What’s next, doc? The after-residency plan (or lack thereof)
Every single day they ask. Every single day, unless I hermit it in my apartment, someone will ask me “What will you do when you are done Residency?” “Will you stay here?” “We need more young/lady/nice/working doctors.” Even if I’m snowshoeing with strangers or chatting about dragonfruit at the grocery store, a person will politely ask what I do, and of course, “Oh, and then what will you do next? Where will you go?” When I ask them about their job, their kids, their hobbies, etc. it would be rude and personal for me to ask them “so, what are you going to do next? Live in the same place? Keep the same job?” even though I know that when they ask me they are being polite and genuinely interested. It’s not really a double-standard. I think I’m just a little upset that I have no idea where I’m headed. I never have.
Moving across the country at 17 wasn’t planned. Feeding fruit loops to lab rats wasn’t something I’d dreamed of. I didn’t know where Cambodia was 5 years before I went there. Medical School just kind of happened. Life is beautiful that way, but it makes answering polite inquires that much harder. I don’t have a good answer for the future. Some of those who don’t understand Residency will wonder if I am to specialize – at least I can definitely say that I’ll be some kind of Family Doctor, although in my mind, I think I’ll be everything but the traditional picture of the office-based GP. For all those who want a nice ‘lady doctor’ like me to do their pap tests, I’m sorry, but it is about the least interesting thing on the planet for me to examine healthy people. I get to tell inquiring minds that Family Practice is basically a specialty of it’s own, but that within it, there are hundreds of branches and I might pursue any one of them – save Obstetrics!
I know I like sick people. I also like old, demented ones and hardworking middle-aged blue-collar dudes. I love British Columbia and I also love to travel. I dislike paperwork, enjoy technology, and like working in a team with people smarter than me. Some of these things will guide my choice of work but I’m sure I’ll have new preferences down the road. I’ll start by doing locum tenens (“locuming”) which means filling in for doctors who are on vacation or working temporarily in communities that have a physician shortage. Could I stay where I’ve trained? Maybe. But not yet. Hopsitalist medicine, nursing home care, palliative care, clinic, and small town ER around BC/and the Territories will be how I’ll start. I haven’t signed anything yet but a month in Rankin Inlet, Nunavut has a strong chance of being my first stop.
Even though it’s from 1982, all Canadian med students and residents should read this 1 pager: Life After Residency or, Go North Young Doctor! – By Dr. Susan Phillips (Can Fam Physician. 1982 December; 28: 2239.)
Not only will it be a new kind of job, it will be a whole new ‘state’ for me. I’m getting ready to un-become a resident. It’s time to be a “real” doctor, in less than four months. Ties cut, shelter scuttled-out-from, protection lost. Come July 1st, it’s going to be the Real World. No, I’m not going to be on some MTV reality series. Those people are way too peppy for me – remember, I’m 97 inside, or at least feel it sometimes. I’m going to have to work to eat. I won’t have health care, I won’t have taxes automatically deducted, and I’ll have to figure out what an incorporation is and how to make one. There will be no more formal evaluations or “hey Jess, check out this cool case” learning opportunities. If I screw up – ok, when I screw up – there’ll be no one to hide behind.
There are many benefits to the transition, like not having to explain what a Resident is anymore. Not having to review cases, study for licensing exams, or do things someone else’s way when I think my way is better are things to look forward to. I’ll also get a chance to start paying down the student loans and maybe start warping the young minds of med students.
I’ll never stop learning but pretty soon I’m going to have to be the emmm-arrrrrr-peeeeeee. M.R.P. Most responsible physician. Oh yeah, that’s right. Taking names and not killing people, that’s me! As much as the uncertainty is a point of stress, I finally get to choose the answer to that question, “What the hell am I going to do now?”