I don't know the answer, but I do have some thoughts

There is a certain question that's been haunting me for a while. It's taken many forms: What do you want to be when you grow up? What are you going to major in? What are you going to do when you graduate? What are your goals in the business world? What kind of doctor are you going to be? My answer hasn't really changed...I don't know. The older I get, the weightier the question becomes. As the clock ticks down and I need to make a decision, here are some of my thoughts/options:

• Orthopedics. As I look back on all of the rotations I've completed so far, I've probably enjoyed this rotation this most. I enjoyed the people, I enjoyed the work itself. It fits in naturally with my love of sports. It is the most lucrative of all the specialties I am considering. It also carries some challenges with it. It is the most competitive of all the specialties I am considering, which means I have little to no control over where I would end up for the 5 year residency. I will be so much busier during residency than I've been thus far in medical school. I don't think it's even going to be close. Is it fair to ask Courtney to be move again, and continue to be away from family and friends during such a difficult time? I also think about Kyle and Brynn aging another 5 years without being able to see friends and family more. The bottom line is, we would love to be back in Dallas and that would not be possible with Orthopedics. Another factor is that while I enjoy the work, the lifestyle of a surgeon is the most demanding. I would spend more time at the hospital, be one call more, and miss more t-ball and weekends than for anything else I'm considering
• Internal Medicine. This was the hardest rotation I've taken, but it was challenging in a good way. The internists I worked with matched my notion of what a physician should be: they are supremely knowledgeable, value the physical exam, and excel at communicating with their patients. The residency is 3 years, and there are plenty of opportunities to specialize if I chose to do so. It less competitive, and I have more of an opportunity to control where I take a residency. With my scores, etc; I have at least a decent chance of ending up in Dallas. On the other hand, I am not sure to what extent I was able to picture myself in this field and be excited. I certainly found it interesting, but I'm not sure that I truly enjoyed it. It's difficult to say, though, if I was able to truly gauge the field with my brief look as a medical student
• MBA/MD. UTMB is partnering with a Houston school to offer a MBA/MD program. This would add an additional year to my studies, and I would increase my flexibility. It would certainly be an asset if I chose to open my own practice at any time. It would allow me to go into hospital administration if I became interested in that, and I'd also have the opportunity to be some type of consultant if I chose to do that. I do find that I miss some aspects of business, and this would be a unique opportunity to combine both of my interests. It would also give me another year to sift through my goals in medicine. On the other hand, I do not have any specific goals in mind in pursuing this, and it is difficult to justify dedicating another year, money, etc to something when I'm not sure how I would use it.
• Lifestyle specialties. One of my current fears about Medicine is about being able to strike the appropriate balance with my family life and career life. Most specialties are not forgiving with the amount of time required. Certain specialities offer a very good balance, and very good work hours. Anesthesia and Psychiatry fall into this category. Of the two, I'd say I'm more interested in Psychiatry; but I'm not sure to what extent....

The decision is both overwhelming, and exciting. I'm not sure I'll ever know exactly what I want to be when I grow up, and honestly, I'm not sure I'd want to. I never want to feel like I have all of the answers. I never want to feel like there isn't something else out there. I never want to feel 100% comfortable. For better or worse, I'm trying to do my best. Thanks for your support. Please know that I could never be at my best without you!