I remain optimistic, although not seeing the metaphorical glass as half full or empty. My mantra normally is drink up and move forward, but in hindsight I likely was rather naive about some aspects of this interim transition period when I am no longer a fellow, but not yet an attending physician. This uncertainty arises from the broad array of issues that one after another confronted my family and me following graduation and subsequent long-distance move to my new place of employment. While this has at times felt overwhelming and unique, I realize that mine is by no means an isolated case considering that, as a statistical group, we physicians tend to move frequently and be quite mobile.
On the Move
Of course, our moves often are dictated by forces wholly beyond our control—MATCH results and availability of residency and fellowship positions. While disruptive, the moving from one position to another can promote making new friends and contacts in areas in which we ordinarily would not live and work. While at UT Southwestern in Dallas and after previously finishing training in the Northeast, I had several interesting conversations about this mobile lifestyle with other similarly situated colleagues. Our profession’s mobility tends to provide opportunity for unique connections—or at least the ability to break the ice with other medical travelers.
In the course of attending my fellowship program and then finding work, I moved from Massachusetts to Texas and then back to New England. The relocations provided the predictable anxiety levels and culture shock. When I initially planned to undertake the Texas fellowship, it was planned to be a two-year deal, period. I did not predict considering staying there, but that proved wrong—I grew to like the state, its people and the opportunities that presented themselves while in training. I found the can-do Texas spirit invigorating and attractive, to the extent that I contemplated remaining there. I imagine that many transient trainees face the same dilemma after becoming comfortable with the place of training: Should I stay, or should I go now?
Professional mobility likely is simpler when you are single, but as we age and advance in our careers, there is, with each passing year, less chance that the decision will be unilateral and without collateral damage upon those life companions who have chosen to accompany us. Although a long-term Texas commitment was not on the agenda of everyone in my family, I have a sentimental tie with the Lone Star State that I tried to explore for 48 months. I got familiar with my immediate territory, then visited some major tourist attractions, then became friendly with people I did not want to leave behind. Modern technology may try to bridge those gaps, but attempting to stay in touch via Facebook is not the answer for me. I find it impersonal, fake and “hug-less” (Can something be done about the latter?). So leaving Texas took an emotional toll on me. There is always the second-guessing of whether moving to another state made me miss out on professional opportunities and further growth in the one I left behind. Don’t get me wrong: I am content and excited about my choice of employment. But the truth is that it is a bunch of gray unknown compared to the tried, tested and comfortable environment that I left behind.
Be nice to [administrative assistants & liaisons]: They often hold unofficial, but great sway in their places of employ.
The Details
Simply searching for work in a distant state proved a formidable task. With graduation normally occurring in spring, this unfortunately translates into winter air travel, with its consequent delays, closures and missed connections. Even in the best of times, you find that your well-earned vacation time quickly is dissipated with even a couple interviews in foreign locales. Travel arrangements and scheduling require lots of communication and follow-up with program directors and, perhaps more often, their administrative assistants and liaisons. Be nice to these people: They often hold unofficial, but great sway in their places of employ. The second-look interviews provide another unwelcome expense, unless prospective employers agree to cover the costs. Thank heavens, the wonders of technology and Skype came to my rescue in this situation.
