You should specialize.

It's been 2.5 years since I've written a blog post!

In that time period, I've completed half of my  internal medicine and pediatrics residency.

I've met a wonderful young lady, who I've been with for almost 19 months.

I've been stuck in a blizzard and 30 inches of snow.

I've had my tire slashed by some disgruntled employee at my apartment complex.

I've gotten a bike, which I'm slowly breaking in. I need to ride more.

But the reason I'm writing this.
After two years I've made a decision on what I want to do with my life.

I started off Congenital Cardio (after spending a month in Orlando @ Arnold Palmer), then considered Nephrology strongly. My goal was to do boards in Adult Nephro and see both kids/adults.  Now, finally, I'll do my alma mater proud and go into primary care.

Med School Alma Mater

Despite the warnings of :

1. You should specialize
2. You'll never make enough money.
3. Primary care is underpaid, under-appreciated.

I've come to realize something.

According to Webster:  Primary means
a : of first rank, importance, or value : principal primary
 purpose>

b : basic, fundamental primary
 need>
They are potentially the most important doctor you see.
Having done ICU, Cardiac Units, 1 month in ER, I've learned just how important a good primary care doctor is.
They can be your cardiologist, nephrologist, endocrinologist, pulmonologist, gastroenterologist, psychiatrist. 
They can be your nutritionist, your advocate, your ally, your friend. 

I've had the pleasure of working with some amazing attendings in my continuity clinic , both in pediatrics and medicine. I've also worked with private attendings as well.  It's enjoyable to see the same patients, to help fix their diseases. I enjoy my conversations with my patients. I enjoy seeing them lose weight and get their diabetes under control. I enjoy seeing them overcome diseases and diagnoses and prognoses. I am humbled every day in clinic. I am challenged.  

The good internist/primary care doc is a Renaissance Man/Woman. They will know enough about every organ system to start a good workup and often complete and treat those diseases. I can schedule a colonoscopy, follow up the results and keep surveillance on my patients. I can titrate their statins to optimize their LDL goals. 

The most important thing about this realization is that I can see myself doing this for many years. In 20, 30 , 40 years, experience will only add to me knowledge and skill as a generalist. 

Perhaps, my mind will change in the next two years, though unlikely.