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Finding My People: How I Discovered My Dream Specialty

Jun 22, 2021

Written by Elli Izrailov

Elli is a final year postgraduate Monash medical student, with a love for general practice, rural health, mental health, and memes.

When I was younger, I always wanted to be a superhero. 

Realising that I was unlikely to develop superpowers, be exceedingly rich or an alien from another world, I decided to be the next best thing, a doctor. As I’ve become older, I’ve realised that fundamentally, doctors and superheroes do the same thing—save lives. So a doctor it was. But not just a doctor...

In Year 12, strangers would ask me what I wanted to do after school.

“I want to be a neurologist,” I would say.  

The fact that I had literally zero inkling of what neurologists actually did made no matter. I wanted to be a doctor, and the brain interested me. What makes the entire farce of this preconceived notion of pursuing neurology that much more naive was that I actually wanted to pursue psychiatry. At the age of 17, I didn’t know what the difference between psychology, psychiatry, or neurology were. I loved learning about Schizophrenia or Dissociative Personality Disorders (formerly known as Multiple Personality Disorders), as inspired by some of my favourite films: A Beautiful Mind, 12 Monkeys and Fight Club. So I thought what better way to fuse my interests and desire to help others than by pursuing N E U R O L O G Y

“How do you know you want to be a neurologist?,” people would ask. 

I would reply in modestly huffed tones “I find the concept of neuroplasticity so interesting. Reading Dr. Norman Doidge’s work on the matter in The Brain that Changes Itself is just so fascinating.”

That was about the extent of how much I had looked into ‘neurology’. Regardless, I was committed, my mind was fixed, and I was determined – neurology!

Fast forward three years of undergraduate studies, several neuroscience subjects — which reinforced my love of the brain —  and four rejections into medicine, I finally got into my dream degree! 

I moved to a new town, met the rest of my cohort, and as all bland small talk went, we asked each other the age old question, “So what do you want to get into?” 

“Emergency Medicine.”

“Ophthalmology.”

“General Practice.”

“Paediatrics.”

“Obstetrics!”

“Cardiothoracics.”

My favourite answer to this was, “I don’t know.” Showing true conviction to not place your bets on one specialty so early into your journey, I believe is a true mark of wisdom.

And I don’t know why, but a fair few of my colleagues even said, and I shudder to repeat it, “General Surgery.”

And then there was me, still championing my little neurology corner. 

But something happened that I wasn’t quite expecting. Doubt. 

Or rather, the death of conviction— an open mind. A full year of preclinical studies showed me just how fantastic clinical medicine was. Musculoskeletal, rheumatology, respiratory, infectious disease, cardiology, dermatology, gastrointestinal, hepatobiliary, gynaecology, urology, oh is there anything I’m missing? Oh of course, neurology – regardless, I had a love for them all. 

So, I finished the end of my first year of medicine with doubt, and overall excitement. I realised that I had been living a large chapter of my life rather narrow-mindedly, as I was so focused on trying to get into medicine. But now that I was in, well the doors were wide-open. I could pursue my career in any which way I wanted. There was something so liberating in that realisation. 

Going into my first clinical year of study, we were put on the wards, and I had revised my strict ‘neurology’ pursuit. At that point I had realised the difference between neurology and psychiatry, and while I was a neurology nut, the mysteries of psychiatry were so enthralling. I was also interested in paediatrics, emergency medicine, and, to a certain point, general practice. 

I’ve always loved kids so that’s where paediatrics fits in. Emergency medicine is (on a superficial level) the coolest of any speciality, I mean come on, you’re acutely saving lives! And then there’s general practice. Well… I always thought that being a GP was quite mundane. My thinking was, why spend your entire medical school to ‘just be a GP’? 

It was during my psychiatry placement, in my third year, that my view of the future shifted and skewed. Some things in my vision stayed the same; for example my passion for mental health. Others however distorted; for example the way I perceived psychiatrists. Don’t get me wrong, psychiatrists are excellent communicators, genuinely caring and wanting the best for their patients. Having said that, well, as the saying goes, if you don’t use it you lose it, and I had developed too much of a passion for medicine in general to bear the thought of forgetting everything over time. 

Later that year I had my obstetrics and gynaecology rotation which was an incredible experience, and something I am still considering to this day. Then there was paediatrics, which was remarkable. I loved doing the baby checks in the maternity ward, but I came to understand that as much as I enjoy the happy moments, I am a sensitive person, and sick children, which is a fundamental part of the job, well... let’s leave it there. 

Then there was General Practice. 

Over three years in medicine, I had started to look at GPs quite differently. Yes, they are the person you go to when you have a cold or need a sick certificate, but they’re so much more than that. They are the middle people of the healthcare industry, the primary physicians, your base point in helping you circumnavigate the rest of the archipelago which is the medical community. 

I realised in that rotation, but also perhaps I knew at the end of finishing psychiatry that it would have to be GP for me. 

GPs are the jack of all trades and the masters of none (check one). This first point for me meant that I could revel in the wonders of medicine without having to sacrifice the rest. They work in a community setting and get to see patients and establish rapport over the long term (check two). This second point was very satisfying for me, especially after finishing my gen med rotation this year. A career in general practice would be perfect for me as I would actually get the closure of patient outcomes post-discharge that was so lacking in the in-patient setting. Finally, GPs do a large amount of mental health care (check three). This last point meant that I could do counselling/psychology work, and incorporate that into my practice. 

Sigh, so there we have it, my journey to finding out how I realised what I want to do with the rest of my life. I am still open to the fact that I may change my mind, but for the moment, it is a direction which I am happy to pursue. 

But what can you learn from all this? Over my medical school journey I was told and I learnt several things to consider when deciding a specialty.

What I learnt

1) Know your ‘people’

The culture of the team and the specialty that you work with is important. If you don’t fit in with the team that makes up your specialty, then you need to keep that in mind. Having said that, you could have just worked with one particularly bad team. 

Unfortunately, systemic negative practices exist within certain specialties. It is a sad and salient fact, however, that is not to say that your future role may not be pivotal in changing this. 

2) Find your calling

This is best determined by understanding what specialty you find most interesting, or what patient population you gravitate towards most. For me that was realising I have a love of all things medicine. 

3) Let your priorities guide you

I know what my future priorities (career and personal) are and what I want. I want to establish a community with my patients and I want to have a life outside of medicine. GP is not the only specialty that can foster these goals, but it still checks that box. 

4) Don’t let anyone tell you what to do

If other people say you’re not made of the right stuff for this or that, don’t listen to them. If you want to pursue that specialty at the end of the day, don’t let anyone try and deter you. Make up your own mind and decide what works for you. Accept the competition of your dream specialty, but don’t let it deter you.

5) Ask seniors about their journey

When you can, ask your senior supervisors - consultants or registrars - how they got to where they are and why they did it. I find that asking a senior who is x amount of years ahead of you in their medical journey provides perspective of the wide options available in the wider career of medicine.

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