4th year MD student feeling anxiety towards residency choices

[FloweringStem]

TL;DR I'm not sure if I'm feeling cold feet towards a specialty I had always enjoyed or if my body is telling me I should pursue a different path.

Hello internet!

I am a 4th year MD student that could use some help. We are getting close to residency applications, and I'm feeling a lot of anxiety around what my plan is. I am planning to apply to anesthesiology, and was feeling incredibly motivated and excited right up until this week when I started an anesthesia elective that I had planned to be a ramp up to submitting a confident application. However! I woke up on day 1 of the block feeling incredibly anxious about this path, feeling it was overwhelming and suddenly not for me any more, like I wouldn't be able to handle to handle stress of this career. I've done electives in anesthesia before and had always really liked it; it had felt like a comfortable mix of problem solving, procedures, acuity, and adaptation for me. Now this week has been predominantly out-of-the-blue anxiety about not feeling like a fit anymore.

There's a wrinkle to this story! I went through almost the exact same thing with emergency medicine earlier last year. EM was my "first love" in medicine, enjoying it all through my first 3.5 years, enjoying electives in 4th year, and suddenly feeling like it wasn't a fit anymore right at the start of my EM core rotation. After that experience I shifted towards anesthesia, feeling it was a better fit, with fewer patients and more latitude to focus.

And another wrinkle! I've done what I'm hoping is some positive growth and reflection about myself that I had been putting off too long, and have recently come to appreciate the anxiety I have lived with, and how that has pushed me to please others and I haven't developed my own interests as much as I should have previously. This has put some doubt into a lot of what I've previously thought about myself, my relationship with stress and anxiety, and what my true interests and limits are.

All that to say, I'm not sure if I'm just feeling some cold feet towards anesthesia that I will get over once I start residency, or if this is my body telling me this isn't a good fit anymore as I appreciate different aspects about myself (i.e. am I more cut out for something like family med, which I always thought was ok but never truly loved, but offers more flexibility and a different type of stress).

What I'm hoping to get out of this is to see if this resonates with anyone, if anyone has had similar experiences, and if they can offer any advice or perspective to someone having a tough time with it right now.

To anyone else out there who has experienced uncertainty, discomfort, and anxiety, I hope you found your way!

May all things feel peace.

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[Matthew9Thirtyfive]

Sounds like cold feet. It’s a little anxiety inducing scheduling auditions and interviews and committing to a specialty. It means it’s real and you’re eliminating every other specialty which activates some FOMO and some nervousness about not matching. Your body is not going to tell you anything, except maybe if you’re trying to do something like ortho and you have chronic low back pain or something. It’s normal to feel nervous when you’re moving along this path, I think. I don’t know anyone who didn’t have at least a little anxiety at some point.

 

[Maximus2020]

You are not alone. My colleagues and I all felt anxiety over whether we were making the right choice. A colleague initially wanted to do peds cardiac surgery, then switched to peds, then to PICU, then to anesthesia. Like many things in life, this is a gamble on hoping you choose right and not regret the next 40 years of your career. I made a gamble and it paid off.

Others I met as an intern who did full residencies in one area and then switched to another. Or, did 1 year in 1, switched to another. It's not easy. If you felt good about your electives in anesthesia, then I think you are making the right move. Worst case scenario you do a year and then switch to something else. Not the end of the world.

I think at least 3 times I sat down with every specialty and crossed off all those I could never see myself doing. I was left with 3 or 4 and lucked out with my choice. Keep faith in yourself and know you are not alone.

 

[Styrene]

TL;DR I'm not sure if I'm feeling cold feet towards a specialty I had always enjoyed or if my body is telling me I should pursue a different path.

Hello internet!

I am a 4th year MD student that could use some help. We are getting close to residency applications, and I'm feeling a lot of anxiety around what my plan is. I am planning to apply to anesthesiology, and was feeling incredibly motivated and excited right up until this week when I started an anesthesia elective that I had planned to be a ramp up to submitting a confident application. However! I woke up on day 1 of the block feeling incredibly anxious about this path, feeling it was overwhelming and suddenly not for me any more, like I wouldn't be able to handle to handle stress of this career. I've done electives in anesthesia before and had always really liked it; it had felt like a comfortable mix of problem solving, procedures, acuity, and adaptation for me. Now this week has been predominantly out-of-the-blue anxiety about not feeling like a fit anymore.

There's a wrinkle to this story! I went through almost the exact same thing with emergency medicine earlier last year. EM was my "first love" in medicine, enjoying it all through my first 3.5 years, enjoying electives in 4th year, and suddenly feeling like it wasn't a fit anymore right at the start of my EM core rotation. After that experience I shifted towards anesthesia, feeling it was a better fit, with fewer patients and more latitude to focus.

And another wrinkle! I've done what I'm hoping is some positive growth and reflection about myself that I had been putting off too long, and have recently come to appreciate the anxiety I have lived with, and how that has pushed me to please others and I haven't developed my own interests as much as I should have previously. This has put some doubt into a lot of what I've previously thought about myself, my relationship with stress and anxiety, and what my true interests and limits are.

All that to say, I'm not sure if I'm just feeling some cold feet towards anesthesia that I will get over once I start residency, or if this is my body telling me this isn't a good fit anymore as I appreciate different aspects about myself (i.e. am I more cut out for something like family med, which I always thought was ok but never truly loved, but offers more flexibility and a different type of stress).

What I'm hoping to get out of this is to see if this resonates with anyone, if anyone has had similar experiences, and if they can offer any advice or perspective to someone having a tough time with it right now.

To anyone else out there who has experienced uncertainty, discomfort, and anxiety, I hope you found your way!

May all things feel peace.

Your worry is about whether anesthesia is the correct career path generally, as in questioning if you would enjoy something else more, or specifically about the unique stress of anesthesia on a day-to-day basis and if you would tolerate it from a "nerves" perspective? If the former, I would weigh all my experiences thus far; it's impossible to enjoy or feel good during every rotation in a given field. If the latter, I would reflect further about what particular future situations I envision as being stressful, and if I experienced those situations already, did I tolerate it? Also, am I performing well in the current/recent rotation despite these feelings?

I would also attempt to disentangle these specific thoughts from the overall stress of choosing and applying for a given field, which is anxiety-provoking on its own. Anxiety begets anxiety such that the anxious mental and physiologic state promotes further anxious rumination. So in this regard, I'd examine which came first: a stressful event in the clinical setting that perhaps adds value to, for example, the statement "like I wouldn't be able to handle the stress of this career," or anxiety about the whole career selection and application process generally that may have led the mind down the path of anxious rumination about myriad other things.