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Why Internal Medicine?

Updated: Apr 25, 2019

Trying to figure out what kind of doctor you should become? Wondering what specialty you should choose? Then SheMD's Why Specialty Series is perfect for you! We're bringing you female physicians sharing WHY they chose their specialty. Today's post is on why Dr. Collier chose the field of Internal Medicine and why Internal Medicine is a great field for women.

Someone once told me that you know you’ve found the right career in medicine if the career sparks in you a curiosity for lifelong learning in the field and enables you to connect in a way that you find meaningful with your patients, colleagues and family.

I clearly remember the first day of my internal medicine rotation. I was a third year medical student at the University of Michigan and had already completed required clerkships in obstetrics/gynecology and pediatrics. Entering my third year, I had envisioned a career in OB/GYN because of my interest in women’s health. I enjoyed my rotation with the group, but missed seeing male patients and wanted to take care of a broader scope of medical issues than I saw addressed in the rotation. Pediatrics was also great. I enjoyed the way that patients’ problems were addressed in a systematic way that incorporated the societal-cultural aspects of the family dynamic, but I didn’t enjoy having to work through those same dynamics to enact the plan that I thought was best for my patient, who was the child. And then I stepped onto the inpatient GI/Liver medicine service, floor 6B. I was introduced to my team and my senior resident, Glenn Hirsch, who took me aside to give me tips on how to be a successful student on a medicine rotation. He told me that you can tell the students who read every day from the students who don’t and that there is no substitute for reading daily about your patients and their diseases. I learned from him and the other residents, interns, fellows and attendings over my three months on medicine how to start differentiating ‘sick’ from ‘not sick’, how important it is to get to the bedside quickly to lay eyes on a patient about who the nurses are concerned, and what it looks like to take care of the sickest patients in the hospital with calm adroitness. I fell in love with the way the internists approached clinical decision making and the way they addressed multiple problems in multiple systems with impressive skill. I quickly realized that I too wanted to learn how to take care of patients the way that Dr. Hirsch did and I wanted to learn these skills from people like him. I wanted to be an internist.

I went through the rest of my rotations with an open mind and enjoyed my time immensely, but the rest of my time only further served to reinforce my decision to pursue a career in internal medicine. After matching into the internal medicine residency training program at the University of Michigan, I spent three years training under some of the brightest minds in the country on how to take care of some of the sickest patients you’ll ever see. I spent the majority of my time on the inpatient services and ICUs, but also was assigned a weekly continuity clinic at one of our community sites. Every week, for a half day, I would see patients in the outpatient setting and staff them with Dr. Jennifer Nastelin and Dr. Larry McMaster. They are two of the most seasoned, efficient, smart outpatient internists you’ll ever want to meet. I quickly grew to love my time there. I built my panel of patients by recruiting patients that I took care of on the inpatient services who didn’t have a primary care doctor. I enjoyed being able to see both men and women, young adults, the elderly, and the variety of challenges with which my patients presented. I found it energizing that my schedule could have a mix of acute complaints that needed to be figured out, chronic diseases that needed to be managed, as well as preventative health visits. I relished the opportunities to meet patients where they are to help them navigate the health care system and better understand their diseases. As someone who considered education as a career, I loved that outpatient internal medicine allowed me to be a doctor and an educator. I delighted in the opportunities to educate my patients about their conditions and how we could partner together to get them to a healthier place.

Did I consider a specialty choice as I progressed through my IM training? Sure, I think everyone does. But once I did a few days in a row in a specialty clinic and focused on one organ system, I quickly longed to get back to my general medicine clinic where the diversity of concerns and the ability to look more holistically at the person was the norm. Did I also feel some pressure from the ‘hidden curriculum’ that I was ‘wasting my talents’ doing general medicine? Sure, that too, but I was steadfast in defending my career choice as one that had purpose and meaning and that I too was making this decision in an explicit way that capitalized on my talents and interests as a doctor.

So, today as a PGY 19, I am just as thrilled with general medicine as I was on day one, if not more so. I’m still taking care of patients that I picked up as an intern on the wards.

I am both humbled and honored that my patients trust me to take care of them and share with me some of their deepest secrets and fears. It is my belief that the patient physician encounter is a sacred space and I commit daily to seeing my patients as persons and not diseases. Is the job hard? Of course it is. Anything worth doing is hard work. Is it worth it? Unequivocally my answer to this is yes. Getting back to the ‘litmus’ test of how you know you’ve chosen the right career – it still passes the test. I am still in love with the subject matter of medicine and yes, the career has allowed me to connect in ways that I find meaningful with my patients, colleagues and family. But none of this would have been possible without all the people that have gone before me, that have taught me, mentored me, guided me, and ‘fashioned me’ into the internist that I am today -- and for that I am truly thankful.

As Isaac Newton said, “If I have seen further than others, it is by standing upon the shoulders of giants.”

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