I remember the day in July 2015 when I picked up an Ambu-bag and placed it on an infant’s face. After the third squeeze, I thought, “Okay, I’m definitely going to become a pediatric intensivist.”
Omniscient narrator: she would not grow up to become a pediatric intensivist.
This is all about that awkward time I spent realizing what the narrator knew all along, and how I changed my career in medicine at a point where everything already felt set in stone.
I graduated medical school in 2016 and went into pediatrics. I trained at a high-volume, clinically focused program with a very robust pediatric level 1 trauma center, and had no shortage of learning. I adored my co-residents, respected my attendings and mentors, and had a ton of fun on my intern rotation in the pediatric ICU. Then…I did my senior rotations in the ICU, and started thinking about what it would mean to be an attending physician. The burden of caring for patients who were victims of non-accidental trauma (abuse, in non-pediatric lingo), or the tragedy of losing well-known and well-loved kids to cancer really started to wear on me. From a personal and psychological standpoint, my own degree of anxiety, perfectionism, and fear of failure finally started to catch up with me. Over time, it stopped acting as the tool that drove me forward, and became a very heavy anchor. With therapy (and SSRIs), my anxiety improved, but I continued to hold significant reservations about the long-term viability of a career in pediatric intensive care.
As I neared the end of my second year of training (around the time pediatric residents apply for fellowship), I still planned to go into PICU, but had significant reservations about the viability of a long-term career in that field. I knew that I loved sick patients, physiology, and procedures, but I also knew that the idea of being an attending responsible for 20-30 critically ill children in the middle of the night filled me with dread. I was still frozen with indecision when I started a required two-week rotation in pediatric anesthesia. I noticed that anesthesia involved all the things I loved (physiology, procedures, critical care), and minimized my exposure to the things that were draining or depressing. I also liked the one-on-one focus I could have with patients, rather than the anxiety-provoking splitting of my attention in a dozen different directions. My attendings and mentors helped me realize that anesthesia wasn’t just a pipe dream, and so…I made the decision to do a second residency.
Almost five years have gone by, and I’m now in my last year of anesthesia residency. I decided not to pursue a pediatric anesthesia fellowship (another story for another day), but I’m still so happy I made the choice to switch. That’s not to say it hasn’t been hard – real life continues to march on in spite of my Peter Pan status in medical training. I had a baby, fed that baby with my body, experienced very severe PPD/PPA, and have muddled through much of the past few years, but I’m still here. I still like what I do. I can see myself being a real grown-up with a real job that I actually enjoy.
Five years ago, I felt like I was locked into choosing one of three careers that would only exacerbate my mental illness and dissatisfaction with the medical profession. The idea of starting over felt terrifying, uncertain, and rife with opportunities for failure (failure and uncertainty are definitely things all medical professionals love). But it’s never too late to change your mind.
The Nitty-Gritty – how I switched career paths two-thirds of the way through a residency program and the questions I asked myself as I contemplated doing a second residency.