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Lessons Learned While Climbing the Medical Hierarchy

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I’ve often looked forward to graduation season, as it symbolizes the completion of yet another chapter and the accomplishments of yet another handful of training requirements. Every small milestone, whether that be passing a written test, an oral exam, or a small group assignment, culminates in graduation. Graduation has always brought me one step closer to what I thought was the end of medical training.

It would only be a short time before I realized — or perhaps admitted — that medical training never ends. There is always one more research paper that can be written or one more test that needs to be passed, and one could easily spend their entire life climbing the medical hierarchy without making it to the top. 

As this graduation season approaches and the end of my residency training draws near, here are a handful of lessons I’ve learned from so many years of climbing the medical hierarchy just to make it to another graduation:

Lesson 1: Where you train matters less and what you know matters more.

Early in my training, it felt like everyone cared so much about my pedigree. Medical school was unexpected news for many of my friends, as I was an engineering major who previously showed no interest in medicine, with no premedical friends. I had applied to a small handful of schools and had been accepted only into one: my state school. While my friends moved to big cities, the last thing I wanted to do was regress. There was a visible weight on my soul when the resident on my surgery rotation found out I graduated from Stanford University and was now living at home. I remember his sarcastic response, “What happened?” My pedigree felt so important that I made many decisions — about potentially delaying medical school graduation, taking extra time to increase my step 1 score, prioritizing my extracurriculars — just so I could ensure an upward trajectory when it came time for residency.

Throughout residency, though, I’ve realized that more important than pedigree is competence. While having an impressive pedigree certainly doesn’t hurt, no job will be made or broken by where I did my training. As a graduating resident, it is so much more important to me to feel comfortable knowing what I am doing and why I am doing it than to have an impressive CV. As I’ve started looking for jobs, the question I’ve had to answer is what do I feel comfortable doing, rather than where did I do my training. So rather than choosing to train at a program based on name or doing things just to build my application, I would tell myself to choose a program based on whether it would give me the confidence to practice and to do things that make me a better doctor.

Lesson 2: You will value your family and friends more than you realize.

The moment I enrolled in medical school, I made the decision to move back into my parents’ house. I still remember the surprised reactions when I told my friends and the questions I would continue to get about when I would try to move out. I ended up living with my parents for four years as an adult, and it was not until I moved out that I realized how extremely blessed I was to have been able to live with them for that time. I constantly had an extra set of hands to run errands while I was at school and had food readily available when I was running late from clinic. They further supported me with their company, keeping me from feeling isolated throughout medical training. There are many days in residency where I dream about how I can live with my parents again — this time, moving them in with me instead of the other way around.

By living with my parents, I was able to balance the requirements I had at school while feeling like I didn’t have to make an extra effort to see my parents. This time I spent with my parents was incredibly special and meaningful, and it also gave me more time to see my friends. I was able to travel more frequently with the money I saved by living at home, and while every parent-child situation is different, I was lucky in that my parents were immensely supportive about giving me the freedom and independence to be an adult while living at home. 

Lesson 3: It’s OK to do things on your own timeline.

When I started medical school, I felt behind because I had taken two years off after college. As I didn’t want to get further behind, one of the most difficult decisions I made during medical school was to take a quarter off between third and fourth year. It was not a decision to be taken lightly, for I was told that it would be on my record for eternity, and it would potentially delay my graduation as well as affect my acceptance into residency/fellowship. Yet, it was also during this quarter that I recharged and spent several weeks in Greece traveling with lifelong friends. I treasure those memories, for I will likely never ride an ATV through the Greecian countryside or venture out to a club at midnight again. Ultimately, my decision to take my time had no effect on where I matched for residency and fellowship. It only re-inspired me and made me a better physician.

Despite the amount of wisdom my younger self might think my current self possesses, I still have many moments of weakness in which I forget the lessons I’ve learned. There are many nights that I tell myself I just have one more research project to finish or can sacrifice just one more phone call from a friend, but these nights are becoming fewer and fewer. I have become much more flexible about the expectations I set for myself and much more inflexible about what I am willing to give up. 

One of the fundamental aspects of medicine is empathy, which allows physicians to be able to understand and care for sick patients. By neglecting our own humanity and setting unrealistic expectations for ourselves in order to climb the medical hierarchy, we create a recipe for burnout. Of all the things I’ve learned, my most important takeaway is that, as a medical trainee, I benefited more from spending time nourishing my humanistic side and less from trying to accomplish graduation requirements.

What is the most important lesson you learned during medical training? Share in the comments.

Thea L. Swenson received a bachelor’s degree in engineering, product design from Stanford University and a medical degree from the University of Colorado. She is currently a resident in physical medicine and rehabilitation at Vanderbilt University and hopes to specialize in sports medicine. Dr. Swenson is a 2022–2023 Doximity Op-Med Fellow.

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