How I started looking for zebras in my medical career

Sep 23, 2019

After more than two years of blogging on this site, I finally published an “About Me” page. Writing the text for the page got me thinking about how I began looking for zebras in my medical career. I thought it would be fitting to write a post about this to accompany the new page

For new blog readers who have been told to think of horses rather than zebras upon hearing hoofbeats:  The opposite is true of your career in medicine. Looking for zebras in your professional life means seeking out the rare, unique opportunities that are a perfect fit for you. This blog encourages medical professionals to find fulfillment by cultivating a “zebra” career.

Here’s how I began thinking of zebras. It started with a couple of ‘uh-oh!’ moments

My first uh-oh moment in medical school

I’m quite the introvert. 

When I travel for work, I frequently turn down optional social events to spend time by myself and recharge.

If I don’t speak to a single person all day until my husband gets home from work, that’s a good (albeit rare) day. 

So, I’m unsure why it came as a surprise to me when, during my very first session of longitudinal clinical experience as a first-year medical student, I realized I didn’t really enjoy talking to patients all day.

I shared this with a close friend who responded:

Well, did you think you would enjoy it?

It’s not that I thought I’d enjoy back-to-back patient encounters for hours on end, it’s that I never really even thought about it at all. I’d always had this dream of being a doctor. So that’s what I was pursuing.

I was concerned.

My second uh-oh moment in medical school

In that very same outpatient clinic session, I observed my preceptor writing prescriptions for an obese patient for hypertension and type II diabetes without even mentioning adjustments to her diet and physical activity. 

“What about lifestyle changes?” I asked. Those medications would help her, but wouldn’t cure her disease. Weren’t diet and exercise more likely to get at the heart of her problems? 

My preceptor didn’t disagree with my line of thought. She had, in fact, provided education about lifestyle interventions previously to this long-term patient. There simply wasn’t time in her busy clinic schedule to do this every visit. Moreover, she knew this patient wouldn’t heed her advice.

Oh dear, I thought. It seems that doctors are too busy to provide the best management, and we attempt to make up for it with medications that act as a Band-Aid.

I was concerned.

Considering my options as a physician

I thought about quitting. But even as a first-semester student with at least 7 years of training ahead of me, I felt like I’d already come too far to give up. Just keeping up my grades as an undergrad, preparing for the MCAT, and getting accepted to medical school had been a giant effort. 

Plus, I loved what I was learning in my core science courses. The science of medicine was enthralling. 

But, to my dismay, clinical rotations during my third year of med school left me in a lurch as to where to head. With each rotation I did, I couldn’t see myself dedicating a career to that specialty. By the end of that year, my list of potential medical specialties looked like this:

Pediatrics

Internal medicine

Surgery

Family medicine

Ob/GYN

Psychiatry

I’d completed rotations in six specialties, and I’d ruled out those six specialties as career possibilities.

Looking for – and finding – my zebra medical specialty

I decided that there must be career options other than despondently seeing patients every day that didn’t require giving up on medicine altogether. 

As it turns out, there were.

Preventive medicine was a solution to both of the concerns I’d identified as a first-year student:

  • Its training equips doctors for non-clinical work such as healthcare management and epidemiology
  • It focuses on disease prevention

I was sold. 

I buckled down and completed the remainder of medical school and a transitional internship. Then I got to the good stuff: preventive medicine residency.  

Residency training, not unlike the third and fourth years of medical school, providing me with a series of rotations. This time, however, my list of possibilities grew instead of shrinking. Each rotation exposed me to an area within preventive medicine that I could see myself in for the long run:

…I liked them all. Every rotation was rewarding, stimulating, and challenged me in a good way.

I went from eliminating medical specialties while thinking “None of these is right for me” to a kid-in-a-candy-shop excitement of all the options.

The majority of my time in residency was dedicated to rotations in non-clinical roles. I rotated at pharma giant GlaxoSmithKline, a managed care company, the Food and Drug Administration, and more. Thanks to a reasonable schedule, I spent some free time working as a consultant in clinical informatics and doing freelance medical writing

Looking for zebras as my career progresses

Since residency, I’ve worked mainly in utilization management, medical writing, and clinical documentation improvement. I’ve also done clinical work in addiction medicine and correctional health. 

On the surface, it may seem that I simply have my hand in several pots. But the theme in all the work that I do is this:  I work to improve health and reduce disease by assisting organizations in delivering high-quality, evidence-based health-related services or products.

This mission guides my decisions and pursuits. It also allows me to tell people what I do without sounding schizophrenic, and it helps me make a case for my proficiency when speaking with potential clients.

There’s a world of opportunity for someone with a medical degree

I recall a conversation I had with another doctor when I was about two years out of residency. I was telling him about my role as a medical director and described the training and experience that led me there. His response was this:

So this all just fell into your lap.

It took some restraint to respond professionally rather than rolling my eyes and walking away.

This is the mentality that sets physicians with tolerable careers apart from physicians with awesome careers. An awesome career in medicine doesn’t just fall into your lap. You work hard for it. And you recognize the deliberate effort that you put into cultivating it.

Those who aren’t looking for zebras often try to convince themselves that their unfulfilling job is beyond their control.

I encourage you to begin looking for zebras by acknowledging that your happiness and success are the results of your own efforts. Suddenly you’ll see fewer horses and begin seeing zebras all over the place.

 

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