We focus on the financial sacrifices of physician training. The personal sacrifices are worse.

The sky was overcast as my girlfriend dropped me off at the airport on a June day several years back. I was headed to Chicago to take the last meaningful high stakes exam of my medical training, a mandatory board exam available only at two sites, a test that 1 in 6 residents now fail. One might think of such an event as something to look forward to, the culmination of an adulthood of training and the punctuation at the end of grueling years of study and preparation.

This was not the case for me. The reason I was being dropped off at the airport is because my sentimentally-cherished car had just unexpectedly reached the end of its life. As for the person taking me to the airport, we both knew that this would be the last time we would see each other. The downturn of the radiology job market had made it impossible for us to both work in the same city together, and I absorbed this personally as a feeling of failure to meet the expectations of another even though the relationship was compromised in other ways. To make matters worse, my mother was undergoing radiation for her later-fatal cancer while I struggled to prepare. It was the case then that radiology residents were easily among the upper half of all test-taking resident physicians in the country. Trying to remain competitive in this incredibly intelligent pool of doctors over the years had taken its toll.

In the months that followed, I struggled to come to terms with my inability to get a job or fellowship after residency. From the start of residency to the end of my last fellowship, I had lived in 5 cities in 4 different states while making new friends along the stops but always having to leave. A lot of attention is paid to the financial burden of physician training, but the personal sacrifices are probably worse.

In my case, I was particularly affected by what I perceived to be a series of failures as I transitioned through the end of training, and a new sense of anxiety and insecurity set in as I eventually moved onward to become an attending physician. For a few years, I actively avoided the dreaded airport that brought me back to that June day. In many ways, starting out as a newly practicing doctor can be worse than having a trainee’s role, as you are now the last person to touch a given patient encounter. No training adequately prepares someone for managing this responsibility. It is something that you must learn on the job.

As luck or God or fate would have it, I was blessed by an angel who came into my life before I left my residency, a person so pure and genuine to me who literally kept me from falling into the level of depression we read about all-to-often in medicine. I guess sometimes those of us who try to save lives are the ones who need saving.

Once I had accumulated enough vacation time at the end of my first year on the job, I made it a point to visit some of my estranged friends, people who had gone off on disparate paths, medical and non-medical. While I was in training, my friends had become successful in too many disparate ways to count, their lives clearly enhanced by their beautiful families. Through a collection of smiles, stories, hugs, and pictures, I was able to find my bearing again and embrace success over insecurity. This confidence has since been met with professional reward, and now I find myself learning more from practicing medicine and teaching trainees than I ever thought possible.

My hope is that other early-career physicians who are struggling can glean hope from my experience. It does get better, though coping requires leaning on those who care about you most outside of the militaristic world of physician training. As for that silly airport that is now situated 2 miles from my home, it’s just an airport like any other. I have a special friend to thank for that. It turns out that there are angels on Earth.

Cory Michael is a radiologist.

Image credit: Shutterstock.com

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