During my third year of medical school it became clear to me how I would contribute to mankind as a physician. Having been involved in team sports and because of my excellent hand-eye coordination, I decided that surgery was a natural fit.
During the first few months of my internal medicine internship, I began to reconsider. I was having fun in this discipline, so I decided to complete the full three years of internal medicine training. There were three events that occurred over that third year that clenched my choice in becoming a rheumatologist.
The first occurred while I was rotating on the cardiology service. A patient was admitted for consideration of ischemic heart disease, but her only complaints were related to her arthritis and musculoskeletal problems. Each day on morning rounds, I would convey this information to my senior resident - whose opinion I valued - and each day he would say that we should only be "concerned about her heart." My resident had no idea what her arthritic condition was, and after three days and a negative cardiac workup, we discharged a markedly dissatisfied patient.
The second event occurred during elective rotations in my second year of residency. The Chair of the Department of Internal Medicine recommended I do a rotation in rheumatology. I learned more about medicine that month than I had learned at any other time during my residency, and I was truly beginning to understand the diseases that had previously seemed like a black hole in my education.
A third event solidified my career choice. Because of my newfound interest in rheumatic disease, I decided to embark on a research study in patients with systemic lupus erythematosus. While conducting research, I had the opportunity to learn about the patients as well as the current research in the field. I realized that rheumatology was a field in which I could make tremendous contributions in terms of care for patients, while also being able to make academic contributions should I choose to pursue an academic career.
I took several of the rheumatology clinic patients to my internal medicine clinic to manage with periodic consultation by rheumatology. In so doing, I developed a burning desire to better understand the clinical immunology related to autoimmune diseases and the management of musculoskeletal diseases in general. With motivation and enthusiasm, I could easily envision myself embarking on a career in rheumatology and was excited by the possible contributions I could make. All I had to do was connect the dots.