It’s OK to Be Unsure and Ask for Help

After taking a quiz at Kingdomality.com, which tells you what type of job you would have if you had lived during the Middle Ages — jobs like dreamer-minstrel, discoverer, and even doctor — Stephen Kavic, MD, the program director of the General Surgery Residency Program at the University of Maryland School of Medicine, Baltimore, was less than thrilled to get shepherd.

His friend, who had gotten benevolent ruler, offered advice. Just take the quiz again and change your answers. So Kavic did, but he still got shepherd.

He had to admit it was sort of true.

“I really enjoy being in the role of helping people figure things out,” Kavic told Medscape Medical News.

People who work in research are about developing new knowledge, he said. “That’s not what I do. What I do is introduce knowledge that’s new to you.” Kavic takes pride when he teaches a surgical resident how to fix a hernia and then that physician goes off and repairs hernias for other patients. “I feel like I have a little piece of that,” Kavic said.

Kavic couldn’t seem to escape his “shepherd” destiny, and his advice to surgical residents — and all residents — is to take the time to try different parts of their field to see what they really connect to. We explore the best advice that residents may want to keep in mind as they move forward in their careers.

It’s OK to Be Unsure

One of the secrets of residency is that not everybody has it figured out right away, Kavic said.

Kavic, a laparoscopic surgeon, advises residents to relax and look around. In surgery residency, everyone does a month of each: Vascular, pediatric, urology, and plastic surgery. The goal is to take advantage of the breadth of options, he said. A resident may have done trauma and vascular surgery as a medical student but maybe never did intensive care or outpatient hernias, he noted, so how do you know what area of the field you’ll gravitate to the most?

“The early part of residency — whether it’s medical or surgical — is to provide that broad exposure, the ‘sampler platter,’ so you can see what the field is all about,” Kavic said.

“When you go on to plastic surgery, say, ‘I’m a plastic surgeon this month.’”

Try it and see if it fits. As you go through residency training, “give yourself that sort of mental freedom to say, ‘maybe I’m going to find my home in a different place than I suspected,’” Kavic said. “You don’t have to put yourself in a box and decide in your intern year.”

Alan Chin, MD, program director for the UCLA Pediatric Residency Program, recently saw a residency graduate from a few years earlier return to UCLA after realizing they wanted to do a fellowship. “It’s ok to be a little unsure and to kind of discover that as part of the process,” Chin said.

After graduating from his own residency program, Chin, a pediatric hospitalist, took a clinical job at Cedars-Sinai Medical Center, Los Angeles, working in their neonatal intensive care unit. He worked there for 2.5 years before realizing he wanted more space to pursue his interest in medical education. So he began to look for an opportunity to come back to UCLA to work in education.

It’s OK to Ask for Help After Residency

Doctors may think when residency is done, they are on their own, and they may be embarrassed to ask for help, Kavic said. But the truth is, you are going to know more at year 10 than at year 5, but you are never too old to learn or to ask for help.

The good news is they’ll be people around to help, such as senior partners and faculty members, to advise and guide early-career doctors, said Kavic.

“The training process of learning doesn’t stop with your formal education,” Kavic said. “It continues forever.”

“You’ll always be confronted with the ambiguity in clinical medicine,” Chin added, “And our job isn’t necessarily to always know exactly the right answer off the top of our heads but to really understand how do we learn how to get to that right answer. Or how do we kind of deal with that ambiguity.”

You’ll Have Many Mentors

You won’t be alone.

As residents test out different parts of their fields, they should know they’ll likely have many mentors along the way, Kavic said. Residents may have that one person they go to for financial advice — say if they’re thinking of buying a home. Another person may serve as a relationship mentor if, for example, they don’t get along with a certain faculty member or they may want advice about managing conflict among junior residents. Another mentor may help with career advice.

“I got a lot of advice” along the way, Kavic said. “Some of it was even good.”

Technological Advancements

Technology will change throughout your career, Chin said. Think about how you will adapt, and try not to be opposed to change.

When Chin was training, he still wrote paper notes at certain clinics and hospital sites and transitioning to an electronic medical record was “a little bit tough,” he recalled. Technology can change how you interact with a patient and their family because, at times, you’d be staring at the screen and not at them, he said.

These days, we’re going through a time where use of artificial intelligence and scribes and other things will change how we interact with families “hopefully for the better,” Chin said.

“Be willing to kind of engage in that change as long as the focus is really on the clinical care and the interpersonal relationship that you get to build with those patients and families,” Chin said. “Never, never lose sight of that with all the things that change around you.”