Author: Meaghan Mercer, DO
Originally Published: Common Sense March/April 2015
Writing this around New Year's Day makes me nostalgic. There is a contagious sense of hope and excitement this time of year. Fourth-year medical students are thrilled that interviews have come to a close, rank lists are in, and Match Day looms around the corner. Interns are feeling comfortable in their shoes, seasoned residents are in the groove, graduating residents are applying for licensure, and nervous excitement accompanies the end of residency. Each New Year's Day I write a letter to myself that includes what I expect from the year and what I hope to achieve. I then seal it, and one year later open it and read it. As I reflect back on the last seven years, I want to leave you my experience and advice.
If you are not stressed, pressured, and stepping outside your comfort zone you are doing something wrong. I have had my fair share of frustrating days, wondering if this training process is healthy. One day when we were rocking and rolling and I was on a mental high over beating my patient per hour numbers, a coding patient was wheeled through the door. As my colleague placed an ultrasound probe on the chest, we realized the patient was coding from cardiac tamponade. As a novice at pericardiocentesis, every ounce of adrenaline I had was released as the needle advanced, hit fluid, and a pulse returned. Such euphoria comes when that hail-Mary procedure actually works! That feeling was quickly punctured by the realization that the department had completely turned over and an attending was dead set on having me run my side of it. As my stress peaked I began to waver, hoping my attending would pick up just one patient, just one, to take the load off my shoulders. He continued to push me and I was angry — I wanted to bask in our success. Looking back on that day I realize all that I have been taught and am capable of doing. I learned more than clinical medicine that day — I was taught how to manage a busy department and how to cope with the highs and lows of a shift — how to be an emergency physician.
Find people who will push you to that breaking point and beyond. In the words of writer Neil Gaiman: I hope that in this year to come, you make mistakes. Because if you are making mistakes, then you are making new things, trying new things, learning, living, pushing yourself, changing yourself, changing your world. You’re doing things you’ve never done before, and more importantly, you’re doing something.
Find what motivates you. Starting residency, my program director was that person for me, my mentor, and I thrived on positive reinforcement. As residency proceeded, a new program director took over and the spotlight I enjoyed so much was gone. Losing that stimulus turned out to be one of the best things I went through in residency. Initially I knew just how to get a pat on the back, and that is addictive for a student. Once that was gone, I evaluated what actually made me happy instead of setting goals based on someone else. Knowing what you want in your practice and life will lead to a long and happy career.
Let go of ego. We have been in school for so long that we are always looking for that “A” grade, the good evaluation, and to be the best. Emergency medicine is a team sport and we are the goalkeepers. Do what is best for the patient and do what is best for you. Put aside your pride and seek out those individuals who will challenge you. Entering the teaching role as a third-year, I appreciate how difficult it is to find a student's weakness and improve it. Thank those educators who give you the feedback you need to improve yourself, even if it stings a little bit.
Overall, be happy! This is a wild ride and some of your best friends will be made in the process. Be good to yourself, your friends, and family. May your coming year be filled with success, growth, and good madness. You will be surprised at all you are capable of. Good luck to you medical students — match is just around the corner and we can’t wait to welcome you to the ranks of emergency physicians. Congratulations to all graduating residents! We hope to see you on the rolls of AAEM's Young Physicians Section. We wish you all the luck and happiness in the world, as this chapter of your life comes to a close and a new one begins.