“A doctor’s mission should not be just to prevent death, but to improve the quality of life. You treat a disease, you win-you lose. You treat a person, I guarantee you’ll win, no matter what the outcome” – Patch Adams (1998)
It’s that time of year where everyone begins residency applications and you commonly hear conversations along the lines of ‘what are you going into?’ or ‘what type of doctor are you going to be?’. Of course, the reply is with one of the many specialties that exist, and the conversation naturally ends there. One of my attending physicians recently asked me to send him a brief write up of my career goals to help him in writing a recommendation letter. It was something I had to think about for a long time, as I was originally clueless with how to answer this question.
I want to be a physiatrist, I thought, and he should already know that, so what else do I say?
OK, I want to be a GOOD physiatrist. Nope, still not good enough. Everyone wants to be a good doctor.
My wife suggested that I instead consider what type of physician I wanted to become in the sense of how I provided care, what I would value as most important, and the qualities that I hoped to exhibit as a physician. This was a thought exercise that I had never really undergone in medical school. It’s a time that flies by, and we have so much material we have to study and learn in order to provide care that we don’t really have that much time to reflect on the more abstract aspects of our future career and roles as physicians. There is so much going on that it’s easy to forget the humanistic aspect of the care we are learning to provide. I fall guilty to this all the time. We can become so inundated with showing up on time, completing our clerkship requirements, studying to pass an exam, and then moving on to repeat it all over in a different setting that we can forget that behind all of this learning is a person with thoughts and feelings and loved ones that are placing their hope in the system that we are a part of. I often find myself identifying patients on my rotation solely by their chief complaint and record number. I know that I need to learn how manage disease X, so I start to revert to a mode in which the patient in front of me is a case file from a text book. This might sound really drab, but it’s a reality that is very hard to break from as a medical student, and maybe it’s actually the most effective way to learn the material we are studying so that we are prepared to take care of similar patients when we are working on our own after graduation. But I can’t help but feel like there is another layer to patient care that is easy to overlook as a student but is vital in laying the foundation for the type of physician we actually want to become one day so that when asked about our career goals and what type of doctor we want to be, we can answer with more than just what speciality we want to go into.
It doesn’t matter if you want to go into trauma surgery or psychiatry, I think each field offers various ways you can provide this additional aspect of patient care and find a unique way to define yourself as a future physician. We will all learn basic medicine as we progress through school and our careers. After we choose our specific field, we will be taught and exposed to the same stuff as everyone else in that field. It will be easy to think of ourselves as just another medical student, or just another internist or pediatrician, but at some point we will start to develop our own identity as a physician and the type of care we provide our patients. Whether you’re a first year student just starting classes, or a 4th year like me, trying to establish your identity and what makes you unique as you pursue the next step of training, I encourage you to take a moment to reflect on who you want to become as a future doctor. Don’t be afraid to start establishing these characteristics early on in school and implementing them as that added layer of patient care. It doesn’t matter what field you go in to eventually, you can be whatever type of doctor you want to be. Don’t let stereotypes of different fields keep you from being who you want to be. The quote at the beginning of this post is from a movie that I’m sure most of us are familiar with. I came across it recently as I was trying to answer this question of what I wanted to be and my what my career goals are. It provided a lot of inspiration for what truly matters to me in medicine and how I want to care for my patients. Even if you’ve seen it, I encourage you to watch it again and reflect on how it relates to the type of doctor you want to become.
Brian
