On third base but not home yet.

565 IN 28 YEARS of a busy and rewarding medical career I have had the opportunity to work in three different environments during three distinct stages of my career and life. As with many other young professionals I had some reasonable knowledge about how and when I would get to first base (medical degree and specialty). However, I was not able to predict when or where the next stage would take me. In most cases professional decisions are greatly influenced by personal circumstances and therefore one of the life long challenges is to continuously adapt professional and personal goals to a changing environment. This paper summarizes the first three bases in my run for home and some things I have learned along the way.