Electives - Initial Thoughts

Got to start my electives over the past few weeks. They say the 4th year of medicine is the best year, and based on my experiences so far, it's hard to disagree. I don't have to worry about evaluations, I'm getting sleep and a bit of actual exercise, and I'm learning a ton. Getting to choose my rotations, or at least have significant input on them, is a major bonus. Learning comes so much easier when you want to learn and are motivated to do so.

It is a bit disorienting though. Perhaps not quite as much as clerkship, because I at least know the medicine well enough. Yet, being in a different environment every 2 weeks, particularly when that often involves being in a different city, it does take a fair bit of mental energy just to keep up.

There's a trade-off between variety and consistency when it comes to absorbing new information. Too much variety and there's so much rattling around in your brain that little if anything sticks. Too much consistency and you only pick up what's right in front of you, missing experiences you may have to encounter on your own later down the line. Right now I'm on the "variety" side of things and I am definitely missing my time where I could count on doing roughly the same thing for weeks on end - I'm getting a lot of experience I otherwise wouldn't, but less is sticking than I'd like.

The other wrinkle here is that this is my main chance to explore different settings for residency considerations. As someone leaning heavily into FM, the main question I'm wrestling with right now is how rural do I want to go? I knew I didn't want to do the extremes on either end - I don't want to be in the GTA, nor do I want to do overly remote medicine. However, that still leaves open anything from mid-sized cities to small towns with only a few thousand inhabitants. I don't have any major preferences when it comes to living in these locations, so it's coming down to practice types. In larger centres, FM is much more restricted to clinic work, home visits, and nursing home care, possibly with some OB thrown in. Smaller centres, you could be running clinic, covering the ER, taking care of inpatients, then doing trips to people's houses or to nursing homes, potentially all in the same day.

I'll have more to say on that soon - right now, I'm trying to keep an open mind to fully explore each of these settings and which ones might be a better fit for my residency, and my eventual practice.