What do I want to do when I grow up?

In my program, we work as small groups of 8 or 9 students with a tutor. At my first tutorial in August, our tutor asked us to introduce ourselves. One of the question he asked was "what you want to do when you grow up?" With a bunch of 19 or 20 someting years old, it make sense. When it got to me, he said that I was already grown up... Am I, really? Some days, I doubt it, but anyway, let's leave this unanswered...

However, I still like this question. I think it is interesting to see how our ideas evolve during med school. So, as Medaholic did in his notorious post (http://www.medaholic.com/the-shortlist-year-one/), I thought I would capture my feeling about what kind of practice I would like to have in my carreer. 

There is a lot to think when you choose a specialty.  The most important one (that supercedes all the others) is to love what you do. After that, work/life balance is high in my list. You should also think about the kind of patient-physician relationship you would like. Finally, some advice I got from a friend: think about the specialty you want to do, about the least glamourous part of the job. If you don't want to do that day in day out, maybe it is not the right place for you (Pap test for Ob/Gyn, runny noses for pediatrician, or both for family physician)

I feel that people believe that, because I went to medical school so late in life (and again, it is all a question of perspective), I would do family medicine. I think that, after investing 4 years in this, you shouldn't choose a specialty because it takes a few less years to complete (and again, I might change my mind in 4 years). I truly believe that primary care is the most important one, the anchor of the patient in this difficult healthcare system we have. In my previous life, I have worked with a few of them and I understand that there could be a lot of different ways to practice family medicine. Still, I believe I would not feel that I belong there. I need to be able to find answers to questions (when possible), and not to refer to some colleagues to find it for me. Here's how I see it, family doctors knows a little about a lot, while specialists knows a lot about a little. To be comfortable with what I do, I need to feel that I am in control, and for that, I need to be the expert of my field. I am a scientist in the bottom of my soul, and I want to dig deep to find answers.  So I am not closing this door, but it would not be my first choice if I had to choose today.

There is a lot of specialties, so let see if there are a few that we can discard... After this long statement about primary care, I suppose you can understand that emergency medicine is not what I am looking for.  I don't exactly see the buzz about anesthesiology either... And even though, I try to keep an open mind about all specialties, I have to say I have no interest in surgery. First, I like to have something of a life outside of medicine. Second, I am not very skilled with my hands. I remember working in the lab, using the multi-pipette and having difficulty because my hands where not steady enough. So you can see, it's not not for me... I am not looking forward to becoming a dermatologist either: psoriasis, warts and moles, day in, day out, I don't think so. And I would like some interaction with living patients - there goes pathology. I don't like watching pictures all day long, so there goes radiology.

Let's talk about what I could find interesting... There is a reason my Master degree is in microbiology-immunology and I started a Ph.D. in virology-immunology. It was because I thought the immune system is the most interesting system of our body, and I still think it is. That being said, you can see that I could have some interest in immunology (even though I am not quite sure what kind of practice it involves at this point), rhumatology (when the immune system goes crazy) or hematology (when it causes blood disease). When I remember my time in the lab, it wasn't the best part of my life. However, I believe in balance. All my time in the lab might not be my place, but some time might be very interesting. And that is what hematology could be - real bench to bedside. Microbiology/infectious disease is another one I think could be very interesting. There is so much variety into this one! Can you just imagine the amount of infectious agents that surrounds you? Some of them are so intriguing! From RSV to HIV to tuberculosis, and everything in between. Even though, we know so much about them, we still have to fight hard and the battle is not yet finished... 

So, as of today, and if I understand well how things works, everything I am interested in would be subspecialty of internal medicine. That's my plan for the next year or so... And we'll see as it goes.