Does your career reflect your values?

As part of our first year of medical school advising, we are supposed to take a variety of "tests" or "surveys" to determine what sorts of specialties and career paths we should think about pursuing. Each year there are more ways to do this, but right now, it involves taking a survey about your values in your career. After answering 15 minutes of questions that all begin with:
"It is important to me..."
and end with things like "that I am involved with teaching medical students" or "that I can control the hours that I work" or "that I manage the economic components of my work"

My results (listed below) are actually pretty reflective of my values and (perhaps unsurprisingly, to those who know me) tell me that I want to do everything except maybe a super specialized field.

So that narrows it down a bit. Sort of.


Prestige Your score: 2.8, Medium
High scores on the value of "Prestige" suggest a desire to be recognized by others as a top physician. Medical specialties related to Prestige afford high levels of power, stature in the community and among peers, and achievement. Surgery and most subspecialty areas of practice typically provide high levels of prestige.

Service Your score: 4.1, High
A high score on "Service" suggests a desire to care for others regardless of financial gains or other rewards. Individuals who score high on this value want to help others simply for the sake of helping. Medical specialties highly related to Service allow for contributing to the welfare of others. Primary care areas of medical practice may be associated highly with this value.

Autonomy Your score: 3.7, High
High scorers on "Autonomy" want freedom, independence, and control over their own work style, schedule, and lives. They want to do things in their own way, creatively, and with little constraint. Medical specialties related highly to Autonomy, such as pathology and radiology, allow working alone and in one's own way.

Lifestyle Your score: 3.0, Medium
High scores on the value of "Lifestyle" indicate a desire for security, stability, and consistency. A high score on this value suggests someone who does not want a lot of change, responsibility, or demands placed upon them. Medical specialty areas of practice that allow for routine, regularity, and predictability relate highly to this value.

Management Your score: 3.7, High
A high score on "Management" suggests a desire to supervise and have responsibility for others. High scorers on Management seek administrative responsibilities and find meaning in planning the work of other people.

Scholarly Pursuits Your score: 3.9, High
A high score on this value suggests a desire to engage in research and scholarship activities. High scorers typically seek opportunities to engage in intellectual pursuits and to be challenged by difficult cases or situations. Involvement in academic medicine, clinical or basic research, and teaching activities relates highly to this value.

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“I think, at a child’s birth, if a mother could ask a fairy godmother to endow it with the most useful gift, that gift should be curiosity.”
-Eleanor Roosevelt

New Languages

One of our pathology professors today told us that medical school is like learning 2-3 new languages. I would say that's a lot of Greek, a lot of Latin, along with some more surprising vocabulary:
war terminology (invade, protect, quarantine),
all the titles and rankings (resident, attending, MS2, fellow, tech, charge nurse, NP, PA, chief resident)
colloquialisms ("they pimped me on my peds rotation"...excuse me?),
and abbreviations ("just get the ALT, AST, and CBC before we tell him that his RUQ pain is from his CBD").

They tell us to try as hard as we can to remember how to talk to other people in normal ways. I can feel it slipping away already as I try to make sure all the new information stays in...

But the good news is, now when we have a 9 hour day where we learn 400 new enzymes and pathways and 67 new disorders, I don't get overwhelmed and think, "OH NO, we'll never learn this!" - instead I say, "how crazy cool that soon we'll know all of that".

Learning the language of medicine is pretty awesome.

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"Symptoms are the body's mother tongue; signs are in a foreign language."
-John Brown, MD

This is what I do

The other day I was talking to my father, not a doctor, about a case he's working on right now and how it was taking him all over the world to track down all the information he needed, but when I asked him if he was tired or stressed, he said, a little tired, maybe, but no, this is what I do.

What I do.

It's such an interesting concept - this thing, this job or career or role is WHAT I DO - my purpose, my passion, my greatest skill ?


What is it that I do exactly? Help people? Listen? Try to figure out what's wrong?

Oh wait...study.


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"you better do you cause I damn sure does me"
-fabolous (in his song, baby don't go)

Sexuality in Medical School

Yesterday we had a presentation on Sexuality and how to incorporate appropriate questions about it, as well as be sensitive to issues that may come as part of it, into our medical practices.

The session began with us all filling out (anonymously) a questionnaire that was probably 35 questions long. The questions ranged from:

"I am male/female/other" (circle one answer) to

"I have/have not given/received anal sex" to

"I feel very open/mostly open/not at all open about talking about sexuality" to

"I was/was not been sexually molested by an adult before the age of 14"

After we had each filled one out, we sealed them in blank, white envelopes and handed them up to the front of the class, where they were mixed up and redistributed until we each had someone else's (anonymous) survey in our hands.

Then, one of the Attending physicians in the Pediatrics department read each question and answer aloud, and if your person's sheet (the one that was redistributed to you) had circled that answer, you stood up. For example, my person was male, so when the physician leading the forum said "I am male" I stood up, because that's what my person had circled.

It was fascinating to see the range of responses. About ten people stood up when the response "I have never had sexual intercourse"; about half the class stood up to the answer "I have had a sexual fantasy about someone of the same sex"; and only two people stood up in response to the final question "I have lied somewhere on this questionnaire".

Afterward, they collected the surveys which were shredded, and we had a guest panel talk to us about their experiences with the medical system and their sexuality. One of the panelists was a fourth year medical student, who talked about his experience being a gay man with a serious partner applying to medical school - and how it did or didn't come up. He talked about his frustration with not wanting that to be the defining thing about him, but also wanting to talk about how his experiences have given him great perspective and sensitivity that hopefully will be really helpful with his patients. He stressed being not just open but CURIOUS about your patients, their sexuality included, but not just that.

The second panelist was a Professor of Psychology who talked about his experience as a gay man in the 80s going to see physicians and their responses, especially their fears about HIV/AIDS. He also talked about what it was like for him and his partner to take their daughters to different doctors offices, and how they never quite knew how much to reveal or how to fill out the forms that say "mothers occupation:" etc. He stressed that we need to identify when patients make us uncomfortable, because if we just push through, we're doing a disservice to them and to us - because they can tell we're uncomfortable. He also talked about how to nonverbally create a space where people feel open to expressing whatever they need to - including making more inclusive forms and, especially in places where we treat adolescents, putting up a rainbow sticker or a purple triangle to identify a SAFE SPACE. He said adolescents look for those as a sign that it's okay to talk through whatever they need to.

The third panelist was a PhD student in Psychology who talked about the language we use - both verbal and nonverbal, and how it's a big deal every time she has to tell someone she is a lesbian - a "re-outing" of sorts, and it's nice to not have to do that right away. She suggested asking not "are you a lesbian" but "are you sexually active with men?" and when she says, no, saying, "are you sexually active with women?". She also mentioned that she appreciated when doctors didn't dismiss the idea of her ever getting STDs or ever getting pregnant, but didn't push either of those on her.

It was a fascinating presentation and we have small group tomorrow to discuss it (and some readings) further. While some of the stories they told were horrifying and made me appalled at some of the behaviors of some physicians - I am so pleased that this presentation is a part of our curriculum and that everyone seemed really receptive to at least talking about it.

PS: I ran 10 miles today at 8min/mile pace - training for a marathon during medical school feels somewhat less crazy now. Or maybe just crazy feels good.

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"As I grow older, I pay less attention to what men say, I just watch what they do"

-Andrew Carnegie