It would be disingenuous to refer to this stage of my life as a new beginning, since I’ve already completed my first year of being a Trauma & Orthopaedic Surgery Registrar (also termed “ST3” since it succeeds two years of Core Surgical Training (CST)). However, it’s the perfect juncture for some reflection given the infamous potency of hindsight.
As it stands, I’m in the thick of a yet another rotation after some of the most hectic yet personally transformative months of my life. The rate of growth I’ve experienced has been quite unprecedented and something that I couldn’t possibly have ever truly felt prepared for. Notwithstanding the challenging nature of CST, the step up to specialist registrar training is intense in a different way. I ultimately approached this testy period with every item in the proverbial toolbox; it felt pretty sink or swim.
The best way to describe starting a specialist registrar training programme is that it disrupts every constituent element of your life. From personal to professional, psychological to physical, it’s impossible to determine whether you’re coming or going. Most of the time is spent feeling like you’re chasing your tail in some perverted game of cat and mouse where you embody both players and the game is actually your own life. This is due to the fact that expectations dramatically increase, as do the stakes, since you’re essentially a consultant surgeon in training and accordingly the first port of call for all the patients under your particular consultant’s care. It takes a while to figure out exactly what’s expected of you and even then it can be a telepathic guessing game.
The most crucial lesson that I’ve learned during this year is the importance of asserting my own work-life balance to facilitate longevity. My baseline had always been to err more heavily on the side of work than life when things became particularly stressful. I had an inherent misconception that a work-life balance is a passive rather than active process. “It’ll happen”, I thought; perhaps an obvious yet helplessly naive and reductive belief. Accordingly, redefining my work-life balance was the single most powerful action I could incorporate into my life in order to feel some sense of agency. Prior planning, a physically and mentally healthy routine, and time for family and friends.
If there was any advice to impart from this reflection then it would be this.
Another important reflection to share is how much anxiety I felt during ST3, particularly the first six months. For me, entering directly from CT2 to ST3 with a 6 month gap between the two stages of training felt somewhat terrifying. Faced with a heady combination of deskilling and juniority, the fear of failure was overwhelming and I experienced daily crises over whether I would be discovered to be an incompetent registrar. “Vasudev is not suitable for surgical training” played in the back of my mind like a broken record.
I’ve often held unhealthily high expectations of myself. However, during this period, I experienced a heightened state of mental vilification. Ostensibly small criticisms would often inflict harsh wounds over which I would ruminate until black and blue. This invariably caused an already stressful step up to feel even worse.
Fortunately, as time has passed, this futility has morphed into hope. I feel it’s crucial for me to be candid about this, since so much of our lives as medics are spent unjustly chasing a Sisyphean image of invincibility and infallibility. In fact, it’s highly unlikely any of my anxiety was ever outwardly noticeable. Usually, whilst we are consumed by our inner battles imagining that everyone can see through us, those around us are actually too consumed by their own respective battles to notice. We’re paradoxically so well-versed in disguising our insecurities through the adoption of an assumed confidence that it’s nigh on impossible for anyone else to detect the turmoil that lies beneath. So we go on with our daily lives imagining everyone else has it together apart from us…
But, as it happens, imposter syndrome is not a stranger to many. Having spoken to mentors, supervisors and colleagues alike, the universality of imposter syndrome is simultaneously surprising and humbling. It’s like an unspoken, unanimously shared experience between all who are in a state of continuous development. Growth relies on an extension of personal boundaries outside of our respective loci of control. If we never endeavour to step outside of our comfort zones, every process remains habitual and development will therefore not take place. I can promise you’d be pleasantly surprised to find which individuals around you are subjects to this complex.
This is why principles such as progressive overload exist in activities like sport. Progressive overload literally involves incrementally increasing stress on the body with adequate recovery to stimulate physical development. As time goes by, the body’s physical capabilities improve as it grows accustomed to each incremental increase in load/stress. I closely equate this paradigm to my experience over the last 12 months and no doubt it is also applicable to what is yet to come as I train to become a consultant surgeon.
So, religious or not, spiritually inclined or otherwise, I would surmise that these situations present themselves to test us and offer a wealth of opportunity to grow and extend beyond our personal boundaries. Having better understood what is required of me as a specialist registrar surgeon, I am now able to focus more on learning the craft and developing my skills. This, in conjunction with an ameliorated appreciation of curating my own work-life balance, has afforded me greater control over the helter-skelter feeling I’d walked into at the start of ST3. The constituent elements of my life that had been so vehemently disrupted into a vortex of worry and anxiety are now slowly coalescing and solidifying into a new and improved sense of self and perspective.
Be reasonable.
Be patient.
And above all, be kind to yourself and others around you.
Vasudev Zaver 