The Medical Student Perspective

One year into medical school, each new concept I learn about medicine brings up a flurry of questions. Yet one thing has become quite clear: The physician community has already welcomed the class of 2010 into the profession, and all are willing to provide advice and share experiences that will help us navigate the questions we will face on long road ahead.

Medical training is much like drinking from a fire hose: gathering as much information as possible in order to make educated decisions regarding patient care and one’s own career. Choosing a specialty is the first career-focused hurdle we face, clearing it through evaluations of clinical experiences, lifestyle expectations, personal circumstances, and advice from our mentors.

I have 121 wonderful classmates at the UCSD School of Medicine. Many of us entered medical school with idealistic views on how we will impact our patients and the world as physicians. Yet, even through watching the evening news, it has become increasingly difficult to ignore the fact that healthcare is a business and, as a doctor, there will be a multitude of considerations beyond simply caring for patients. These details of the profession will inherently contribute to our practice decisions.

For many, lifestyle will be a heavy consideration in our career paths. Balancing family commitments with call coverage responsibilities may drive some towards group practices, where these responsibilities can be shared. The unfortunate reality of paying off college and medical school loans may indeed impact many students’ choice of practice, accepting a job offer that pays more at the expense of other attractive practice attributes.

However, lifestyle will not be the only factor determining choice of practice among my classmates. I can foresee the business-savvy personalities thriving under the management demands of private practice, while those who have a passion for teaching may find their careers in academic medicine. Some devoted to serving the medically underserved may pursue careers in community clinics. Whatever be our ultimate choices, I hope the strengths that each of us bring to the greater physician community will serve to improve healthcare as a whole.

The mode of practice exposure that we receive as medical students in the United States is largely limited to hospital-based academic medicine. However, at UCSD, we begin to learn about the different practice settings that frame the medical profession during a second year course, “Introduction to Health Care Policy.” Clinically, through ambulatory care preceptorships and primary care continuity clinics, students have the opportunity to learn about one of many practice settings through pairings with community physicians. Additionally, by participating in the UCSD Student-Run Free Clinic and in an underserved medicine clinical elective, we are able to experience work as health professionals in community clinics.

I speculate about these decisions now but understand that only through soaking up experiences and advice in the coming years will I feel capable of selecting both a specialty and a mode of practice. Perspectives change, those professional and personal — especially with the range of experiences that is yet to come.

So for now I turn back to the life of a first-year student, selectively retaining some of my idealism, looking forward to the road ahead, and asking all those who have been in my shoes one thing: Please, continue to share your invaluable wisdom and experiences with all of us in short white coats.