Episode 18 How to Ace Your Attending Job
[00:00:00] If you're starting your attending job and wondering how to get it right, this one's for you. Grab your coffee and a notebook.
[00:00:11] I became a full professor in 2016, built clinical research and administrative programs, and helped hundreds of early career physicians find clarity and direction in academic medicine. Now, I coach physicians to build careers that they love without losing themselves along the way. So, if you're ready to design a fulfilling career and still make it home for dinner, you're in the right place.
[00:00:31] Welcome to the Medical Mentor Coaching Podcast.
[00:00:40] I'm Stacey Ishman, and today we're going to be talking about your first attending job. Now, the other thing I want to talk about is I haven't actually been doing this podcast for a while because I got distracted. I got excited. I started really working one-on-one with coaching clients and doing group coaching and working with departments.
[00:00:58] But I miss talking to people directly about the things that I'm really working on, and so I'm back. So today what we want to talk about is how to set the stage for a fulfilling career in academic medicine. First of all, congratulations on finishing your residency or your fellowship, or whatever you've been doing for the last couple of years, and your transition to being the one in charge of your own destiny. Or at least the attending. After years of supervision and structure. It's exciting, but there's also a lot of decisions to be made, and this is something I didn't recognize when I first started, but I really want you to understand that becoming a great attending does not happen by default. It is intentional, and I want you to design the life that works for you.
[00:01:40] I have helped hundreds of physicians make this transition, and I want to do what I can to help you. If you're interested, I have a handout called the Academic Launchpad. All you have to do is DM me or message me or however you're finding this. Feel free to email me. It's [email protected], and it's [email protected] or it's in the show notes if you have not got the ability to process that as quickly as I just said it. Now, there's a few things I think that are really, really important, and if anybody has been listening to me, I have a Kickstarter course where I have four fundamental modules, and I think these are really the four fundamental things to think about at the beginning of your career.
[00:02:21] The first is, how do you want to envision your life, not just your job, not just your home life, but how do you put it together? How do you integrate it, and what does it look like? And so one of the most exciting things is to really think about what do you want your Tuesday to look like? What do you want your week to look like?
[00:02:38] What's a good day? And then design your life to look like that. Now start by asking, what are my clinical responsibilities? What are my teaching responsibilities? What do I want to do for research? What kind of life do you want to build around it? You don't need perfect clarity or direction. You can start one place and switch that is beautiful in this life.
[00:02:58] It's something that took me 20 something years to learn. I thought I had to be perfect until I realized failing quickly is far more valuable. Try something, see if it fits for you. Keep the things that do and discard the things that don't. But when you think about this ideal Tuesday or an ideal work week, it helps you think about mapping out your time.
[00:03:17] It might be getting up to workout or meditate or read or rush to work, whatever you like to do first thing in the morning and use your ideal time Ideally. If you really are the smartest in the evening, do your academic work. Then if you feel like you're really, really much more nimble in the morning, do it in the morning, but it just has to be something that works for you.
[00:03:39] And there may be stages of life where one works and the other doesn't. And the other thing I recommend is think about coaches if you can, and this may be into your institutional, these may be people you work for outside. You may be in a group coaching program, but it can really help you clarify your goals, think about your blind spots, and take your actions faster.
[00:03:59] It's like a GPS for your career. And I know I'm a coach and I'm espousing coaching, but I have coaches and I find them really useful for me to help move ahead. One of the tips I want to give you today is, if you're not sure about what to do with all this is, think about a vision Post-it. I have one on my computer right now, and it's the three things that your ideal job includes.
[00:04:17] So if you know what those things are, great. Mine include the fact that I want to spend quality time with my family. I then I want to grow my coaching business and my real estate business, and then I want to make sure that I have some clinical time, but that I limit it to the amount of time that I set the boundary for.
[00:04:35] So those are the three big things for me right now. Yours may be completely different. You might have two papers you want to get out this year or may want to get that grant in, or you might want to make sure that you mentor your medical student mentees as well as you can, or get those two lectures out, get on the podium, you know, pick whatever makes sense for you.
[00:04:53] Maybe you just wanted to get your clinic templates set up, which are really important, and I want you to start with that. What's ideal, and then start thinking about what does your clinic look like? What are the boundaries? How many clinics are there? How many slots, when do you stop? How do you make sure you get lunch?
[00:05:10] Or do you work through lunch and leave early? If you're smarter in the morning like I am, maybe you want to make sure you have academic time in the morning, and clinic in the afternoon, or you want to make sure that you always have clinic in the morning in or after. Because then you're not bumping yourself.
[00:05:24] But think about those things. And then I tell people to really come up with their research plan. When we think about your research plan, you want to really understand your niche. What are you going to be doing? What do you want to be known for? This could be a methodology, it could be a topic area it could be, you know, pipeline issues inside your specialty. There are all kinds of things you can consider maybe methodology. I'm a, I'm a guideline methodologist, and so I do a lot of guideline work and looking at, you know, the, maybe the best way to do that and the outcomes of those guidelines. So consider those and then create that plan.
[00:06:00] Put it on paper. I also think a promotion plan from the very beginning is really critical. If you don't, you're going to end up doing all kinds of things that aren't necessarily going to get you where you want to go. So if you know what the exact criteria is, your institution, then you can make sure that that's how you structure your next few years.
[00:06:19] So you're doing things that you love, but that also reflect well for your movement forward. Now there are some other key things I really think are important at the start. One is to build your professional identity. This isn't really just how you see yourself, but how others see you. And so one of the most useful things is to pick a focus area and this can evolve.
[00:06:40] So I can tell you, I knew I wanted to work in pediatric sleep apnea when I started, and unfortunately I had projects all over the place and they didn't make sense to anybody else. And they didn't make sense to anybody who might invite me to be on the program or who might ask me to give a talk. And so it was a problem and once I really focused what I was going to do on the area that I wanted to be known for.
[00:07:00] It was much easier for people to visualize me as their next speaker or to accept my abstract, and so that has really been critical advice that I received early in my career. I. I recommend you track your growth. You may put everything on a project sheet, or you may put it on a, on a leveled up cv, which has some extra sections.
[00:07:18] I have bonuses about both of those in my Kickstarter course if you're interested. But I want you to add things in real time. What's the talk I just gave? What's the paper that has got accepted? What committees am I on? Am I taking increased roles? Who am I mentoring? All of that stuff needs to get written down so it gets reflected later and that work is given credit to you. And then I want you to set up a recurring time on your calendar to do some of this updating, update your cv, update your LinkedIn, update your bio sketch and try and include outcomes if you can. So, one of the best things you can do is say something like, you know, I went from.
[00:07:53] Six patients a month in my complex sleep apnea clinic to nine clinics a month in this multidisciplinary clinic. So, it helps people understand scale and may be that you reduced or turnover by 20%, or that you put out 16 papers last year or two. By the way, if you got one out, good job. But as you move along and you start collaborating and your name is on other people's primary projects, it gets a little hectic, so keep track. The other thing is how to say yes strategically and no graciously. Now, one of the biggest shifts from being a trainee to being an attending is learning that you are in charge of your time. And that means saying yes when you really should and, and no when you shouldn't. There is lots of advice where people say, say yes to everything at the beginning.
[00:08:38] And there's some good reasoning behind this. One is these give you opportunities to really put yourself out there to be known to, for people to understand you're part of the team, but you also want to make sure that you're saying yes to things that value your time, that get you where you want to go and are aligned with your values.
[00:08:55] So if you're starting to feel guilty that you said no to something, I want you to really look, is this something that aligns with my values? And I said No, and I feel bad because it doesn't align with my values anymore. Okay, that's something to reconsider. But hey, this doesn't fit what I want to do at all. I just feel like I'm disappointing somebody.
[00:09:12] If it's somebody that's really important and you're like, Hey, I'm going to do this for you, even though it doesn't fit where my vision is but I would love if you could find me something in my vision next time. That's okay. But if you're just doing it out of guilt, it's not going to get you anywhere and it's not somebody you necessarily feel like you have that obligation to, I would tell you, don't worry about it. Don't do it.
[00:09:32] So start in that yes phase, but don't stay there forever. Be strategic and make sure your yeses aligned with your goals and then avoid the chop of being the perpetual helper. This is especially a problem for women or underrepresented minorities as it's easy to get over, volunteered as, especially for things that affect women and underrepresented minorities, but saying no isn't rude, it's professional, and there's a good way to do it.
[00:09:56] Thank you for thinking of me. I'm currently focused on whatever you're focused on, but I'd be happy to revisit this in the future if you want to make sure that you're doing something that's a respectful no, or you can sponsor somebody else. This really isn't my area of interest, but I hear that Joe really, really loves doing this kind of thing, or this would help him, or those connections would be great for him and you can recommend them.
[00:10:18] Now, the other thing is investing in relationships matters more than you think. We all know we need mentors. And mentors, give advice and perspective what we need sponsors to, and those are people who open doors for you and often behind closed doors. So they may be in a room that you are not yet in recommending that you get there or giving your name for a talk.
[00:10:38] And then coaches can really help you think deeply, set goals and stay accountable. They're forward thinking, how do I get there? I to recommend you build laterally as well as vertically. So, your peers are your future collaborators, your co-authors, your conference roommates. So don't underestimate those relationships and I would tell you cultivate them.
[00:10:56] Because one of the best pieces of advice I ever got is to work with people you like. So talk to those people and see what you can do together. There's a friend who I used to sit at every meeting in January, and we would come up with a paper for the year. It was fun. I liked talking to her. We liked thinking about it.
[00:11:10] We could collaborate on patients. We extended the reach of the work that we were doing by allowing us to collaborate between institutions. So, consider it. And then I also recommend creating maybe a board of advisors to help you regardless of the area, maybe in your career, in your emotional life, in your leadership life.
[00:11:28] The last thing is to make space for growth outside of clinic. No matter how exciting your clinical work is, you're going to need time and space to develop yourself, your life, your family. I want you to protect your academic time. It's so easy to give it away because you have one more case or one more clinic patient or one more procedure, but that time is not going to come back.
[00:11:47] And I'm going to tell you there's always another case or another procedure. And so. Give yourself the time to do the things that matter, that work you towards your goals, whether that's scheduling writing, or planning time, or grant writing time, or just time to go for a run because that's important and helps clear your mind.
[00:12:05] I also recommend you explore creative growth, whether it's teaching or quality improvement, or starting a podcast, you have permission to pursue interests outside the traditional mold. You may have the world's best social media site to give advice about your topic. And then again, I think these are areas where working with others can be really useful.
[00:12:23] I recommend you block one hour a week for strategic work, whatever that is to you. Career planning, writing, reading, getting resources so you can do the things that you care about. Now, whether you're stepping into your career as a new graduate or you've been doing it for a little while, the beginning five years of your career are a time of massive possibility.
[00:12:42] Academic medicine is changing and so are our definitions of success and leadership and boundaries. So, make sure you start with some clarity. Understand your path. Know when to say yes, and to say no. Do it gracefully. And surround yourself with the right relationships, whether those are mentors, peers or sponsors.
[00:13:03] And most importantly, don't forget this is your career. You get to lead it. If you want help creating your roadmap, I created the Academic Launchpad Guide for New attendings. DM me or email me at [email protected] and I'm happy to send it along. I. I also appreciate if you would rate, review and follow the Medical Mentor Coaching podcast because we are back.
[00:13:24] And if you want to do that on your favorite app, that's great. I know for sure I'm on Apple and Spotify and if you want to get in touch with me to share feedback or you're interested in a free checklist or you want to optimize your time, DM me and. Find me @sishmancoach on Instagram or message me on LinkedIn or email me at [email protected] or just contact me at the website.
[00:13:48] In any case, I hope you have a fantastic time and I look forward to talking to you soon.
