What was the best decision of your career and life?

[vanfanal]

On an extended car drive this morning, I reflected on the fact that my life now is very different to how I thought it would be when in graduated med school - a lot of the things I worried about at the time I've surpassed. In career and in life, seldom do we end up exactly where we thought we would be; sometimes a decision or series of small decisions can change the course of things and lead to some wonderful, and sometimes not, opportunities and experiences that we wouldn't have thought of. These can be great moments for reflection and learning and I'm appreciate that we're all on here to teach and learn from each other.

So what are your best decisions, those integral moments that changed the course of things?

I'll start. So far, and I'm early career, I would say it was my decision to do fellowship. I like my niche and it's opened up unique opportunities (and I hope will continue to do so) and it's also how I met my SO.

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[FlowRate]

I am not a big schmoozer or into constantly networking but a large number of my best decisions were to develop relationships with mentors (various professors/attendings/etc.) Now that I'm a few years out of residency there's not nearly as much built-in opportunity to do that the way there was during school/training and it's probably something I should put more effort into cultivating. It's really helpful to have people who can give tailored advice, share experience, advocate for you, etc.

 

[whopper]

Continuing my training at a top institution. I've mentioned that about half the psychiatrists out there are terrible. I went to a place where almost all the psychiatrists were outstanding. It upped my game to a level I don't think I would've been able to achieve otherwise.

Where I graduated from most of the attendings were average with 1 being excellent, 2 being good but not great.

Edit-for clarification. I did my general psych training in NJ at a university program. It wasn't a bad program but I didn't get to my potential and I was frankly better than about half the attendings by the time I graduated. My fellowship-and that's where I mentioned most of the doctors were outstanding was at U of Cincinnati. Paul Keck, Henry Nasrallah, Steve Strachowski, Doug Mossman, among several others were all in one place, with 5 of the psychiatrists at the time being ranked within the top 100 physicians in the country. Lots of things ahead of the times things I never would've considered such as Tramadol for treatment resistant OCD, Ketamine being given out years ahead of anyone else, were being done.

 

[Atreides]

Changing my application from Emergency Medicine to Psychiatry at the 11th hour. Had my SLOEs, had already gotten a pre-match offer (my med school somehow offers these in a few specialties, not sure how it's allowed but they still do it to this day), and had even scheduled my 4th year electives to focus on EM (had an ICU, ultrasound, EKG rotation scheduled).

So thankful I didn't go that route. I doubt I'd be practicing medicine right now if I went the EM route.

 

[Celexa]

Changing my application from Emergency Medicine to Psychiatry at the 11th hour. Had my SLOEs, had already gotten a pre-match offer (my med school somehow offers these in a few specialties, not sure how it's allowed but they still do it to this day), and had even scheduled my 4th year electives to focus on EM (had an ICU, ultrasound, EKG rotation scheduled).

So thankful I didn't go that route. I doubt I'd be practicing medicine right now if I went the EM route.

Wow, bullet dodged indeed!

I have had a lot of those moments. Networking has been crucial. Probably one of the biggest in retrospect though was picking a residency due to a big geographic factor, not realizing how intense the therapy training was, and then that therapy training being the part of my training I'm most grateful for.

I wasn't necessarily looking for a therapy heavy program when I applied and might not have ranked the program quite as high if I'd known. An important lesson in not knowing what you don't know and how trainees don't always know what's best for them!

 

[Merovinge]

Changing my application from Emergency Medicine to Psychiatry at the 11th hour. Had my SLOEs, had already gotten a pre-match offer (my med school somehow offers these in a few specialties, not sure how it's allowed but they still do it to this day), and had even scheduled my 4th year electives to focus on EM (had an ICU, ultrasound, EKG rotation scheduled).

So thankful I didn't go that route. I doubt I'd be practicing medicine right now if I went the EM route.

Wild, I had the same thing. Switched at the last second from Ob/gyn, had all my electives/research in ob/gyn and had to reschedule my 4th year electives to psych. Somehow CAP was still available as a selective and voila that ended up being how I get to spend the rest of my life.

My other profound moment was breaking up with a girl I had been dating for a few weeks mostly related to just wanting to be single and party during residency. I ran into her a few months later and she somehow hit things back off with me (despite me calling things off with her) and we've been together for the past decade since. She's a better partner than I could have ever even imagined finding, I say as someone who was quite the serial monogamist for a decade or so prior.

These experiences strongly add to my belief that while skill, intent, work ethic, etc. are all important in determining how one's life plays out, luck is also a big factor for everyone.

 

[comp1]

I mean med school was the best decision. After that, psych residency. There wasn't really a series of small decisions, just a couple of very big ones.

 

[psychmd03]

Two things a switch from ortho focused through my first two years in medical school to psych. And then making the choice to leave the VA after 6 months to fully pursue only jobs that would reward more work with more pay and work in places where the teams actually respect their own work rather than avoid like you find commonly in the VA systems.

 

[DOswag]

Changing my application from Emergency Medicine to Psychiatry at the 11th hour. Had my SLOEs, had already gotten a pre-match offer (my med school somehow offers these in a few specialties, not sure how it's allowed but they still do it to this day), and had even scheduled my 4th year electives to focus on EM (had an ICU, ultrasound, EKG rotation scheduled).

So thankful I didn't go that route. I doubt I'd be practicing medicine right now if I went the EM route.

Same here. Except I applied EM in the military match but ended up not matching to one of the spots, got deferred for a civ transitional year which ended up being an awesome year, albeit delaying formal training a year. Reapplied to psych in mil match. Soooooooooo glad I decided to switch as pretty sure I’d be miserable in EM. Next big decisions have been made recently that I’m still waiting on the results: separating from the military (pretty confident this will turn out to be a good decision), the clinic I decided to sign with (also confident and start training in a week with them), moving to a new city (well back to where I did residency so we know we enjoyed the city).

 

[DOswag]

Should probably add marrying my wife as one of the best decisions I’ve made in life. She’s been a rockstar staying home with our kids and supporting me through this adventure. Had a 1 yr old when started med school, baby #2 born in 4th year of med school, baby #3 in 3rd year of residency, baby #4 after arriving to first duty station after residency. All born in different states lol.

 

[Stagg737]

Changing my application from Emergency Medicine to Psychiatry at the 11th hour. Had my SLOEs, had already gotten a pre-match offer (my med school somehow offers these in a few specialties, not sure how it's allowed but they still do it to this day), and had even scheduled my 4th year electives to focus on EM (had an ICU, ultrasound, EKG rotation scheduled).

So thankful I didn't go that route. I doubt I'd be practicing medicine right now if I went the EM route.

Wild, I had the same thing. Switched at the last second from Ob/gyn, had all my electives/research in ob/gyn and had to reschedule my 4th year electives to psych. Somehow CAP was still available as a selective and voila that ended up being how I get to spend the rest of my life.

My other profound moment was breaking up with a girl I had been dating for a few weeks mostly related to just wanting to be single and party during residency. I ran into her a few months later and she somehow hit things back off with me (despite me calling things off with her) and we've been together for the past decade since. She's a better partner than I could have ever even imagined finding, I say as someone who was quite the serial monogamist for a decade or so prior.

These experiences strongly add to my belief that while skill, intent, work ethic, etc. are all important in determining how one's life plays out, luck is also a big factor for everyone.

Same here. Except I applied EM in the military match but ended up not matching to one of the spots, got deferred for a civ transitional year which ended up being an awesome year, albeit delaying formal training a year. Reapplied to psych in mil match. Soooooooooo glad I decided to switch as pretty sure I’d be miserable in EM. Next big decisions have been made recently that I’m still waiting on the results: separating from the military (pretty confident this will turn out to be a good decision), the clinic I decided to sign with (also confident and start training in a week with them), moving to a new city (well back to where I did residency so we know we enjoyed the city).

Kind of funny because OB/gyn and EM were my number 2 and 3 choices behind psych after 3rd year. If I had been single I may not be a psychiatrist right now, but with being married and planning a family I did and still do value sleep and not having to take miserable call too much for EM or OB.

 

[littlefred]

Should probably add marrying my wife as one of the best decisions I’ve made in life. She’s been a rockstar staying home with our kids and supporting me through this adventure. Had a 1 yr old when started med school, baby #2 born in 4th year of med school, baby #3 in 3rd year of residency, baby #4 after arriving to first duty station after residency. All born in different states lol.

You going for the basketball team.

 

[TexasPhysician]

I’m assuming my best decision was selecting my spouse who got me wonderful kids. Unfortunately or fortunately I don’t have a crystal ball to see what life would have been had I chosen any of my exes instead.

 

[finalpsychyear]

Best decision in life was never settling in my personal life and marrying my wife.

Career wise I guess i had a strange moment post med school where I didn't go through with the match and instead was considering MBA/MPH and maybe even dental school cause i thought 15 years ago dentistry was a great lifestyle/career/etc. Somehow ended up in psych 2 years later realizing this was the path but was told by many you'll always be on the low end in terms of salary. Went into PP and a side tele gig which has given me a a very blessed combo of lifestyle/autonomy

 

[DOswag]

You going for the basketball team.

Yeah we’re officially done now lol

 

[psychemdoc]

Yeah we’re officially done now lol

We need more you wuss!

 

[milesed]

Career? Going into CAP. I love my job and most of the kids I see. I also chose a job with good work/family life balance.
Life? Marrying the right person.

 

[Merovinge]

Career? Going into CAP. I love my job and most of the kids I see. I also chose a job with good work/family life balance.
Life? Marrying the right person.

Very parsimonious. 100% my experience. I once and a while yearn for some bigshot VC/PE life (it's in my DNA unfortunately) and taunt myself by listening to finance/econ podcasts as a major hobby. Then I stepback and realize how great my life is, smile, and get back to actually helping people and loving my wonderful and blessed family. We try to take 1 kidfree baller vacation each year so I still get to live my fantasy out 1 week at a time, next stop, the Maldives!

 

[clozareal]

Career? Going into CAP. I love my job and most of the kids I see. I also chose a job with good work/family life balance.
Life? Marrying the right person.

Wait this is me too. Also about career: going into private practice.

Very parsimonious. 100% my experience. I once and a while yearn for some bigshot VC/PE life (it's in my DNA unfortunately) and taunt myself by listening to finance/econ podcasts as a major hobby. Then I stepback and realize how great my life is, smile, and get back to actually helping people and loving my wonderful and blessed family. We try to take 1 kidfree baller vacation each year so I still get to live my fantasy out 1 week at a time, next stop, the Maldives!

This is me too. Unfortunately, my mind tends to wander into the grass is greener when I think about teaching more in academia, being part of a group that's expanding, those who are buying bigger homes in lower cost of living areas, those who are building a real estate empire, people who are doing groundbreaking research, etc. But then I come back to reality and I'm very happy with my life right now. Haven't taken a kid-free vacation yet though but I hope that'll be soon.