You’ve got the degree, but are you really a physician?
On May 25th of 2021, I walked across the stage in front of family, friends, and a class of over 260 peers, ecstatic to celebrate the commencement of my career as a physician. On that day, letters were added to my name declaring that I was now qualified to go out and practice medicine! But what did that really mean? Was I really a doctor? Part awe and disbelief, part legitimate and utter uncertainty. I didn’t have any close role models as the first doctor in my family—especially ones that looked like me and could illustrate the coming processes for me. How would I reconcile these conflicting emotions?
Outlook and expectations help manage discomfort
When I arrived at Duke to begin my training as a Family Medicine physician, the very first step in finding solace in this process became clear. Inscribing the clichéd description of medicine as “a career of life-long learning” into my already humbled ego was foundational in my progression toward feeling secure in my role as a young, training physician.
With that outlook, the first issue quickly became one of identity. I noticed it with the very first patient I saw in clinic as a new physician. Despite the piece of paper hanging on my wall at home, it just didn’t feel right to introduce myself as a doctor. Immediate, real-time feedback and encouragement from my preceptor that day, proved to be the critical nudge I needed. “Introduce yourself...you’re their doctor.” Simple yet impactful and somehow groundbreaking for me at the time.
After letting these words settle, coping with the reality of doctoring with a limited competence set in. Fortunately, the tone faculty leadership helped set on day one proved useful. It became clear that as a young physician, I was not expected to know much of anything. Rather it was only required that I be enthusiastic, engaged, and continue to care about my patients’ health and well-being. Matching words with behavior, my Family Medicine clinic preceptors normalized saying “Let's look this up.” For the first time, I wasn't alone in not knowing something. This both made me feel comfortable with my role as a learner and exemplified the value in deferring to up-to-date evidence to provide the highest quality care and medical advice. It effectively removed the awkwardness of not knowing everything and empowered me to rely on medical literature to instill confidence in my clinical decisions.
From there, the solution to my initial internal dissonance became a matter of time and volume. Just about a month and some change into residency, my preceptors, faculty leadership, and personal optimistic spirit had set the tone for a successful transition into physicianship. I learned to introduce myself as “Dr. Davis, resident physician” when meeting a patient. More and more I began to feel confident managing the space between owning the show and admitting that I didn’t know. With that attitude, I began to accept more and more that I was providing care (with support of a supervising physician, of course).
Granted, there were still times when I felt what I refer to as growing pains, moments where a lack of patience with the process of developing competence becomes frustrating to the ego. Quickly, I learned that these experiences were nothing more than an opportunity to direct myself toward reading. A quick reference to medical literature like an Uptodate article to drive learning kept me mentally engaged and enthusiastic about my development in the toughest times. Of course, in these moments, support from my peers in the form of normalization, acknowledgement, and validation of the struggles of being a resident physician was extremely valuable in accepting and understanding my role as a physician-in-training.
Becoming secure in identity opens the door for progress
Midway through my intern year, that concern of whether I can actually call myself a doctor or physician has become minuscule. More pressing is self-actualization: becoming the competent, compassionate physician and community practitioner I envisioned becoming before walking across that stage seven months ago. Certainly, fortunate to have been afforded such a safe training environment, I feel confident that I’ll see that dream come to fruition.
Jeremiah Davis is a first-year resident with the Duke Family Medicine Residency Program. Email jeremiah.a.williams@duke.edu with questions.
Editor’s note: Duke Family Medicine residents guest blog every month. Blogs represent the opinion of the author, not the Duke Family Medicine Residency Program, the Department of Community and Family Medicine or Duke University.