We are grateful to Ms. Lichtenstein for taking the time both to read our paper and for offering her thoughts and observations on the issues raised.
The purpose of our study was partly to try to quantify the scale of the problem of career dissatisfaction in surgery at the resident level, but also to create some food for thought among those on either side of the Canadian Resident Matching Service (CaRMS) process. The observation that it is difficult to confidently recognize what one will want to be doing for the next 30 or 40 years based on a few weeks of limited exposure is well recognized in the world of medical education. This appears to be equally true whether one has entered medical school directly from high school, as is the European model, or after a period of undergraduate tertiary education, as is required in North America. Indeed changes in preferences, values and life goals can occur at any age, not least in the early stages of one’s career regardless of the field or vocation.
Ultimately the best advice we can offer to those entering the CaRMS match is to do everything you can to “know what you’re getting yourselves into.” This is, after all, why students are favoured if they have shown a commitment to a specialty — not that it constitutes a guarantee of subsequent fulfilment and happiness, but because it is simply an indication that they have as good an idea of what they’re getting themselves into as they can possibly get for their stage in life. Further academic research into medical students’ career decision-making processes and their level of appreciation into what a career in the various specialties entails would undoubtedly be of value to both medical students and postgraduate educators alike. Unfortunately, with medical education being as demanding and intensive as it is and with the volume of knowledge that must be instilled in this timeframe there can only ever be a short, finite window of opportunity in which medical students can consider and research their potential future careers. On that rather poignant note we wish Ms. Lichtenstein and all those entering CaRMS the very best of luck in matching to the specialty to which they are most suited.
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