THOUGHT EXPERIMENT
"If you could go back in time and speak to yourself as an intern or resident ...
What is the One Thing you would want that sapling version of you to know about what is coming?
- One Important Thing to Keep in Mind
- Or Understand
As "intern you" moves forward in this physician career and life to this present day?
We have asked this question across our blog, social media pages and our Burnout Proof MD support ecosystem. This is the Master File of answers from all sources.
CURRENT WISDOM COUNT = 35 Entries
See the MASTER LIST BELOW
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- PLEASE LEAVE A COMMENT in the box at the very bottom of this post.
Feel free to put your top 2 or 3 things in your comment and give feedback/support to other's statements.
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Physician Wisdom Time Bank - MASTER LIST
I would want my Resident Self to Always Remember THIS:
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You don't have to keep doing this if it does not work for you any more. Life has phases. You can change course. Nothing is set in stone. You can choose your own way forward.
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🤔 Keep a careful watch for a psychopath boss and RUN. 🤭
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1) the patient does not come first. I do. My wellness is the most important thing so that I can give of myself to patients for a longer future.
2) Learn and understand the power of real estate investing and leveraging the value. Buy early and grow. Huge tax advantages and good way to balance a standard stock/bond/mutual fund investments.
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1. Keep up with your hobbies and friends who give you strength and joy. Despite your crazy schedule this is time we'll spent.
2. Keep saving. Even if you want to work at age 95, financial independence is priceless.
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YOU are the boss of yourself. YOU choose. YOU decide. There are ALWAYS options you just have to notice them- they are not always where you think they are. Don’t let your head be the sole guy in charge. Develop and learn to trust your gut. You catch more flies with honey and be kind.
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Don't feel you have to know everything before finishing residency. Part of being a good doctor is that you are continually learning.
~~~~~~~~~~This is your first real full time job. Serve your patients, learn, and also remember to treat it like a job. That means reviewing your benefits, communicating with your boss, and keeping some separation between your personal life and your work life.
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You didn't choose medicine to be abused day in and day out by your superiors. When you suffer your patients suffer because you have nothing left to give. Set boundaries, choose yourself before your health fails you, and know you have options.
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I have the right to say "no".
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Don’t always put the needs of you and your family last.
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You don’t have to get right. You just have to get it started.
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Don’t listen to them when they say you have to limit yourself. Don’t let them put you in a box. Create your own damned box.
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Most of the things will change. And you'll never know if things happening around you are good or turn out bad. Best you can do is keep on breathing, keep on learning, and always think about getting help.
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Do good medicine and the money will follow, but if you follow only the money you will never do good medicine.
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Be strong, yet flexible. Be confident, not cocky. Never stop learning and experimenting - every patient, every peer and every colleague may unknowingly teach you a skill or a technique or a trait that you want to incorporate into your toolbox or consciously avoid repeating. As a clinician, we become a conglomerate of all of the pieces of wisdom that we pick up along the way - so stay sticky! Be dedicated - but not just to work...to yourself, your family, your passions and the greater community. Remember, even though you may work in just 1 hospital or office, continue to look outside your bubble to explore the possibilities of healthcare. There is amazing knowledge within our peers across the country and across the globe - keep you eyes and ears open and never assume you know the answers without constantly repeating the questions and listening... Lastly, medicine (and life) is a team sport. Lead by example and treat your peers, patients, family, support staff, cleaning crew, etc with respect - because without them, you will never become the best version of yourself at work or at home. And have some fun, dammit. 🤪
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It’s fascinating to me the various permutations of presentations and circumstances. The variability is astounding. Even plain old blood pressure treatment. In Hungarian there is a saying that a good priest learns to the moment of his death. There is always something new to learn or different circumstance to grapple with. Keep an open mind.
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You are there for training. The work you did in medical school got you into this program. Continue to read what you need to learn or brush up on first, care for patients and ask questions what you need clarification later. Be open to what worked for you in the past may not serve you going forward. Residency is a transformative experience. If your sense of “ self “ is derived from the approval of others it may be a rocky ride until you realize… what makes you tick …
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We have amazing opportunities to make big impact with patients, our teammates, and those we lead. We have our best life when we are at our best. Don’t forget that, and don’t let the work of medicine destroy the beautiful things in medicine. You get to decide who you are in this life! Let’s do this!!!
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1) Never compromise your values, be they related to family, ethical decisions, etc. It doesn't mean you can't bend a little at times in service of a greater good, but be careful with that, too. It can be a slippery slope.
2) Never get too full of yourself. The earth is but a tiny moat of dust in a galaxy far vaster than we can understand. After your grandkids are gone, few will remember you unless you have done something extraordinarily good or bad. Stay humble and connected to the earth. Remember that all humans everywhere deserve dignity, compassion, and respect.
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You deserve to be happy and to either be your own boss or work for an institution that values physicians. Patients come second. If physicians and staff are not cared for then we have no health care system. All of us can contribute to making things better. You can always make changes in your life and are never stuck. Your happiness is #1, honor yourself and your thoughts and feelings, trust your internal wisdom.
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Medicine isn't a contest of skills, personality, wisdom, sarcasm, wit, numbers, dollars, sacrifices made, etc. Medicine is a commitment to life-long learning, teaching, self-care and absolute humility. Your patients value your time, attention and willingness to really hear them. Before each encounter, remind yourself that is what really matters. After each encounter, remind yourself that your needs are just as important and in order to be there for those you serve (patients, family, colleagues), you have to shore up for yourself first. Hobbies, learning, counseling, your own healthcare, sleep, nutrition, exercise, family time, friendships - those things make us whole and restore what we give away. Do not underestimate your value - not as a medical professional but as a human being! Evaluate your own health but also go to another professional and follow their advice. Take time away when you need it. Learn the signs of burnout and take them seriously. Don’t live with regret. Let it point you to the areas where you need to heal and find the good, turning regret into wisdom. Declutter your life by testing all things against joy. If it’s not bringing you joy, maybe it’s time to let it go.
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Don’t let a corporation (clinic, Hospital, insurance company) determine your priorities as a physician. The shift will be gradual, like the proverbial boiling frog. Stay aware and if something feels contrary to your gut, take the time to evaluate it and look for other alternatives. Learn the signs of manipulation, personality disorders and bullying and avoid those at all costs.
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It's a priviledge to be a physician. Do not act privileged... stay humble, listen deeply to your patients, their trust will follow. Then they will take their medicines, therapies....and get well. Take pride in your work. Be happy you have the gifts to be a physician.
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Put a dollar value on your education. Do not waste this opportunity! Remember, you have a chance to make millions. If you blow this, you might end up peddling insurance.
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Single payer single payer single payer
As a generalist I had to choose special skills to make me look special. Choose and market those early.
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Think small. Small acts of kindness, small compliments, small dollops of positive feedback to colleagues will have a huge cumulative impact. Slow down to speed up - you become more efficient when you slow down and breathe.~~~~~~~~~~
1. You will never be perfect. Be your best self.
2. There will never be enough time. Choose how you spend it: YOU decide.
3. You will make mistakes. Own them, fix them when you can and be grateful for the learning opportunity.
3. Use the key social lubricants: Please. Thank you. I'm sorry. A little humility goes a long way.
4. Be grateful. For everything. Always.
5. Be profligate with your listening and frugal with your speaking.~~~~~~~~~~
1. Relax! You can only do what you can with the resources that you have available. 2. Remember that you are only one part of an amazing team. Don't be afraid to ask for help - asking for help is a sign of strength, not a sign of weakness. Ask others, especially experienced nurses, about critical decisions - even if it turns out not to be the best decision, having your team behind you is invaluable. 3. None of us are perfect. We all make mistakes. None of us could have done anything differently. Be accountable to others, learn from your mistakes, but realise this. Realise this also about your patients - they cannot change their past actions any more than they can change their genes. This realisation brings compassion for yourself and for your patients, all of your patients. Judging yourself or your patients is a path to misery. 4. Clear your mind, whether through meditation, walking, a hobby, whatever works for you. If you cannot stop thinking, it is hard to be happy and difficult to stay focused on your job. 5. Bring some snacks in for your team if you can, preferably something healthy 6. Say "please", "thank you", and "sorry" often. Be quick to admit your faults and slow to blame others - e.g. start with "I might not have communicated that very well", when an instruction hasn't been followed. 7. Smile and greet everyone like you really want to see them. If you don't really want to see them it's probably time to take a break and look at and look after yourself.
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If its not working well, explore the option of switching residencies/programs-this is not necessarily a failure, rather a bad fit sometimes. Know that one persons opinion of your performance is not the end all be all of who you are and what you are capable of. Accept criticism with as much grace as you can, but know sometimes its not well thought out and may be true in the context of your sleep deprived self, but not true when you're at your best. You may have some highly burned out attendings. Attending physicians are human just like interns. Physicians aren't trained enough if adequate communication skills. Prioritize sleep over everything else. Small self care is crucial. Meditate for 5-10 minutes daily. 10 minutes of cardiovascular on the bad days even if its jumping jacks in a call room
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you belong here.
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1) It’s ok not to be ok - this is hard and takes a log of great vulnerability skills to model as a leader and then reward the residents when they practice it.
2) Suncess is built on failure - intentionally celebrate the mistakes, share vulnerable stories to normalize them and use them as great tool to memorialize it as a tool teach medicine and empathy.
3) Find your true north - not everyone is build to provide patient care. Some of resident have other exceptional talents, human skills that more difficult to teach and a great leader should be able to recognize theses talents and capitalize on them.
4) Stop pitching glorified medicine and physician idealism and selfless heroisms.
5) Reward the intentions and not just actions.~~~~~~~~~~
1. You can do everything right and still have a bad outcome.
2. And- it’s impossible to do everything right all the time.
3. So- learn from your mistakes but don’t be defined by them.
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Up to this point in life, you have been very successful, with a few hiccups, by following and accepting other people's agendas - teacher's assignments, work responsibilities, parent's and society's expectations, and even your own thoughts that achievement and subsequent positive evaluation by others equals success.
You have already seen though, that this approach has led also to pain and self judgment, rather than feelings of peace, happiness and acceptance. I challenge you now to look at things a little differently by answering the following questions for yourself.
What is your mission statement, for where you are in life now?
What are your core values, for your work as a resident, but also for your life?
After so many years of doing the work given to you by others, I recommend you sit yourself down, think about these questions, and spend quality time formulating some answers. It doesn't need to be a long list. In fact, start by picking a core list of around 4 to 6 core values, that speak to who you are and what you want in life.
The answers to these questions will give you a framework in which everything else will either fit or not fit with your core values, and lead you to good decisions. It is much more common to look at the nuts and bolts of an opportunity, e.g. the job requirements and benefits, when people decide what is a best fit. I challenge you to turn that on it's head - know your core values, then find the work that best fits to get you to the next step.
When you know what your core values are, and when you know what you want to feel, then you can better figure out what to practice to help you live by your own mission statement and core values. Be gentle with yourself in the process. I have confidence with you, and with your pursuit of your own core values. It will reap benefits for you and for making the world a better place.
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Professionally speaking, see the forest not just the trees. Surgical attendings (maybe) excellent clinical mentors, but outside of that their scope is often limited in coaching for larger career and life goals. Likely because their adaptation to life may be as stunted as mine.
I have benefited from engaging with people outside of my specialty and outside medicine. Perspective getting, compassion, a dog, a plant-based diet, and a workout routine all make things a little easier.
Ultimately ask people what they are thinking and avoid dairy. Both will lead to less discomfort.
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YOUR TURN
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What is the One Thing you would want the resident version of you to know?
- One Important Thing to Keep in Mind
- Or Understand
As you move forward in this life and this career to the present day?