Match is one year away!

It was an exciting week for the MSIVs. The Osteopaths got the results of their Match and the Allopaths had to submit their Match lists. The latter's results won't be out until the middle of March. I wonder how many AZCOM MSIVs were scrambling for Residencies on campus this last week?

All this talk of Residency has made me reflect on FP pretty hard. So be forewarned, this post is more about another week of soul searching than medicine.

I believe I would be good at rural FP and the job would be thoroughly satisfying. My lingering doubts are around whether the family would like living in a rural town and being stuck there once we establish ourselves. Becky won't have many careers options other than helping to run my practice. Maybe she find a foundation to run or get elected to something, but not much need for a CFO.

At this is my justification for not reading much the last two days. I've spending most of my time researching Emergency Medicine, Anesthesia and Surgery residencies to see what options are out there and how they "feel" as I try to envision those specialties as careers. Yes, I've made a couple of spreadsheets.

The timing is getting pretty important now because there's still a possibility of changing of my last rotation this year. I also need to start applying for audition rotations the beginning of my fourth year in order to reserve openings. I may just start and double book myself to be prepared.

EM is nice in that you work reasonable hours. Typical schedules include 4 x 12 hrs for three weeks then the fourth week off, or 7 x 12 hours every other week. Those hours are usually very busy and can be quite stressful. But when you're off, you're off (no call). You make more than FP and do lots of procedures. You make good money from day one and can readily move to a different hospital with no drop in income. The down-sides are screwing with your circadian rhythms (night shifts), no continuity of care (triage-stabilize-move on) and always working in an ER environment.

Anesthesiologists work longer hours, have an additional year of residency and have job that can be very boring (punctuated by moments of terror). They do a fair amount of procedures, have some patient interaction and make a very nice living.

Both of these have one big negative I just discovered. The residency options aren't very good. EM has few Western US programs, but tons of DO programs in the Midwest. Anesthesia just has programs spread out everywhere. Both are fairly competitive, but the latter even more so. We would probably have to be willing to move where ever I got accepted. With FP I feel pretty confident I can pick three top programs in nice places to live and get one for sure.

Surgery worries me because residency and practice hours suck. You have to love the ER because it's your mistress. And there's my age factor. I know surgeons that operate into their 70's but that is the exception. That's why rural FP is so appealing. You can do minor surgeries (still great fun!) but they don't dictate your lifestyle and you can stop whenever you choose.

Becky is also doing a bit of soul searching herself while spending the weekend with the kids at my Dad's place in SD. Maybe he'll have some words of wisdom for her. Her careers desires may very well be the deciding factor on my specialty.

My uncle form Ann Arbor is on his way down to pick me up. I've never seen his place. It will be nice to get away for a few hours and talk this out myself. His daughter, my cousin, just started medical school at U. of Washington so he may have more interest seeing as how his daughter will be going through this in a couple of years.