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The Day After Residency: How to Maximize Your Career in Medicine

Physician Advice for the Day After Residency

Congratulate yourself for finishing residency. It’s an impressive accomplishment and testament to your dedication. While the knowledge and skill acquired in training allow the privilege of caring for others, do not mistake your present reality for the end. Life-long learning is critical, and continuing to gain more knowledge and skill from your first day as an attending onward provides immense value.

Learning offers stimulation, helps to ensure competence, and makes you an exciting colleague to consult or simply share conversation. Block time on your calendar to accomplish this mission-critical task. A mentor of mine carries a small moleskin notebook and writes one or two things to read more about each day. By the end of the month, he has filed away twenty or so relevant clinical pearls that may prevent suffering and heal a patient or save a life

It has been said that half of what doctors learn is wrong, and it’s our job to figure out which half. I’ve always hated that phrase, as it implies a bit of ignorance and laziness for all involved. The rapid expansion of medical and scientific knowledge ensures the impossibility of any single doctor knowing everything in its most correct iteration. Fans of historical medicine will recall trephining, bloodletting, and evil humors with a smile. I’ve been around long enough to have witnessed leeches used to reduce edema after a severed ear was reattached.

That said, be open to disagreement. Learn to question what you think you know. Small advances in a biotech lab will reach the masses and reshape how we treat disease. Contrast cancer treatment 15 years ago with current trends in immuno-oncology. Your future selves will look back and shudder at what you thought of as cutting-edge therapy.

Your career in medicine will span several decades. Don’t become complacent and assume what you know now is the best and only option for your patients. Keep a curious mind and push yourself to explore interests and passions; your patients will thank you for it.

Celebrate Small Wins

As in medical school and residency, there are good and bad days. There will be truly horrible moments. I don’t share this to rain on anyone’s parade but to share a tactic for survival. Days can be similar, but each will hold several small wins. Celebrate them. Maybe your intuition caused you to ask one more question that changed the diagnosis. Perhaps a pause allowed you to catch a medication error. What you do every day is important. Reward yourself for victories.

Also, learn from the mistakes. I made many. You will too. We are human, and this is the practice of medicine. We try to be perfect as a laudable goal, but that will never be a reality. Physicians are faced with thousands of decisions, and many must be made quickly with incomplete information. That’s the nature of the job. Accept it. Find a way to process these times, but let them go. Do not keep score – it will kill your enthusiasm and shorten your career and perhaps, life.

Be Flexible and Open

I was fortunate to gain exposure to physician-entrepreneurs during my training and beyond. While the tunnel vision of finishing residency is powerful, adopting a permanent set of blinders and engraving the single title of doctor on your soul is tragically limiting. Go back to the etymology of doctor: roughly translated as “teacher.” This is just grazing the surface. You are so much more already. The past seven to ten years of your life has allowed you to become a master communicator, organizer, teacher, leader, and explorer. Being only smart would not have landed you where you are today. Use the talents developed to chart your own course. You have the power to shape destiny and influence countless lives. Use your gifts to their fullest.

Some are blessed and discover their creative urges early. Others take a bit longer to embrace opportunities. I recall a pivotal moment at the end of my second year of residency. I was sitting in the emergency department having a conversation with my attending mentor and was struck by an unfamiliar feeling. A thought suddenly exploded in my soul. There is more to being a doctor than plowing through the unending stream of patients. There was so much more, and I was going to find it. I did, and I enjoy sharing that journey with other physicians curious about the journey.

Resist Temptation

Medical students are capable of generating massive amounts of debt. You know the situation perhaps all too intimately. While resident salaries are nearly double today than when I trained, living is expensive. As those new attending physician paychecks roll in, the temptation to reward oneself can cloud rational judgment. The sentiment of deserving your just reward can result in debt that quickly spirals out of control and removes any hope of freedom. Don’t get caught on a high-speed treadmill that you can’t escape. Prudent financial planning and stewardship may not be sexy, but those who create a system of debt reduction and savings will enjoy freedom.

Residents accept working long hours and accepting schedules they have little control over. It goes with the job. Only a masochist would revel in a future that is more of that same pattern. Small rewards are deserved, but the temptation to buy a massive house, get that boat, or trade up to the hottest car every year will chain you to the hospital or clinic for the indefinite future. Those who work to reduce and eliminate debt will enjoy career choices and options unavailable to more liberal spending peers. Experiences, not things, are what adds flavor to life.

Take Care

Hopefully, you developed healthy strategies while in college that have carried forward and are ingrained in your psyche. Time passes at an accelerating pace and suddenly you’re pushing fifty as I am. Life in medicine is hard, and doctors are not immune to the ravages of disease. Care for not only your body but also your mind. You are not reading this for a lecture on lifestyle, but I want to share a simple mantra shared by one of my surgeon teachers:

Eat good food and sleep whenever you can. 

You never know when the pager will go off, a colleague will call in sick, or the call schedule will change. While residency work limits have improved the situation, many doctors wear the badge of suffering as if it were a medal to be displayed on their chest.  Depending on the specialty, we are forced to go without food, miss out on precious sleep, and often hard pressed to find time for a bathroom break. Find a recipe to recharge that works for you. Develop a strategy to keep your health and stick to it. Walk, run, CrossFit, yoga, meditate – whatever it takes to keep you whole. Nurture your body and mind – you deserve at least that.

If any of this resonated with you, I love connecting with passionate and open-minded colleagues. Reach out to me on LinkedIn or whatever social media platform you like.

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About Mitchel Schwindt, MD

Dr. Mitchel Schwindt is a board-certified emergency medicine physician who practices in a variety of clinical settings. He completed his residency at Butterworth Hospital in Grand Rapids, Michigan. As part of Michigan State University, Butterworth was renamed Spectrum Health, and is one of the busiest level 1 emergency and trauma centers in the United States. He served as chief resident his final year. While there he was inducted into Alpha Omega Alpha, a prestigious medical honor society. He also devoted a significant amount of time working as a flight physician (helicopter) for an aeromedical company.

Dr. Schwindt has served on many committees and steering groups related to health care, quality and process improvement and was a former trauma program medical director. He serves as a volunteer physician for local sporting and martial arts events. He is a consultant and medical advisor to several dental groups and has developed protocols and policies related to medical issues in the dental practice.

Wellness and nutrition are a passionate interest for Dr. Schwindt. He writes extensively on the subject and has published several related books. He is a member of the A4M – The American Academy of Anti-Aging Medicine and is currently pursing a functional and sports medicine fellowship.

In his free time, he enjoys competing in triathlons, skiing, water sports, time with family, foreign travel and pursuing entrepreneurial activities.