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Emergentology

Looking for Your Future Self

Walker, Graham MD

doi: 10.1097/01.EEM.0000578628.23970.8e
Emergentology

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I was interviewing a job candidate, and I ended up with a bunch of topics after frantically googling the best interview questions. I started running down the list, somewhat randomly. “How would you describe your working style?” “Do you work best alone or as part of a team?” “What do you like to do outside of work?” I had a general idea of how I'd answer them mostly because I've done so many interviews, from medical school, to residency, to employer interviews.

But then I landed on a question that left me totally stumped: “In which areas would you like to grow?” I had no idea. Grow? I'm an attending. Does not compute.

I've heard similar questions asked of job candidates in the past but usually framed in a different way: “Where do you see yourself in five years? Ten years?” And candidates typically auto-responded that they want to improve their skills in their current role and hopefully gain leadership experience or manage a team. But rarely is this question asked of attending physicians because we don't really think of ourselves as growing in our medical careers.

We are done growing. We were children in medical school, pubescent adolescents in residency, and maybe young adults in fellowship. Once you're an attending, you're mature! You're grown up! You survived! You made it! There's no more growing; you've reached the end of the line. My answer to the question of “Where do you see yourself in five years?” is pretty easy: “Seeing patients, just like I'll be doing for the next 30 years until I retire?” What does that even mean?

But frame it in terms of growth, and it opens up a whole new way for us to think about the future. We should want to grow as a doctor (or a human) over time. We should expect to handle situations better as we age, learn a new skill, or gain a new outlook on life. It's that whole wisdom thing that comes with gray or balding hair.

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‘This is Who I Am!’

It turns out it really depends on how you ask the question. Ask us about our future selves, and we're pretty confident that we're done growing. “This is it—this is who I am!” we lie to ourselves. Because it turns out it doesn't matter whether you ask a 25-year-old, a 30-year-old, or a 75-year-old, we arbitrarily decide that our current age is our final destination of our personalities. “I'll definitely be the same person I am five years from today.”

Ask the same person to reflect on past growth and change, however, and you get an entirely different story. “Are you the same person you were five years ago?” Most people laugh immediately with shame, remorse, or incredulity. “Not at all! Boy, was I [naïve, innocent, immature, inexperienced] back then. I'm so much more [adjective] now than I ever was!”

So emergency physicians, I dare you to ask yourself: Are you the same physician you were five years ago? What kind of physician do you want to be in five years? Sure, you might still be seeing patients, but how do you want to be seeing them? Do you want to see more of them? Less? Or have a different approach? Do you want to contribute in some other way?

Emergency physicians are really good at lots of things, so I wouldn't be surprised if you would also be good at running the hospital credentialing committee, reviewing quality metrics for your group, launching a wellness program, or developing a medical student or resident elective at your hospital. Or forget medicine; you might be good at another language, an instrument, blogging, photography, or running an Etsy store. It's all possible.

Dr. Walkeris an emergency physician at Kaiser San Francisco. He is the developer and co-creator of MDCalc (www.mdcalc.com), a medical calculator for clinical scores, equations, and risk stratifications, which also has an app (http://apps.mdcalc.com/), and The NNT (www.thennt.com), a number-needed-to-treat tool to communicate benefit and harm. Follow him on Twitter @grahamwalker, and read his past columns athttp://bit.ly/EMN-Emergentology.

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