Minor Pre-Residency Rant

So our school just had a Career Day, where all the program directors and quite a few residents came out to talk about the residency programs at our school with us medical students. It was really well done and everyone I spoke to was extremely helpful. I came out of it feeling like I knew at least somewhat where I stood at each of the specialties I'm interested in here. Since I would prefer to stay in this city for my residency, that becomes extraordinarily useful information. I can't say enough about how much events like this help me as a student.

However, one element that really stuck out for me - and one which I've been worried about since I got accepted to Medical School - is that most programs really care about showing a deep interest in their field.

On the face of it, that makes sense, but there's a bit of a dilemma at this stage, and it goes a bit like this:

Step 1: Acknowledge the need to show interest in the specialties I'm genuinely interested in.
Step 2: Realize I don't know exactly what specialties I'm genuinely interested in.
Step 3: Do some activities in specialties I think I'm genuinely interested in.
Step 4: Find out through those activities that I'm not actually as interested in some of those specialties as I initially thought.
Step 5: Panic, because now I've expressed interest in specialties that I might not actually want.
Step 6: Panic more, because I haven't expressed enough interest in specialties that may now be higher up on my preferred list of specialties to match to, but now have no time to do it.
Step 7: Weep softly in the fetal position.

The crux of the problem is that it's quite difficult to figure out what you want to match to and the most useful information on that front comes in Clerkship and Electives, when it's often too late to do anything significant to express interest in fields you haven't already, such as doing research within that specialty. Programs want commitment on students' part well before they commit to students and even before commitments can be realistically made.

Right now, I have a number of commitments and I think I can show some interest in every field I care about at this point - and I think I've managed to narrow it down pretty well. Yet, because I start some projects in fields that I'm not considering very highly anymore, I'm a bit constrained. I want to show deeper interest in the specialties I still care about, but have no time. Research is the big one - I've got two significant research projects on the go, but because they're not directly in the specialties I'm now looking at, I worry they may not count for as much as they could.

Yet, for all that doom-and-gloom, many residents I've spoken to have told me they really figured out their specialty in 3rd year. They all managed to match, so there's got to be a way. In 3rd year, once my preferences become a bit more clear, I'll have to start to go all-out for whatever specialty I settle on. I just hope that'll be enough.