Being a Medico – Choosing your Post-Graduation Specialty

Considering the multiple queries that I received asking for advice on how to go about the Indian NEET PG counselling, I thought this would be a good time to write about choosing the right post graduation. An honest disclaimer, this would be a very personal blog with my very biased personal opinions. So please bear with me in case you think differently.

 

You may have decided to pursue medicine for reasons of your own – continuing a family legacy or having a desire to truly help people or you were just enamored by the profession. Well, ultimately, the reason tends to take a backstage. When your class of 100 students, from multiple backgrounds, graduate as doctors, it means each one of you endured 5 years of pretty hard core studying and survived some really stressful examinations.

While one graduates with the weird feeling of having worked hard, yet wondering if one is up to the mark to face the challenges that lie ahead, what you don’t realize is that all the while, your training was never just about teaching you to make correct diagnoses, but invariably by making you interact with all sorts of patients right from second year, you were also being trained to develop basic communication skills and a baseline empathy as this is the backbone of your entire career. All those annoying daily case presentations which dictated you to examine, analyze, come to a diagnosis, formulate a treatment plan, document it all and summarize it was all just a preview of  what you are expected to do with every patient for the rest of your life in probably less than half the time. Those weekly seminars and case discussions that you compulsorily must do have made you confident individuals who won’t shy from talking in front of a group of people if handed a mic. You have been given opportunities to interact with people from all walks of life including VIP persona as well as underprivileged people in dire circumstances, while they were most vulnerable, which in turn, helped you to develop your own approach to anyone suffering and gaining their trust and confidence with kindness and empathy, regardless of who they are or where they come from.

 

Now as you enter internship, you realize it is time to put all that theoretical knowledge into practice and trust me, internship can be an exhilarating ride – well if you let it. There are many who choose to use this time to do the bare minimum paperwork handed out to them and focus the rest on their energy and time on Postgraduate Entrance exam coaching which is not all bad if you think about it. It will definitely benefit you by either helping you to clear your exams earlier than their peers or having a higher rank in the exam, thus ensuring a better likelihood of being able to pick the post-graduation seat of your choice.

 

But I, for one, would never ever advocate missing out on even a day of your internship simply because I believe that it is the one year when you completely realize what being a doctor actually means. It is your ticket to experience every specialty and super specialty actively, know how you feel while working in different fields which could truly help you in making a decision regarding what to pursue. It is the opportunity you get to learn from the best doctors in your hospital, their basic OPD practices, how they interact with their patients, how they come about to their diagnoses, observe the finest points in their surgical techniques and actually have them teach you basic procedural and surgical skills the right way which is literally a baseline for the rest of your life. It is the time you directly get to interact with them over your post-rounds’ tea sessions or mid-afternoon breaks and talk to them about their experiences. All those practical things which you could never learn from a textbook. If you are lucky enough you may be able to find yourself a mentor who could genuinely guide and support you in making the right career choices.

 

Personally, the most thrilling bit of internship for me was doing the various procedures I couldn’t have fathomed I would ever be able to do. It gives you a sense of empowerment and also in turn you recognize where your real interests and abilities are. One may love precise suturing, another may love looking through radio diagnostic scans, another may love the fast paced action in an ER. One truly never knows where you really fit in till you have been through all your rotations. 

 

When it comes to choosing a PG, people give you tons of advice about what is 'in demand', what has a high earning potential and what other people would be impressed with. While these may have some significance, making a decision about your career depends on a lot of other factors as well, which pertain to your persona and interests and skill set.

 

One of the most basic things you need to decide is whether you want a surgical specialty or a medical one or a non-clinical one. A surgical specialty may honestly be associated with more chances of litigation but if you have skilled hands and you revel in the experience of a successful surgical post-op, nothing in the world can truly match that. I equally advocate medical specialties and the thrills of a successful diagnosis and treatment. Which may be the reason Ophthalmology is a perfect fit for me as it is a perfect blend of precision microsurgery as well as a medical specialty. I am equally happy when my post-op patient has 6/6 vision or when one with corneal ulcer successfully heals without complications. Talking about non clinical specialties, I have many classmates who have pursued them and are successful and extremely happy in their fields.

One also needs to roughly estimate the extent of time you can dedicate to your job. Neurosurgery and Plastic surgery are some of the most exciting fields there is but you also need to ask yourself whether you can be committed enough to do 9-hour surgeries all your life.

Talking about time, you also need to decide how many years of your life you want to invest in studying. No specialty is really an end specialty any more. It is common knowledge that General Medicine and General surgery is usually followed up with a DM or M Ch. respectively. But then, doing the so-called end specialties, say Paediatrics, ENT, Psychiatry, Anaesthesia will ultimately, invariably lead to fellowships. Well, simply put, after doing Masters in Ophthalmology, my fellowship options currently would be Oculoplastics, Glaucoma, Medical retina, Cornea, VR, Phaco - refractive, Paediatric ophthalmology, Uvea, Neuro ophthalmology…. Hard to believe that all these sub specializations are for just the tiny eyes, right?!  But I hope you get my point that it is no longer just about your PG, you are ultimately what you specialize in, post your PG. Of course, it’s not an absolute must to do so but generally most practitioners end up narrowing into their fields of interest, invariably.

 

Now regarding making money, I think with each specialty, you can always find a way to do so, depending on your expertise and skill, of course. The difference is that with some specialties, the path is relatively easier and clear cut because of a greater number of clinics or hospitals supporting you or your patient pool being more. But if having comfortable money is your end goal, you can always find a lucrative and suitable subspecialty in every field.

 

Having said all of this, I come back to internship. That is truly the one time and one place where you don’t need to imagine any of this but can actually experience what it feels like working in a prospective field and whether it clicks for you.

 

End of the day no matter what specialty, your job satisfaction will always come from how satisfied and happy your patient is with you and as long as you remember that and you strive for that, success is inevitable, wherever you go, whatever you do.

 

Till next time.

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