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Do I need to love the medical science or the work when I pick a specialty? Which matters more?

I’ve spent tremendous amounts of times thinking about what I wanted to do with my future, weighing the question of whether I needed to love the science and medicine or love the work. Often times, these can feel mutually exclusive. So what matters more?

The answer is: they both matter, and it depends on how you approach it.

Take cardiology, for example. I love cardiac physiology. Thinking about the heart as a pump with all its waveforms, pressure gradients, and hemodynamic parameters makes me excited. It just makes total sense.

Yet clinically, on cardiology rotations, I found myself annoyed when titrating furosemide doses and looking at jugular venous pulses (JVP) all day long. Yes, the physiology was clear and I understood the concepts behind JVP and furosemide. But the disconnect between physiology and the actual practice was so frustrating.

So I ruled out cardiology (or so I thought).

I went on to do a subsequent rotation in electrophysiology, and I remember again loving the physiology behind electrocardiograms, and falling in love with the heart again. Again, I hated the patient interactions and the repetitiveness of cardiology.

It wasn’t until I went on to do multiple other rotations that I realized that all fields of medicine are repetitive in that way to some extent. The day-to-day work by definition is work and that is why we are paid to do it. The best job in the world would have me doing something different at every moment, but those kinds of jobs don’t exist in medicine. But I realized something really unique about cardiology: it was that when I wanted to, I could think about a patient’s problems from a physiologic point of view and become excited. And despite the day-to-day work, I knew that in theory, everything I was doing was exhilarating on an intellectual level. Somehow, the more I tried to do this, the less the day-to-day work seemed to drag on.

So to answer the original question again, yes, both science and day-to-day work matter in each specialty. But if you find yourself not loving the day-to-day work, try to find excitement in the science or physiology of the medicine you practice. You might find the everyday work becomes a lot more interesting. At least, that’s what worked for me.

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