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10 Lessons From My First Year as a Female Attending Physician

Below is a list of some of the major topics that continually come up in conversations I have with fellow female attending physicians and friends. While my experiences, and these lessons, are limited to the medical field, I think many of these issues affect women in all industries.

Lesson 1. Change is Slow

This is something I figured I’d have to deal with, but not to the extent that I have. Part of the issue is that people just don’t like change and don’t like having their workflows disrupted. Another is that if the culture of the workplace is not supportive of new ideas, then change is even harder. People have to be open-minded and willing to try new things and when they aren’t, it’s that much more of an uphill battle.

Tackling this issue: Shift your focus. Get to know people first. Say hi. Be present. Show them you’re paying attention. As an anesthesiologist, I am part of a stereotype where it is assumed that we hide behind drapes and play Sudoku all day long. While this is not entirely untrue, we do also work. We pay attention to our patients and know when to take action.

I take it a step further. I wander around the OR (assuming my patient is stable, of course). I peek over the drape. I (wait for it) — make eye contact with the surgeons! I TALK to them (have you fainted yet?). I ask them how it's going. I say what’s up. Really, it's a small thing, but the result? They ask about the patient. They ask questions about me (yes, this has happened!!). And voila. I have a new onset cordial working relationship with my fellow colleagues. Then, when an issue arises, I am not “anesthesia with no name.” I am “oh hey Dr. so and so, what's your concern?”

And thus, a change occurs which then opens the conversational doors for anything and everything you can imagine.

Lesson 2. Patience is a Virtue

It’s always better to think before you say something; wait before you send an angry response to an email that you’ll later regret.

Tackling this issue: When you are able to stay calm and speak calmly, regardless of how anyone else is speaking to you, you automatically have the upper hand. Nothing says “crazy and irrational” like someone who angers easily. The moment you lose your cool, especially as a female attending physician, you start to lose credibility and people stop listening to what you’re saying.

Lesson 3. Generational Differences Exist

Leading those that are older than you can be very challenging. You must be patient (ha) and learn to communicate on another level.

Example: The first thing I do when I’m running the OR board and need to tell a senior attending what to do: smile. Then, tell them my plan and ask them if they’d be OK with my decision. I’m actually quite friendly with a lot of the senior attendings I work with now and am comfortable being a little bossy with them, but when I first started, I always made sure to ask. It sets a different tone for the dynamic and, I think, can serve to soften the weirdness of having a younger person telling you what to do.

Lesson 4. Female Resentment is Real

This has been the hardest for me to deal with. Many women don’t like being told what to do by another woman, let alone one who is younger than them. In addition, we will not get the same undue respect as our male counterparts. We are held to a different standard, come under greater scrutiny, and are questioned way more often than our male colleagues.

Tackling this issue: This is tough, but what others think of you should not guide your decision making. I'm not saying you act crazy and irrational — definitely still utilize your tools as a leader to listen to and hear those you work with. Just remember that ultimately, you are responsible for your patients, it is your decision that is final. Don't let the opinions and resentment of others drown out your abilities or make you feel like you don't deserve to be where you are. (Hello imposter syndrome!)

Lesson 5. You Must Develop Coping Mechanisms

Medicine is a frustrating beast of a profession. Lots of players, lots of moving parts, lots of things out of a doctor’s and administrator’s control. You must find a way to cope, otherwise, you will go insane.

Tackling this issue: Find some work friends you trust and vent, join a gym, take vacations to give yourself breaks, see a therapist, learn to practice letting go and being more mindful. Whatever it is, do it and do it regularly.

Lesson 6. Don’t Take Anything Personally

This I think goes hand in hand with coping. Often times the reason for someone else’s anger/frustration/non-compliance has absolutely nothing to do with you. We women are emotional creatures, so it's natural for us to get offended when things are said to us that we don’t like or understand. This then leads to self doubt, wondering whether we are good enough, and feeling like we don’t belong (Imposter syndrome again!)

I promise you, it's not personal.

Tackling this issue: As an attending physician, you will fall prey to this more often than not. Train yourself to remember that it’s not personal. I repeat this fact to myself constantly.

Lesson 7. Pick Your Battles

Don’t sweat the small stuff. Don’t drive yourself crazy if something doesn’t go exactly how you see it. It’s your choice what you are passionate about or get worked up for. Choose the things that will really matter in the long run. Not every fight is worth fighting.

Example: There are a thousand ways to administer anesthesia. When people do things in a way that I don’t necessarily like, I have to evaluate if what they are doing is actually unsafe or if I’m just being my Type A, picky self. If I’m just being picky, then I leave it alone. I only put my foot down if the patient is really sick or I think my colleague is truly being unsafe — because at the end of the day, safety trumps all.

Lesson 8. People Will Comment on Your Age/Appearance

As a female physician, this happens much more often to us than it does to mean. You will also be mistaken for a nurse or other staff worker.

Tackling this issue: Learn to ignore it or develop a way to respond that effectively addresses their comment and also helps you move the conversation along. For instance, when a patient asks how old I am, I cheerfully reply “I’m definitely old enough to be your doctor!” I usually get a laugh or a chuckle in response and then I move the conversation back to where it was.

Lesson 9. You Will Not Be Good at Everything

You’ve worked hard to land where you are, but a big lesson that you’ll learn when you first start out as an attending physician is that you actually are not good at everything. I think I’ve learned more about my strengths and weaknesses within my profession since becoming an attending physician than I ever knew when in school or in training. Attending life can change how you view things, including yourself, and can alter your plans for your career altogether.

Tackling this issue: Don’t try to be good at everything. Some people are, but if you aren’t, it's OK. Recognize your strengths and continue to refine and build them up. When you find yourself in a situation where you know you are weak, ask for help or a second opinion. Don’t pretend to be good at it.

For instance, I’m quite comfortable with my decision-making as an anesthesiologist. However certain situations tend to make me second guess everything. A prime example of this is trauma cases. In general, I’m comfortable knowing what to do, but I sometimes get too many ideas running through my head on how to go about doing it. As a result, I usually end up asking my colleagues for their opinions and advice.

I know asking for help can be difficult. The last thing you want is to make yourself appear as if you are incompetent. I basically force myself to think about it as a learning opportunity: by asking for another opinion I either learn that my original idea was sound or that I could do it another way. That’s a win-win. At the end of the day, who knows, maybe this weakness of mine will turn into a strength!

In business, I’ve read several articles that describe good managers as those that play up their strengths and delegate their weaknesses. This is not always possible when practicing medicine, where we are expected to know everything and be good at everything. So for us, I think we can acknowledge and promote our strengths and then ask for help with our weaknesses as we continue to work on and improve them.

Lesson 10. As Women, We are Much More Critical of Ourselves

As mentioned above, we are emotional creatures. I know I can be very hard on myself. How many of you blame yourself whenever something goes wrong, even if it wasn’t your fault? How many of us know someone who will berate themselves for days after a perceived mistake was made? Critically analyzing situations and your behaviors is important. However, being so hard on ourselves can be debilitating.

Tackling this issue: Instead, try to use your self-criticism to your advantage. Learn as much as you can from your mistakes, from your awkward interactions, and build yourself up rather than beat yourself up. Remind yourself that everyone makes mistakes. No one is perfect, not even a crazy smart attending physician as yourself. As much as you are thinking about your mistake long after it happened, everyone else has likely forgotten about it. So be nice to yourself and give yourself a break. In fact, doing so is associated with emotional resilience and psychological well being.

There’s a learning curve when you become an attending physician. Everyone goes through it. So, give yourself a chance to figure things out: give yourself breaks, forgive yourself, take care of yourself, keep an open mind so that you continue to learn and grow, and don’t let anyone or any situation bring you down.

Be confident (you will figure it out)

Be forgiving (to yourself and others).

Be open and caring (to yourself. Self care, then care for others).

Do you have anything to add to this list? Thoughts and comments welcome!

Previously published in YouBeThree.

Illustration by April Brust

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