My Plans for Residency, Practice, and "Retirement"Okay. I started med school in May 2005. I'll be done with basic medical sciences in spring of 2008. I'll start clinical rotations in the summer of 2008, and be done with them in May 2010. Then I'll graduate, and that's the end of my undergraduate medical education. Once they graduate, medical students become physicians, that is, they get to stick "M.D." at the ends of their names, they get to write prescriptions, and other such things, but they still usually do not know enough to practice medicine on their own. So they move on to graduate medical education, to a residency, which involves three or more years dedicated to learning more and more breadth and depth in the area of medicine wherein they want to practice. It used to be the case that graduates of U.S. medical schools could open up shop right away as "General Practitioners." That is no longer the case. Even General Practice no longer exists. It has been replaced by Family Medicine, which requires a three-year residency. I shall start my residency in family medicine in the summer or fall of 2010. When I have completed my residency, I hope to return to Lovely Central Illinois to practice in a small town or rural community. I would be especially interested in living and practicing in the small town of Petersburg, Illinois in Menard County. Some branches of my mother's family have lived there for for nearly 200 years. My mother was born on a small farm a few miles outside of Petersburg, and her family moved into town when she was a teenager. My dad was born in the nearby Menard County village of Tallula, Illinois. Some branches of his family have lived in Menard County and nearby counties for nearly 200 years, too. Though my mother and dad have passed on as well as have all their siblings and their siblings' spouses who still lived in that area (though my mother's brother, my Uncle Tom Robertson, and his wife, my Aunt Ann Robertson, are thankfully still with us, living in Bethesda, Maryland), I want to return to Petersburg to practice family medicine where it is most needed, in one the small towns and rural communities of the U.S., to try to repay the remarkable gift of having been allowed to study medicine so late in my life, that is, my "extremely late thirties." Morerover, many of my cousins live on farms or in small towns in Menard County or nearby, and my sister and brother still live in Springfield, Illinois, in Sangamon County, less than 20 miles away. Springfield is where I grew up. I want to return to Lovely Central Illinois, I want to give back, I want to repay. But I am also interested in doing a residency in psychiatry. Short version of a long story: I read Sigmund Freud's A General Introduction to Psychoanalysis when I was 15. I didn't understand much of it, and I found that much of it seemed to be somewhat circular logic and based on too few examples to be a generalization, but I read it, and I was instantly captivated, one of those moments in my life when I knew that something had clicked inside my heart, inside my mind, inside my soul. Since then, I have read much more about Freud and his theories, other psychoanalytic theorists and their theories, and psychology in general. I have also taken many classes, to the point where I am but three classes short of finishing a BA in Psychology. Moreover, psychoanalytic theories, those of Freud and others, constitute one of the theoretical tools for analyzing literature that I studied in graduate school in the Department of English and the Program in Comparative and World Literature at the University of Illinois at Urbana-Champaign. In short, I am deeply interested in psychology, psychoanalysis, and psychiatry. Both Family Med and Psychiatry are three-year residencies, but there are seven residency programs in the U.S. that unite family med and psych into a combined five-year residency, and I am especially interested in one of those. Doing a combined residency would have a practical application in my future as well. Most small towns cannot support a full-time psychiatrist, but a family med doc who is also trained in psych can provide both services. Two such programs are the University of California at San Diego's School of Medicine's combined family med/psych residency, and the University of Iowa's Carver College of Medicine's combined family med/psych residency. Either of those would be good for me. I have friends in San Diego, and that would be okay, but I'd rather go to the University of Iowa in Iowa City because it's a university community much like my hometown of Urbana, Illinois, and because the program is more directed at physicians who want to practice in small towns and small cities in the Midwest, which is much, much nicer than California. As for ultimately finding a job, finding a place to practice, although I hope I can go to Petersburg, I am also signed up with two agencies that recruit docs for hard-to-fill slots throughout the nation. One of them is interested in me for a job in International Falls, Minnesota, but there are other such jobs throughout the Midwest, which is where I am most interested in going and especially Illinois, and elsewhere. I am not required to accept any position they offer. They are just trying to help find something that fits me as well as I fit it. Probably because I am a med student, and probably because they think that I am a twenty-something as most med students are, I have been getting a lot of recruiting info from the Army and Navy. As you probably have learned from television and newspapers, the Army is in rather desperate need of both family med docs and psychiatrists. Given the state of medical care for soldiers, I am considering joining the Army after residency. The Army would pay off my loans, and I'd be giving something back. I cannot stand the thought of young women and men needing medical care, especially psychiatric care, and not getting it. I would do that for a few years, and then I could return to the Midwest and practice in a small town. I would get to help in both areas of need. My goal is to wind up in Urbana when I retire at about age 76. That would mean practicing medicine for about 15 years. Even though I will be retired, I intend to continue practicing maybe two afternoons a week at a free clinic there and to return to the Caribbean for 2-3 weeks 2 or 3 times a year to practice in a free clinic down here. Helping folks in all parts of my life as a physician from now on is what motivated me in the first place. And I'm gonna do it. I'm moving the darned rubber tree plant, and ain't nuthin' and ain't nobody gonna stop me. And I shall be delighted to return to Urbana. Perhaps I can even practice there for awhile before I retire. Perhaps I can even become a staff physician and practice family medicine or psychiatry at the University of Illinois at Urbana-Champaign. And I would be living in a community that I greatly enjoy, becoming again a member of a church family that is so dear to me, becoming again a member of a fraternity brotherhood that means so much to me. A fine way to spend my years. And when my task on Earth is accomplished, and when it is time for me to shuffle off this mortal coil, I shall go, happy, satisfied, having moved the darned rubber tree plant, more than once, I think. This is one of the first poems I ever read, but it has stuck with me, full of more meaning now than when I first read it at age eight. I'm still busy moving the darned rubber tree plant, but when I have accomplished that for the last time, I shall gladly cross the bar ... probably dragging the darned rubber tree plant! ;-) Crossing the Bar
Sunset and evening star,
But such a tide as moving seems asleep,
Twilight and evening bell,
For though from out our Bourne of Time and Place
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