I’m currently on call with my surgery team right now and thought I’d take a few minutes of down time to write a word or two. So first off, surgery can be very intense…with mostly calm seas in between. So while intermittently studying, I contemplate about the career choices that lay ahead of me. One of the first things you figure out during third year is whether you’re a cutter or not. A senior resident on my team told me about how she made the decision to go into general surgery. For her, it was the sound of locking in the needle driver, ‘click,click,click’. She couldn’t get enough of it. Then during one operation, her attending told her to make the incision for a laporoscopic port site. It was the first time she was allowed to cut on a patient, and the feeling of the scalpel in her hand, the way it cut through skin like butter, all but sealed the deal for her. I think of it as a sort of sophisticated form of operant conditioning with visual and auditory cues serving as positive reinforcement on behavior. In fact, I think factors similar to these affect most medical students’ specialty choices. Although, the cues aren’t always necessarily something sensual (the OTHER meaning of the word, you guys), as in my case…
One of two specialties that I’m considering is pediatrics and more specifically, neonatology. Why? Well, one of the major motivators for me is the idea of the NICU. That is, I’m infatuated with the fact that I would have the most innocent patient population possible, that they would be resilient, and that they would be dependent on myself and my fellow team members for helping ensure their survival. To top it off, if/when they grow up, they will likely have no idea that I was the one of the medical team members taking care of them at the most crucial point in their lives. Those are my motivators, my positive reinforcers. Though unlike my resident, they are mostly ones that don’t directly appeal to the senses, yet have the same effect…so I know exactly what she meant. Of course, similar narrations can be played out with just about any job or hobby. Like in high school, it was the sound of a basketball hitting nothing but the bottom of the net that kept me outside for hours practicing my shot. With the specialty I choose, I expect to fall in love just the same.
Disclaimer: I assume that whatever specialty choice is made is definitively appealing in its science, but I think that it is the nuances that clinch the decision for medical students.
**BTW, as I said earlier I’m on my surgery rotation, and one of the things that is feared about this rotation is being pimped by your senior colleagues. So now that I’m four weeks in, I have an observation: There are two ways of being pimped. The first, a style of questioning that is a fair assessment of one’s knowledge and that’s accompanied with a sincere intention of teaching. The second, a style of questioning in which the intentions are not to teach, nor are they to actually hear the right answer…no, no, no…instead they serve to reinforce the fact that you are merely a medical student, or to expose knowledge deficits. The only way I can remotely justify it is it’s an esoteric way of showing tough love (tiger mom). The former is effective, and much appreciated. Unfortunately, the latter works as well, it just sucks. J