Article by Allison Gray, MD | “Doctor’s Orders” curated by editor Sasha Yakhkind
I am the kind of person who can become interested in anything. When it came to thinking about a medical specialty, I was pretty open-minded from the get-go. That said, I grew up talking about the brain with my dad, a neuropsychologist. He would tell us fascinating stories about patients who had problems with different aspects of their cognition because of traumatic brain injuries that they had suffered. My sister and I grew up wearing helmets for everything — ice skating, tricycle-riding, you name it. Any activity in which you could potentially bump your head meant that we were wearing helmets. I guess in a way I was destined to be a neurologist — an interest in the brain was part of my DNA.
As a first-year student in medical school, I loved my neuroscience course — it was the most interesting one for me of everything we studied that year. So, while some of my classmates took that one golden summer between first and second year to start a research project or travel Europe, I decided to explore clinical neurology. I asked my instructor if he knew of a neurologist with whom I could shadow while home in Boston for the summer. He connected me with a practicing neurologist in the Boston area, and we arranged to have me work with him several days per week that summer.
I quickly fell in love with neurology — I was fascinated by the way the brain worked when it was normal and when it was not. I was struck by the variety of pathology I was exposed to that summer. I felt like a big sponge, soaking up everything I could. I would come home at night and talk with my family for hours about the amazing things I had seen. By the time I headed back to medical school for my second year, I was sure that I wanted to become a neurologist.
Fast forward about a year and a half later to my third-year neurology rotation. I went in with tons of energy and passion … but, after four weeks, I finished the rotation completely confused. While I saw some very interesting patients, the teaching I had loved so much all summer was completely missing. The residents were not there to teach — they were there to finish their work and get home. The rotation was also completely inpatient-focused, and many of the patients we saw were comatose and unable to communicate. With education, you can learn how to take care of and evaluate these patients; without the education, these encounters can be mystifying and even anxiety-provoking.
After my third-year neurology rotation, I felt truly lost. Even though I had absolutely loved my shadowing experience with a neurologist, my third-year rotation made me doubt my interest altogether. I started thinking that maybe I should go into internal medicine instead. I began to tell people that I was going into IM when they would ask, but I never felt excited about it. Don’t get me wrong, I loved internal medicine, but I couldn’t see myself becoming a primary care physician, or going into cardiology or any of the other specialties that came with IM. I was in the midst of having a full-on crisis of faith, and I started to feel really down in the dumps.
After months of feeling lost and with fourth year quickly approaching, I suddenly had an epiphany. I realized that four weeks of a neurology rotation at one hospital shouldn’t take away that passion and love for neurology that I had discovered two summers ago. I realized that I needed to put aside the sub-par rotation I had in my third year and hold tight to that first awesome experience. After all, the quality of the education you receive on a particular rotation can depend so much on the residents you are working with and their own interest in teaching. Once I realized this, I suddenly felt that a huge weight had been lifted. I emerged from my crisis of faith feeling rejuvenated and once again excited.
I applied to neurology, and early on in my fourth year, I did an away rotation in neurology at my dream program. I loved every minute of the rotation, and the experience cemented my interest and passion for neurology. In March, I matched at my dream program, and the rest is history. Today I am a practicing neurologist, and I love what I do.
If I had to do it all again, I wouldn’t change a thing. But, I would save myself from the heartache I went through by remembering that medical school rotations are not always perfect. If you love a subject matter but find yourself disappointed in your clinical rotation in third year, take the opportunity to do another rotation in that field somewhere else. Remember that rotations can be completely different at different institutions. The education that you receive in your first and second year classes in medical school is protected — you have instructors who have (hopefully) been teaching this same material for years, and they know how to teach it well. Not all residents are good teachers, and even when they are, these are people who are sleep-deprived, hungry, and sometimes unfortunately not the least bit invested in your education. If you love radiology or dermatology, or whatever field it may be, don’t be thrown off course if your rotation is a disappointment. Stay true to what you know in your heart, and don’t lose sight of what you are called to do.
Dr. Allison Gray, MD is an attending neurologist in the Boston area. Allison graduated from McGill University with a BS in physiology and received her MD from New York Medical College. After graduating from medical school, Allison completed her internship in internal medicine at Rhode Island Hospital through Brown University. She then completed her residency training at the Harvard Neurology Residency Program at Massachusetts General Hospital and Brigham and Women’s Hospital in Boston. She is the co-founder of Medical School HQ with Dr. Ryan Gray, MD.