Third years — this one’s for you. You’re already a few months into the year, and probably getting the hang of things by now. As you wade through the ocean of scut, progress notes, and evaluations, it can be easy to lose sight of the potential bias in your perspective. However, if you remain mindful of your perspective, you may be a better judge of your specialty interests while simultaneously getting more enjoyment out of your current rotation. Chances are, the more you enjoy your rotation, the more you’ll learn and grow — a benefit to both you and your future patients.
The factors of influence are abundant and some more obvious than others. What may not be obvious is the magnitude of their impact. Moreover, these factors can be both positively and negatively skewing. For example, you may have been on a service where you got along with your team members especially well (or didn’t). It is not unreasonable to imagine yourself leaving the rotation with a more positive (or negative) view of that particular specialty than what you came in with. Indeed, it’s important to remember that you’ll be interacting with all kinds of personalities, in med school and beyond for the rest of your career, and to couple an emotional response you have of your team to the specialty itself is most imprudent.
Your patient population is another variable that can bias your perspective. To illustrate this point, imagine yourself with a strong interest in endocrinology, especially because of its broad spectrum of organ system involvement. Now imagine that your first experience with endocrinology is at an outpatient clinic in an inner-city; the majority of your patients may come in for diabetes management as opposed to the type of patients you may see at a tertiary-level referral center. You may leave your rotation with a very narrow idea of what type of cases you’ll see as an endocrinologist, when in reality a lot of it depends on your patient population and institution. In general, it’s probably more realistic to assess whether or not the bread-and-butter of a particular specialty is something you’d like doing, not just the zebras, or likewise the horses from one barn.
No doubt, a great deal of your interactions will be with residents, many from a variety of backgrounds, ethnicities, and personalities. Despite their differences, they will all experience the burdens of being overworked and under-rested, under a cloud of cynicism and student-loan repayments. Just remember that the life of a resident is not necessarily the life of an attending. Therefore, value their opinions as they share their viewpoints with you but be careful about which opinions you take to heart.
We all enter our clinical rotations with a particular lens; the work, people, and environment are all constantly shaping this lens to a narrower field of view and may leave us out of focus if we are not careful. However, by being mindful of your perspective (and indeed, those of others), you can make unbiased judgments of the specialties you may be considering and have the confidence that you’ve approached your choice with objectivity and prudence.