Engineer Your Dream Life As A Physician

I was scared. Residency was ending and I had no idea what I was going to do. I just knew that I wanted to help patients and practice medicine abroad in a resource poor setting… whatever that meant.

“You’re a f***ing idiot.” I almost laughed but judging by the serious look on my mentor’s face he was disappointed. “There’s a tremendous need for your services here! Help me provide care to the homeless, stay at Bellevue, do anything- just realize that you don’t need to go overseas.” He was right, but now was the perfect time to escape NYC. Besides my hefty $165 000 student loan debt, I had no dependents, and no real responsibilities. I respectfully ignored his advice.

Fast forward three years, and my time after residency had been exhilarating. I had been fortunate enough to have worked in Haiti, Nepal, New York, Boston, and San Francisco. I had met some of my idols in Medicine, learned a lot, and traveled to a dozen countries during my time off. Most importantly – I had done what I envisioned when I started on my journey as a physician; helping vulnerable patients around the world with colleagues that believed that healthcare was a human right.

Discouragement in Medicine is in no short supply. Physicians who have seen the ‘golden days’ talk incessantly about the hardships of paperwork, bureaucracy, unnecessary oversight, and the encroachment by non-physician providers. I urge you to ignore all of this and forge forward with passion. Being a physician is still the greatest privilege and best career in healthcare. Looking back, these are the things I would advise to any physician looking to engineer their own dream career:

1/ Be Honest With Yourself – And Then Take The Leap

Mentors, friends, and family will all give you genuinely good advice. The problem is that the advice is filtered by the lens of their own reality. You have one life, and you are the only one that faces the consequences of your choices.

At every junction in your professional career – be honest with yourself, carefully weigh the options, make a decision, and then take the leap off the hamster wheel. What’s the worst that will happen? You may fail. As long as you have your health, you will get another shot.

2/ Learn To Compromise

After I graduated residency, I signed up with ‘Famous Not-For-Profit Organization,’ and then sat around for nearly 90 days without a job waiting for an international assignment. Panic began to set in when I realized my checking account was close to 0. I had to do something to survive.

I sold my furniture, moved my remaining belongings to my parents place and I got the first locum tenens assignment I could find (rural Maine). Although the people were lovely and the work fulfilling; Maine was isolating, lonely and I abhorred working nights. Despite this, the opportunity gave me 6 months of runway to do exactly what I wanted to do – volunteer in Haiti for the rest of the year.

If you want to truly live your dreams – compromise is essential. Whether it is finances, the ill health of a family member, a new budding relationship; many things will demand your attention and seemingly distract you from your goals. Stay focused on your passions, but realize that you have responsibilities and compromising along your journey is not failing.

3/ Get Comfortable Saying No

Locum tenens work was intoxicating. It was lucrative, and I seemed to be really helping a community that couldn’t otherwise recruit a permanent physician. The problem was that some aspects were cringe-worthy. My next job was in Upstate New York, and I was horrified by the unsafe patient load and the unrealistic expectations of the private practice group. I also learned that I couldn’t work night shifts anymore- I felt unhealthy and disconnected. After a lot of anguish, I executed the exit clause on my contract and got out after my initial month long commitment.

The experience served as a valuable lesson for future contract negotiations. I realized it is imperative to ensure that responsibilities are clearly outlined, and that nothing goes against your ethics. Learn to say no. Your reputation is hard to build up, but easily squandered. Also, if you find that something isn’t right for your personal well-being – fight hard to ensure you don’t have to endure a similar situation again. For me it was the string of never ending nights, but for others it could be performing invasive procedures, staffing an open ICU, or working in a particular part of the country.

4/ Find Your Tribe

I realized quickly that going on short volunteer trips with different organizations wasn’t the way to make a lasting impact. Despite enjoying the responsibility of being an Attending Physician and the freedom to volunteer abroad at-will, I decided to apply for a Global Health Hospital Medicine Fellowship at UCSF. In addition to working shifts as a hospitalist in San Francisco – it allowed me to work 6 months in Haiti with a whole team of inspiring local healthcare professionals. An added bonus was meeting some true giants of global health delivery – Dr. Joia Mukherjee, Dr. Raj Panjabi and Dr. Paul Farmer.

Healthcare is obviously a team sport, and successful people in all industries will tell you that you become the average of the five people you spend the most time with. Surround yourself with people doing meaningful work who inspire you.

5/ Say Yes To Change

The ultimate blessing amid these experiences was finding a loving partner who was supportive of my career choices. She had stayed in New York as a practicing physician herself, and the long distance relationship was not easy across time zones. When my time in Haiti was coming to an end, I received a job offer to split time between Boston and Nepal. I had never considered working in Nepal, and besides – I was about to move back to NYC so we could be close. To my surprise she encouraged me to accept the position, we got through that year together, and I am now lucky to be her husband.

Change may be painful, however it often helps you gain perspective, valuable experience, and opens a world of future opportunities. Strive to explore whether there is any way to possibly say ‘yes’ before you immediately discount an opportunity.

© 2018 Varun Verma, MD www.varunvermamd.com

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Dr. Verma is a board certified internal medicine physician. He believes that quality healthcare is a human right and has worked around the United States and internationally.