KaraPepperMD Profile picture
Dec 14 7 tweets 2 min read
Things I wish we told #residents and #fellows before they start practice:

- Your first year as an attending is the steepest learning curve of your career. Your inner #impostor will be very loud. This is normal. Surround yourself with great mentors, pace yourself, and learn.
- There is no “right” way to practice medicine. This is YOUR life. You have mostly seen the narrow career path to academics but 80% of docs work outside of the ivory towers. We are really smart too.
- You don’t have to stay in academics to teach and write. There are unlimited opportunities if you look for them.
- Practices may want to “hire you and retire you.” You do not have to make a life long commitment to a practice. Just pick the best place for you to start your career based on personal and professional reasons. You are allowed to change your mind.
- Hire an attorney to review your contract before you sign. Understand your non-compete.

(This is worth taking out credit card debt for).
- This is YOUR life. It is allowed to look different from that of your peers and attendings.

This may be the first time there is choice or flexibility in your decisions. Know that there is no wrong choice - just the right next step for you.
What else #medtwitter?

• • •

Missing some Tweet in this thread? You can try to force a refresh
 

Keep Current with KaraPepperMD

KaraPepperMD Profile picture

Stay in touch and get notified when new unrolls are available from this author!

Read all threads

This Thread may be Removed Anytime!

PDF

Twitter may remove this content at anytime! Save it as PDF for later use!

Try unrolling a thread yourself!

how to unroll video
  1. Follow @ThreadReaderApp to mention us!

  2. From a Twitter thread mention us with a keyword "unroll"
@threadreaderapp unroll

Practice here first or read more on our help page!

More from @KaraPepperMD

Nov 3
One year sober today.

I always said that work was my drug. As it turns out, alcohol was too.
I am from a multigenerational family of alcoholics, and I never wanted to struggle with alcohol use disorder. Instead, I discovered that I could avoid feelings of discomfort by overworking, achieving, and staying perpetually busy. Workaholism became my drug of choice.
As an adult, I worked obsessively Sunday evening to Friday afternoon. By Friday at 6pm I would think, “I just want to turn my brain off,” pour myself a glass of wine, and unwind.
Read 16 tweets
Oct 5
Coaching works. Sometimes it can be hard to quantify but here we have empirical data. A thread: 🧵👇🏼
A recent article in JAMA reports that in a randomized trial with 100 female residents. Control group got no coaching. The other group got live coaching via Zoom and written coaching weekly for 6 months.
The findings:
Residents who received coaching:
Less exhausted.
Impostor Syndrome improved.
Self-compassion improved.
Read 5 tweets
Feb 25
How do you know when you’ve worked “enough?”

I’m not talking about the end of a shift or maxing work hours.

For anyone who is eternally striving for “work-life” balance but never finds it - because work continues to compress your life - this is for you.

A thread 🧵:
When I ask the question “How do you know you’ve worked enough?the answers are typically:

- when I’m exhausted
- when I can’t think any more
- when my family complains
- when I literally can’t do another thing
- when I fall asleep

Why is suffering our metric of “enough?”
Suffering is deeply intrenched and celebrated in the culture of medicine.

We explicitly and implicitly teach that good doctors:
- always put patients first
- are team players
- stop when the work is done
- self-sacrifice
- are always available to help
Read 11 tweets
Dec 12, 2021
Brief history of #BMI and why its broad use is inappropriate and discriminatory.

a thread 🧵
Aldolphe Quetelet, a Danish astronomer, developed the BMI in the 1830's using a cohort of French and Scottish men.

Typical of the time, these participants were lean, active, white males with unstable food supply.

academic.oup.com/ndt/article/23…
Quetelet's goal was defining the characteristics of ‘normal man’ and fitting the distribution around the mean.

By measuring a large cohort with their physical deviances, one would come closest to the ideal of what a human being should look like.

academic.oup.com/ndt/article/23…
Read 19 tweets
Dec 8, 2021
Leaving my primary care practice:
a thread 🧵 Image
In March 2020, my practice of 13 years closed to protect our patients and staff. Thanks to the #telemedicine platforms I put in place a year prior, we overnight converted our 70+ provider practice to telemedicine for the next 2.5 months.
After years of hustling in clinic, full-time #telemedicine provided time to skillfully coordinate care and provide thorough counseling. Working from home without the frenetic churn of the clinic, I was living my best life and delivering the best medical care of my career.
Read 12 tweets
May 9, 2021
“I’m so burned out. I can’t do this anymore.”

This is one of the most common issues I address with my #physicancoaching clients.

We avoid #burnout and increase/maintain our #resilience when our basic needs are met.

Let’s start with the basics.

A thread 🧵:
Physician burnout is largely due to organizational culture and operations.

Personal resilience plays a smaller role.

wellmd.stanford.edu/about/model-ex…
Physicians are more resilient than the average adult population.

Yet, resilience training is often promoted as the primary way to prevent burnout.

jamanetwork.com/journals/jaman…
Read 11 tweets

Did Thread Reader help you today?

Support us! We are indie developers!


This site is made by just two indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3/month or $30/year) and get exclusive features!

Become Premium

Don't want to be a Premium member but still want to support us?

Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal

Or Donate anonymously using crypto!

Ethereum

0xfe58350B80634f60Fa6Dc149a72b4DFbc17D341E copy

Bitcoin

3ATGMxNzCUFzxpMCHL5sWSt4DVtS8UqXpi copy

Thank you for your support!

Follow Us on Twitter!

:(