10 Things I’ve Learned 10+ Years After Residency

By Dr. Anna Wright | Medical Director, Hugh Chatham Memorial Hospital

Residency is the next step in the journey but not the ultimate greenlight into the world of medicine. For many, the journey after residency is so important. For me, I would say the 10 years after were some of the most precious for my career, my education, myself and my family. In the ten years following residency, I’ve learned more than all of those hours I spent in school, but in a different way. One day, you too will look back and have plenty of advice for those entering the field for the very first time. Here are the top ten things I’ve learned since residency.

1. It is OK to take a winding career road. You can learn from it all!

I finished my emergency medicine residency and immediately entered a primary care sports medicine fellowship. After my fellowship, I joined an orthopedic surgery practice. After three years in orthopedic surgery, I started itching to get back to a broader set of skills, and I wound my way back through urgent care and a year of a global public health study. Eventually, I ended up back home in the emergency department. While I certainly had to explain my eclectic resumé during interviews, I could emphatically state all of my experiences added depth and breadth to my training. I was confident interpreting my musculoskeletal plain films and had solid orthopedic knowledge. I also learned how to collaborate with my surgical colleagues, a skill that would prove valuable when interacting with consultants in the ED. I was very confident in providing care to urgent care patients, a group of patients I spent a lot less time caring for in residency than the sickest patients. Ultimately, I also learned about the business aspect of urgent care, and I was able to translate those lessons into improving throughput in the ED. When I came back home to the ED, I found I had not forgotten it all. Rather I was coming from a different place with a more spacious view, and this new vantage point helped me on every shift. So, if your career takes detours and pauses as you navigate your goals or your life or whatever is in front of you, it is OK and it can all be valuable.

2. I’ve become a better doctor when I’ve been a patient.

In the 10 years after residency, I careened headfirst over my mountain bike and ended up in a rural ED with rib fractures, had three children, experienced some minor surgeries, and have also accompanied my family members to the ED. Seeing the landscape of medicine from the side of the patient or their family teaches you what makes you feel seen, comforted, and healed as a patient. Sometimes you learn that by experiencing the opposite! I have always entered the ED after one of those experiences with a new commitment to being compassionate, clear, and patient.

3. You can balance a family, a career, and kids. And, it can make you a better ER doctor!

I have three children, and early in my medical training, I worried about balancing a medical career and a family. It’s not always been easy, but it is possible. Sometimes the needs of my family have influenced a particular job choice, and those stages ebb and flow. Ultimately any decision made at the seeming expense of another is not irreversible. (See the first point!) The positive side is helping with algebra while simultaneously cooking a meal and oohing over a Mine Craft creation mimics the multi-tasking I do every shift! I am more flexible when disaster strikes at home or in the ED because kids and the ED are anything but predictable. The best part is I am not alone. There are other women and men balancing family, a career, and children too. At ApolloMD, our Women’s Committee is a community of people who understand and empathize with being a parent and a physician. We support each other, and most recently, developed a mentorship program to extend this reach.

4. Take a page from the business world.

Residency prepares you for a career in medicine, and there is not enough time to learn all the other skills that might be useful additions to the nuts and bolts of your specialty. I learned a lot by delving into books and other resources about more traditional business topics. For example, negotiation skills, crucial conversations and improving team dynamics. Even though I do not work in a cubicle, these topics translate surprisingly well into the ED and offer helpful tips on navigating some of the sticky non-clinical problems.

5. Learning is still essential in your years after residency.

In residency, I was motivated by the thought of the in-service exam, my eventual board exam, and good old fear of appearing stupid in front of an attending on a shift. I genuinely wanted to learn, but I had more extrinsic motivation during that time. In practice, there are fewer tests, and nobody scrutinizing your every decision. The autonomy is amazing, and I am even more motivated to update and expand my knowledge so that I can take excellent care of my patients each time I work.

6. Confidence and humility can exist at the same time.

As a resident and a new member of the long coat club, I wanted to be perceived as the person in charge. At the same time, I was still learning, and it was hard to feel or even act confident all the time. Confidence comes naturally with time and a growing body of patient encounters. Yet, after practicing for more than 10 years I am probably more humble about the uncertainty that exists in every patient encounter. It is also easier to accept my mistakes and to admit that I am imperfect even as I strive to become a better doctor every day.

7. Humor lightens the load.

I love to laugh. Seeing the absurdity of life, in and out of the ER, helps keep me sane. There is nothing better than side-splitting laughter to ease the burden of all the really difficult situations we encounter as doctors. Sharing a laugh forges bonds with colleagues and staff. It is even healthy to laugh at yourself – at your little quirks and pet peeves and how the ED is a weird, bubbling, wonderful soup of humanity that sometimes is hard to swallow without some humor.

8. Community is key. Invest in your team and connect with the larger medical community.

We all spend so much time with our coworkers. Those relationships and the team we build can, just like laughter, really bolster you through the hard parts of the job. Make an effort to get to know your team, to reach out when things are tough, and to go out of your way to be helpful. Sometimes these people, no matter how similar or different they are from you, are some of the only people who truly understand what it is like in the ER. Have each other’s backs. Also, tap into the broader community of your specialty. Being a member of ACEP and participating in several ACEP committees was one of the biggest coping measures I found during the early days of the COVID-19 pandemic. Participating in ApolloMD as a leader has also encouraged me that there are other people out there who are passionate about their jobs and who understand not only the best parts of medicine but also the hardest parts.

9. The human side of medicine is as important as the technical side – maybe more.

At the end of the day, the technical practice of medicine matters less than the compassion you convey. Words can hurt and they can heal. Knowing what to do is important, and showing you care is probably more crucial. Sometimes it takes time you do not have to sit down and explain a minor problem to a patient in ways they can understand or reassure someone with an implausible fear. As much as residency teaches you to master the knowledge, medicine demands the integration of that information with the practice of empathy.

10. It was all worth it, and I am right where I was always meant to be. 

Residency was tough, and there were times I questioned my decision to enter such a demanding and stressful field of medicine. But, the opportunity to consistently make a difference and to care for others at any time of day with any type of problem, is an amazing privilege I would never turn down. You are ready for the road ahead no matter where it takes you. __________________________________________________________________________ Dr. Anna Wright received her Bachelor of Science from Mississippi State University in Starkville, Miss. and her Master of Public Health Leadership from the University of North Carolina Chapel Hill. She received her medical degree from the University of Mississippi School of Medicine in Jackson, Miss. Dr. Wright completed her emergency medicine residency and primary care sports medicine fellowship at Wake Forest University Baptist Medical Center in Winston Salem, N.C. Dr. Wright is an accomplished researcher and writer having medical research published in American Medical Society for Sports Medicine, North Carolina Medical Journal, Clinical Pediatrics, The 5 Minute Sports Medicine Consult and Association for Vision and Ophthalmology. She is also a published freelance writer with her work appearing in Study.com and Beginner Triathlete. Dr. Wright joined the Hugh Chatham Memorial Hospital ED team in December 2018 and transitioned into the Medical Director role in 2020.