Tuba city ramblings and self career advice

Yá’át’ééh y’all! (hello in Navajo, you all in Texan)

Whhhheeeeeewwwwwww, Family medicine is just da bomb. 8-5 clinic, no call, fun patients, beautiful sunshine in Arizona, frybread, instant noodles and cable TV and maid service. Doesn’t get much better than this. Hey, and I actually have time to write on my blog which is always a good sign.

So what am I up to these days? Well, it looks like my summer is all set which is always good. I am going to be in SF May/June for internal medicine to finish out my 3rd year of med school. Then I take step 2 of the US Medical Licensing Exam (three steps total before becoming a physician) in June/July along with doing geriatric medicine. I also set up an away elective in Oakland for emergency medicine at Alameda Highland Hospital which is considered one of the best ER programs in the country which is exciting and daunting at the same time. Then its off to Tuck and possibly a return to the cold hearted business world.

So what’s the “differential diagnosis” for my career these days? A few thoughts that have come up
1) Emergency medicine + startup business – Finishing an ER residency in three years then working part time while starting up a business or helping Dan with one of his medical device ideas
Advantages: high cashflow, low risk, fun and exciting
Disadvantages: Something about just doing residency to work part time (even if it is for $250 bucks an hour) doesn’t seem quite right to me.

2) Organizational Psychoanalysis – I’ve always loved analyzing people and myself, this would allow me to do psychoanalysis and work with organizations, two of my favorite things
Advantages: Can travel, make lots of money, the time flies by when I am talking with or about people, can consult as a psychoanalyst to CEOs
Disadvantages: Long training process (4yrs psychiatry residency + 2 yrs of psychoanalysis) and need to build up credibility, very narrow also, would not feel like a physician w/o some physiology involved

3) Build an industry, help the poor and make money doing it – For profit health care interventions at the base of the pyramid (serving those making less than $1/d)
Advantages: I would be excited and motivated about my job every day
Disadvantages: Although the point of building an industry providing public health through private means requires that one generate profits, I feel like it would be easier to make money doing something where the primary motivation was profits. It would certainly be risky and I am afraid the risks do not balance the rewards.

In the spirit of self-analysis and advice, I have gotten several snippets of truths around selecting a career that I have found very useful.
1) Dr. Coursin has always urged his kids to listen to their “quieter voices” in choosing a career in paths that may not lead to money or fame but could lead to happiness and personal expression.

2) Skip, Mark’s uncle said to me that he thought I was “creative”. Indeed I think I have always had a propensity for creativity whether it is in terms of business models, creative writing or creative analysis of a person or situation. Perhaps my quieter voice is one which resists conforming to a specialized career track and must look at all possibilities to accomplish a task before choosing one.

3) My dad told me that it is best to “widen the road you walk on” in terms of choosing a career such that you explore new possibilities even as you go down a career path and to maximize one’s flexibility. I have always naturally resisted the social pressure to specialize and become an “expert” preferring instead to be a generalist, translator, bridge between disparate groups and knowledge areas. Why not continue to find a career that increases my flexibility rather than diminishes it?

4) Finally my bro told me the importance of cash generation + smart investing in wealth accumulation. In other words its not about maximizing your income so much as having some income and investing it in cash generating activities.