Half a decade ago, I was in the same seat that you currently find yourself – newly minted, apprehensive about taking my boards, questioning my preparedness, yet ready to start my career.  And truthfully, I was eager to start making money.  This short-lived phase is a whirlwind of excitement and trepidation.  These same emotions flood my mind as I reflect on this phase of my life.      One theme continues to shine through my memories of this experience:  Transitory Beauty.  The theme depicts this phase’s impermanent nature contrasting with the beauty and significance of these moments.  I encourage you to take a breath and, at least for a moment, appreciate that there is no looming exam or due date for you to meet.  I hope to bestow some quick tip knowledge to guide you through this transition period from student to medical professional through some of my experiences. 

I have been a sports fan and a competitive athlete since my earliest memories.  As a competitor, I was naturally drawn to athletes with what sports enthusiasts often call ‘Mamba Mentality.’  Kobe Bryant, one of my all-time favorite athletes, once shared a quote that has resonated with me: “I would rather be 0-30 than 0-9”.  Now, this might require some explanation for those who aren’t sports fans.  What Kobe was trying to convey was unwavering confidence in his own abilities.  He believed so profoundly in his scoring ability that he would rather take 30 shots and miss them all than attempt only 9 and give up.  Why?  Because he knew that his 31st shot might be the game-winning three-pointer in overtime.  Therefore, my first piece of advice to you is this: be confident in your abilities.  Strive for the kind of confidence that sets you apart from your colleagues.  Confidence is a crucial asset in patient interactions, specialist consultations, and discussions with physicians.  Confidence is difficult to teach, but remember that you worked hard to get a piece of paper that says you can diagnose and treat patients.  It’s natural to experience some level of imposter syndrome, and I would be lying to you if I didn’t tell you there was a little  ‘fake it until you make it’ component to this transitional period.  But embrace that Mamba Mentality!  Have such unwavering confidence in the fact that you have worked tirelessly to reach this point, and trust in your ability to continually refine your skills and shape your practice into what you envisioned during your master’s program interview.  

One of the most invaluable pieces of advice I received in my early days as a PA was to outwork everyone, to have the drive to see patients, and to harbor an unwavering commitment to mastering my craft.  It’s a challenge to teach someone to genuinely want to engage with patients, to instill the hustle and grind mentality.  It’s difficult to convince someone to pick up extra shifts simply to refine their skills.  This leads to my second piece of advice: work hard.  Work harder than your colleagues.  See more patients because it will give you more repetitions.  Pick up extra shifts not just for the extra income but to seize every chance to hone your abilities.  In my relatively short time as a PA, I’ve encountered both new and experienced APPs filling positions who lack the drive and grind to excel.  My high school basketball coach would say, ‘All it takes is effort to be the best rebounder in the game.’  The drive and grind ingrained in me from a young age that has transitioned into my professional career is tough to teach.  It has to come from within.  However, anyone can choose to work hard.  If you find yourself reading this blog, I believe you’re ahead of some of your peers, at least in terms of your eagerness to learn how to succeed in medicine and business.  I encourage you to hustle early in your career.  This season is the time to ask questions, absorb all the knowledge you can, and lay the foundation for becoming a formidable provider right from the start.  In contrast to confidence and hard work, medicine can be taught and will be as you transition from a student to a seasoned provider.  Never shy away from asking questions and look at every patient interaction as an opportunity to deepen your medical knowledge, understand yourself better, and determine the type of provider you aspire to be.  

Positive Team Work

As you enter your new career, you will inevitably forge relationships with colleagues, which can be either positive or negative.  What makes our field unique is that, unlike industries where competition for promotions or sales is a driving force, our focus, for the most part, is on collaboration.  I encourage you to build positive relationships with other physicians within your specialty, the consults you might find yourself calling, your supervising physician, coworkers, and community medical professionals.  These relationships have multiple benefits.  The most apparent advantage is the opportunity to collaborate with fellow medical professionals to provide the best possible patient care.  Beyond that, these connections can serve as invaluable resources, founts of advice, potential partners in business ventures, references for professional opportunities, avenues for career advancements, and allies in advocating for policy reform.  By fostering positive relationships with your local community, you create the prospect of becoming the Advanced Practice Provider (APP) you envisioned when you penned those essays for your master’s program application.  These connections have the potential to transform your career and amplify your impact on the field of medicine. 

As I reflect on my circle of influence, those practitioners I hold in high regard all share a common characteristic that is paramount to embrace: an unceasing commitment to continuous learning and a thirst for knowledge.  The field of medicine is in a perpetual state of evolution, and it is crucial to adopt a mindset of lifelong learning early in your professional career.  This ongoing quest for knowledge is what fuels innovation in healthcare and can propel you towards achieving your entrepreneurial aspirations.  It is similar to the choice between the red pill and the blue pill in the movie The Matrix.  If you take the blue pill, you remain complacent, investing little effort in expanding your knowledge.  Consequently, you wake up as the same APP two decades later, having stagnated in your growth and evolution.  Conversely, if you choose the red pill, you awaken with a hunger for knowledge and a relentless drive to learn more.  I want to be among those physicians who continually seek to expand their horizons.  I encourage you to seek out your own circle of influence that inspires you to become a better practitioner.  Always position yourself to learn, grow, and evolve into the best version of yourself in your chosen field. 

Part of my story that I feel fortunate to share with you is how I chose my first job.  Picture this: Week 12 of my Emergency Medicine rotation, my final shift.  As I walked out of the ER that I had grown to love- I yearned to work there.  Every fiber of my being resonated with the desire to be an Emergency Medicine Physician Assistant, and I had unwavering confidence in my ability to excel there.  Yet, the response I received was disheartening: “We won’t hire a new grad.”  I would be lying if I said there wasn’t a part of me that felt discouraged because I wanted to be an exception.  While I was confident I would succeed, I was also humble enough to acknowledge that starting in the ER would have posed a significant challenge during the initial months.  I would have grappled with feelings of inadequacy and ill-preparedness.  But I also knew that emerging from that period, however long it took, I would become a seasoned ER PA.  They say hindsight is 20/20, right?  I am thankful this is not how my story went.  While rotating in the ER, I was connected with a locally owned and operated Urgent Care, where I ultimately worked for my first year as a PA.  This experience introduced me to patient care dynamics, honed my procedural skills, and bolstered my marketability for future positions.  To be candid, I didn’t fully appreciate the experience and knowledge I gained by starting in urgent care because I still felt confident that I had what it took to be successful in the ER, even right out of school.  However, when I transitioned from Urgent Care into the ER a year later, I recognized that the physicians who encouraged me (and did not hire me as a new PA) to start in a broad specialty like Urgent Care knew what they were doing.  Your first job is valuable.  Pick the “right” first job.  Education is only a part of the pie that will mold you into a proficient practitioner.  There were valuable lessons learned in my first year.  I learned how to run a clinic and “be the adult in the room,” the one entrusted to have the answers when I was the sole medical professional present.  I learned to see patients quickly and efficiently, even dialing in on my favorite resources.  If you are curious why I opted for a broad specialty and, more importantly, why I recommend that other APPs begin their careers in such a versatile setting, I delve deeper into this topic in a separate post linked here. 

Throughout my upbringing, my parents, much like many of yours, emphasized the importance of integrity.  We’ve all heard the saying: Integrity is doing the right thing when nobody’s watching.  As we embark on our careers, particularly in healthcare, we will undoubtedly encounter situations where individuals test the boundaries of ethical conduct in ways that will make us uncomfortable.  My advice is to develop a solid ethical framework.  A guiding principle from my first employer was “We are patient-centered,” which has remained with me in my approach to patient care.  Putting patients first is a solid foundation on which to build your ethical framework.  As healthcare providers, our primary objective is to do what is right for our patients.  We should always be on the side of an ethical debate that aligns with the best interests of those we serve.  It’s not about ordering costlier medication or performing procedures for higher reimbursements; instead, it’s about delivering the highest quality medical care to our patients with the available resources in a timely and efficient manner.  Mold your inner circle of colleagues to share similar values and views in this aspect, and your choices will be as clear as crystal water.  Conversely, if you find yourself surrounded by physicians primarily driven by financial gain, regardless of patient care and safety, your journey may become a murky river to navigate.   

There are several pieces of financial advice I find essential for new graduates as well.  These include creating a budget, establishing an emergency fund, setting clear financial goals, maximizing retirement contributions, and beginning to invest your money to make it work for you.  If these topics pique your interest, you can delve deeper into them here.  However, this post serves as a reflection on my journey as a new graduate and why I consider this phase of life to be such a beautiful transition. 

The beauty of your experience lies in the transient nature of those experiences, relationships, and emotions, highlighting the profound impact even these brief moments have in our lives.  Embrace these fleeting moments.  Use these tips to navigate this transitional phase, sparking meaningful conversations with current or potential employers.  Share these stories with friends or colleagues to find common ground or contrast with their own journey.  Embrace your own mistakes, as I have made plenty.  But take solace in knowing that in just a few short years, you’ll realize that everything unfolds as it should, and your unwavering effort can propel you far ahead in your career.  Bring your thoughts for an open discussion in the comments section below.  At Business is the Best Medicine, we want to create a community of health professionals that can grow together and ultimately learn from one another’s experiences.