Some people end up in academic medicine by chance. They like to teach, they like to learn, they accept a faculty position. They enjoy their work, they get opportunities, they grow into a program director or a chair or a dean.
Not me.
I was miserable in medical school. The pointless lectures, the endless tests, the ruthless gunners. Why did I ever want to be a doctor? I had made a terrible mistake. I wanted out. Instead, I took a break and learned about medical education. I began to understand why I was miserable, and I decided to fix it. I built a dream. I would use educational theory to improve the lectures and the tests, get rid of the toxic environment, make medical school both kind and effective. I would be an academic.
Along the way, I fell in love with the man who would become my husband.
Some family medicine-bound students look for unopposed programs in a specific geographic area. Some want a program with a particular fellowship or opportunities for a particular rotation. Some want to be close to home or close to the beach or close to an airport.
Not me.
I sought out programs that would teach me how to thrive in an academic health center. Programs that would groom me to be a leader in medical education. Challenging programs, where I would work hard and learn from the best. Equip me to realize my dream. I traveled the country to find a place that would help make me the academic I wanted to be.
Along the way, I got married, then moved my husband to be with me.
Some faculty members shy away from research, committee work, writing curriculum, academic promotion. They love patient care and teaching and grow their career by following those loves. They want to mentor residents to satisfying careers as community physicians. They don’t want to sit in meetings all day or write reports that ramble on for page after page.
Not me.
I wanted to be in charge. I would chair those committees, and our team would redo the entire curriculum instead of just tweaking one rotation. I would build a portfolio of research and service that would see me promoted to the highest ranks. I would craft meaningful and significant reports that everyone would admire. I was different, special. I had a dream, and I would do whatever it took to see it realized.
Along the way, my daughter was born. I hired a team of people so I could put work first and my family second.
Some faculty members spend their entire career building something extraordinary in a single location. Different roles, different jobs, but with the same people in the same place. They retire with great fanfare from adoring patients, heaps of teaching awards, years of experience and wisdom.
Not me.
I realized that I might not get what I wanted where I was, so I left. I moved across the country to a place where I knew no one. I bought a house sight unseen. I got new business cards, new titles, a new email address. All so I could finally get my chance. I could realize my dream.
Along the way, the biopsy showed my mom had cancer and it seemed prudent that the new job was a little bit closer to her.
Some people are scared to let go of a dream. They have wanted something for as long as they can remember; they have been working towards it. They’ve scoffed at others who took the easy way out. They’ve followed this dream for so long that it has become their whole identity, and it’s impossible to imagine who they are if they aren’t that person anymore.
This is me.
I was miserable in academic medicine. The committee work that lasted all day felt meaningless, the push towards academic promotion felt exhausting, the reports that rambled on for page after page felt cumbersome. At home, I had a husband frustrated that his dream was coming second, a daughter who just wanted her mama, a mother whose cancer had spread. Why did I ever want to be an academic? I had made a terrible mistake. I wanted out. So, I quit.
Today, I am scared, angry, confused, and sad. Who am I if I am not an academic family physician? Where will I go if I am not going up? How can I just throw away all of my learning, all of my training, all of my skills? I am different, special. The dream is right there; I just had to take the next step. I built a ladder with the tools and the materials given to me by my many wise and experienced mentors. They know I’m ready to take that step. They want me to take that step. I didn’t want to take that step.
This is not a redemption story. I have not found myself a new dream that completely fulfills me the way the other dream did. I have a job l like, I am doing work I enjoy. I am more available for my husband and my daughter and my mother. The life that I had once judged too harshly, the life I considered a cliché, a cop-out—I have that life. While this life is not the dream I had been working towards, it is meaningful. It is important. It is good enough, for now.
Along the way, I find a little time to teach medical students. I hear a whisper that someone should make medical education kinder, more effective.
Maybe me. But not today.
