Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative

5 Lessons From my Nonlinear Career in Medicine


Instead of asking medical students what specialty they intend to pursue, we should help them reflect on their natural strengths and values in planning their career.

Do you remember as a child being asked, “What do you want to be when you grow up?” How did this question make you feel? Were you excited imagining the possibilities? Or were you confused why an adult thought you might already know what you wanted to do with the rest of your life? For most medical students this question is usually, “What type of doctor do you want to be?”


Healthcare is becoming increasingly sub-specialized. According to a commentary published in the American Journal of Medicine, the percentage of U.S. primary care physicians decreased from 50 percent in 1961 to 33 percent in 2015. There are various reasons why U.S. doctors may choose to sub-specialize. These include research interests, perceptions of specialty prestige, debt, income potential, and lifestyle considerations. This trend of sub-specialization has shaped healthcare in two major ways, specifically, how patients access care and physician workforce distribution. Studies have shown incrementally greater levels of training lead to better outcomes especially when there’s a team-based approach between sub-specialists and primary care doctors.


Because of this changing landscape in medicine, it would be challenging, if not impossible, to adequately expose medical students to every sub-specialty during their clerkships in time for them to make an informed decision. Some medical students may know what they’d like to specialize in before they enter medical school, but according to a report released by the AAMC in 2015, only about 25 percent of medical school graduates actually ended up in that same specialty.


Personally, I explored what kind of career I wanted to have even after completing pediatric residency training. I worked for a few years in rural Alaska before deciding to build a hybrid career in pediatrics and pediatric anesthesiology. I then pursued anesthesia training after having practiced as a pediatrician for three years only to find that it wasn’t a good fit and so I quit. My nonlinear path has taught me that question we often ask medical students should be more about ensuring that the specialty we choose aligns with our personal values, unique skillsets, and overarching career goals. I believe this may lead to higher job satisfaction and improved patient care. Here are 5 lessons I’d like to share with you:


1. There’s no substitute for knowing yourself and what you value.

Learn to encourage and listen to your intuition.


2. Be a storyteller. What’s your unique story?

Embrace where you come from and where you’re going.


3. Know why you do what you do.

Use simple and specific language to describe your professional mission and/or focus.


4. Embrace the change that comes from growth.

You aren’t the same person you were in undergraduate, medical school, or residency.


5. Gage how skills, professional relationships, and job opportunities support your focus.

Align your passions, interests, and talents to hone your focus.





This piece expresses the views solely of the author. It does not represent the views of any organization, including Johns Hopkins Medicine.