American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

Top Eight Mistakes to Avoid During Your First Year in Practice (and Beyond)

Congratulations on finishing your residency and/or fellowship. Entering into practice is exciting, but some mistakes are easy to make, even if you know about them beforehand. Based on the actions I or my colleagues took that ultimately turned out poorly, I have a developed a list to help you in this transition.

  1. Saying yes to everything. Being energetic and efficient at completing multiple tasks daily is common at the beginning of your career. The added pressure of wanting to please your supervisor, whether a senior partner or your chair, can be overwhelming. If you let it, these duties can take over your life. For example, early on I had agreed to so many jobs (i.e., trauma, general surgery, endoscopy, clerkship director, research, duplex ultrasound, transesophageal echocardiography, etc.), that I was getting home at 2:00 or 3:00 am—just in time to greet my husband as he was getting up to study for his masters. It’s difficult to say “no,” but you need to learn how in order to maintain your sanity.
  2. Ignoring your health, including exercise. As a corollary to the above, it’s easy to say, “I’ll work out tomorrow,” but that turns into next week, next month, and before you know it, you’re overweight, out of shape and have developed high blood pressure. It’s always easier to maintain fitness than to try to regain it. Schedule time for exercise—it is a good way to clear your head.
  3. Neglecting family and friends. Your friends and family may say that it’s OK to be late to dinner, miss important school/social activities, skip date night, etc., but in the long run it will eventually cause problems.
  4. Trying to do everything at work and at home. Pay other people to do the routine daily tasks for which you don’t have time (within reason). After I got married, my husband and I spent every weekend cleaning the house until we realized that this definitely wasn’t quality time. Once I hired a cleaning service, we could actually enjoy the limited time we had together.
  5. Skipping your vacation. Don’t feel guilty; you work hard and you’ve earned it. Twenty years from now, you’ll cherish the memories you made with family and friends. Remember, no one ever said, “I wish I had worked more” on their deathbed.
  6. Mismanaging your finances. You’re likely finishing with huge debt and it may seem easier to continue borrowing. Pay off the high interest debts and drag out the ones with lower interest rates. Buy the house/car you can afford, not the one you think you deserve and START SAVING, which hopefully you have been doing all along.
  7. Neglecting to buy disability insurance. You never know when disaster will strike and leave you unable to work as a surgeon. For example, due to an accident, a family member who was a dentist received severe injuries to his first through fourth fingers of his right hand. He did not have enough disability insurance and had to pursue legal options in order to pay his bills. In addition, he had to hire another dentist to cover the office. As a result of learning about this situation, I bought a disability policy the following week.
  8. Not admitting when you’re over your head. Everyone has heard the adage, “Call me if you need help, but remember, calling for help is a sign of weakness.” Although everyone laughs, secretly many physicians take this to heart. It requires much more confidence to admit that you don’t know what to do in a situation than it does to perform in your comfort zone. To ease into it, you can always describe the situation and say, “This is what I plan to do, what do you think?” The corollary here is, “Never go down alone.”