April 2, 2007
Student Scene
Re-match Day Leads to New Specialty
Photo by Jeff Cleary
Tarayn (Grizzard) Fairlie |
No doubt about it, I feel more than a bit guilty. At the end of the academic
year, I’m leaving my current residency program and also my current specialty,
family medicine, for greener or at least more suitable pastures. As Match Day
drew near last month, I was faced yet again with the horrendous anxiety that
faces all U.S. residency applicants in March. Uncertain of where I and my newly
immigrated husband might end up living and working in July, there were definitely
a few sleepless nights and moments of rising panic as the big day drew near.
Match Day itself was thrilling. I was unbelievably happy to match in pediatrics
at the program that had welcomed me the most heartily during the interview season.
But at the same time, I feel an odd twisting sensation of guilt and consternation
as I now tell my story, repeatedly, to my current colleagues and faculty members,
only a few of whom were aware I was looking to leave the program after this year.
Of course, I know that some of this anxiety and discomfort is just nerves and a fear of the unknown that keeps me from celebrating the new change in my professional life with the friends that I’ve made in the program. But the other feelings that form the pit in my stomach are harder to identify and dismiss. There’s a lingering sense that I’ve abandoned not only my program but also left behind a specialty much in demand and much needed in underserved communities. Despite months of preparation and soul-searching, I still feel at times that I have been selfish in deciding to reapply to specialize in pediatrics and to leave family medicine behind.
The Calling
I made the choice early on in my internship. I realized then, after a difficult
perinatal case on our service, that I needed to pick one thing, one area,
in which to build skill and comfort. A few weeks later, I realized in the
middle of a rotation in pediatrics that this was the field I found most enjoyable,
most edifying, and the best fit for my abilities and experience.
Despite this epiphany, it took me the bulk of my internship year to convince myself that it was OK to switch midstream, to change—for personal reasons—a professional commitment I had made to a program and a specialty. It’s not, after all, that I wasn’t doing well in family medicine. As an intern, I, like my peers, quickly acquired a knowledge base and physician survival skills, and I feel like I take good enough care of my panel of outpatients as well as my patients on service. I think that I would have been a good enough family physician.
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It took me the bulk of my internship year to convince myself that it was OK to switch midstream, to change—for personal reasons—a professional commitment I had made to a program and a specialty. |
Yet I knew that I wasn’t thriving in family medicine. I found it too broad, too encompassing, and at the same time, lacking the detail and specificity I enjoyed so much in my pediatrics rotations. As the workload increased, I found myself more and more out of step. I was less sensitive, less caring, and more depressed than my co-interns, a maladjustment I couldn’t ignore. I began to worry that I would neglect my patients or my family and that the phantom of provider burnout, which frequently hovers about physician professional meetings, would become a part of my day-to-day life.
Getting Past Guilt
I knew that I needed to switch my specialty to find a place where I could be
passionate about my patients, where I could be planted and bloom. I needed
to find a space for my own academic interests in breastfeeding and child
development to nurture my own intellectual curiosity, a need I believe I
will be able to meet as a pediatrician.
That my guilt at switching specialty has lingered so long surprises me, but I take comfort in the knowledge that further neglecting my own needs might have led me to violate all that I’d been taught about first causing no harm to my patients. At any rate, I am sure to expiate my guilt fully as I do penance by completing yet another intern year, a year at whose end I hope to find myself exactly where I need and want to be.
The opinions expressed in this column are not necessarily those of Harvard Medical School, its affiliated institutions, or Harvard University.
Copyright 2007 by the President and Fellows of Harvard College