Tuesday Musings: On “Good Enough”

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When I thought about returning to blogging, one of the things I knew for sure was that I really didn’t want to end up writing only fluffier pieces. Don’t get me wrong, I love fashion posts as much as the next girl, but I also wanted the blog to reflect my life and the things I’m thinking about a little more than it has in the past. I’ll probably play around with this column in the next little while, but for now I’ll try to post these articles on Tuesdays. If there’s a topic that you think is relevant and want to hear more on, feel free to send me an email! Since this post is a bit of a doozy, I’m putting it after a jump. Click through to read more!

I’ve been thinking a lot about the message of this article in the last few weeks. I’m coming to a point in my very young career where I need to make what’s probably the first major decision – the kind of medicine I want to practice. I’ll explain briefly. In Canada, to be a doctor you first attend medical schools. Depending on the school you go to, this takes either three or four years. The first 1.5-2 years is mainly classroom-based learning; it’s when we explore all of the biology, physiology, and psychology that make up medicine. The remaining 1.5-2 years is called “clerkship”. During this phase we go into the hospitals and rotate through different specialities. The purpose of this is two-fold: a) we get to practise using the knowledge we’ve just acquired (or are supposed to have acquired!) and b) we get to see what we like.

I’m in that clerkship phase right now – and with a little over 12 months left in medical school, I need to start preparing for the next step. This is residency, which happens after medical school and is a time when a doctor focuses on learning how to be the kind of doctor they’ve chosen. The length of a residency program changes based on the specialty, but usually ranges anywhere from 2-5+ years. Now, the caveat to all of this is that a medical student (like me) is not guaranteed to get into the residency program they’d like. At the end of medical school, we all apply to programs via a service called the Canadian Residency Matching Service (or CaRMS). It’s a very stressful time, as the program you get into (or “match” to) dictates what kind of doctor you’ll get to be, and where you’re going to spend the next few years of your life. Not only does this impact your career, but also your family, your partner if you have one, your friendships, and likely also your hobbies, routines, and lifestyle. In short: it’s huge. And I can’t stop thinking about it.

When I came into medical school, I was pretty sure that I wanted to be an obstetrician. I think the medicine is awesome, with a great mix of surgery and office to suit my personality. I love the patient population: young and usually healthy, and even when they’re not, most of the time you can fix it. After my first year of med school, I went to Kenya to get some hands-on experience in OB. My experience left me with mixed feelings (a whole other topic), but I’ll never forget the high I felt after delivering my first baby.

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When I came back to Canada I started doing a little more research into OB/GYN as a career, and got my first reality check. These doctors work constantly. As in, according to the Canadian Medical Association, the average number of hours worked per week is 55, + 30 hours of call. That’s an average of 85 hours/week. To put things in perspective, there are a total of 168 hours in a week. I like to sleep a minimum of 6 hours per night, which right away knocks off 42 hours. If I work for 85, I’m left with 41 hours for my family (and myself) per week. This includes time for everything from brushing my teeth to running errands to spending time with my family. It’s no wonder that almost half of all OB’s in Canada report being dissatisfied or neutral about their balance of personal and professional lives. Only 12% report being very satisfied.

Yesterday I had an awesome day in the ER. I was working with the program director, and just ended up getting into a groove of seeing patients, figuring them out and coming up with plans. He was really happy with all of this, I was happy that I was remembering things like the symptoms of aortic stenosis (narrowing of a heart valve), and actually helping patients. Plus, I got to pop a shoulder back into place (the most satisfying clunk ever) and had more than a few moments of “I could so get used to this”. My shift ended at 4, so by the time I was done seeing patients, it was 5. That left plenty of time for a run, quick dinner, and relaxing all before 8 pm. It’s days like this that make me think I should just lean in, work hard and not be afraid to spend a lot of time on my career.

So this is what I’ve been thinking about. Should I practice a field of medicine that is (marginally) less interesting to me, and have time for a life? Or should I say, well, I’ve come this far, I’m not stopping short now! I’ve been in school for 20 years. When I’m done it will be 26, and 12 of those years will be post-secondary education, well over $100,000 worth of schooling. Do I owe it to my family, myself, society to work as hard as I can? Many days I feel that I do. Sometimes, though, I think “no”. I want to have kids, and then I want to be around to see them. I want to travel. I want to have time for running and my partner and brunches with friends.

When I stumbled across Walsh’s article, about how it’s ok for women to make choices that aren’t 100% career-driven, I breathed a tiny sigh of relief. Maybe it wouldn’t be failing for me to study family medicine, and do a fellowship in Women’s Health. Maybe I could still work hard, and make valuable contributions, and be okay with not billing 200 hours each month. And, just like Walsh, I still agree with many of the points made by Sheryl Sandberg in Lean In: I will earn a generous salary. I will sit at the table and use the voice that the precious letters after my name earn me. I will take opportunities, and I will make my career a priority. I just won’t make it the only one.

The jury is still out on what kind of doctor I’ll become. I’m just glad that for now, the dialogue about the expectations placed upon physicians (and working women in general) has been started, and I’m glad that women like Elsa Walsh are brave enough to say that it’s ok to not “have it all”. In the interest of not riling up too many opinions, though, I also feel compelled to add how grateful I am for my career. I feel lucky every day to get to do what I do, and I absolutely don’t want this reflection to come across as entitled. I’m very much aware that I have a lot of hard work ahead of me, and that’s perfectly alright. I’m curious to hear about what other women and men, doctors or otherwise, have to add to this (and any advice is always appreciated)!

Thanks for reading!

PS – if you’re curious about data on other specialties, like the OB set I’ve linked above, the CMA has a list of pdf’s for your perusal.

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