How Can I Become "So Good They Can't Ignore Me" as a Physician?

00:00:00.000 | [MUSIC PLAYING]

00:00:03.440 | I'm a resident physician in internal medicine

00:00:08.040 | at a large research institution.

00:00:10.320 | I'm struggling to make deep work part of my routine.

00:00:13.400 | For me, deep work consists of doing clinical research,

00:00:16.280 | staying up to date on the literature,

00:00:17.880 | and studying for board exams.

00:00:20.120 | The structure of my days changes every two to four weeks,

00:00:23.400 | with some blocks of intensive 10 to 12-hour shifts,

00:00:26.760 | other blocks with a more typical 9 to 5 schedule,

00:00:29.320 | and very occasional, quote unquote,

00:00:31.440 | "research blocks" of unstructured time.

00:00:34.520 | My one day off a week varies from one week to the next.

00:00:38.160 | When I'm at work, I do have unpredictable periods

00:00:40.880 | of relative quiet, but my door is open, my pager is on,

00:00:44.240 | and there's always the possibility

00:00:45.680 | it's truly an emergency.

00:00:47.960 | In order to become so good they can't ignore me,

00:00:50.920 | I aspire to become a productive researcher in addition

00:00:53.520 | to a skilled clinician.

00:00:55.120 | How should I approach this?

00:00:58.240 | Well, it's a good question.

00:00:59.280 | I get asked these type of questions a lot.

00:01:02.160 | There's a lot of concern/interest right now

00:01:06.600 | among physicians when it comes to issues of concentration

00:01:09.760 | and distraction.

00:01:11.000 | You would be surprised, for example,

00:01:12.960 | how often I'm invited to speak at Grand Rounds.

00:01:15.960 | I get a bunch of these invitations,

00:01:17.960 | because doctors care a lot about this.

00:01:20.080 | So I want to start with that.

00:01:21.280 | You're not alone in having this question.

00:01:24.040 | The second thing I want to do here is a reality check.

00:01:28.520 | Your clinical schedule setup right now, as described,

00:01:32.680 | is very demanding.

00:01:33.960 | That is a lot of work you are doing,

00:01:35.960 | and it is difficult, cognitively demanding work.

00:01:39.640 | The reality is the reality.

00:01:42.480 | I don't know that it's possible for you to prepare for boards

00:01:46.520 | and do a significant amount of original research

00:01:50.080 | at the same time that you have such a difficult schedule.

00:01:52.560 | Because it sounds like you're doing shifts,

00:01:55.000 | these 12-hour shifts, and then you

00:01:56.600 | have 9 to 5 clinical hours sort of outside of those shifts,

00:02:00.760 | and you're only having one day off.

00:02:02.240 | That's actually quite a heavy load.

00:02:03.920 | So I don't know if this is good news or bad news,

00:02:06.440 | but I'm basically giving you permission to slow down here

00:02:08.800 | a little bit.

00:02:10.360 | If boards are the next thing that's coming up,

00:02:13.040 | that's what you should be focusing on.

00:02:15.240 | And then after boards, if you want to figure out

00:02:17.280 | how to do research, again, you can

00:02:19.280 | work with these existing research blocks

00:02:21.680 | and be highly effective in the time.

00:02:23.200 | That might work for you.

00:02:25.160 | But you might have to find a way to reconfigure your situation.

00:02:28.000 | I mean, you have to keep in mind that the really killer MD

00:02:31.360 | research types that have the great academic positions

00:02:33.960 | at the big schools, I mean, they work a lot,

00:02:36.120 | but they probably aren't working the same schedule

00:02:38.240 | that you're talking about here.

00:02:39.680 | I mean, they have research labs.

00:02:41.400 | They have more significant time when they're just

00:02:43.480 | working on that research.

00:02:44.320 | You're already starting from a high point of view.

00:02:45.760 | So this is what I want to say to you here,

00:02:47.520 | is let's reality check, have a little bit more

00:02:50.600 | self-compassion here.

00:02:51.560 | You can't do all those things at the same time.

00:02:54.320 | Work on your clinical skills, pass your boards,

00:02:56.720 | figure out, OK, what's the next research thing I want to do?

00:03:00.520 | Do I have time for it?

00:03:01.800 | If not, are there changes I can make that would free up

00:03:04.320 | more time for it?

00:03:06.160 | And if the answer is no, the type of clinical position

00:03:08.560 | I have makes it very hard to do research, then maybe you say,

00:03:11.200 | let me just focus on killing it--

00:03:13.360 | that's probably the absolute worst adjective to use there--

00:03:16.880 | but killing it in my clinical work

00:03:19.560 | and doing that really well.

00:03:21.440 | Or shifting to an academic position

00:03:23.400 | in which a lot more time is given

00:03:24.680 | for the non-clinical work.

00:03:25.760 | But it's all about reality checks here.

00:03:28.720 | It's easy to fall into a trap where you say,

00:03:31.480 | it would be great if I could do x and y and z.

00:03:35.360 | But oftentimes, it's impossible to do x and y and z

00:03:38.640 | at the same time.

00:03:39.400 | Take it from someone who falls into that trap all the time

00:03:43.120 | and constantly has to step back out again,

00:03:45.760 | constantly has to re-simplify things again.

00:03:48.680 | There's only so much time you have.

00:03:50.200 | And I think it's OK.

00:03:51.160 | I think it's OK to recognize that.

00:03:55.120 | [MUSIC PLAYING]

00:03:58.480 | (upbeat music)

How Can I Become "So Good They Can't Ignore Me" as a Physician?

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