Today’s inane image of the day:
I spent the majority of my life feeling the pressure to “hustle.” That productivity was equated with my worth. If I wasn’t productive, then what purpose do I serve?
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Last week, I reflected on 2023. As sort-of-promised, I decided to set some 2024 intentions. I think that every single day is a new opportunity to set and achieve goals; I don’t think we need a designated time of the year to do these things. I have short-term, intermediate-term, and long-term goals that I set and review on a semi-regular basis. But the idea of intentions feels like the right approach for 2024; they are touchy-feely types of ideas that I’d like to work toward in the new year. There is no checkbox for these items… they are lofty ideals that I hope I can remind myself to embody throughout the year. Maybe my 2024 reflections post will be assessing how these intentions came into play [or didn’t!]. Who knows. Maybe there will be silence on the blog for almost a year again [let’s hope not].
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I keep telling myself I will get back into blogging regularly but the words don’t flow the way they used to. The further along in my career I get [and the older I get], the more it seems “risky” to pour my heart and soul out to the internet. Yet, it feels like there is a part of me I am not honoring by being silent. There is also something to be said about the loss of connection to those of you still reading my updates with anticipation and excitement [I appreciate you – I know you’re out there and support my writing endeavors].
This is by no means a declaration of more consistent writing in 2024, but a reflection that this space is an important one that I want to integrate into my life in a more consistent manner again.
A couple years ago in an effort to reflect upon a relationship ending, I started journaling on a regular basis. I’ve actually kept a journal/blog for most of my life, but consistency was never my strong suit. Or perhaps I should say frequency was never my strong suit since I consistently went back to it. Either way, a couple years ago, I picked up journaling and it stuck. As a result, I have my own written words/emotions/thoughts/feelings to reflect upon on an annual basis. As we near the end of 2023, I figured I’d share some the reflections I had from 2023.
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If you’ve stumbled across this entry, it is likely that either you or someone that you care deeply about has failed some sort of examination. It may be a low-stakes or a high-stakes one. It may be in the setting of a course, or it may be in the setting of a medical board examination. Either way, there is something so disarming about failing an exam. It really cuts deep. I am going to make the generalization that most people who are seeking advice after failing an exam are those who typically haven’t encountered this challenge before.
Either way, you are here and seeking advice on how to move forward.
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I’ve been asked whether my schedule is more “humane” or “manageable” now that I’m an attending. The answer is a resounding “yes!”… but, I still have blocks of long weeks. The work never stops being challenging for one reason or another. There are certainly still weeks when I am scheduled to work 70 hours. Yet even with this assignment, the work still feels so much better than when I was in training. Long weeks as a trainee felt exhausting because there was always something new to learn. Long weeks as a first-year attending also felt exhausting for the same reason. Now that I’m a few years out, I feel more at ease, confident in my clinical skills, and able to appreciate how incredible the work I get to do is.
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It has been almost a decade since I applied to anesthesia residency. It’s crazy how time flies. When I applied to the specialty back in 2014, anesthesiology was a somewhat competitive specialty – for the 2015 match, there was a total of 1,859 applicants for the 1,094 PGY-1 positions offered in through 120 anesthesiology programs [of note, back in my time, there were many more advanced spots available, so of note, there were also 1,581 applicants for the 506 PGY-2 anesthesiology positions; for the sake of consistency to compare between 2014 and currently, I’m going to only focus on the PGY-1 positions]. In the 2023 match, there were a total of 2,959 applicants for the 1,609 PGY-1 positions offered through 172 anesthesiology programs [and there were 2,006 applicants for 301 PGY-2 positions].
If we only look at PGY-1 positions and assume that everyone who applied could occupy a spot, back in 2015, the match rate would be 1,094/1,859 = 58.8% while in 2023 the match rate would be 1,609/2959 = 54%.
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At heart, I am a selfless, people-pleaser that would rather suffer in silence than let others down. When I feel like I’ve let someone down, it crushes my soul. This leads me to tumble down the rabbit hole of saying “yes” to things. At work, this often translates into non-promotable assignments [aside: did you know that women are 48% more likely to to volunteer for non-promotable work and even when we learn to say no, we are disproportionately assigned to these types of tasks?]. In medicine, it’s often exceptionally difficult to tease out which tasks are “non-promotable work” and which ones will have indirect benefits through gaining knowledge, learning a new skill, or valuable connections that could lead to career advancement in the future.
Throughout medical training, we are conditioned to be generous with volunteering our time for research projects, organizations, and anything that might help get us to that next step. Understandably, when training is finally done, some of us are left wondering… now what? Especially in an academic environment, it seems like everyone has a million projects they’re working on and those who have “made it” to professorship/leadership were the ones that hustled the most [i.e. said “yes” to everything].
But is that approach sustainable? And most importantly, is that the approach you should take?
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It has been a while since I updated here [woah, almost a year?!]. I kept telling myself it was time to write something or record something but the passion just hasn’t been there. A couple weeks back, I actually recorded a video, but I wasn’t excited to edit it. Either way, I’ve wanted to explore writing regularly again as a way to stay true to myself and practice articulating things that are important to me. Someday, I’d love to write a book [yup, I’m writing it here so that all two of you reading this entry can hold me accountable].
Anyway, for my first entry of 2023, I thought I’d start with a big one.
For those of you who follow along on YouTube or my social media channels, I’ve been very open about the fact that I enjoy my job. Sure, I can come up with reasons to hate it, but there is no such thing as the perfect job/career/anything. In general, I think I’m the type of person who would try to see the best in any job I’m in, or figure out how to make the most of it. But there was actually a time after I finished fellowship when I wondered if my current job was the right fit.
I actually went as far as reaching out to someone I knew in a private practice group to ask if they would hire me[!].
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I took my anesthesia critical care medicine board examination on October 9, 2021 – a significant delay from my graduation from my fellowship in June 2020 because of pandemic restrictions. It was a different experience studying for this exam because I was working as an attending at that point and this board exam doesn’t have as “straightforward” of resources to use [e.g. BASIC/ADVANCED/ITE = TrueLearn + review book]. Also, it feels weird to have to study for yet another exam when you’re finally DONE with training.
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During a talk I gave recently to an anesthesia department about social media for use by medical professionals, I used the example of typing into Google: “Are anesthesiologists…” and allowing the predictive text to fill in the rest. The FIRST response on Google is: “Are anesthesiologists doctors?” which I used as a demonstration that we [as anesthesiologists] need to do a better job with letting the public know our role in the surgical team.
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