“Is there to be found on earth a fullness of joy, or is there no such thing? Is there some way to make life fully worth living, or is this impossible?”1
The question follows you through every rotation in clerkship. It is almost a standard greeting from residents and others, “What specialty are you interested in?” Some know early, other find a path later, many change their minds. With CaRMS applications closing many had to take stock in of their passions, commitments, aptitudes, relationships and more in choosing programs. Another challenge will come shortly with interviews and submitting rank order lists. Come Match Day there will be many cheers and tears of joy, there will also be private anger and disappointment. This is a stressful time in the lives of medical trainees. Should so much joy and sorrow hang on the pursuit of a specialty?
“If there is such a way, how do you go about finding it? What should you try to do? What should you seek to avoid? What should be the goal in which your activity comes to rest?”1
Considering the work and dedication required to get to this point in our lives it is understandable that the possibility of not matching to the preferred field or location would be disappointing. The path is long and the training difficult; from undergraduate grade point level to the MCAT score; all the while ensuring substantial extracurricular or research involvement when applying to medicine. Then, after three or four years of training and much harder work along the way, those who have made the journey begin to feel entitled to pursue specialization in their preferred field.
“The ambitious run day and night in pursuit of honours, constantly in anguish about the success of their plan, dreading the miscalculation that may wreck everything.”1
Conversely, so many only dream of the opportunity to pursue higher education let alone medical training. Considering the lack of socioeconomic diversity in medical school along with the high median income of the families medical students come from2-4, we enjoy privileges many lack, and lamenting not being able to pursue a chosen field seems petty. Doctors continue to enjoying high social status, income, and the privilege to enter other’s lives and provide care. Shouldn’t pursuit of any field be appreciated? Why should a career in a single specialty determine one’s contentment? In the end, no matter the field or training location you still bring yourself to your vocation.
“Thus they are alienated from themselves, exhausting their real life in service of the shadow created by their insatiable hope.”1
Kevin Dueck is a Family Medicine resident at McMaster’s Brampton site. His interests in the health humanities include medical narratives of illness and care, exploration of medical culture, and the history of medicine. Kevin is the author of the blog Aboot Medicine (Twitter: @AbootMedicine) and co-founder of the student wellness project Western Vitals.
Zhuangzi, Merton T. The Way of Chuang–Tzu. Excerpts from Perfect Joy. New Directions, 1965.
Grbic D, Jones DJ, Case ST. The Role of Socioeconomic Status in Medical School Admissions: Validation of a Socioeconomic Indicator for Use in Medical School Admissions. Acad Med 2015 Jul;90(7):953-60.
Dhalla IA, Kwong JC, Streiner DL, Baddour RE, Waddell AE, Johnson IL. Characteristics of first-year students in Canadian medical schools. CMAJ 2002;166(8):1029-35.
Trisha G, Kieran S, Petra B. “Not a university type”: focus group study of social class, ethnic, and sex differences in school pupils’ perceptions about medical school BMJ 2004; 328 :1541