I'm coming to the end of my orthopedics (foot/ankle/trauma) rotation.  In the past 4 (almost) weeks, many people have asked or assumed that I'm going into orthopedics.  Some are surprised, some not so surprised, when I tell them I'm actually going into Family Medicine and want to do Sports Medicine.

For those of you who have not known me since I was a youngin' (or, in high school I guess), orthopedic surgery was kind of the plan since I decided I wanted to go into medicine.  That was also the plan as I started medical school.  I was never really interested in the spine/joint replacement side of orthopedics, but really liked musculoskeletal medicine, trauma, and sports medicine.  I think a lot of it comes from orthopedics being very mechanical, and very logical.  But as I went through the first two years, and into third year when we started doing rotations, I realized that I also really liked patient continuity (not that that really surprised me), taking care of everyday problems, and getting to know patients and being able to at least address all of their problems and concerns.  I also discovered the world of primary care sports medicine.

Prior to coming to medical school, I thought the only way you got to take care of athletes was to be an orthopedic surgeon.  I'd never though about all the other stuff that athletes need that doesn't fall into the realm of things that orthopedists take care of.  But as I rotated through family medicine, got to know some of our primary care sports medicine docs, and spent time doing event coverage with them, I realized that I was incredibly comfortable and happy in that setting.  It gave me all the musculoskeletal medicine I liked, the acute sports injuries, but also the ability to take care of concussions, heat illness, normal illness in an athlete, nutrition, conditioning, and also leaves the flexibility to take care of normal family medicine patients.

Now, don't get me wrong, I still definitely enjoy the actual surgery part of orthopedic surgery.  And on some level I know I will miss not being able to take care of patients from injury through complete recovery (if their injuries require surgery).  I also think that I would probably be a pretty good surgeon.  But I've figured out over the last couple years of trying to make this "career" decision, that no matter what I choose to do, I will have to give up something I know I would enjoy doing.  But, unfortunately, I can't do EVERYTHING.  Fact.  Sad, but true.  So the question became, what will I miss less?  Will I miss surgery less, or will I miss family medicine/patient continuity less.  And I decided that I would rather give up the surgery than give up the ability to continue to take care of every day medical problems. 

I don't want to be the doctor on the sidelines who gets called to the stands for a spectator whose passed out or had a seizure, or is having a heart attack, and have no idea what to do.  It's important to me to have the skills to take care of people, not just injuries.  I know that if I did orthopedic surgery, I would miss being able to take care of everything else, being able to be the one person who takes care of a whole patient.  I know that as a sports medicine doctor, I want to be able to take care of athletes of all ages and abilities, through many injuries and illnesses, and during different times in their life.  And I'm confident that this is the decision that is right for me. 

Sometimes, I get twinges of sadness that I won't be in the OR once I finish my training...

And then I spend a day in clinic, an evening on the sidelines, and I get over it.