At the end of a journey 3,650 days long, there is a path leading into the wilderness. From the first day of medical school until the last day of fellowship, we safely follow the well-paved and often-traveled road of medical education with its preset and regimented responsibilities, objectives, and milestones. We become comfortable in the academic routine of newly prescribed goals and responsibilities every year of training. We continually push forward with the stated desire of completing our education, beginning our dream job, and discovering our personas as physicians and human beings along the way. Balance, while an ideal to aspire to, is often put aside for the perceived greater glory of practical knowledge, competition, and the finish line. The assumption all along is that happiness is preordained by this path. However, when the routine comes to an end and we take our first steps into life as an attending surgeon, we can come face to face with an inexplicable void.
It is often said that the best period of training is the first years of practice. We spend those initial years drinking from the fire hose that is the attending surgeon learning curve, but that learning curve often too quickly plateaus. We can be paralyzed by the uncertainty of what the future may bring and of our roles in it. At that moment we have a profound new choice to make: to relish the freedom to reinvent ourselves and create new adventures, or to succumb to the unhealthy temptations and outside influences that abound. Bad decisions are inevitable if we never spend any time reflecting on what actually makes us happy. The sesquipedalian prose of self-improvement books often belabors the fact that we are all at risk of becoming clichés. To fight the cliché, we believe the essence of healthy success in practice after training lies in 3 principles: reinvention, passion, and inspiration. The rest is filler.
Reinvent yourself within medicine. As physicians, part of our identities is built upon our abilities to compassionately care for patients and effectively treat disease. However, the vast majority of procedures and skills we acquire during training will be obsolete in a decade or less. Therefore, it is imperative that we change with time, or else we will become stagnant. If we choose to compare ourselves only to those around us and similar to us, we can be unaware of our standing still as the world moves forward. Medicine as a career can remain exciting if we persistently demand that we improve every day in some way, no matter how small. Previous training cannot limit future learning, and we must strive to never give in to excuses and constantly seek out new skills. Research, teaching, administration, society involvement, politics, governance, and business can all serve as catalysts in our work lives to instigate meaningful change and discover new challenges. The pursuit of new experiences in medicine is the lifeblood of our future careers and constant reinvention is the heartbeat that sustains it. No talented person in the business or technology sectors would ever be asked to do the exact same job for an entire career. Therefore, why should we? Reinvention every 5 to 7 years is a must.
Find passion outside of medicine. Our interests outside of medicine are assets no different than finances, property, and material goods. As such, we need a plan for asset allocation and diversification that involves more than just numbers and percentages. We need healthy passions that evoke emotions and solidify memories. A busy practice can be a jealous mistress. Therefore, be careful to allocate time in your calendar to develop your identity outside of the practice environment. The overwhelming urge is to ignore the lack of attention to life outside medicine because it’s not as comfortable as seeing familiar patients who need your help. As ignoring an infection can be deadly for patients, this approach can pull us inescapably far away from the things and people that we love. While a simple hike in the woods, a dinner with friends, or quiet conversation with family can seem trivial and easily pushed aside for clinics and cases, these are the anchors in our lives that will prevent us from going astray. As we develop healthy passions in our personal lives outside of medicine, we in turn create more anchors, keeping us grounded and true to ourselves and to those around us. When we decide what is important in our personal lives we must ensure that our schedules diligently protect the time devoted to these priorities. Control your schedule or your schedule will control you.