July 1st Rules of Engagement
Congratulations to ALL who have just graduated and are about to embark on the journey of a lifetime!
Job well done!
I spent nine years in post graduate medical training (6 years general surgery, 2 years Plastics and 1 year Hand Surgery) and no one ever sat me down and said ‘Hey, these are the things that you must understand and do, so that you WILL succeed.’
I worked hard, made mistakes and learned many, many life lessons that have been essential in my professional and personal life.
As a trainee and now as a mentor, I have, unfortunately, witnessed the professional, emotional and physical unraveling and/or demise of Docs-in-training for a variety of different reasons, but there are some personality traits and actions that have consistently resulted in distress, isolation and failure.
Over the last 24 months I have been inundated with multiple resident physicians in distress and often times the issues have been longstanding, and by the time I have been contacted the damage is often irreversible.
My hope is that these recommendations aid you on your journey and help you enjoy the process and SUCCEED.
1. Find a mentor. You ALL are venturing into a new realm of existence where the language and practices vary significantly.
Your advisor will be able to provide recommendations and feedback regarding simple and complex issues-clinical, professional, personal and otherwise.
Be intentional and ask to meet periodically to touch bases and check in on your progress.
Utilize them to discuss progress, concerns and plans for the future. You’ll be surprised how much you will learn from each other on your journey.
2. Learn the rules of engagement for your team/program/specialty.
Know YOUR responsibilities-ask at the beginning of the rotation and ask for feedback midway through the rotation.
If you sense hostility/resentment from your senior and/or attending ask for a brief word or meeting.
If you are given feedback, whether you like or agree with it, say thank you. Tell them that you will address ALL concerns, reflect on the information and then discuss this with your mentor and devise a plan of action.
Please DO NOT become combative, confrontational, bitter, defensive or sulk.
Criticism and challenge are part of becoming a professional.
Choose your words and actions, wisely, and always phone a friend/mentor before responding to highly contentious situations.
Delay responding in anger. Believe me, you will thank yourself later for not responding with emotion in ‘the heat of the moment’.
It is very hard to put out fires and so much easier to prevent them.
Think things over and discuss things with a more experienced and neutral advisor, rather than attempting to navigate complex situations alone…believe me, I’ve been there.
3. You are no longer a solo student championing for yourself, you are now and forever part of a TEAM.
Your actions impact, and are a reflection on, your team.
Patients lives and your career depend on it. If you make a mistake, own it, correct it and move on.
Be on time. Tardiness is perceived as sloppy, lackadaisical and careless, because that’s what it is.
Everything is not your fault, but it is all your responsibility.
Follow up on procedures/labs, check on your patients, help your colleagues, read up on pathology related to your patients.
BE PREPARED for the operating room, mortality & morbidity conference and all didactics.
Now is the time when folks care about whether you learn or not, after this it’s your responsibility to stay abreast and informed.
Above all, avoid the following DANGEROUS traits that disrupt the team and patient care: Unprofessionalism, Unavailability and Unreliability. You are a doctor and are on the frontline of patient care and service…Never forget this.
4. Go Comey on them.
There is a saying in medicine ‘If it’s not documented, it didn’t happen.’
THIS IS ESSENTIAL.
If you see a patient, meet with a family member, talk to a social worker regarding a patient or engage in any medical/legal/social issue regarding your patients, please DOCUMENT.
These are practices that have kept me out of lawsuits when a host of other docs have not been so fortunate, and vice versa. The only malpractice case I have ever been involved in was one from residency where I relied on a colleague to document events and I did not take the time to provide information that would have definitely protected me.
The same rule applies when you meet with attendings, residents, administrators and ancillary staff, regarding behavioral issues related to yourself or team.
Take contemporaneous notes and store them on your email hard drive. This provides a date stamp and summary of events that may help You in further discussions.
5. Be careful about your social media and ‘outside of work’ activity. You are a professional and are bound by a certain code of conduct and ethics. Your institutions are observing your interactions, off and on the clock.
6. Take care of yourself.
Keep mini bottles of water and light snacks in the inside pocket of your lab coat.
Stay connected to your ‘Life’.
Go to weddings…Parties…Reuni
Call Your Momma…Friends…
Find ways to RESTORE your balance…Yoga…Running..
If you start feeling depressed, anxious, overwhelmed, YOU ARE NOT ALONE. Please ask for help. We have journeyed this road and know how you feel. There is mental health support, get it if you need it.
We lose almost 1 Doc per day to SUICIDE!!!
Always, always, always know that there are thousands of docs out here that you can ask for help, guidance and support.
7. I would be remiss if I did not at least mention that it is never too late or early to start building a financial, legal and long term plan for success for your career and personal plans.
A. Get Disability (Own Occupation) Insurance. I was diagnosed with MS four and a half years into my surgical practice and had exceptional coverage that protected me and my family from financial devastation.
I also mentor physicians who have been diagnosed with chronic medical conditions during residency.
IT CAN HAPPEN TO YOU.
Talk to a financial advisor and create a plan of action. Get coverage when you are young and healthy!!!
***I will have a separate post on essentials of disability insurance***
B. Find a Financial Advisor who specializes in Physicians/Doctors. You all have a particular set of earning potential, skills and debt burden that is unique and requires a skilled professional to help you manage these components of your life.
Please be cautious, diligent and expert in your choices and avoid choosing professionals because of your familial/intimate relationships and obligations.
8. Be an asset to your profession and team.
9. Remember your purpose and reason for pursing your profession.
10. Enjoy the ride.
****This is a brief summary of recommendations and I HIGHLY RECOMMEND checking out ‘The New Doctor Toolkit’ by Bonnie Simpson Mason for an in-depth, concise and essential course to navigate professionalism in medicine****
Welcome to the ride of your life!
Lisa Whitty Bradley, M.D., FACS
Loop Plastic Surgery, SC
Chicks With MDs, LLC