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Choosing Internal Medicine: Reflections from a Graduating Medical School Senior

“Leadership is taking responsibility for enabling others to achieve shared purpose in the face of uncertainty.”
Marshall Ganz

The first time I heard one of Marshall Ganz’s lectures, I was astounded. His topic that day was leadership in social movements and was informed by his work experiences, including his contributions to the civil rights movement under the leadership of Martin Luther King, Jr. Ganz used his examples to outline five practices of leadership that we all can employ and already intuitively do to some degree:  relationship building, storytelling, strategizing, structuring and action. I appreciated his clear concept of leadership on the large scale, but also saw it simply as a robust process of decision making–something useful to even our smallest of life decisions that can be harnessed immediately.

Of course, choosing a medical specialty, let alone a residency program, is no small, everyday decision. This is even more reason why we should organize a clear approach. There is a connection between Ganz’s concept of leadership and our concept of our important life decisions that we can use to our advantage. As an intern just starting at a new institution, for example, I have my moments where I wish I could just consult Gandhi. Let’s break down Ganz’s five leadership practices to help us discover our own paths to success.

First, let’s begin with strategy. This was my go-to for choosing a medical specialty. How do my Step scores compare? How much research have I done? How many residency spots exist for a desired program? I highly recommend “The Successful Match: 200 Rules to Succeed in the Residency Match,” and even reading more than just your specialties of consideration for a wider appreciation of your options. However, do not forget there are four more leadership practices left to cover in this essay. And I think that was something I forgot during my medical specialty decision process: there’s more to medicine than just cerebrating, and I caution you not to reduce your important decision into an Excel spreadsheet or a checklist.

Moving on, let’s talk about storytelling. This is essentially the opposite of strategy because the motivation is much more emotional. It took me all four years of medical school to realize how important the death of a friend from cancer really affected my interest in oncology and palliative care. It took a lot of talking and writing–even before mock interviews or personal statement rough drafts–to understand my own story enough to tell it and act on it. Do not hesitate to talk about your interests with classmates and mentors when you feel they are not fully formulated–that is actually how we begin to formulate them.

Thirdly, there is relationship building. Mentors were crucial in helping me decide to go into internal medicine at a large university program where I would be a good personality fit. I have to say many thanks to Dr. Elisabeth Heath, MD, an oncologist who always made time for even my silliest questions, like recommending good TV shows. She helped shape me beyond just my medical specialty decision. Do not be afraid to reach out to your attendings beyond getting recommendation letters.

Fourth is structuring–I think of this term as “life balance.” Learning to ask for help from loved ones actually took self-discipline and creativity, since I was used to getting everything done myself and felt it went faster this way. Of course, it is quite the opposite. It is important to have structured support to afford yourself some regular exercise, healthier food choices, and personal time with loved ones. That does not make you a lesser doctor–again, quite the opposite. In fact, I recommend considering a specialty that will support some flexible version of your desired life structure and balance.

Finally, take action. There is not much to add in this section if you work with yourself honestly in the above four areas. Yes, it may be hard to make the big decision and hit the submit button. But, life is long enough to revise things later even if ERAS says you cannot.

Your leadership process will mean different things to you. The point is to remember to find your own path, which is something no one can know or tell you. I have a hard time when people tell me that, but the truth is that if someone sets an expected path before you, it is probably because they are talking about their own desired path. Do not be afraid of the uncertain. In every twist and turn in the plots of our lives, we become examples for others who are about to go through the same thing. Let your choice make you a leader.

Editor’s note: Dr. Kimberly Ku, MD matched into the internal medicine program at the Indiana University School of Medicine in Indianapolis, IN.

Kimberly Ku (2 Posts)

Editor Emeritus: Former Medical Student Editor (2012-2013) and Former Resident Editor (2013-2015)

Wayne State University School of Medicine

My name is Kimberly Ku, and I am a member of the Wayne State University School of Medicine Class of 2013. I graduated from the University of Michigan Ann Arbor with a double major in biology and anthropology. Since the start of medical school, I have been a fervent advocate of patient safety and quality improvement, founding the WSU Chapter of the Institute for Healthcare Improvement (IHI) as well as the WSU SOM student organization, Wayne IHI. Through the IHI, I have written multiple quality improvement projects, including a grant award-winning project at the Barbara Ann Karmanos Cancer Institute in Detroit. I work closely with WSU's Vice Chair of Medical Education as well as many other faculty to promote greater patient safety and quality improvement mindfulness in the clinical curriculum of both the WSU SOM and the residency programs at the Detroit Medical Center.

Outside of patient safety and quality improvement, I contribute widely to authorship and co-authorship of clinical research projects at the DMC. As a member of the Gold Humanism Honor Society, I am a strong believer of volunteerism and dedicating spare time to the creative arts. I am applying for an Internal Medicine residency program with specific interest in Oncology/Palliative Care. I also plan to pursue an MPH or MBA after residency in order to incorporate public policy/business management into my work as a future academic physician.