I'm getting ready to apply to residencies and this brings to the forefront a few things.
First, I really don't want to work for a religious institution. I think. Probably. Or at least not a particularly prevalent one that runs an awful lot of health care establishments. Think hospitals named after saints and you've got the right idea. I'm too lazy to disguise the name of this particular religion and I don't want to invite a legion of angry commenters here by using its name.
My major reason for not wanting to work for one of these institutions is the disservice done to women in the face of obstetric problems. Nobody with pPROM who wants labor induced should have to wait until signs of infection to do so. Nobody with an ectopic should have her tube removed because using the standard of care medication amounts to an "indirect ab.orti.on." I'm perfectly content to let anyone think whatever they want and use their own thoughts to decide on appropriate obstetric treatments for themselves, but I absolutely don't want a hospital to prevent a woman from getting appropriate care for any reason.
It gets a bit more complex though. I live in an area where the closest non-this-faith-based hospital is an hour and a half away across state lines. I don't think the hospitals nearer are doing any terrible things most of the time. They're just the only hospitals around and they happen to be run by some extension of this particular faith. The level to which they subscribe to the official doctrine varies but it isn't one of those things it's easy to ask before you work somewhere.
My personal job acceptance line has been "absolutely no job is worth having at a certain big blue box store" and "if at all possible, a job at a giant red pharmacy chain should be avoided." Beyond that I'd consider myself open but I continue to have mixed feelings about even considering such a religious institution while finding that an awful lot of the places that are otherwise appealing are also religiously affiliated... I'm continuing to consider the merits of maintaining my line as previously defined or to change my values to allow for working for a health system that has a faith-based sponsor.
Then I wonder if I'm compromising too much. There are lots of places similar to this one that we could move to that have secular health systems where I could work.
Second is that I am more likely to get a really satisfying job in a community pharmacy if I take a job offer sooner rather than later. Specifically the job interviewing season is starting in November and my classmates who work for a big chain are starting to be offered jobs there already. I really feel like we live in a decent place now and it would be nice to stay put if we can manage it, but that means working for a faith-based hospital system or getting a job with a chain community pharmacy.
Third is that I'm trying to avoid just going with the flow, or seeming to just go with the flow. My plan is to cultivate a few possible paths, to explore even the ones that are scary and that I'm likely to fail at, and to be on the look out for the ideal opportunity that is the right fit. I'm sure that I will know it when it arrives but I am impatient as ever. I want the certainty of saying, "Here are my career goals and I really want to meet them and I clearly see how I can accomplish that" instead of the liminal space that exists now where I have some pretty good ideas for what I'd like to do but I am unsure which direction is the right one for me, for us. If things go perfectly smoothly, I would love to work in a hospital doing clinical and technical pharmacy. If things go in another direction, I'd be very happy working in a community pharmacy. If things go in a third direction, I'd really enjoy working in an ambulatory setting.
So I guess I know what I'd like most but I'm not sure how to articulate the "I don't commit to one way yet because I don't trust my certainty of my own judgment" place that I'm in. I stick with the next right thing and I do that and then I do the next right thing after that. If I try to plan for years ahead I usually am wrong because I skipped that next right thing in favor of dreaming.