My aptitude for family medicine: poor, apparently

I did the University of Virginia medical specialty aptitude test purely for sport recently and was startled to learn that of 36 medical specialties, the one I am least suited for is family medicine. 

I'm not surprised that family medicine did not rank first. I chose it only partially because of any natural inclination toward it, and mostly because the training and practice of it meshed best with other priorities in my life, particularly raising a family. What did take me aback was that it occupied the very last spot on the list.

Pathology and radiology ranked at the top. 

From time to time I flirt with the idea of returning to residency, but what it comes down to is that I would rank my current job satisfaction as a family physician at a 9/10. Is a chance at boosting that to a perfect score worth three more years of residency, a massive reorganization of family roles, a significant reduction in my time spent with the kids and a hefty kick in the pocketbook? I don't know.

William Maxwell, fiction editor of the New Yorker from 1936 to 1975, said upon retirement: "For nearly forty years I have shaved with pleasure in the thought that I was about to come to this job." How I love that quote. What a gift, such perfect happiness with one's work. 

Of course, while he was shaving his wife Emmy was likely frying up the breakfast bacon, readying their daughters for school, preparing for a day of housework and granting him the enviable ability to be single-minded. 

That is what I find most difficult about mixing medicine and motherhood: the diffusion of focus. 

My work in refugee medicine is profoundly rewarding; raising three little ones even more so. The two have proven to be compatible. And yet at some point the efforts put into one require sacrifices made of the other. There simply are not enough hours in the day for me to invest what I wish I could into both spheres. I have erred on the side of mothering, and while I do good work at the clinic, my career trajectory has been modest.

I say this cheerfully. So far, I don't regret any decisions I've made. And every day presents an opportunity for new and different choices. Maybe one day, when the kids are a little older, I'll alter my career track or return to residency.

But for now, and maybe forever, a 9/10 is good enough.

(Cross-posted at Mothers in Medicine.)

Comments

[nicolien]

Of course every life is different, but what you describe sounds a bit like my mother: she's a physical therapist/psychologist, and for 20-odd years, she has worked part-time while raising four children. Now that all of us are in university or working, she has started her own practice and is on top of learning everything that's new in her field... soo many things are still possible! :)

[The Other Pete]

Yes, it's one of the most important lessons in life. You can't have your cake and eat it too.

I have this feeling regularly when I call up a friend and ask him if he wants to go out birding. Most often he has to apologize because his wife is out working.

Every silver lining has a touch of grey.

[Hilary]

I remember my father telling me how he had once had ambitions of being a surgeon. When I asked him why he didn't follow his dreams, he replied that his then young family needed him more than the residency would allow. I know he still loves his job as GP perhaps because he occasionally gets a surgery fix by assisting.

[Jlyn]

Oh i can't even explain to you how much i needed to read this today. Many people have fears of snakes or planes or heights...but i'm sure of myself in saying that my biggest fear, the one that lurks like a monster in my closet, is the BALANCE of physician-hood & motherhood. Hearing from a mommy-dr that is happy, satisfied with her job, & able to love on her kiddos more that 3 hours while they are sleeping...hearing that is truly INSPIRING. :) (i'd love to hear how you came to find your job...& if there are similar financial setbacks from student loans in canada as there are in the US)

[Icedlatte]

I second Jlyn. Thanks. The mind-share between mommy & doctor is exhausting, but also invigorating. There's no opportunity to be lazy, but plenty of opportunities for resourcefulness, concentration, and efficiency, which speaks to my ruthlessly busy, restless mind. I forget to give myself permission sometimes to say, Yippee! I'm where I want to be. So thanks for validating me. Now for more coffee.

[Katherine]

Interesting. My dad is a FP and has been for 20 years. He still occasionally mentions going back to residency for radiology.

I feel the same way about the "diffusion" the occurs between parenting and doctoring. I think I do both reasonably well, but neither one spectacularly.

[Vicki]

you are totally blessed with a 9/10 for job satisfaction!!! It sounds like you're doing a great job at balancing your career and your family... I love reading your blog :)

[Sara/Inkling]

Beautiful post. I've recently grown to appreciate my family doc in the Lower Mainland more than ever because of his bulldog like determination to get me well after a specialist gave me severe childbirth injuries with her poor decision making. He is having to learn all about my injuries, which go beyond the scope of his training, but I see him working hard and being a great advocate for me. Coming from the States where a family practitioner is someone I would have only seen for things like strep to being in Canada and having my family doc be my first and main care provider has been an adventure - a good one. From reading your posts these past many months, I have the feeling that many of your patients feel the same trust and appreciation for you that I feel for my family doc.

[Katie!]

What a brilliant way to phrase it: diffusion of focus. It's perfect.

[Janet]

Maybe in time (future decades) you'll want a change and you'll already have a list of potential avenues to explore.

[Liz Castro]

Beautiful pictures, inspiring quote and thoughts. Seems like 9/10 is pretty good. The way I think about it, you can't do everything at once, and right now I need to spend time with my kids. I am confident there will be time when they're grown when I can continue writing in earnest. But I know I can't write now and share their childhood later.

Thanks for your kind words on my blog. I'm glad my flickr info was helpful.

[mstpbound]

oh my god. I took the survey, and the top three specialties are SPOT ON. they were 1. neurology 2. neurosurgery and 3. pathology. i'm currently most interested in neurosurgery, with neurology as a possibility....and actually i found pathology to be the most enjoyable out of pharm, pathophys, and pathology classes this year!!!!

[FreshMD]

Thanks for these very interesting and encouraging comments. I particularly enjoyed Icedlatte's remark: "I forget to give myself permission sometimes to say, Yippee! I'm where I want to be." So true! There should be more cheering, less second-guessing.

@Sara/Inkling - Yes, family physicians seem to have a different role in Canada. My American friends who have moved north are surprised when FPs don't refer healthy children to pediatricians or routine gyne exams to OB/GYNs.