I had a chat sometime ago with a promising junior who was struggling with the rigors of residency training. As I was drawing from my own previous experiences in figuring out what I had to say, it dawned on me that it would be of much better use to a greater number of people if I were able to condense that into a universally relevant message..
With that being said, this post is dedicated to all the residents- and fellows-in-training, no matter what your specialty or subspec may be... (although I guess it would be more relevant to the junior residents, since the fellows already know what they are getting into, having finished their own residency programs earlier. hehe)
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To all those struggling in their training, I say to you, don't give up!
There will SURELY come a time (or multiple times even) in your training where you would contemplate just giving up, abandoning everything, and just going home.. It's not exclusive to being a junior, because I have felt that compulsion too as a fellow-in-training..
The reasons are varied: they would often be those things that are beyond your control like hostile seniors or a hospital/department system that doesn't work well for you, toxic patients (or relatives of said patients), a heavy patient load, rigid academic standards, difficult batchmates, the list just goes on and on...
Having said all this, there is one thing you have to understand.. These things that you are experiencing, they will not go on forever.. The bad seniors will eventually graduate, the toxic patient will eventually get discharged, the patient and academic loads will stop once you graduate, and your won't necessarily have to deal with your batchmates again after you finish training.
So, to leave just because of these things would be a major folly.. Yes, sure, leaving the program might result in an end to whatever hardship you are presently going through, but you will deprive yourself of the proper training as a specialist, which would have led to proper certification and a fruitful practice for the rest of your life..
Another discouraging feeling I recall which could drive a person to quit would be the feeling of inadequacy.. A conscientious trainee would feel that he or she is not good enough to train when he/she would commit a lot of errors and understandably be repeatedly chastised by seniors or consultants. These feelings of shame and guilt would build up inside you and make you question why the hell you started training in the first place..
Having been on both sides of the coin first as a hapless junior on the verge of quitting and then as a senior trainee evaluating prospective juniors, I just have to say this: The training committee of your respective departments generally accept trainees because they see the potential in you, otherwise you would not be accepted outright. The personal challenge for you is to grow into that potential and be what they see you can eventually become. This would entail a lot of personal growth, not just academically, but emotionally (and even spiritually as well) if you are to survive to the end of your training.
Going back to the basics, being told that you made a mistake really sucks. Different people have their own ways of processing this. Some would get angry and lash outward, especially those who are so full of themselves and think that they are so much better than they really are. Others would get depressed and punish themselves internally, since they would see themselves as failures and this just validates their own insecurities about their abilities. Both of these methods are not only throughly useless, but are very destructive as well.. If left unchecked, continuing on with any of these would result to either an expulsion from the program or the trainee dropping out due to the pressure.
Being wrong hurts, I get that. The mindset is very important here though.. Undergoing training would expose you to the uncomfortable truth that you are still inadequate. It would render visible to all the deficiencies and gaps in your clinical knowledge. How you would respond to that would be entirely up to you.. You could just throw your hands in the air, say "I give up" and just leave, or you could take note of these deficiencies and use this as an opportunity to grow by filling in the identified gaps through study and research (if the need arises).Getting better in training is not an option, it is the only way to go. This growth would entail some degree of sacrifice. It is a well known cliche that nothing easy is ever worth it, and medical training is no exception. The hardships you encounter here will mould you into a better and wiser version of yourself, as long as you let it. You may not be comfortable leaving some facets of your past behind, like being comfortable with mediocrity or procrastinating 'til the last minute, but if you have the will to improve and be a better version of yourself, these "sacrifices" would eventually matter little to you since the better version of you no longer has need for them.
An image about training I thought of recently was that of a plant in a garden.. Imagine an untamed bush (which would represent the new trainee). This bush would have grown wildly since the prospective trainee had just probably finished medical school and have so many different bits of acquired knowledge but with little wisdom when it comes to application. When the trainee anters the program, he/she enters the custody of a gardener (which would represent the training program, seniors, consultants) which would trim the plant as it grows, removing unecessary branches and allowing other parts to grow.
Training does that to you. It removes any preconcieved erroneous/flawed.incomplete notions about disease entities including the diagnostic and therapeutic approaches which may have been misunderstood in medical school. It allows other necessary parts to grow by letting the trainess fill the gaps in his or her knowledge. New branches would also grow, which would repepresent new skills that would have otherwise not been learned under the wing of a program (advanced medical and surgical procedures for example). It would also create a change in the way you perceive the world, and the way you work and deal with people. All of these are part of your growth, so you don't have to fight it. More often than not, these adaptaions would result in changing you for the better. Eventually, the plant in the garden would grow to be a beautiful well-manicured tree which would bear much fruit for years to come, and thus be of benefit to a great number of people.
So when you are thinking of quitting, take time to step back and take a look at the bigger picture. This brief moment in your life is insignificant compared to the beautiful and complicated tapestry that lies far ahead and stretches as far as the eye can see, and all that is needed of you is to stay on this path.. Get better and grow if you need to. Acknowledge your deficiencies and work to fill in the gaps. Growth is never instantaneous and would sometimes require a great deal of effort. Keep your eye on the prize and never lose sight of what you want to become. Eventually though, you would be able to look back after everything has been said and done and tell yourself "Damn, I went through all that??". ;)
Good luck guys! I will be praying for you! :)
