It amazes me how fast life marches on. I feel like I was just a medical student not too long ago. But here I am in my final year of residency. I have almost completed two months. Ten months remain after this. I have my first fellowship interview this coming Tuesday.
It is amazing how one changes over time. I remember when I started medical school. Like 90% of medical students, I briefly entertained the idea of pursuing a surgical specialty at some point. As it came time to apply for residencies I chose Internal Medicine with the intention of going into primary care. I wanted the long-term relationship with my patients. I wanted to get to know them. I wanted to work with them for the improvement of their overall health.
Interests change. Goals change. As I have gone through residency I feel very comfortable on the inpatient setting. Maybe that is a by-product of a heavily based inpatient Internal Medicine residency. My program produces some fine internists that make great hospitalists. Or maybe it is the result of working in a continuity clinic based at a county hospital mainly seeing underserved patients. Only a handful of my patients have any actual “continuity.” Sometimes it feels like every patient I see is a brand new patient to the system. And sometimes I wonder what ever happened to Mrs. X or Mr. Z. Some say that private practice is different. The patient population is different. Perhaps. But I may never actually find out.
Along the way I have decided to pursue sub-specialization. That means that after I complete this Internal Medicine Residency, I will hopefully complete my time as a resident and begin my time as a fellow in an Internal Medicine subspecialty. Of course, there is the chance I won’t match. So for the time being, allow me some privacy. Once (or if) I become a fellow, I will talk about it then.
If I don’t become a fellow I will be able to begin practicing medicine as an attending. That is a weird thought. It’s comfortable NOT having the final say. It’s easier when the decisions and responsibilities don’t fall on your shoulders alone.
The rest of the year promises to be challenging. But I should probably enjoy the ride. Because before I know it, this year will be done.