Where do we go from here?

Ever hear that song by David Essex - "Rock On"? You can see a YouTube video here. There's a line where he says, "Where do we go from here..."

That's how I'm feeling these days.

I'm near the point in my fellowship where I have to decide what I want to do when I'm done. This doesn't sound hard -- I've been training to be an Infectious Diseases specialist...so, duh, go and be an ID doc! It's not that easy.

There's outpatient HIV work. There's hospital consulting. There's any combination of those two. There's joining a group, starting your own group or (for those who love risk) starting your own solo practice. There's research - many, many different types. There's staying LA (which is a pretty saturated market) or looking out in the 'burbs.

Here's the kicker: I don't know what I want.

I know what I don't want. I don't want to be bored. I don't want to work 28 days a month. I don't want the pressure of starting my own group. I enjoy research and teaching. I am fascinated by HIV and Hep C. I love international HIV work.

Ideally, I want a job where I can do frequent over-seas trips to either do research or direct patient care, possibly some teaching of residents or med students there. I want to do HIV work with some HCV work here. Teach and supervise residents/fellows here. So, I think I need to stay in academics. In order to try and get a job in that competitive world, I think I'm going to need to do a 3rd year of fellowship. This pains me mostly because of the salary. I'll have to moonlight still to make enough to pay off the house and such. But, it's just one more year in the grand scheme of life.

So, I've got some meetings coming up to see where that 3rd year will be and how it will be structured. So many questions still.