOR: Saul Hymes received his MD from Columbia U and completed a pediatric residency at Mount Sinai. He then returned to Columbia where he completed a fellowship in pediatric infectious diseases, and is now an Asst Prof of Clinical Pediatrics at Stony Brook U. His current clinical and research interests include management of resistant bacterial infections, appropriate antibiotic usage, and development of novel antimicrobials. He is interested in the role of social media and online communication in healthcare, especially in helping disseminate accurate medical information. He blogs about infectious ideas and is a contributor to The Magazine. You can also find him on Twitter @IDDocHymes.