Stressing Out About Electives Choices

I mentioned previously that my electives choices are coming up in a few months, faster than I expected. I am stressing out about them, way more than I probably should be. I can't even start to make my choices for electives yet, but I've reached a near-obsession state about planning them.

Here's my basic conundrum: do I choose electives to maximize my chances of getting my preferred spot in the CaRMS match, or do I choose electives to maximize my learning? In the end, it will be a balance of both, but how far to go down each path is giving me pause. All of this is complicated by the fact that I haven't yet chosen what my target specialty will be, though I'm getting closer.

Nothing has yet to really grab me as a must-do specialty though this isn't too surprising as I've always been leaning towards a generalist role in one way or another. There are bits of each specialty I've seen so far that I enjoy, but nothing that hits me overall as uniquely interesting. What has become clear is that I value having a degree of control over my career - location, practice type, hours, that sort of thing. (This makes Family Medicine a rather attractive choice, given its excellent job market, flexible practice option, wide scope of practice, and shorter residency. I'm not set on it quite yet, and I still have some reservations about the field, but the pros of Family Med are definitely starting to outweigh the cons)

Anyway, back to electives. I have 16 weeks to work with, essentially eight 2-week stints (or perhaps one 4-week and six 2-week rotations). I'd like to do at least 8 weeks in whatever specialty I'd think of ranking first, if only to get a sense of what programs are like across the country and to maximize my chances at a good reference letter. Ideally these would come earlier in the rotation, before I have to submit my CaRMS documents. That leaves 8 weeks or less for learning, mostly on the back-end of my electives time.

But, then I think, maybe more time in the main specialty is necessary to maximize chances of matching to a place I'll like. After all, in every program I'm thinking about, I have more than 4 programs that I think would be good fits. Doing some "learning" electives within that specialty could be useful too, particularly in areas I'm not too keen on matching into (like Nunavut! Sorry Nunavut, you're really interesting, but my dog would probably freeze up there...).

And then I go back again, thinking more learning time might be best, considering most specialties I'm looking at aren't that competitive. Some rotations I may never get a chance to see again, such as Dermatology, even though I have zero interest in becoming a Dermatologist (I've quickly learned skin stuff pops up all the freaking time and most physicians aren't that good with these issues). I could take a bit of a gamble on myself - most people do match to their top 3 programs anyway - and hope that I have enough exposure between my clerkship experiences and my electives to find a good fit. Whatever specialty I decide on, if there's a choice between improving my capability as a physician and advancing my career, I'd rather pick the former than the latter - if I can still land a career I'm reasonably happy with.

Anyway, you see my indecision, before I even have a decision to make. Fingers crossed the next few months provide some clarity here!