by Jared Smith, MD
Recently, we had new residents join our residency program and some great residents who moved on to the next step of their career. For the rest of us who are already in residency but not completing residency, this means advancing forward with new experiences and responsibilities. Over the last few weeks, this has caused me to pause and reflect over my first year as a resident and my growth in medicine and as an individual. Initially, I have thoughts of inadequacy and thoughts that maybe I haven’t developed the abilities and skills I should at this point in my training and then my mind even entertains the thought that I haven’t grown at all. Of course, this could not be the case as I have undergone rigorous and challenging training over the last year, but there is always the fear of not being good enough. When I think about how do I know that I’ve learned what I need to be a good physician, I don’t come up with a simple answer, but I have some thoughts that apply to growth in all areas of life not just as a doctor.
Recently, I had an experience outside of medicine that helped me with my question about growth as a doctor. Over the last year, I have developed an interest in mountaineering. It inherently has many challenges and dangers. I have always been motivated by lofty goals so I set the goal to climb Mt. Rainier. I started training with straightforward hikes and a light pack. I read books on mountaineering and slowly increased the technical and physical challenge of my hikes. In what seemed like just the blink of an eye, I was carrying a 50-pound pack with crampons (spikes on your boots that dig into snow to give you traction), roped up in a climbing harness, wearing a helmet, and carrying an ice axe headed up Mt Rainier. When my team first started climbing the glacier, we were on gentler slopes with small crevasses. Even though this was fairly mild compared to what was to come, I was still hesitant and anxious. Eventually, on my journey I was hiking through the middle of the night in complete darkness other than my headlamp glowing. I was traversing very steep slopes with crevasses so deep I couldn’t see the bottom. This naturally further worried me, even though I had been well prepared. To reassure myself I recalled that I had trained for a year, had completed a training course on technique and safety, I was equipped with the proper gear, and I had guides keeping me on track. Eventually, I made the summit, which was so rewarding and satisfying. However, the lesson didn’t come from summiting the mountain and reaching my goal. It came at an unexpected time as I was headed back down to the bottom of the mountain. While passing some of the shallower crevasses and gentler slopes I thought to myself, was I actually nervous around these? After climbing much more challenging terrain this section of the climb was no longer anxiety-provoking to me and I was comfortable.
What I realized on Mt. Rainier was that by going outside my comfort zone my comfort zone had expanded and I had grown in what I was capable of handling on the mountain. Mirroring that lesson to my residency, I realized that compared to what I was expected to do as an intern I was much more comfortable seeing many more patients and patients with much more complex problems. The only way I was able to do this was from repeatedly stepping outside my comfort zone and forcing myself to grow. As a result of that, I have grown as a doctor and as a person.
I may not have fully answered my initial question if I have learned enough as a resident, but going forward I know that as a resident I will continue to be forced outside my comfort zone. I will try to embrace it rather than shy away from these experiences. I have also learned that if I am outside of my comfort zone too often I become burned out and my emotional reserve sometimes is not enough to bolster me through the unfamiliar and challenging experiences. So, finding a healthy balance of being outside my comfort zone is important. However, certainly we can all benefit from pushing ourselves beyond what we think we are capable of because we will accomplish much more than we ever thought possible.
Dr. Smith is from Centerville, Utah. He completed his undergraduate degree at Weber State University and his medical degree at Creighton University. His medical interests include sports medicine, health promotion, social determinants of health, behavioral health, pediatrics, and integrative medicine. He enjoys golfing, hiking, trail running, doing anything outdoors, walks with his German shepherd, spending time with his wife and daughter, and watching sports. He chose the University of Utah because of the supportive residents and faculty, great combination of academic and community medicine, sports medicine opportunities, commitment to innovation in patient care, emphasis on creating leaders in family medicine, and the close proximity to outdoor activities and family.