Chapter 3

Residency

As far back as the age of about eleven, I knew I wanted to be a doctor. Prior to that I thought I was destined to be a veterinarian. My father and mother joked with me during my youth that I could always dig ditches for a living, as long as I received my M.D. first. And so, it was decided.

My father, of course, was a physician, as had been my grandfather and great-grandfather. The reasons for my going into medicine were clear: I wanted to be like my dad. As previously discussed, he was an ophthalmologist. But what he actually did for a living was less important to me than the manner in which he did it. He was a kind, gentle person, and I had always looked up to him. He was respected by everyone I knew, and his interest in understanding how things work rubbed off on me. He always wanted to build things, to fix them, to make them better. This encouraged my interest in science, and since I also had two older brothers who were either in medical training or on that same trajectory, it seemed the right thing for me to do as well. If nothing else, I wanted to be able to understand and participate in the dinnertime conversation.

I entered college with one intent: to go to medical school. I remember my dormitory friends constantly reminding me of how low the acceptance rate was for applicants to medical school. I was undeterred by their pessimism. In fact, it only fortified my resolve. I studied hard and was academically successful as a student. I achieved my goal and was accepted to the medical school of my choice.

Then I learned that medical school was a unique experience—beyond anything undergraduate accomplishment had prepared me for. The work load alone far exceeded that of even my hardest semesters in college. Medical education is divided essentially into two segments. During the preclinical years, the student is pounded with physiology, anatomy, pharmacology, microbiology, and biochemistry. Then two years are spent on clinical rotations, during which the student learns the basics of being a doctor. Rotations involve the student spending hands-on time with practitioners in various fields of medicine, including, for example, general surgery, internal medicine, pediatrics, and psychiatry. The last year of medical school is spent learning the subspecialties, such as orthopedics, otolaryngology, plastic surgery, and urology. It is during rotations that the student is faced with the daunting task of deciding which branch of medicine he or she desires eventually to pursue.

Although the romantic ideal is to practice in an area of medicine for which one seems to h