Today I Turn 33 [Everything I Wish I Knew]

So, today I turn 33. The reason that matters is not just cuz I'm getting older, but it's finally the year where I'm done with my medical training. So, this is a video of all the lessons that I've learned over the past 13 plus years. What's going on, my friends? Welcome to another episode. Today, I'm going to be walking you through exactly what my thoughts are going into my 33rd birthday and the setting where I am now, which I'm officially done with all of my medical training. Done with medical school, done with residency, and then recently finished cardiology fellowship. In just about [music] a week away is the making of this video when my first job as cardiology attending will [music] start. It's crazy, but this is like an important video because I would have wanted somebody to [music] make this for me when I was starting as medical school, which is what does it feel like? Do you feel old? Do you feel like the process [music] took forever? Are you happy? Do you feel young? And so, really, I just came down through a few insights that I wanted to share. I shared these in our email newsletter, so if you're not part of that, you can go ahead and sign up for any of our free downloads down below. You'll also get access [music] to all like the free tidbits and tips and advice that I write to our email audience of several thousands of people. So, if you want to join, go ahead and click down below. The White Coat Success Guide is our [music] most comprehensive one with all the systems that I wish I had during my medical training. So, if you want that, that's linked down [music] below. But, in this email newsletter, I wrote about all of the lessons I wish somebody had given me on my first day of medical training to prepare me for what [music] the finish line or like this quote-unquote finish line would look like. When you're done with training, what does that feel like? Are you excited? Are you scared? Are you nervous? Do you [music] feel prepared? Do you feel overprepared? And then like what type of things do you want to make sure you also think about on the journey besides just medicine? So, let's get into it. Number one, most important lesson is that an extra year or two here and there is not going to make any difference. Coming from somebody who felt like they were initially trying to [music] hack the system of like speeding up how long medicine would take. I was trying to graduate college early. I was trying to [music] finish as many credits as possible and then think about, well, if I use this specialty as my dream [music] specialty, then maybe I'll be done at like 29 or 30 instead of like 32 and 33. I was trying to use the [music] time that I would be at the finish line to be a marker of happiness and success, but you forget that you actually also want to be happy and [music] excited about the finish line you're crossing. If you choose a specialty because it's shorter or a route that's more [music] overwhelming and intense, but in the end you cross the same finish line as a person who like sprinted the whole thing, then it doesn't really matter. And again, I finished college a year early because I was trying to hack medicine, [music] but I took a nice pause, decided to take a gap year and work with kids with autism, and that was awesome. Then I did 4 years of medical school, went to 3 years of residency, [music] and I thought, "Well, I kind of like cardiology, but like do I want to be a hospitalist and just like be okay with this life?" So I took 1 year [music] just to work as a hospitalist, and that was a great experience cuz I quickly realized for many reasons [music] that I've shared on this channel that that wasn't for me. And then I applied to cardiology fellowship [music] quickly thereafter and then spent another 3 years in training. Those two kind of extra years really made me who I am today. Working with autistic kids really got me interested in just working with people, using your expertise, and then patience. Such an important part about patient communication. That was a great job. And then working as a hospitalist taught me one of the things that I didn't want in my future career, >> [music] >> but also just how to be efficient, how to make decisions and as an attending, which if you go through the journey cleanly, meaning go to medical school and then all of your years of training without any like attending years, [music] then you don't really know what it feels like to make your own decisions. But because I was a hospitalist, it worked really well in my favor when I was a fellow because I could say, "Well, [music] I've made calls before. I feel comfortable as a fellow doing the same." But now I graduate and I start my job at 33, [music] and really there would have been no difference if I finished 2 years faster and not 32. Or if I chose to stay as a hospitalist and be done at like 28 or 29, my life would more or less be the same. Maybe financially [music] you would have more years of higher income, but if again, if you don't like the job that you're going to have, then it doesn't matter. If I had stopped at being a hospitalist, it could have been for somebody else, but for me I quickly realized it just didn't fit [music] my goals and personality. Then yes, I would have been younger. I think I was 29 going to 30 when I started my job as a hospitalist, and yes, I was young, but 3 years later it wouldn't have mattered of what age [music] I started at. So you'd rather finish the finish line you're happy with than worry about hacking the system and being done a few years in or there early cuz the rest of life as you'll see in this episode [music] continues to happen. So, trying to speed up when you finish your career kind of milestones really doesn't matter. Number two, medicine cannot be the only [music] pillar of your life. Now, I've learned this through purpose and through accident, but my main goal as you guys have probably known through this channel is I want the journey to be successful. I want it to be happy. And often the equation of being happy doesn't come [music] with them the job. Yes, there are elements of like liking what you do, interacting with patients, remembering the really kind of golden nuggets in your career. But, most of the happiness comes from the balance that [music] is in your outside life. So, your fitness, your relationships, your personal health, your hobbies and progress outside of medicine. And so, [music] that's why it's equally important as you're going through the early training years of creating the habit of prioritizing yourself. We work with [music] so many students where they'll come to me saying, "I'm struggling so much of getting the grades that I want that I've given up working out, I've given up on good sleep, I've given up on my hobbies and friends and relationships. And I hope I figure out that later." But, in reality, this individual has taught themselves that medicine is allowed to take all of their time and thus when they get busier, which you will in rotations, you'll have less time, in residency, you'll have less time, in fellowship, you'll have less time, cuz then attending, [music] imagine I'll have even less time and more and more of adult responsibilities will also start to take up that time. If you don't build the habits of creating those extra pillars that grow with you, you're going to continue to be unhappy because the balance will feel off. Even if medicine is like a pedestal and you're doing amazing, you'll feel like the other aspects of your life are not fulfilling. [music] So, work on those relationships if that's important to you. Work on your personal fitness cuz that [music] should be important to you. Work on creating those hobbies that you already had and developing those or creating new ones. For me in [music] medicine when I was in medical school, I started this channel which became a hobby and then a business. I ultimately got married at the end [music] of medical school to my wonderful wife. We had two kids, bought a home, I ran marathons, I wrote books for [music] the MD Journey, learned the piano, learned the harmonium, learned singing. And those aspects of my life are equally and arguably more important to me than my job as a doctor. [music] But because they've grown together, like everything feels like it's heading in the right direction versus one part crossing the finish line, you feel like you've been dragging the rest of it [music] and then picking up the pieces later. Number three kind of goes on the same point is that your health will reveal itself or how well [music] you treated it during your 20s and early training years. Again, in medical school you'll have more time to exercise [music] and get good sleep than you will in rotations residency and fellowship. And while it may not seem true, it is. And so creating those good habits of saying [music] after this time I'm not going to be studying anymore. I'm going to make sure I go to bed at this hour. My workouts are going to be scheduled at these times [music] during these days of the week. This is what I intend to do. This is how I intend to get better at my workouts. Not just showing up for some push-ups, [music] but maybe trying to do a few more that I did before. Lifting more weight, running a little bit faster. But using those earlier years and if you start medicine at a later year, you're still younger than you'll be when you graduate. But [music] using that to really build your fitness. For me, you know, it was a normal routine in medical [music] school that classes would be recorded and so I would wait till like 10:00 till the first 9:00 lecture went live. And so from [music] like 6:00 till 9:00, 6:00 is when the gym opened. I worked out for an hour, got a quick [music] shower in and then I was kind of reviewing flash cards until the first lecture went live so I could watch it. That was my routine every single [music] day in medicine. And it worked nicely because even if the rest of the day was utter crap, I got my workout in and I probably got at least a little bit of studying in. And that made a big difference. But that has shown itself going into my 30s. Yes, I have aches [music] and muscles that are sore that I didn't even know existed. Kind of did. Thank you, anatomy. But the point is is that I naturally [music] focus on making sure that my body was as optimal as possible. And there are elements where I've neglected [music] it as well. When I was a resident, I didn't work out as well as I did as a medical student. When I was a fellow, because we had kids, it also became less of a priority. Then we built a gym in our garage. And now going into my attending life, it's become a re-part of my priority. And I want to make sure it remains a part of my priority. So, just remember, by the time that you're at my stage in [music] training, you will thank yourself or hate yourself for how little or more much time [music] you gave to you and your body. Number four, your hobbies make your medical journey so much [music] more exciting. For me, it was learning music, learning how to sing, play the harmonium, which is like this piano wind instrument mix that's often [music] used in Indian classical music. Learning that over the years and becoming a little bit better, but having that being a skill set that I'm just developing for balance's [music] sake. Running marathons, getting better at that, becoming more fit, creating this channel. But again, those have been elements that made me more interesting, made me more happy. And so, make sure, this is like my third [music] time saying it in a different way, that those priorities stick as much as you give attention to your job. Number five, super [music] important, really this is like the bread and butter and theme of this entire channel, is that systems [music] make almost anything easier. Yes, it doesn't necessarily make hard things completely easy, but it will make hard things more manageable. [music] As I've realized throughout the years of coaching students and making these kind of channels, is that you don't have to reinvent the wheel. I often thought that how I studied as a [music] medical student would have to change as a resident, would have to change as a fellow, and now as an attending, but the core principles exist [music] to be the same. If you're interested in what those systems are, again, that free WhiteCoat Success Guide breaks down a lot of my initial kind [music] of study and learning systems that have helped hundreds and thousands of students over the past like 10 years. And if you're interested even more step-by-step, then our WhiteCoat Operating System or OS program really gives a deep dive into all the systems, including learning, board prep, [music] time management, and more. But through the creations of these programs, I realized that the tips and advice and systems have [music] been the same. I studied for my echo boards, which I took like 3 weeks ago, the same way that I took [music] Step 2 CK how many years ago. The system is exactly the same. Yes, studying for echo boards wasn't easy. Yes, studying for Step 2 wasn't easy, but how I approached them was [music] the same. And thus, I could start any preparation saying kind of have a gist of how I'm going to approach this next. And so, it's easier to get into the motion versus if you don't have a system of how you manage a busy schedule or how you catch up when you're behind [music] or how you prioritize yourself or how you deal with demotivation, or an upcoming board exam, or interviews, or applications. Like, if you don't have systems for each [music] of these, you feel like you're having to reinvent the wheel each time, and then the burden and stress of medicine becomes even more so daunting. So, again, if you're interested in the systems [music] that helped me, or the systems that I didn't have that I wish I did when I was in your shoes, the White Coat Success Guide [music] is an easy place to start. In addition, you'll get all of these kind of tips and tricks in our emails newsletter. Number six, something that I did not do well enough, so I hope [music] that you do, is to slow down and enjoy the phase that you're in. Often, again, we're so focused on the finish line that we realize that the finish line is just the start of a new journey. For me, as an attending, [music] I am going to look at this as not like the end all be all. If anything, it's the start of my attending journey, and that's it's a new phase in my job as like a forever cardiologist. [music] I'm going to have new stressors of managing patients, being efficient, writing notes, billing, all of that other stuff that comes with it. Just making decisions again as a cardiologist, and [music] that is going to be a new phase. It's really not another finish line. It's just like another mile marker. [music] And so, as much as we're focused on trying to get into the new milestone, or getting to the next finish line, try to do your best to enjoy the phase [music] you're in. So, if you're in rotations and you're on a rotation that you hate, try to gain something positive from it. If you're on a class that you just hate learning about, try to get something that is enjoyable from it. Find a way to learn that [music] it makes it at least a little bit more interesting. That way you remember this phase as being something at least of a positive nature. Otherwise, you feel like you're just again torturing yourself [music] through the journey. So, slow down, enjoy the patients that you interact with, the people who teach you, collect pearls that they share with you. [music] If you're able to take extra second or an extra effort to learn a little bit more than just [music] your textbook or syllabus or exam would require of you, those often tend to be the nuggets that we kind [music] of stow away randomly in our brains and then know that when we can help a patient in the future. So, as much as it is to enjoy the journey, that starts [music] with enjoying the phase you're currently in. And if it's especially if it's a phase that you didn't like, take that extra [music] second. An example from my own journey, I knew I wasn't going to go into OB/GYN or OB/GYN, but as a medical student on that rotation, I knew it was also probably the least comfortable aspect of medicine that I was going to be with because like women's health is not something that you know about as much as a male unless you're like [music] well versed into it and taking care of them as a medical professional. And so that rotation was like I want to know as much [music] as I can that way if I have to interact with patients in the future, female patients for example, and helping them with OB/GYN related issues or being aware of what those would even be, I want to make sure that I use this [music] rotation to the best of my ability. And it was a very fun and enjoyable rotation because of that. I was looking for nuggets to help [music] me in the future for any patients that I may interact with. In cardiology, there's OB/GYN related issues [music] that happen all the time. Postpartum cardiomyopathy for example. And so having dealt with that, having seen patients with that on my OB/GYN rotation, [music] now in hindsight, back then I didn't know I was going to be a cardiologist, but it's helped me now because I kind of can connect to those [music] experiences back then to those experiences now. Number seven, study the people who inspire you. It is such [music] an interesting fact that we'll be admiring people from kind of that balcony even though you're kind of rounding with them on a daily [music] basis. This could be your colleagues, this could be your attendings, your residents, your mentors, but we don't think enough about what systems and skills do they [music] have that inspire you and then more importantly, how do we install that to where we infuse some of that in our own daily practice. For somebody who interacts with patients, that's very admirable. Instead of just appreciating that fact about them, think about what they do that's different and how you should instill that for yourself cuz then you may have that skill set that somebody else may admire in the future. Or more importantly, you'll just be a better position to your patients. If you have a colleague who's just a very patient [music] or a very good team worker or just has a good attitude even when sometimes things get skewed to be frustrated relatively quickly. Take a second, appreciate that, ask them how they [music] do it, think about how they do it, try to instill that for yourself. This is a great way of chameleon-like kind of growing with your colleagues and your peers and those around [music] you including your patients. Instead of the default which is like you're very good at this, I appreciate you for this and then move [music] on. If you're going to interact with so many aspirational and amazing, smart, dedicated individuals, it [music] makes sense to use all of them. It's kind of almost like a cheat sheet. Like, how can I become better at myself, my own craft by taking stuff from you that I can use for my own patients and my own daily practice. Number eight is a big one and it's it's something that I will teach my kids when they're able to understand it is that your definition of hard [music] will change often. It'll impress you as you get further and further in the journey. If I ask myself at this phase how hard [music] something like middle school was, it's like a it's a laughing stock. But if you're student in middle school, it's like the hardest thing you've ever dealt with. Being in high school, >> [music] >> prepping for the SAT, seems like the hardest thing you're dealing with. But after taking the MCAT and all these exams that I have, it's like it's a joke. [music] And it's just because your brain becomes more well-versed of saying, "This is difficult. I've dealt with something like this before. Yes, it was challenging, but I was able to do it and thus I'm going [music] to able to do this as well." Once you overcome that, for example, if it's like taking Step 1, hard exam, and you're able [music] to build the skills, the dedication, the study kind of methods to do that, then next time you take something hard, saying, "Yes, [music] this is going to be hard. Yes, I've done something equally as hard or similar in the past and thus [music] that shows me an evidence enough that I'm able to do this in the future. Your definition of hard will continue to change. It'll [music] impress you. So, use that to motivate yourself whenever you find yourself kind of like an uphill battle. Doesn't mean that uphill is going to be [music] nice and easy. It just means that, "Okay, I have done the steps like this before. I've climbed [music] a staircase like this before. I can do this again." I've used that a lot of times when things are challenging of saying, "I am [music] stressed because this is going to be tricky, but not because it is impossible." So, appreciate all the examples that you'll have in your own life of the things that you've done that are hard and it will get you [music] a long way. Um especially in this like marathon of the medical journey where you're so focused on the finish line, the individual steps [music] seem like they're impossible, but in reality you've proven yourself over and over again that they truly aren't. [music] Number nine is as you get closer and closer to becoming an attending or this finish line, is always focused on improving your level of average. There is a status quo that we each show up with in our daily life, in our clinical life, in our personal life that we become complacent of saying, "This is good good for me." But I realized [music] this when I was a hospitalist, is that there are individuals who were closer to retirement age, meaning that they'd been practicing for 20, 30, 40 years, but clearly they had stagnated on how much they were progressing in their medical life, [music] because like they were able to take care of enough patients without any consequences. But, that means that they also weren't writing good notes, or really weren't thinking about all the differentials that me, somebody coming in from [music] training, where I was like forced to do that all the time, was saying, "What if we did this instead? What if I thought about this differential? What if I took the extra step [music] to help this patient by doing this?" For somebody who's constantly okay with their level of average and their level of status quo, even though it's be good, [music] you prevent yourself from progressing. And so, try not to be complacent in all elements of your life, your relationships, [music] your medical journey, your personal hobbies, your personal progress. Because, as you get further and further along, I've learned this through fellowship, is that as [music] you get further in training, you will have less hand-holding and more so, here are the experiences, make most of it that you will, but we're not going to baby you. As long as you're able to meet the [music] minimum standards, and often that bar is pretty low. But, for you to really feel like you got the most out of every experience, [music] you want to make sure that you've really ask yourself, like, "What is my standard?" And then, what can I do a little bit above that and improve on it as often as possible. That's how you become impressive, not [music] just to others, which really doesn't matter, but more so importantly, you can look at yourself saying, "6 months ago I couldn't do this, but like now, like it makes [music] sense. I'm quicker. I'm managing ICU patients. I am just better at taking care of patients, having tough conversations, making decisions [music] when it's like time pressing, and being calm under pressure." Those are all skills that build over time. And really it comes from questioning, [music] like, "What is your level? What is your status quo? And what do you need to do to where you say, 'I refuse to stay at this level for the next year, next 2 years, [music] etc.'" And that's really how I've been able to make the most amount of progress in my own medical journey, is [music] that I've been always pushing that kind of threshold as high as possible. And then finally, I'll leave you something that's kind of a two-part. Create something that you're proud of [music] while minimizing your ego. The whole point of crossing the finish line, it really is for you and then the opportunities [music] that it gives yourself. I am a very early cardiologist, meaning that there is so much more for me to learn how to take care [music] of patients. There thus comes in that checking my ego. I am no better or worse than anyone that I interact with. I have a lot to learn from everybody. I hope to also think that I have a lot to offer my patients as well as my colleagues [music] in terms of new perspectives and skills that I can share with them. But, create something you're proud of when you're crossing the finish line. If you are running on empty the whole way through when you cross the finish line, [music] then you don't really enjoy the fact that you crossed a marathon, for example, and nor do you want to keep going. But, if you enjoyed the experience, and you look back and you say like, "That was hard. I did it. I'm proud of myself for doing so." And [music] now, instead of like shining my metal in front of everybody, you know, who can I use the experience of getting to this finish line to help? And [music] that's really the part that I am very happy about in this journey is when I was a second year medical student, all of this started. All of the blog post, all of the videos that initially were very crappy that I at least are a little bit better now, but I am proud of the journey that I've taken, but also the journey that I've allowed individuals [music] like you to join me on. And hopefully, as long as it helps you with one thing of saying, "I should do this. I shouldn't do that. Here's something that that random guy on YouTube taught me of what to do or what not to do." And if that's helped me avoid repeated mistakes because I've journaled it for you guys, like I'm proud [music] of that. I'm proud that I have a happy and healthy family. I'm proud that I can be a present dad. I am proud that I can be a good physician who is [music] somewhat composed enough to understand that I'm not the best. I have more to improve on, but I do have something to offer every individual who comes in front of me. That is like a nice check [music] of ego as well as avoiding to be like overly zealously hum- humble, but that's a nice check of [music] being between this egotistic as well as like overly zealous humble individual. Um I'm neither of those, I hope to think. But, that's kind of where I am, right in the middle, hopefully kind of documenting these experiences [music] and these perspectives over the journey has been helpful to you. As always, I appreciate you joining me on mine. If there's any [music] way that I can help you, go ahead and add your comments down below. Questions and comments and suggestions [music] and future episodes ahead. But as always my friends, thank you so much for being a part of my journey. Hopefully I was a little help to you guys on [music] yours. I'll catch you guys in the next one. Peace.