As a trainee and early in my career, I despised the "boring" cases. The mild anemias, MGUS, Stage IA breast cancer, etc. Nowadays, I see my schedule stacked with those cases and I'm like "F*** Yeah! I'm getting out of here early today!".
Exactly.
Look, bread and butter is great. As a rheumatologist, I’d be thrilled to have a full gout or osteoporosis clinic. I had a mentor in residency who said “you can’t really be a rheumatologist unless you enjoy a good case of gout”, and now I know exactly what they meant by that. It’s straightforward, you can actually help someone, and pts are grateful for you fixing them up. Win/win.
Now I still do like tackling complex cases to get my brain working, but with the volumes you generally have to see in the community, too many of those cases can get overwhelming.
Honestly, I think I'm just grappling hard with the stark contrast between the initial elation I felt getting into medical school and the dank, repetitive, and boring hole that the actual practice of hospital medicine is.
When we start medical school, everything is new and fresh and thrilling. There’s a lot of competition going on, too, which ups the ante for a lot of folks. And I think some young doctors envision their entire career as being this swashbuckling adventure where you puff up your chest every day like William Osler, swing your balls, make brilliant diagnoses and solve everyone’s problems perfectly every time. (And I think academic docs are, at least in part, people who couldn’t let that fantasy go and/or still identify with it.)
But this isn’t how medicine is - and more importantly, it’s not actually how you’d want it to be. Everything eventually becomes a job - with ups and downs and varying degrees of obligation, health insurance and a certain amount of pay for what you do. (And as pointed out above, academic medicine sucks because the pay isn’t nearly what it should be.)
Get a good job that pays you well for what you do. Go to work, do a good job, and then focus on everything else. Hobbies, your family, that thing called life.