Thoughts on a specialty at the end of 3rd year

I have finally finished one of the busiest, most interesting, most useful, and most exhausting years of my life. Unfortunately I still don't know what I want to do for the rest of my life, but I have some thoughts.

Medicine or peds, that is how I started the year out. I thought I valued having more time to talk to patients that anything. Then I did medicine and it didn't seem all that enjoyable to me. The internal medicine clerkship director says we shouldn't judge internal medicine on our 3rd year experience. But that's all I have to judge. That left pediatrics, which I really enjoyed.

Then I did surgery. I did 1 month of trauma surgery, 1 month of urology, and 1 month of orthopedics. vascular surgery, and ENT (ears nose throat). I actually had a really great time. I got better evaluations from my residents and attendings than I had received all year. The flow worked for me well. You see the patient, ask them only pertinent questions, make a plan to solve the one problem that you as a specialist can solve and move on to the next patient. Surgery is a quick-fix. In general, you do surgery, the problem gets better, and you are done.

I realized that I wasn't a "I just want to talk to patients as much as possible" kind of guy. I like to get things moving. So, surgery is for me: right?

Well, surgeons spend a good portion of their time in the operating room (OR). Do I like doing surgery? I have no idea. For the most part, I haven't done much more than sew the skin at the end of the surgery. Frankly, the OR has in general been pretty long and boring. Sometimes the procedures are really interesting and look like the would probably be fun to do but standing for hours on end just watching is not my idea of a good time. I really have no idea if I would like to do surgery as a career and am not sure how I will figure this out.

There is one more specialty that I find very appealing: emergency medicine. I will get a chance to really experience it until 4th year but emergency medicine is a nice balance. You get to think a lot and try and figure out what the diagnosis is for lots of different problems, you see quite a bit of action and get to do various procedures during emergencies (like sewing up cuts, putting various tubes into people, etc. but I'm not really sure to tell you the truth).

And there is the final possibility: working at the CDC permanently. If I enjoy my next year immensely I could end up doing public health for the rest of my life. This is a real possibility. Maybe even working in a foreign country. I won't be able to judge this much until I see how much I like next year in Atlanta.

But no matter what specialty I choose, I hope to be able to do research and advance the field. It's one of my favorite parts of medicine: the possibility to improve awaits, and that results in more lives saved.