How do you know you’ve made the right decision?

Today’s inane image of the day:

Dr. Amanda Xi white coat and badge
I officially have a long white coat and my badge proclaims my “Dr.” status!

During a rare television binge, I was struck by a question the main character poses: “How do you know you’ve made the right decision?”

In approximately a week, I will be entering the hospital as a medical professional with responsibility. My limited educational medical license has been issued by the State of Michigan and I’ve renewed my Basic Life Support/Advanced Cardiac Life Support certifications. I’ve picked up my first long white coat and badge that proclaims my “Dr.” status. I am in possession of a pager; a pager that will no longer serve as a prop with the occasional administrative reminder or misdirected message. [Sometimes, I find it incredulous that this dated piece of technology will facilitate patient care.]

Many of my peers across the country have been facing similar transitions. Some have moved across multiple time zones, some are now homeowners and some have already begun orientation week. This month represents a major turning point for medical trainees.

I was recently asked by a premedical student if I would do it [medical school] all over again. Undoubtedly, I am happy with my decision and persistence through the innumerable hoops to gain admission to medical school and now, a residency position. There was a period of time in my first year when I felt hopelessly lost – I was in a new environment, struggling with a long distance relationship and had failed an exam. For individuals that have worked most of their life to become a physician, finally gaining entrance to medical school can also be anti-climactic. Often, we see acceptance into medical school – and ultimately the road to becoming a physician – as a goal. A means to an end. Sometimes, we lose sight of the journey and people that got us to this point. Sometimes we are too focused on what’s ahead to really enjoy what is here, right now. I’ve really been trying to stop focusing all of my attention on planning for the future and relishing in the here and now.

One of the major decisions I made during medical school was to pursue the field of anesthesiology. A quick glance through the Student Doctor Network Anesthesiology forum paints a picture filled with doom and gloom. We are producing too many anesthesiologists! CRNAs are increasing their scope of practice! All of us will be working for peanuts in a few short years! I’m not immune to the fear of the future, but I am confident that there will never be a shortfall of opportunities for physicians. If we look at the bigger picture, it is clear that the practice of medicine is changing for all stakeholders and anesthesiology is not the only specialty feeling pressure. I do not claim to know what the future holds, but I do know that it is in my best interest to focus my efforts on learning as much as I can in the next 4-6 years of training so that I can apply this knowledge to being the best possible clinician I can.

Last January when I sat down to rank the programs I interviewed at, there was a clear front-runner for my anesthesiology training. However, many of my top choices were advanced programs [approximately 1/3 of anesthesiology programs require applicants obtain a separate transitional year, preliminary medicine or preliminary surgery year, similar to fields such as ophthalmology, dermatology and PM&R], which left me with a supplemental rank list to order. This was perhaps a more difficult list for me – luckily, I interviewed at just about every single transitional year program in the metro-Detroit area, so I had a lot of options. At one point, my list favored the “easier” programs. However, as time passed, I started to have second thoughts. The field of anesthesiology demands a strong foundation in medicine and I’ve learned the most from caring for patients; it seemed like I was doing myself a disservice by opting out of a more rigorous, academic, intern year. I switched my rank list around and immediately knew that I had made the right decision when I saw my match.

This week, I start orientation at Henry Ford Hospital. Next week, I begin on the Nephrology inpatient unit. To say that I’m nervous about being an intern is an understatement. [Mike will absolutely vouch for this – poor thing.] It has been well over a year since I’ve been part of an inpatient medicine team. I’ve had very limited experience with patients on dialysis, patients status post kidney transplantation or patients with nephrotic/nephritic syndromes. However, I’m doing what I can to refresh my memory and will start my first day ready to soak up all the knowledge I possibly can. My anxiety is, in some ways, reassuring – I know that I will be challenged every single day and will feel the urgency to read and learn.

How do I know if I made the right decisions? Well, I don’t. But at this point, they feel right. Perhaps I’ve just learned how to make the most out of the situations I find myself in. Either way, I am happy with my place in life and look forward to what lies ahead.

To my fellow interns across the country – we’ve got this. Let’s put our education to work!

4 thoughts on “How do you know you’ve made the right decision?

  • October 9, 2015 at 10:53 pm

    Knock knock, anybody home? 🙂

  • November 8, 2015 at 1:42 pm

    Lol, I’m making a comeback now! =)

  • February 29, 2016 at 6:51 am

    Amanda, which basic science course do you wish you had taken prior to starting medical school?
    Immunology, cell Bio, molecular Bio, histology, neurobiology?

  • June 11, 2016 at 9:43 am

    Hi Leo,

    At least a few introductory biology courses are required for admittance to medical schools, so I remember I did cell/molecular biology courses that were at least helpful for the basic science portion of medical school (which is actually pretty limited). Immunology is so complex and interesting that I wish I had done it for that purpose and not just for medical school. In general, I recommend taking college courses that interest you (in addition to requirements for premeds) as this will be the last time you’ll have a chance to explore other areas outside of medicine! Remember, most schools focus on well-rounded candidates.

    Good luck!

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