choosing residency

i have been putting much of my lull time, in between hospital duties, into a meditative state concerning the biggest decision a medical intern has to make: which specialist residency to apply for, if at all.

WHAT
i'm not saying i've already figured out mine; no, far from that. obviously, my time to decide is several months away, six to be exact, and now that we still have the choice to back out, our brains tend not to commit to anything specific: "basta hindi surgical", "ayaw ko ng on-call", "yung makakauwi ako ng probinsya".

it's cool to not commit for now; i'm not at that stage yet. residency is much like marriage, and a resident is marrying that specialty for life. some marriages that have been rushed end up getting divorced; a waste of time and effort, but some life lessons are learned the hard way. the other side of the coin also tells us that some rushed marriages actually last a lifetime, having learned to cope and live happily with the situation.

WHEN
alternately i also have a question at the back of my head, if i should enter residency immediately. i had a talk with several first year residents in IM, fammed, pedia, as well as several moonlighters, and they unanimously agree to taking a year off if one is not yet decided. i tell them agreeably, "yes, why not?" but the caveat is, as one fammed resident puts it, "plan your year off ahead".

i know quite a number of MD friends who took alternate career paths, mostly as doctors to rural areas where health care is sparse, but the pay is great (50-60K/month). only a few went to research and academia, where money is difficult to come by (20-40K/month, depending on the work involved). the rest of #teamyearoff got into moonlighting in different private hospitals and clinics, some earning modest sums for purely clinical work (20-40K/mo largely depending on how often you go on duty), while others, i heard, got ridiculously large sums (upwards 100K a month). for some, money will look like a superficial endeavor to pursue, but for many pragmatics, it does help pay off bills if you earn the most while doing honest work.

WHERE
another difficult question for some would be where to apply for residency. some friends will give automatic answers, "best training hospital i know", "volume of patients seen", "learning to deal with low-resource settings", "uptodate world-class facilities", "best consultants on board", "nearest to home". others have deeper reasons, such as wanting to practice in a specific private hospital, and doing residency there already gives them the edge. still, others are wary of admissions committee bias, especially since these resident trainees will soon be future competitors in the geog after they successfully graduate residency (e.g., hospitals in cebu and davao).

WHY
the most difficult question by far, after choosing which specialty over all others, is the constant re-assessment you ask yourself, "why pursue this road i'm taking?"

choosing residency, or an alternate career path, is a hard decision, but it must be something you like, to a fault actually, something that neither your friends or parents would understand. well maybe, you hate some parts about it, surely (who likes scut work, really), but there should be at least some aspect about it that makes you want to accomplish it to the end.

truthfully i haven't figured out mine yet, and my deadline is still six months away, but i crossed out a lot of differentials now, and that's a start.