Help me not second guess the decision I want to make

July 29, 2013 7:56 AM

I've been agonizing over making a career choice for over a year. Now it's crunch time- I need to commit to a path like NOW and figure out how to live with it and not second guess my decision. Help.

I'm in my final year of medical school and about to be applying for residency. Over the past couple years I've been going in circles trying to choose between a few unrelated specialties. It's becoming maddening- because they're so different, the pros and cons of each are different and I can't seem to decide which things matter more to me. In particular the trade-offs include: living in a city I like vs probably ending up somewhere I don't like (due to the difference in competitiveness of each field), having reasonable hours vs kinda crazy hours, making more money vs less money, having a physically demanding job or not, etc. The deadline for picking one is approaching fast- I really need to be applying, like, yesterday.


I've been thinking (and thinking, and thinking) and I have tentatively come to the conclusion that my reasons for wanting to go into the first specialty are kind of weak- it's more money, more prestigious (terrible reason I know but it's a hard one to shake) and based on my background I think I have the skills required to be really good at it. The drawback is that it's difficult to get into and the residency is tough, the hours are insane and the work is physically demanding. Even if I decided I wanted to go that route, it would be a long shot for me to get in.


The second one has always been kind of my fallback idea. I've always liked the work- maybe not quite as much as the first field, but enough that I think I could be pretty happy doing it. It's much easier to get into which means better geographic options. What's appealing to me now is the idea of simply getting started on my life- it would be more manageable hours, and I'd probably be able to live somewhere I really wanted to during residency and start putting down roots, versus in the other field where I'd probably have to suck it up in a town I didn't like for several years. (For those who are unfamiliar- residency match assigns you to exactly one place out of a ranked list you submit- you don't get multiple offers that you can pick and choose from.) I'm also single, which I maintained on purpose up to this point knowing I want to move, but once I move I'm going to be ready to start dating again. I fear that dating while doing the first specialty will be near impossible and I used to think this was a weak thing to have as a criteria for choosing a field but now I'm quickly changing my mind. I'm not happy being single. In addition to having more time for dating in the second field, I'd (hopefully) end up living in a city that fits my personality well and therefore will have better matches for me in it.


So I realize it kind of sounds like I've made my choice already. Here's my problem. I'm currently doing an audition rotation in the first specialty. Meaning, I'm doing an elective at an institution that is not my home school with the intention of applying to the residency program here (well, that was my intention when I arranged it.) Doing this means I am granted a formal interview for the program (with the expectation that I will be applying, but since the deadline isn't for a while I haven't yet.) They just do this as a courtesy since we're there, so we don't have to travel back for a formal interview later in the season. It's actually several interviews throughout the week. They sent out an email saying "if you don't intend to apply here let us know and we won't interview you."


Honestly, being here has sort of pushed me towards this decision- I can see now how I don't quite feel comfortable or like I fit in, and I don't love it quite as much as I thought. I really want to just email them and say "I'm not applying. Don't interview me." But I haven't yet. I keep arguing with myself: 'What if I regret it? I've already put in the effort to come here. I'm here, I should just fucking interview. It will be embarrassing to finish out the week with everyone knowing I've given up. I've wanted to do this specialty for so long, am I really going to just give up on it? What is wrong with me?' Etc, etc. But on the flip side there's a part of me that I think would be relieved at the finality of just deciding to throw in the towel on it now and focus on the other specialty. I fear that if I just do the interviews "just to see" then I'll get sucked back into wanting to do it for the wrong reasons and continue in this miserable spiral of indecision for months. (Technically I could apply for residencies in both fields but it would be a lot of work and very expensive.) Also, at the end of the day I'm a pretty weak candidate and expect to be rejected from the first specialty anyway. I don't know that I want to go through all that.


It's just so hard to make a final decision like this because it defines what the rest of my life/career will be like, and the difference between the two are pretty extreme. Technically it's possible to change my mind and switch to another residency after the fact but it's difficult and complicated to do and I'd prefer to make the right choice the first time. It just seems like such a huge decision that I've been unable to commit to one way or another. But I have to. So I guess my question is- how can I be confident in my choice and not second guess myself? No matter what I pick, there will be drawbacks. I have to just accept it. I've just never had to make such a big decision before. And whether or not I do this interview, I think, is the first step towards committing one way or the other. If I don't interview, I really can't ask for a letter of recommendation from the faculty here, which will mean I won't have enough LORs to apply for any other programs in the field. Asking them not to interview me will effectively close the door on this field for me.


Should I decline the interview? If I don't I'll probably continue applying to and interviewing for both fields. The thought of doing that stresses me out. But I have this ridiculous yet unshakable feeling that I'm being 'lazy' by taking the 'easy way out.'


How can I be confident in my decision? I know I have my reasons, I wrote them all out above. But I still fear that I'm wrong. (So on that point, anyone who can chime in on the value of the criteria I weighted above in terms of choosing a career, that'd be helpful too.)

i know that's all kind of complicated but i didn't want to make it longer. throwaway is [e-mail] . I understand that therapy probably would have been helpful, like, months ago but that ship has sailed, I need to decide fast. (I mean, it's not really like this is a fast decision, I've been weighing the pros and cons for years now and still not decided . . .)

posted by anonymous to Work & Money (12 answers total)

it's more money, more prestigious (terrible reason I know but it's a hard one to shake) and based on my background I think I have the skills required to be really good at it

These are all great reasons, not bad ones.

It's much easier to get into which means better geographic options. What's appealing to me now is the idea of simply getting started on my life- it would be more manageable hours, and I'd probably be able to live somewhere I really wanted to during residency and start putting down roots, versus in the other field where I'd probably have to suck it up in a town I didn't like for several years.

These are great reasons too.

Which will make you happier tomorrow? Do that one. Don't overthink it, it's just life. I guarantee neither choice will make you miserable or regretful, so stop beanplating and do what makes you happy.
posted by wrok at 8:04 AM on July 29, 2013

my reasons for wanting to go into the first specialty are kind of weak- it's more money, more prestigious (terrible reason I know but it's a hard one to shake) and based on my background I think I have the skills required to be really good at it.

Cripes. That is not a bad reason at all-- in fact, those are some of the best reasons. If you would be really good at something (and enjoy it), and it has the side benefit of being remunerative and prestigious, you should do that.

You're young, too-- this is the time in your life to make those geographic sacrifices (like getting a residency in a far-off place) in order to generate returns down the road (a highly desired specialty that you enjoy).
posted by deanc at 8:08 AM on July 29, 2013 [1 favorite]

Don't fear regret so much.

Personally, I'd go with option B. I value quality of life. If I could pick and choose a good city, and decent hours, that's what I'd go with.

Money and Prestige are nice, but if you don't think you like it, bag it and choose the one you think will give you the whole life you think you want.

Go ahead and do an informational interview where you are. Instead of auditioning for a space, ask questions you think will help you narrow your decision down.

"I'm really attracted to X, I like this, this and this about it, but my concerns are, Y, Y and Y. I'm also leaning towards Z. Z appeals to me for these reasons. You once made a similar decisions, what factored into that?"

Hey, pick the brain of someone who has already made the decsion. At least you'll get more insight. Also, you won't come across as some brown-nosing douche, but as someone who is seriously evaluating all the options.
posted by Ruthless Bunny at 8:11 AM on July 29, 2013 [5 favorites]

What kind of life do you imagine for yourself? Rather than just looking at the career, try to imagine your day-to-day, what kind of relationships you have with people, how much time you have to spend for hobbies, what's your general level of stress, but also how well does the career sit inside you, to what extent does it feel like you are doing what you are best at, do you feel valued and does your career give your life meaning. Try to visualize the actual person living this life. You might be able to feel what this person is feeling. Are they happy, or not? Is one happier than the other?

I would spend an entire day alone on the beach or something to sit with this. Pay close attention to what's going on inside, because your heart will know what's best for you, though it is often crowded out by other voices about what other people think is best, and what you think is expected of you.

In the end confidence in the decision comes with knowing that whatever happens, things will be okay. If you really believe either of these will lead to happy and fulfilling life, then nothing can harm you no matter which path you choose. But learning to be okay with anxiety can be a long process -- and here, therapy can help, even after the decision is made.
posted by PercussivePaul at 8:16 AM on July 29, 2013 [5 favorites]

If you decline the interview and/or go with the second option only, will you regret not at least trying to get into first specialty? If yes, then do the interview. Having said that...

How can I be confident in my decision? I know I have my reasons, I wrote them all out above.

Whichever one you pick, you'll still have the occasional "the grass is greener" moment. So when you've decided, write down all the reasons for picking that one, and also write down why you didn't go with the other one. Read it when you hear that little voice that tells you you should have jumped the other way.

Also echoing PercussivePaul - it sounds like either way you'll have a career you'll be good at and enjoy, and a reasonable level of prestige and money. There is no wrong choice here!
posted by pianissimo at 8:50 AM on July 29, 2013 [1 favorite]

Have you done a weighted pro/con list yet? Write down the pros and cons of each job. Everything. Then assign each item a # 1-10, 10 being fantastically wonderful, and 1 being absolutely terrible. Then you can have a numeric value to each option. This isnt 100% accurate, always, but can help clarify things a lot.
posted by Jacen at 9:03 AM on July 29, 2013

It's OK to choose a career path based on quality of life issues, and it's OK to be honest enough to say that fining a compatible mate is a high-priority quality of life factor. In fact, it sounds like you're not enjoying Option 1 and have actually decided you'd rather go for Option 2, but you're hung up on the making a decision that will impact you for the rest of your life because you're imagining some transitory discomfort you'll experience for the rest of the week.
posted by DarlingBri at 9:36 AM on July 29, 2013 [2 favorites]

Something you might want to factor in: various studies have shown that every dollar you make beyond 70k or so has a lot less impact on your overall quality of life than every dollar up to 70k.
posted by a snickering nuthatch at 10:48 AM on July 29, 2013

every dollar you make beyond 70k or so has a lot less impact on your overall quality of life than every dollar up to 70k.

That survey was about personal happiness and contentment, not "quality of life." Quality of life, of course, is very subjective, but if the OP has specific financial/personal goals that would be better served by the more lucrative field that the OP would "be really good at it" (though, really, it depends on whether the OP would actually like it on a day-to-day basis), then that is a serious factor.

Consider not just what specialty would allow you to do a residency in a city that you would enjoy but also what specialty would allow you to practice in an area that you enjoy. You might, for example, be able to find a great residency in family practice in plenty of great cities. But being an independent family practice physician is only viable in fairly underserved areas that you might not enjoy living in.

A lot of your thinking sounds very much like about what would make you happy over the next year or two, rather than what would be something that would serve your career.
posted by deanc at 11:09 AM on July 29, 2013

First and foremost, whatever you decide will be the right decision. Period. You are going to live an awesome, fulfilled and happy life no matter what you decide in the next few weeks.

I feel for you (and all of your peers) making this decision. After being and probably being perceived as a high achiever your entire life and spending the last 3+ years of your life surrounded by super motivated and accomplished classmates, it is foreign to even consider wanting anything other than the most difficult, competitive and prestigious thing you can get. But here’s the deal: you aren’t any less smart or awesome or accomplished than your classmates for choosing to go in to a less competitive specialty, and the patients you would see in the less competitive specialty are no less deserving of your skills and brains. You are absolutely not being “lazy” or “taking the easy way out “. You’ve been in school for essentially your entire life to be a physician who will spend your career helping sick people-no matter what specialty, life as a physician isn’t how anyone defines the easy way out.

The whole residency/match process makes this feel like such a big, final decision (and I agree, it is) but you have made big, final, life changing decisions like this before without even knowing it. Choosing your undergraduate college closed the door on all sorts of possible awesome opportunities at your second choice school. Deciding to become a doctor pretty much closed the door on ever becoming an engineer. You probably made these decisions and dozens of others without even really knowing you were doing it, and it sounds like they turned out pretty ok. The most important part of this is to stop beating yourself up, make a decision and commit in your head to this being the best decision for you. Embrace the things on the “pros” side of the pros and cons list of whatever you decide and don’t look back.

Good luck!
posted by mjcon at 12:10 PM on July 29, 2013 [1 favorite]

at the end of the day I'm a pretty weak candidate

based on my background I think I have the skills required to be really good at it

If you have weak grades or scores, that might not matter. If they like what they've seen at your audition rotation, that trumps the rest.

Interview. See how it goes. Also, if anyone who'd be making the decision has said the slightest thing about you applying there, or about giving you a recommendation -- this is a BIG positive sign as to your chances.

I fear that if I just do the interviews "just to see" then I'll get sucked back into wanting to do it for the wrong reasons and continue in this miserable spiral of indecision for months.

This isn't a good reason not to do the interview, cutting yourself off like this isn't magically going to make you content with the decision you made from inaction.
posted by yohko at 2:28 PM on July 29, 2013

I'm on my second career because the first one stressed me out and was eating my soul. I'm much happier now, and I'm pretty good at this, but maybe I'll change careers again one day. There is no right or wrong choice here, just choose as best you can and live an awesome life (no matter which you picked!).
posted by rakaidan at 5:33 PM on July 29, 2013