Thursday, July 8, 2010


I am scared.

Next week I'm going to be starting my first Real Doctor job. After nine blissful years of getting to look over my shoulder, I am going to be on my own, trusted to make my own decisions.

I probably shouldn't be scared. First of all, I did have some attending privileges as a fellow, so this isn't entirely new for me. In fact, much of the time during fellowship, the attending presence kind of annoyed me. I feel ready to make my own decisions.

Second of all, it's not like I'm being released into the OR with a scalpel. My job as a rehab consultant is not the kind where I'm likely to be making any life or death decisions. Harming a patient in any serious way would be challenging, even if I were totally incompetent (which I don't think I am).

Third of all, I won't be in private practice by myself. There will be tons of other senior physicians around that I can ask for advice if need be.

Still, I'm scared. For all the same reasons I was scared on my first day of high school:

What if nobody likes me?

What if I'm not any good at it?

What if I hate it?

What if I'm overwhelmed with work?

What if they steal my lunch money? (Unlikely, but not outside the realm of possibility.)

On my last day of fellowship, they threw a pizza party for me, gave me a card that everyone signed, along with a gift card. I felt so loved. I started to wonder why I'm striking out on my own when I could stay a fellow for another year if I wanted. I know I had really good reasons: (lack of) money, the lack of a future in my fellowship (hiring freeze), a chance for a secure permanent position elsewhere. But I can't help but doubt myself. And be scared.


  1. Change is always unsettling. I'm moving to my 2nd job since completing residency, and I'm a little nervous too about how things will be. The learning curve is always steep after training, but you'll enjoy being out in the "real world" practicing what you were trained for. Good luck!

  2. Starting out after being "protected" in residency and fellowship is always scary. Trust in your training - and your ability to ask for help as needed - and you'll do OK (or even great on some days :) ).

    Congrats on finishing!

  3. I'm a week into internship and still pretty terrified. It's good to know the feeling never really goes away :) Best of luck and congratulations on finishing your fellowship!

  4. I heard someone say once, "If your next move doesn't make you at least a little bit scared, then you're not challenging yourself enough."

    I thought it was excellent advice.

    You'll do great, I'm sure.

  5. Fear is healthy, and natural, when you are transitioning from residency to work.

    Still, I've been there, and it is tough. Three years into practice, I still get scared, but nothing compared to that first year.

    I remember one of my senior partners looking over my anxious, over analyzing cases self my first year out.

    "Giz, you look at things so hard, and find things so obscure, it makes me feel like I need to do more."

    Talk about a great compliment! Sometimes fear leads to discovery. And that can only be good for your patients.

  6. I think it would be easier if I hadn't been given the choice to stay in fellowship another year. Fellowship was so easy and cushy, yet as OMDG said, I wasn't feeling at all challenged. And there was really no chance of it leading to a permanent job, which was a major source of stress.

  7. You'll do well. Best to you! :)

  8. Necessary new job mantra: "I am a well trained professional. I am a well trained professional. I am ..."

  9. Fizzy congratulations. I look forward to reading your posts as you continue on your journey!

    ****Old MD Girl, thanks, that was just what I needed to hear. I got my acceptance letter to the University (been getting the basics done at a community college... a good one, but a CC nonetheless)
    I had this immediate sense of relief as I realized I'd been expecting them to say "no thank you, try someplace else" and then sudden fear as I realized I was leaving the safety net of my CC.

    All the what if's floated to the surface ... .

    It's my next step ... I'm a bit scared (and feeling silly for being scared) but knowing that it's normal ..and should be ... is a good thing.

  10. Fizzy, see the PMR comic - I think you may be the one who made it! All you PMR docs need to know is to prescribe PT, botox, and do EMG/NCV studies! Woot!

    I wouldn't mind some more Botox to my calves... Ahhh... The previous dose made my feet stop hurting! You can be my (real) doc! All you need is the ability to hit the soleus with a 28 gauge!

  11. The fear and doubt are good (to a certain point). They are protective.

    You will do fine.

    I've been told it takes about 2 years of practice for the fear and doubt to abate somewhat.

  12. So you mean I'm going to feel like this for two more years??

  13. Fizzy, I don't think the fear will last that long. Everyone is different, of course. Once you get in the new job and learn the new people/computers/community, and especially once you've seen and treated your first few patients, your confidence will rise dramatically.

    I felt the same way when I started practicing after residency. I was absolutely terrified walking into the OR to do my first case.

    You realize quickly that the patients and the diseases/problems are no different than what you saw in residency/fellowship. You find that people are grateful to you when they feel better as a result of what you've done. You'll make mistakes, but you'll learn from them.

    The fear is healthy; it will help keep you out of trouble! You'll come to realize the joy of being good at what you do and being able to do it your way, not Attending X's way. You have much to look forward to.

    I have found over the years that I should have feared the non-patient side of medicine more; the business, the politics, the employee issues - all the things we were never trained to deal with. But even those things are not going to kill anybody. They just produce stress and raise your blood pressure.

    Best of luck! And don't ever let them see you sweat!


Comments on posts older than 14 days are moderated as a spam precaution. So.Much.Spam.