Simon Abi aad, MD
Medicine requires by far the longest "schooling" of any career. By the time we finally become independent practice–eligible physicians, we are already in our mid-30s and have almost never had the opportunity to make an unsupervised decision on a patient’s care plan. The day that comes will be scary for most of us, because we are conditioned to always double-check with the boss, to be under someone’s wing. Suddenly we are the boss, with all the responsibility and liability that come with it. Until that day, we will always have several attending supervisors, some with whom we will work often and others with whom we may not even cross paths.
That’s the part of training no one tells you about: "managing up." I first heard this term during my 2-year career in the pharmaceutical industry, between medical school and residency. It was a mandatory training for new hires. A whole weekend was spent teaching me how to manage the different challenges I would face with the different types of personalities that might end up being my managers. Despite all the evidence- and science-based methods out there, nothing can fully prepare you to work one-on-one with so many people of different personalities and from different cultural and personal backgrounds.
At first, they don’t know you, they don’t trust you, and they almost never believe a word you say. With time, this cold start to your fellowship slowly changes—or not, depending on whom you are working with and the reputation you build. Attendings talk with each other, so expect your performance when working with one of them to be shared with the others. It’s human nature; accept it.
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