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

Top 10 Things I Wish I Had Known about My First Job

Surgery is a tough discipline. The work is not easy, the hours are long, and surgical patients are some of the most challenging. It is also one of the most rewarding professions. The start of one’s career in surgery represents a truly exciting time. Many lessons will be learned and passed along to the next generation. Here are some of the lessons that I have learned and found particularly helpful in the early years of my career.

1. Find mentors early

This piece advice is perhaps the most important of the list. Identifying mentors who want to help you succeed is critically important. Develop relationships with experienced people who can help guide you and provide critical feedback. Remember that you can have more than one type of mentor—clinical, research, teaching, life, and so on. One day, you will be someone else’s mentor, a role that is perhaps one the most rewarding aspects of surgical practice.

2. Be flexible

Everyone has an idea of what the ideal job might look like (for example, a surgical oncology job with a heavy HPB focus). What you have to realize is that it takes years of hard work to develop that sort of niche practice. Be willing to help in areas that might not be your favorite but where you can provide a service that is needed. This approach will help you build relationships and gain trust, and you can slowly grow the type of practice that you really enjoy.

3. Know your market and find a niche

When looking for a job, realize that a hiring institution has a need and you are being interviewed to fill that need. If you are hired to do general surgery but there is a lack of expertise in a specific area, such as anti-reflux surgery, then you have the opportunity to develop that niche and make a name (and practice) for yourself. This piece of advice ties in directly with being flexible. If you are in an academic position, finding a research niche is very rewarding. It is especially helpful if your research efforts align with your clinical interests.

4. Realize that you may have to reinvent yourself

At first, you may be focusing a majority of your efforts on your clinical practice, including learning how you do it. Indeed, many have noted that the steepest learning curve of their career was the first year or two in practice. As you mature, however, there may be a shift in your focus. Hospital and departmental leadership opportunities, societal leadership positions, and educational endeavors all may begin to require more and more of your time. This progress is a natural evolution for many, and it can be very rewarding. These service opportunities are often required for surgeons who practice in academic settings and are a source of great occupational satisfaction. Administrative roles are another way that one can serve and influence. As with any change in focus, there is the need to remain flexible and embrace the change.

5. Advanced degrees might be helpful

Although certainly not required, having an advanced degree (other than your MD) might provide you with the expertise you need to fulfill some nonclinical aspects of your job. They can also help differentiate you and open other doors. For example, an MBA might be useful for a person who has interest in administration and leadership roles. An MPH might be particularly applicable for researchers who are involved in clinical and translational research.

6. Trust your boss

This is perhaps the most important aspect of starting a career. When searching for a job, find out if your boss is the kind of person you want to work for. Your boss (or chair) is absolutely key to your development and success. Trusting that your chair has your best interests in mind and that he or she will be a good mentor will help set you up for success.

7. Know the rules

Like in any sport, knowing how the game is played makes all the difference in the world. You have to know how to act, how to get things done, and what to do to get promoted. Having a game plan allows goals to be set and achieved. For academicians, each university has specific requirements for promotion and tenure. Develop an organized method to keep track of these requirements and set yourself up for a successful tenure review.

8. Have work-life balance

Happy surgeons are productive surgeons. You have to maintain a healthy work-life balance. It is all too easy to work incessantly and neglect your family. Make time for your family and friends. Exercise regularly. Eat right. Be the kind of person your mother wanted you to be, and you will be happy.

Taking care of your personal finances is also critical to happiness. Although money cannot buy happiness, having good financial habits and consistently saving for retirement will provide a sense of security. Find a reputable financial advisor who can help you invest sensibly.

9. Develop your research program early

If having a research effort is part of your job, then developing this effort early on is absolutely key. Everyone wants to get busy clinically (after all, you’ve been training for the day when you could have your own patients), and this will happen faster than you think. So much so that if your research engine is not running efficiently, there is the real risk that clinical duties might derail this critical aspect of your career. Taking the time to establish and maintain databases, develop experimental models and efforts, and develop clinical trials before your clinical schedule is overwhelming will pay dividends toward having a successful career.

10. Get involved with surgical societies

Surgeons who actively participate in local, regional, and national societies are well connected and have ample opportunities to earn Continuing Medical Education Credit. Take the time to investigate societies that represent your subspecialties as well as the American College of Surgeons. Get involved and be active. As your career advances, you will have opportunities to serve on committees and in leadership roles within these societies.