Our lives are often divided into chapters, delineated by specific transition points. Much like blood flowing through our circulatory system, the trajectory of our lives can be turbulent at times while laminer at others. It can advance and progress, but can also be met with opposition and obstruction. It is in those watershed moments when we recall a notable difference, a growth. Nothing is more emblematic of that than our medical training journey. The sheer length of our training is enormous and often consumes the majority of our energy, time, and focus all while our non-medical peers are progressing in their personal and professional lives. From opening up that first medical school acceptance letter, to passing Step 1, matching into residency, then fellowship, and eventually progressing all the way into attending-hood, these transitions stick out in our minds. Each of these steps have similarities and differences, but always with their own inherent value. I am reflecting on this now because, just last week, I signed my contract to become an attending physician in Endocrinology (woo!) and let me tell you: it was weird.
Why weird? Well, unlike the white coat ceremony which physically symbolized our indoctrination into the medical society, or the excitement and celebration of tearing open that match day envelope, the signing of my contract felt rather flat and bureaucratic. It felt a bit anticlimactic. Signed my name, clicked accept. Boom, done. But in truth, it was so much more. Admittedly, I don’t really know what I had envisioned. A big party? A longer white coat?
While the actual moment lacked a lot of that previous familiar pomp and circumstance, what it did symbolize was one of the most consequential transitions of this entire medical training ride – a “finish line” of sorts. The process was very different in that every previous step was dictated to me, there were no negotiations or much choice once I matched into residency and fellowship. Now, in the post-training world, contracts have more flexibility. You can ask for what you want, not that you’ll necessarily get that, but you still get to ask. Other more tangible differences include a rather shockingly steep pay raise from the mere crumbs of a fellow’s salary. Sometimes as much as triple or in some cases (depending on our speciality- ahem, ahem lookin’ at you ortho) quadruple what you had been making previously. It’s an exponential increase essentially overnight.
The differences are stark, but there are still many similarities to previous transitions. One similarity that seems to be constant at every inflection point is that old friend of ours: Imposter Syndrome. Graduating medical school and starting intern year was when I felt that imposter syndrome the most. I felt as though, despite passing all my exams and having an MD after my name, I was not ready to be a “real” doctor. As is the case with this syndrome, over time and with more experience, the weight of self doubt lessened. That is, until the next transition to becoming a senior resident and what felt like overnight, that sense of being a fraud arose yet again. These last couple years in fellowship allowed me to seemingly get my imposter syndrome under (some) control, to act more as a guard against hubris. Now that safety net is being pulled away as I transition into attending-hood and that familiar feeling in the pit of my stomach is back, questioning if I know enough. Imposter syndrome whispering in my ear “oy, are you sure you’re ready for this?” Yet, what I’ve noticed is a difference in how I am handling this round of trepidation. It feels more of an anchor as opposed to a paralyzing fear. I’ve learned that I do not need to be a library of memorized medical information, but instead a good librarian knowing how and where to look things up and knowing what I do not know.
This meaningful transition point is my first step out of the medical training bubble and has forced me to step back and take stock in how far I’ve come. It feels good. Weird. But good.