The First Job

Virginia Van  Duyne, MD

Virginia Van
Duyne, MD

I have always been sure of my desire to become a family doctor but within my first year out of residency, the assuredness in my course was turned on its head. Maybe some of you have been in the same position. Maybe, like me, your early assurance carried you through many long hours in the library and wards of medical school and the early mornings and late nights of residency. Then before you knew it, you were in the last year of residency about to launch into your first real job as a doctor. For me, the importance of this decision was weighty; it was the pinnacle of all those years of training, finally my chance to go out and do what I had set out to do.

Graduation came and went and soon my husband, our two young children, and I were packing up our home to trek across country where we would set up a new life and establish a career in a rural, underserved community. I jumped headfirst into the practice and community.  At first, my pediatric patients would hide behind their mom’s legs and eye my blonde hair and tallness suspiciously. Many times I laughed with my patients as I made yet another mistake in Spanish, but they delighted in helping me to perfect my Mexican accent. They brought me cantaloupes and I delivered their babies. The staff embraced me as their own families’ doctor and I learned the ecstasy of fresh, hand-made tortillas.

I loved the community of patients I was serving, and I found purpose in knowing that I was providing them with medical care that they truly needed. However, I was constantly pushing to work faster, to see more patients, to work beyond my post-call fatigue. I was tired. I started dreading going to work. I was burning out before I had really even gotten started. I became anxious that I was not doing my best, neither at work or at home, and that this first job would define the kind of family doctor and mom I would be. This is not what I expected in my first, much-anticipated real job as a family doc! (If you’re here or have been here—you’re not alone.)

Thank heavens for mentors. Hopefully, you have also invested time and energy in building relationships with knowledgeable and honest mentors along the way, so you have people to turn to during this time of turmoil. If not, it’s not too late to start! My mentors gave me valuable perspective and helped me to brainstorm ways to approach the situation I found myself in. After some time, I came to a decision with my husband that we needed to make a change and after telling my staff and patients through teary eyes that I would be leaving, we trekked our belongings and children (now a year older) yet again cross country.

Now, your first job might not be a cross country trek, but I want to share with you the three lessons I learned from my first job that applies to anyone, anywhere.

First, give yourself grace. As I have established myself as faculty in the underserved community of my residency program, I have realized that I needed to give myself grace, to allow myself the space to define and redefine my career as I grow. It’s ok to think you know what you want, to go full court press after it, and when it doesn’t work out, to find the grit and determination to pursue the career and family life of which you have dreamed. Life is a journey, as they say, and it’s ok for it to have twists and turns that you don’t expect.

Second, the absence of a thing in your life can bring insight. While working in a community practice where I interacted with only one learner for half a day in a whole year, I felt a sense of unfulfilled passion for teaching. Now in my current faculty job, I am energized on a daily basis by the opportunity to teach, especially having known what it was like to not do so.

Lastly, it is important to maintain relationships with mentors in various stages of their careers who not only care about you, but also share your values.  For me the shared values were a deep sense of commitment to teaching and of serving the underserved. These relationships will continue to enrich and motivate me throughout my career as I continue to invest in them and in new ones.

Similarly for you, I hope that you will also extend yourself grace, find insight, and invest in mentors along the way, wherever your journey takes you.

One response to “The First Job

  1. Randy Longenecker

    If only your first job could have been a teaching practice in that rural, underserved community! (A shameless tip to new graduates, to explore that option!) Although offered a job in an urban residency, I had the wonderful opportunity to create a new life, new career in the rural place in which I was already practicing, as faculty in a Rural Training Track. I was able to practice in that location for many years, avoiding burnout through the variety, the inspiration, and the professional stimulation that teaching brings. And I agree, affording oneself grace is a key factor in avoiding burnout in any setting. I’m glad you learned that early!

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