The Question:
“What would you like to contribute and be remembered for in medicine?”
It’s been six years since I applied to medical school. A lot has changed, but some things remain the same. Two years of medical school done and three years into my PhD, I am finally in a state of clarity. I know exactly what I want to go into, I know the type of physician I want to be, I know I want to stay in academia, and I know I want to be a physician scientist. But it wasn’t always this clear.
I recently heard that a medical school is asking applicants “What would you like to contribute and be remembered for in medicine?” on their secondary application. At first, I cringed. Half of my colleagues, both in medical school and in residency, still do not have a good answer to this question. I am not sure I do. Are you supposed to know how you want to be remembered when you start medical school? Are we supposed to know exactly what specialty we want to go into? Are they asking us if we want to be remembered as an empathetic patient advocating physician or are they asking if we want to be remembered for advancing the procedural toolbelt in a subspecialty like microvascular hand surgery?
This may be the most brilliant question I have ever heard from a school.
Let me explain.
When we started college, we all had a dream. A dream that we would graduate college and one day be a physician. Sure, some of us had hiccups and some joined the premed party late in their undergraduate career, but we all had a dream. A goal. The goal of getting into medical school to become a physician.
It was that goal that fueled us. That goal that drove our motivation. That goal that got us through the tough days and sleepless nights. That goal that pushed us to study for the MCAT even when it was summer.
Then came medical school, our focus: to do the best we can, become the best physicians we can be, do well on our licensing exams, and get into residency. But it is what happens after medical school and residency where this question takes shape.
What if we started medical school with the goal of how we want to be remembered in our respective field? What if we started medical school understanding how we want to contribute to advancing our field of medicine?
It is often the physicians committed to advancing their field that find the most satisfaction from the work they do. But, statistically speaking, most physicians practice clinical medicine with little to no involvement in basic science, clinical research, or one of the many physicians’ groups or specialty groups.
I have written several pieces on burnout, depression, and suicide in the medical field because this is a systemic problem that can be fixed. But just like different organ systems play a role in the progression of systemic illnesses, so do different areas in medicine. Fixing the issue requires a multimodal approach. One solution I have yet to hear, stems from the question above.
If we can motivate physicians to once again find value in their work, we can help prevent and treat physician burnout.
Every residency and medical school should focus on teaching its students and trainees how to set goals for where they want to be in five years, articulate how they want to contribute to their field of medicine, and set goals for how they want to be remembered by their staff, in their field, and by their patients.
We entered a goal-oriented profession. A profession where we had to set goals, structure our future and plan to get to where we wanted to be. In our formative years, we trained ourselves to look to the future, worked towards a goal, and used this model of reinforcement to create a positive feedback loop when we got something we wanted.
Physicians should work to continue this track: To set goals and work to achieve them, even after medical school, residency, and fellowship. Here are some of the top things to consider:
Planning the Future
- Where do I want to be in 5 years?
- What current treatment modality is not working for my patients?
- How can I increase the efficacy of current treatments?
- What are new ways of treating a disease that has few treatment options?
- How can I be a better friend/husband/wife/father/mother to my family?
- What can I do to be a role model for my patients?
- How am I preventing disease in my own life?
- How do I want to contribute to my field of medicine?
- How do I want to be remembered in my field of medicine?
- What type of physician do I want to be known as?
- What type of coworker am I to my colleagues and the house staff?
- What do I want my patients to say about me?
There is a lot that can be changed in the medical profession. There are multiple methods to prevent burnout and increase physician satisfaction. I am not a physician yet, but by thinking about these issues now, I hope to start a dialogue to redirect the trajectory of the profession to foster a sustainable career with 100% physician satisfaction.
What questions are you asking yourself that influence the goals you want to accomplish in 5 years?
Frank Cusimano is a third-year medical student and third-year PhD candidate at AZCOM and Columbia University, respectively. He is the host of the Surviving Medicine Podcast and you can connect with him at his Blog, on Instagram, or on Twitter. Feel free to join the SurvivingMedicine Community of medical students and physicians. He is a 2018–19 Doximity Fellow.
