The more time I spend in the health system, the more I seem to draw the same conclusions.
There’s this strange philosophy coursing through the veins of medicine that if you’re going to bother getting a medical degree, you may as well become a specialist rather than “just” a GP.
That’s a nearly word-for-word statement I’ve heard more than once, especially during my time in med school, when I didn’t have the experience nor the conviction to back up why I wanted what I did. Now, as I near the end of my first year as a doctor, I’m a few steps closer to figuring out where I want to be.
Over the years, I’ve met dozens of GPs: plenty who generally find satisfaction and fulfillment in their jobs, a couple who are so excellent at their jobs that their appointments book out like Taylor Swift tickets, and a handful who openly regret their decision to pursue general practice and will warn you off it at every opportunity.
The latter is an interesting group, because their regrettable decision was because either 1) they spent a while trying to get on to a different training pathway and felt they couldn’t, so they chose GP as a fallback, or 2) they didn’t want to go to the effort of pursuing more rigorous and difficult training programs, so they took what they perceived to be the easy choice – which they’ve since realised is not easy at all.
Both options ultimately lead to GPs who are simply not suited to the job. This is not because they’re bad at medicine, but because of their lack of passion and traits that make them bad at general practice specifically. They aren’t the kind of people who really care to know their patients closely and longitudinally, in a way that no other specialty allows.
I’m realising it’s dangerously easy to end up doing something you’re not passionate about for the rest of your life.
But the beautiful part of being a junior doctor is that you get to just learn. It’s not like med school where full days of placement are bookended by hours of study for impending exams –where there’s so much content to learn that it’s impossible to even begin to enjoy the process.
Every 10 weeks is a new rotation that lets you learn all the things that speciality cares about; and every day is a chance to keep learning more about yourself and what you enjoy.
To my own surprise, I’ve found something to enjoy from almost every rotation I’ve stepped into, but it’s rarely been the tasks that entice those truly interested in that specialty.
In obstetrics and gynaecology, I found the initial consultation for a new diagnosis of endometriosis one of the most revolutionary medical counselling sessions I’ve been privy to. In orthopaedics, I found the discussion of osteoarthritis and the routine post-op follow-up more rewarding than the theatre time. In emergency, I eagerly waited for the roster to assign me to ambulatory care, finding satisfaction in the variety of patients, ones who don’t threaten to deteriorate to the point of needing resuscitation.
Related
One of the most rewarding days in my first year as a doctor came at the end of a long day as a surgical intern, finishing the seemingly neverending job list while still trying to make it home for dinner.
The very last job on my list was to organise a medical certificate for someone going home after an admission for uncomplicated diverticulitis. After I handed the man a medical certificate, he asked me what exactly his diagnosis was. This wasn’t an uncommon question. Doctors in the hospital system (and especially in the surgical field, where all the seniors are rounding on patients before a full day in theatres) are often terrible at explaining to patients exactly what is going on. If not covered on the once-a-day ward round, it’s often left up to nursing staff to read out an indication listed on an electronic medication order, or to GPs to explain their diagnoses from vague patient descriptions of symptoms and a brief understanding of their management (as the discharge summary most often reaches them later than the patient, I’m sure).
In this instance, I hoped my partner would forgive me for delaying our dinner plans, sat down on the chair beside the bed, pulled out a piece of paper, and drew two large bowels – one adorned with diverticula. Halfway through this fairly amateur explanation of diverticulitis, the small room filled with family members – a wife, then a son, then a daughter, then a mother-in-law. I started my explanation again as they too asked to know what was going on with their loved one.
At the end of this explanation, the room fell silent – awkwardly so – and I feared my explanation or my drawings (or maybe both) weren’t very good at all. But mercifully, after a moment, the patient sat up in bed a little straighter, tears swelling in his eyes, and thanked me for explaining something he’d heard of for years, and realised he’d struggled with for years, but not actually understood until then. His wife echoed a similar expression of gratitude and asked if I’d ever thought about becoming a GP, and when that transition may be, and if they could have my name written down in anticipation of that time.
Despite maintaining that I’m keeping an open mind about the specialty I’ll pursue, when I think about my time thus far as a doctor, I feel like my heart is choosing for me. And much to my surprise, it turns out my heart lies with a medical certificate and a scribbled drawing of a colon.
Dr Milleni Weeratunga is a junior doctor working in Metro South Health in Queensland.