This is going to be a raw post. You should probably know that up front. I’ve actually tamed it down quite a bit since I first wrote it. I am done seething from this experience, but still have learned the power of saying “no” and determining where my self-worth comes from.
Let’s dig in.
As an update: My wife ended up starting a full-time job two months after this happened. Dodging this opportunity actually proved to be a very good thing for me, and I’ve still been given the opportunity to work with the residents in meaningful ways. I’ve kept this post intact to encourage others who feel similarly in hopes that it might provide good perspective when a door slams shut, because – the truth is – that another one usually opens.
A Missed Opportunity?
Recently, one of my mentors in training passed me up on an opportunity for a leadership position within the residency program.
After telling me that I didn’t get picked, he asked me to help make the research experience at our residency better, because I am one of the few young faculty conducting successful research.
I respectfully declined, though I said I’d be happy to help any individual residents who had an interest. I simply said that I wasn’t going to commit to starting a formal research endeavor.
Making Intentions Known
For five years (since my second year of residency), I’ve said that I wanted to be a program director someday. I love working with residents. I enjoy giving them a voice and advocating for them when others can’t or won’t.
I’ll stop right here and say that the people that filled the roles are top-notch doctors. No question about it.
The person told me, “just be patient, your turn is coming.”
Driving me to Financial Independence
Like Barry Sanders, I want to leave the game when I am at the top of it. At my prime. It is a big driver for me that I am able to decide when I am done with this career, and that the decision not be dictated by others.
I don’t want to leave when I am old and frail, and don’t have a choice.
How I want to go out: Playing Golf with a Buddy
Speaking of that it reminds me of a patient in which we placed a thoracic epidural for the 12 rib fractures they sustained after receiving chest compressions on the golf course.
You read that right. The golf course. The patient went into a V-fibb arrest while playing golf and drove their golf cart into a tree.
Fortunately, two doctors were playing behind that group and performed CPR, broke 12 ribs, and got them to the hospital following about 5 or 6 two-hundred joule defibrillations with the golf-course AED (adjacent picture).
The patient woke up in the hospital to find that their chest was hurting a lot and that it was hard to breathe with a bunch of broken ribs. Hence, the thoracic epidural and my involvement.
That patient’s experience taught me something. If and when I go, that’s how I want to do it. Playing golf with a friend.
Not at work.
Before I go out, I want to teach as many residents as I can that becoming financially independent is an option. And that they don’t have to wait until they are 65.
That way they can choose to practice medicine rather than realizing they must practice medicine because they can’t afford to leave. Debt is a shackle tied around their ankles. I want them to be free.
I genuinely believe this will make them better doctors.
Valuing my self-worth
Back to my story from earlier.
As part of that tough conversation with my prior mentor, I mentioned to him that I was disappointed that I wasn’t chosen for the role.
I didn’t tell him all the reasons I felt I would be good for the job, and the people who had told me the same over the past couple of months.
The ship had sailed. What’s the point?
When he asked me to add more work to my already full plate, I had to decline. It was more about my self-worth and the already full plate I had. [I didn’t realize that plate was about to explode when my wife took a full-time job a couple of months later].
More work and more burnout is not a goal of mine.
At the end of the day, being a doctor is important to me, but it is not my self-identity. It’s a job. I will go home each day. Jesus will still love me. My wife and kids will still be there. I’ll have friends that love me, too.
The point is that the things that make up my self-worth will be present whether I am given new opportunities or not. In fact, they will be there whether I am a doctor or not.
The power of saying no
After I thought about it more, this experience taught me the power of saying no.
As some doors close, I am sure others will open.
I am hopeful that other opportunities will come up that produce an equal amount of passion. Maybe that opportunity will be in the medical school with med students. Or maybe it will be outside of medicine altogether.
I’ll keep hustlin’ with my main hustle and with my many side hustles. I’ll get to our number as fast as I can, and then I’ll pick and choose the parts of my job that I love.
All of the other parts will go away or I’ll be juke-ing people out of their socks just like Barry Sanders did when he retired in his prime.
I refuse to let others dictate the direction of my life or my self-worth. I’ll keep on hustling. And I hope that you will, too.
Have you ever been denied a certain opportunity or job you felt strongly about? How did you handle it? Have you ever felt the power of saying no when you were asked to add more to your current workload? Leave a comment below.
Sorry you didn’t land the position. I’ve been denied opportunities I coveted plenty of times. The dream college, the first choice of residency, the prestigious fellowship, the attending job with a strong group. And each time, it hurt. Sometimes a lot. We’ve all experienced rejection in some form or another. It’s ok to take time to get over the initial shock, the hurt, and the anger. I would try to rationalize the outcome. Maybe it wasn’t the right time. Maybe it happened for a reason. Maybe I wasn’t good enough. Maybe there was no reason at all. After some self-reflection, I would try to invoke grit – the ability to pick yourself up in the wake of rejection and failure to become stronger and better. The ability to keep moving forward. And of course patience- good things do come to those who wait. Thanks for sharing your story.
Thanks for the encouragement, MD.
For some reason this one stung more than other missed opportunities (not getting an interview, not getting accepted to medical schools, etc). Maybe it’s because this was the direction I saw my career going at the time.
I am now in a much better place and starting to build some of that resilience you are describing (grit, becoming stronger, etc). Patience has never been my strong suit, though this website is certainly making me learn that!
Thanks again for stopping by.
Sometimes rejection is exactly what we need to steer us in the right direction. When I look back at some of the rejections in my life, they always seemed to point me towards my next success.
You can still mold young minds regardless of fancy titles on a business card. You can teach them not only clinical skills but also personal finance skills. I assure you the latter is much more rare in residencies.
Completely agree! Looking forward to seeing where the road leads next.
I will continue to shape the young minds and the next generation no matter what my title is. I am one of the only (I think literally the only) attending that teaches personal finance topics (investing, debt management) to the residents. Everyone else considers it “too taboo” to talk about, or they just don’t have the knowledge base to do so.
I totally get this. Being passed up sucks. Feeling not valued and then asked for help does also.
As I discussed in a recent blog, the ups and downs are all about framing.
When I feel like you did when you wrote this post. I repeat my favorite rhyme…
I am a product. Extracted from an era. An era of greek poverty and terror.
Cruise like a fruit. Shipped like foreign goods. Now all of mine overpopulate neighborhoods.
These thoughts I retain cannot remain inside me.
If people had their way they probably want to hide me.
But never should they think of me as just dust.
I am not the lint for them to just thrush
Because they know who I am.
They dare not laugh.
My skills stem first for me arts and crafts.
I am a builder whose created many nations.
From the time of now to the start of plantations.
Through all the cities and all the neighborhoods.
My meaning is overlooked and I’m never understood.
My mind and body are feared when used together.
Not only am I strong but also clever.
My anatomy is similar, yet it’s unique.
With strength and coordination and a stone hard physique
But be that as it may, I am denied what I’ve earned
this course of knowledge, I cannot hide what I’ve learned
Any land, any structure, I’m the owner, the founder the father, the labor donor
Any invention discovered, I own the rights.
My people and I shared many sleepless nights.
And even after this, they still don’t believe.
That I can advance and grow and achieve.
Just as they can, or maybe even better.
They try to hold me back like a book holds letters.
But I won’t be ignored and I’ll fight to the fall.
So It does not hurt when they call me the underdog.
It’s good to keep that perspective!
Coming back as an underdog isn’t so bad in the end. As long as you recognize your own accomplishments that’s really all that matters.
P.s. I tried searching for this to get the original source and couldn’t find it!
Being sued for my volunteerism on the hospital Board and being screwed by the ABA with it’s MOCA double jeopardy were the driving forces behind me pursuing FIRE.
Sorry you were passed over. The next time an opportunity like this arises, you may be less interested. Especially as you approach FI.
Its amazing how a negative situation can give you perspective.
It definitely made me rethink my future plans and what I would do if offered.
Thanks for stopping by, POF.
Hmm TPP where do I begin…
From what I have read on your blogs, you are VERY interested in helping residents. But this is what I have seen in Canada and I’m guessing it’s the same all over.
My first program director was an EXCELLENT clinician and also very smart financially. He would not and did not have to follow in lock step with the others in his department. He was so much better than all the rest of them. But when in a group, being excellent doesn’t really matter. It’s about group think and NOT being an outlier. Well this program director moved on and became wealthy as a financial analyst. He decided he wanted to return to help residents. Well, they would not hire him back and he ended up working in a position well beneath his skills.
I saw how the residents treated him. Since he was not at the main hospital any longer, many residents simply dismissed him. That is what I most disliked about residency. Medicine is filled with so many people who only know how to obey and strive to climb ephemeral ladders. I was happy to return to my private practice. Just honest work- no politics.
So decide if you care about helping residents. If you do, you need to stay in some capacity with a teaching hospital. They will likely ignore you otherwise. If you keep an important/ influential position in doctor land- they will have to listen to you because they need to impress you. You may then sneak in some FI knowledge to them or just make them listen to you cause you can.
Just be honest about what you truly want TPP. Do not follow my colleague. he was too good for that and I am sure you are as well. Best of luck whatever you decide.
Thanks Dr. MB. I really appreciate the honest advice.
I truly want to help young people following in my footsteps how to avoid the pit falls I ran into or how to find the road I am on now a little bit earlier.
It is a strange problem to have, though, because I’ve always considered that my path. Recent events have opened my eyes to all sorts of possibilities and I’ll have to weigh them all as I go and make the best decision I can.
I am sorry to hear about your prior program director. That really is too bad. Hopefully he found some peace in doing what he came back to.
I am discovering the beauty of saying no, as this allows me to say yes to something else. However, when “no” is said for you, that is a tough pill to swallow.
Priorities shift and change over time. If someone had asked me 7 years ago when I started residency what I wanted the most, I would have said outpatient primary care. Now that I’m here, I’ve found it’s not quite what I thought it would be. Perhaps that would have happened to you as well with this missed opportunity… or not.
Ultimately, if your goal is to attain financial independence and freedom in 10-15 years, this disappointment is not even really a blip in that road though it may have resulted in more career fulfillment for you. You certainly do not appear to be lacking in other avenues of fulfillment.. I hope the sting of this doesn’t last very long for you!
That’s the right perspective to take, I think.
Who I am now and who I am in ten years will probably be vastly different people in terms of career ambitions and professional fulfillment.
I guess only time will tell!
You never know where life will take you except you can be 100% sure it won’t be where you planned. In grad school I was working on the bio-electricity of brain injury and stroke. Very interesting and unique research except nobody would fund it. This was measuring FM waveforms and the moneyed boys all were doing AM. The guy handing out the money for “this year” would make damn sure the guy who was handing out the money “next year” was well funded aka politics. I got sick of it and split and went into engineering. I applied for a job on a Monday and they didn’t have anything. On Wed a guy had a heart attack and died, and on Thursday I had a job. One thing led to another, med school, then anesthesia then cardiac anesthesia, then the Navy where they made me ICU director and a pain doc beside my anesthesia duties. I never did cardiac anesthesia again. All those hours reviewing cath films on that damn viewer and the coronary anatomy, valves and LV function, the hours spent studying TEE, but the pain biz as a side gig turned out to be very lucrative, probably more lucrative than any cardiac job and it was a lot of fun. So that’s my story about politics. It took me somewhere, which was nowhere on my radar.
When I was a resident I liked the young attendings, but truth be told I learned anesthesia from the old timers. The young attendings knew their 10 things cold, the old timers knew 200 things cold and how to not get into trouble while pushing the hell out of the physiology. When I became an old timer I could pull stuff out of my trick bag nobody had ever heard of because of the old timers who taught me. Because of the old timers when I would get called to the ICU or ED stat for an emergency intubation the nurses and resp therapy would say after I was done “if I ever need to be intubated I want you to do it”. I had taught most of the resp therapy and local paramedics how to manage an airway at one time or another. Be that guy. If you’re that guy the rest will follow as your reputation precedes you. The main goal of anesthesia programs is to intensely teach clinical anesthesia.
Probably doesn’t help the sting much, but it’s my story, and maybe a little different perspective. If your director told you you’d get your chance you will.
You never know where the road will lead you. That is definitely true. I’ll keep my eyes wide open, though. Yours is a good example as it sounds like you had quite the circuitous route to where you ended up, but it all seemed worth it.
I think my residents definitely learn different things from me than they do from someone who has been practicing gas for twenty years. The old timers have a lot more experience and can pull tricks out of their bags, for sure. We have some really good ones where I trained (and stayed on). Fortunately, regional anesthesia has been an up and coming field. And none of the other attendings really talk about asset protection or personal finance. And certainly none of them talk about student loan debt management, because none of the programs existed back when they were paying off loans (that were 10% of what our current residents have).
I guess that’s why a well-rounded program has the new and the old! Otherwise you’d be missing something on both ends.
Kudos for you for saying no. I’m not sure if you were financially independent or close to it at the time but I know that certainly helps as well.
I tend to shy away from office politics because it would just aggravate me so much. I think personally you will provide a great example to your residents regardless of if you were a director or not. They will see the effects of financial independence from you and that is probably the best knowledge you can impart to them with or without any titles.
I can only imagine the original post you wrote. I have had many times where I had to tone down my emails from the original version
Nailed it. I toned this down a lot 🙂 But my emotions and perspective on it has toned down a lot, too.
I finished training last July (2017). This conversation happened a few weeks ago from today. So, I am about as far from being financially independent as I can be right now haha. I just have a fiery passionate personality. That gets me in trouble sometimes, as you can imagine.
I don’t need the title to teach, that’s definitely true. I’ll keep plugging away and doing the little that I can!
I was recently offered a senior physician leadership position in my organization. It is a big honor. It is also a big job with a lot of hours. Given my FI status and my clarity around how I want to spend my time, I was able to say ‘No’ quickly and clearly. Even after they asked me to give it more time and “think about it.”
I didn’t say no to anything when starting my practice but I now realize for this later stage it is good to say no to a lot. It allows you time to say yes to the right thing.
I’m not a golfer but I do appreciate the game. I’m not necessarily determined to die at work. On the other hand, there is nothing disgraceful about dying while being productive and serving others.
Yeah, saying no when you have a full plate is definitely empowering. It just wasn’t the right thing for me to do right now if I wasn’t going to be given the time to do it.
And I actually just finished playing 9 with my little girl and boy. It’s a lot of fun, and will get more fun as they grow to love the game, too. And I do agree, there is nothing disgraceful with dying while being productive and serving others, completely agree. I just want that to be my choice, and not because I have to, I guess.
Hmmmm. Seems like you felt entitled to a position you were passed over in favor of other qualified applicants. You then reinforced the good judgement of those that passed you over by choosing not to keep working towards that position (which you would do if you were truly dedicated to it). It’s good you recognized that you heart wasn’t really in it before you were offered the position.
You have it backwards; I’ve never needed the position. There is no reason for me to “work towards” it. I wanted the position because I genuinely believe I can help fix some major issues that we have.
I didn’t want it for personal gain. I’ve got too much going on right now, and wasn’t offered any academic time to help with the research curriculum they wanted.
All I want to do is help the residents in meaningful ways. It has very little to do with my heart being in it.
And call me an entrepreneur, but I am not going to do additional work that isn’t going to help advance my career without being valued.
The beauty of FI is the power of “no”.
Forgive me but the first time you mentioned Barry Sanders my mind read “Bernie Sanders” and for the life of me I couldn’t connect the dots of what you were talking about. It took a minute for me to rectify my mistake and I blame my morning caffeine deficit. But on topic, I’m sorry you were passed over. I, too, know the sting of being an option rather than a priority and subsequently being passed over.
Haha. That’s great! I don’t think Bernie Sanders will ever retire, certainly not in his prime!
I should have thought about that when I originally wrote the post.
And, it happens. Just wasn’t meant to be. At least not right now. We will see what the future holds, but I was certainly not interested in doing additional work when I wasn’t going to be valued.
Nice to hear an honest story about a career/vocational struggle. As an engineer, I have experienced something similar where vocational advancement is not always the same as professional advancement. Some of the best engineers I have known do not end up with prestigious titles. However the excellence they have in their craft is clearly obvious. Somewhat echoing an earlier comment, I hope you are able to continue to grow in your profession on whatever path that leads you.