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Most people believe that a medical education sets them up to be successful practicing physicians. Unfortunately, that is not true.
Today’s 63% physician burnout rate should give us some clue that our traditional medical education does not guarantee a successful practicing physician. Investing your 20s completing the slog through medical school, residency, and fellowship does produce two consistent outcomes.
- You learn the bare minimum to practice in your specialty. I say the bare minimum because no one graduates from the education process completely capable of practicing independently—especially with the work hour restrictions of today’s residency programs. The breadth of the knowledge base in any specialty is so large. Yet, the number of available teaching hours within residency programs has been cut by a third compared to residencies before work hour restrictions were implemented.
- You are taught—and subconsciously conditioned—to be a good resident.
What Makes a Good Resident?
The complete medical education process takes from 7 to 16 years. At the end of that marathon, everyone who survives is programmed to be a great resident. Fortunately, in the industrial practice of medicine, great residents make compliant employees. Unfortunately for the graduating physician, the same conditioning sets us up for burnout in the first place—especially since 73% of physicians become employees these days.
Residency is not about success in your future practice. It is a pure survival contest. Our only goal is to make it through the process by any means possible. And you don’t have to get there all in one piece. If you can drag yourself across that finish line, you can be missing an eye and three fingers off your left hand. After all, what do they call the person who graduates last from their medical school class?
Here is some of the psychological conditioning of a good resident:
- The patient comes first.
- Do what you’re told.
- Color inside the lines.
- Stay on the tracks/with the program.
- Passive acceptance.
- Learned helplessness.
- Imposter syndrome.
- Delayed gratification.
- Never show weakness. Never do anything to make anyone think you don’t have what it takes.
- Keep your head down and work harder.
If that’s not enough of a setup for burnout, a significant percentage of your faculty/attendings will model burnout for you perfectly.
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Mea Culpa
I went through the exact same conditioning process myself as a resident back in the 1990s. I drank every ounce of the Kool-Aid and became the quintessential alpha male, gunner resident. It took me years to recover and develop a more functional relationship with my career.
And I’ve devoted the last 14 years to helping my fellow physicians recognize and recover from this programming. If you are a resident, keep doing whatever it takes to complete your education and graduate into the Free World. If you are no longer a resident, I encourage you to stop acting like one!
What nearly every resident fails to appreciate is the end of this survival contest. Graduation is a complete release into true and unadulterated freedom. You are now free to build your practice or take any job anywhere in the world, in any healthcare system, and even in any other industry besides medicine. You are finally free.
Yet what do most graduates do? They take a W-2 employee position as a clinician inside a large employer, where they are neither an owner nor part of the leadership team. 73% of US physicians are rank-and-file employees now. Their job description resembles your role as a resident almost perfectly. It is a structure they are very familiar with, and it operates by the same unwritten rules above. Even though it’s stacked against their ability to create a practice of meaning and purpose, it is within the comfort zone of a resident.
To rise above your assigned position as a worker bee/cog in the machine/RVU generating unit, you must stop being such a good resident as soon as you graduate from the medical education process. If you choose to be an employee, let us show you how to push back against “the way we do things around here” and carve out enough wiggle room to take back your practice. You can build enough weekly satisfaction, meaning you never doubt your choice to become a lightworker.
Let us teach you the 7 missing skill sets of the medical education process. These are the tools for practice success and a means to burnout-proof your career. And join us in our support community of like-minded doctors on the same weekly journey. Together, we can defend the practice of medicine and your own personal health and well-being as a physician in these difficult times.