DIP Episode 329 - Thriving Through Transitions (an approach to wellness and success in the practice of medicine)

Okay, welcome. My name is Divine. This is episode 329 of the Divine Intervention Podcasts. And in this podcast, I'll be talking about dealing with transitions in medicine, dealing with transitions in medicine. This is not a knowledge podcast, but this is more of a life podcast. This is something that is particularly important for people that are in healthcare. And again, as I do as a reminder, if you're taking step to see here, step three anytime soon, I do have a review course that's taking place this week on Friday and Saturday. It's 10 hours each day. And we'll be going over medicine, PEAT, surgery, OB-GYN, psych, neuro, biostat's ethics, professionalism, communications, and many of those healthcare systems topics. And a lot of ethics as well and biostat, as I said. And then on Thursday, between 24, 30 p.m. Pacific Standard Time, which is 5 to 7 30 p.m. Eastern, I'll be doing the NV Me Testicking Strategies class. Again, I've had many, many, many people attend these courses and do really well. Like they start doing better on their practice exams, they do better on their real exams and things of that nature. I get emails all the time from people that have participated. So if you're interested, just shoot me an email and I'll give you some more informational costs. The course is going to be held over Zoom. Okay, so let's drop into dealing with transitions, right? So I know some of you may be like, divine. This topic is a little weird.

This is kind of like a big break from the norm. Just think of this as a big life lessons podcast, but this is a life lesson that actually has pretty major implications for your life. Because the thing is medicine, many times don't discuss mental health, where many times don't discuss things that can really, really bring down your mind, things that can really, really get you in the wrong direction, right? Because medicine, especially in this country, especially in the US, is a high sticks endeavor. What do I mean by high sticks? Pretty much everything in, I feel like, don't get me wrong, you know, medicine is a pretty great career and everything. But I feel that the way it's handled in the US, it makes it almost like deep, I don't know, I just feel like everything is set up to be harder than it needs to be. One thing people don't realize is that you can make pretty great doctors, pretty great physicians, pretty great healthcare professionals, by just going through a clean, more humane process. Let me put it that way. But I feel that in the US, the common belief and common thought is we're going to make this as hard as possible, we're going to make this as high stress as possible, we're going to make this as intense as possible. We're doing this to draw the best in you, even if in many cases it actually draws out the worst in people. But I think being able to manage those things is very important.

So, because to be honest, I was discussing this with someone recently, but I've always desired to make a podcast. Why just address this issue and just give you some practical tips on how to deal with these problems so that it doesn't consume you. Because I feel that you will think that when people are pursuing a dream, when people are pursuing a career goal, the first thing on their minds will be like, wow, this is how much I want to help people, this is how much I want to do this, this is how much I want to do that. But the thing is at the end of the day, the practice of medicine in the US becomes a journey of can I stay afloat? Again, I know that I'm not alone in this, and I know that many people, I mean like it batters my heart every day when I read posts on Reddit, of people where you're like, wow, I won't be surprised if this person has suicidal ideation, or this person wants to end it all. I mean one of the most common causes of death in a resident, believe it or not, is suicide. I mean I heard recently of like three residents from the same hospital. I'm obviously going to mention any hospitals name, but three residents from the same hospital where all of them commit suicide. That's a bismar. Or you see in certain states of the US, practicing medicine in those states is almost like not advisable in a sense, because you see how many people just pass away from stress, from just different factors that I'm playing that put them in those delirious circumstances.

So I'm just going to talk about 10 points today. Again, like I'm not even going to be able to completely scratch the surface of this problem, but I'm just going to give you some tips from my perspective that I feel have helped, because definitely I will tell you this in my time as a physician, I've absolutely had situations in my life where I just felt completely smooth, right? Where I just felt like wow, how do I keep going? Like what is going on here? Wow, I feel like I'm drowning. There is a lot going on. I don't know what to do, right? But I was thankfully with the help of God and again, many other resources able to come out on the other side with my head on my shoulders. So I would and not just with my head on my shoulders, but actually thriving in medicine. So the thing is you can thrive. I think that's one big thing I want to say. You can thrive, you can rise above, right? But again, I'm not going to give you like some feel good, whatever. No, I'm going to be straight with you here and tell you what the truth really is. So you can have just that true perspective and adjust your behaviors and your life accordingly, right? So what's the first point I really want to make? The first one I really want to make is a transition, I mean some of you may wonder, oh, divine, what is a transition? Well, the thing is a transition is a high-risk period of life. It's a period of change, right? And the thing is change for some people can be very distressing, very, very distressing.

And you know, sometimes the degree of change determines how distressing it could be, right? There are certain changes that are pretty minor like, oh, your salary went from 10 an hour to 9.90 an hour. Okay, yeah, well that affects your quality of life a little. Yeah, but is it the end of the world? Probably not, right? But transitions are periods of change. But the thing is in medicine, medicine is a tough discipline in a sense because the transitions tend to be pretty intense. The thing to be pretty like you're going from zero to one million very quickly. I mean, here many times when you get into Mexico is like drinking water from a fire hydrant. Literally, that's a pretty up to description of many of the transitions that people make. And the thing is when you make a transition in life, you can have one of two outcomes, right? You can thrive through that transition. Alternatively, you can be consumed by that transition, right? So that's the one point I want to make. I just want to establish what a transition is. Now, the second point I want to make is what are some examples of transitions, right? What are some examples of transitions? Again, I know a lot of the people listening to those podcasts that people in health care, right? People that are medical students, right? So what are some transitions? Well, if you're personally medicine, one big transition for you was going from college to math school, right?

You go from learning information in one month that you may have learned in like one or two semesters of college easily, right? Like a microbiology course. We were learning about tons of bugs, their presentations, their staining, the identification. I mean, like literally the stuff I learned as a med student at Johns Hopkins, like in my first seven weeks, was probably about as much information as I'd learned easily in a 16, 20 credit hour semester as a college student. Probably even more, right? I mean, we learned a ton in anatomy. It was a ton of information. I mean, the head and neck, muscles, nerves, insertions, all those things, right? So the thing is that's one big transition going from college to math school. Another classic transition is when you're taking the USMLE exams, right? The first big one is that USMLE step one exam. Thankfully, I'm kind of glad it's going to pass fail, although that also kind of introduces some challenges for certain subsets of medical students. But, and you know, I've talked about that in prior podcasts, but taking the USMLE exams, right? You're going from, you've probably never taken an exam, this long in your life, to a situation where you're going to be sitting down for eight hours, as in the case of step one, you know, seven hours plus the one hour break, or nine hours as in step two, CK, right? Eight hours plus the one hour break, right? Or step three, what you take it over two days, right?

So again, it's just the medical system in this country, just high, high, high sticks, taking the USMLE exams. Again, I feel like there are really good ways to assess a physician's ability and to entrench the abilities you want without putting people through the grinder in certain ways. But again, that's a topic for a different podcast. That's not my main goal today, right? But taking the USMLE exams is a big transition for many people. Going from pre-clinical exams, I mean, pre-clinical years to third year rotations is a big transition because now you have, you no longer have control over your schedule, right? You can't wake up whenever you want. You wake up at a set time. You have to be in a hospital at a set time. You're working with people that may like you or may not like you. You're working with people who you have to impress because your grades in third year are determined by some grade. If a person was really angry with you for like five minutes during a rotation, that may be the thing that may completely destroy your grade in a rotation, right? And again, they will say, oh, we're making the grading system fair and objective, blah, blah, right? But we all know that that's not necessarily true, right? There are many times you'll work your hardest on a rotation and then everything is just writing on the feelings of one individual, right? And this is not just something that happens in the third year of med school or the fourth year of med school.

It also happens in residency, right? If I'm at many times people end up getting, yes, there are sometimes where people get either good evils because they're just objectively good at their job. But there are also many times in a disproportionate number of cases where people get good evils just because they're attending like them. Not because of the fact that they may necessarily be more skilled than another person. They may just be a person that is very good at getting in people's good graces, right? But the thing is at the end of the day, getting in people's good graces is not what makes a good physician. It's one component. What I will argue that a very big component is also just being competent at your job, right? And having like a certain work ethic. So that transition, right? From preclinical years where most of your grades are objective, you study hard, you do well to something where, oh, yes, they are your shelf exams, but wow, gee, like 60% of your grade is determined by some person's feelings about you, right? Again, that's a big transition for people. Or is it even the transition of studying residency? I'm telling you, studying residency is probably one of the biggest transitions of all the transitions you will ever make as a person that is being trained through the medical system in the US.

Because again, you're getting into a place where you have a lot of responsibility, where you're expected to be more independent, where you're literally just thrown off on the deep end from the get go, right? So the thing is, thankfully, there are some programs that are just residency programs that are better than others and helping people adjust to those transitions, but many residency programs unfortunately don't do it in the best way possible. So these are all examples of transitions that people face as they go through medicine, right? So now what's the third point I want to make? The first tool, so now I'm going practical, what are some tools you can use to deal with these transitions? The very first tool in dealing with transitions is perspective. It's perspective is very, very, very important to have a good perspective on life, right? Have a good perspective on residency training, right? The thing is, having the right perspective can make a profound difference in a person's life. You may be surprised that two people, they may face the exact same situation of life, but one person comes out on top, the other person comes out at the bottom just because of the way they process those circumstances, the way they adjusted to those circumstances, right? Because think about it, for example, there are people that, oh, they don't match at their number one choice. So they notice all of a sudden that the residency programs where they really don't want to be, right?

Or the locations where you don't want to be? Or they're in long distance relationships, they were like thinking that, ah, you know what? If I match here, I will, I will be able to be closer to my spouse, but those expectations go on fulfill. The thing is, in the midst of those tough circumstances, I will encourage you to still keep a good perspective, right? The thing is, if your mindset is that, oh, wow, residency will be the death of x, y, z person, right? If, again, I notice I'm not even saying, say me to myself, no, the thing is, I have a very strong belief in the power of your words and the power of your thoughts concerning yourself. So I try my very best to not make careless statements about myself or think careless thoughts about myself, because the thing is, there's a part of the Bible that says as a month thinks in his heart, so he is, right? And even there's a part of the Bible that says that death and life are in the power of the tongue. And people that love it, they'll eat its fruit. So the thing is, perspective, many times, just has to deal with your thoughts concerning yourself. Just has to deal with your words concerning yourself, right? Like, for example, I see on forums and people who use certain terms to refer to themselves while they're in their dedicated periods, they'll put like, FML. Again, I'm not going to see what FML means, but that's not a good thing to say about yourself, right?

You're a human being with a brain that works great, a heart that works great, a GI track that works great. You're a wonderful person, right? Even if all your abuse or people don't like you know, but have some pride in yourself, really sometimes some people need to work on their self-esteem. Have pride in yourself, that you know what? I'm a great person. I'm a good person. Even if I'm in a less than ideal situation, it doesn't change who I am. It doesn't change how wonderful I am. It doesn't change the fact that I can make a difference in a person's life, right? So again, it's very important to have the right perspective, right? Have that perspective that all will be well. Have that perspective that you know what? This tough circumstance I may be going through now is just a stepping stone to my destiny. It's a stepping stone to my destination, right? Have that mindset that you know what this tough circumstance will pass. This too shall pass. That's a very, it's a very profound force forwards, right? This too shall pass. Have that perspective, right? There was this part of the Bible that I've read back in that I've actually read a couple of times, right? About a Shunamaite woman. Literally Hassan had just died. Hassan had literally just died. In fact, if you want more perspective on this, I'll encourage you look at 2nd Kings chapter 4 verse 23. If you're a person that reads the Bible, 2nd Kings 4 verse 23, right? But this woman's son had literally just died.

And what did this woman say? This woman said, the answer, oh, what's going on? She said, oh, will be well, right? In fact, I really love the song that says it is well, it is well with my soul, with my soul, it is well, it is well with my soul, right? Just assuring yourself. The thing is, even if the circumstances around you are not good, tell yourself that everything is good. Thinking your heart that everything is good. Because if you keep having those positive thoughts, speak those positive words, have that positive perspective, you begin to see that almost like a creative force will arise within you. When you start taking steps to work yourself out of that terrible situation, right? So have a good perspective. A good perspective can really, really fuel a person's faith, right? Can really, really fuel a person's faith, right? So again, tell yourself that it's not the circumstances around me that matter. It's my perspective on those circumstances that makes a big difference. Now, what is the fourth point I want to make? The fourth point I want to make is the importance of gaining control of your mind, right? Gain control of your mind. Gain control of your mind. I'm telling you this, if you win the battle of your mind, you can pretty much win any other battle in your life, right? Most times, it's not the external enemies that end up destroying a person. No, is those internal enemies of fears, of doubts, of unbelief that ends up crushing those people, right?

So you see, certain people's spirits are broken, right? The thing is, if a person's spirit has been broken, then it's going to be very hard for them to engage with life on a productive level. So gain control of your mind. Watch your thoughts, right? The thing is, thinking good thoughts is not a passive process. Thinking good thoughts is an active process. You need to decide in your heart. I like the book of Daniel that says, oh, Daniel proposed in his heart, right? You need to settle that battle in your heart first before the life that surrounds you will go well. So I will strongly encourage you watch your thoughts, watch the imputes that you're getting into your life, right? Watch the shows, right? Don't be hanging out with those Debbie Downers, those people that are like, wow, residency is so tough. Oh, residency is going to be the end of XYZ. Oh, residency, I don't think I can survive this. No, if you keep hanging out with those people, then that will be your perspective on life. Even a part of the Bible says, he that walks with the wise will become wives, right? And then the Bible also says evil communication, right? That's interaction with people, corrupts good manners, right? So the thing is, gain control of your mind. Watch what you watch, right? What are you feeding your mind with? The thing is, if you feed your mind with garbage, then your life will be garbage. But if you feed your mind with the good with good stuff, then your life will have good stuff, right?

So gain control of your mind. Don't permit bad conversation. Don't permit bad thoughts, consciously make that decision that you will think good thoughts, that you will pull down those strongholds of negative thoughts and you replace them actively with good thoughts, read whole some material, things that will encourage you, things that will be for your spirit, things that will build your faith. That's very important. Now what's the fifth point that I want to make? The fifth point I want to make is simplification, simplification, simplification. That is one great way to deal with transitions. Simplification. The thing is, when you start a transition, right? It's something new to you. It's not something that you're particularly experienced with. It's something that you're trying to thrive through. It's something that you're trying to overcome. So the thing is, when you get into a new transition, since you're still trying to figure things out, try to limit your other responsibilities. Quite a way, things from your life that are low yield. The thing is, I want you to stop adding too much water to your river. So you can stay afloat. The thing is, when you get into a new transition, it's almost like you're diving into a river. You've not mastered that river yet. But when you keep taking on more and more and more responsibilities, it's almost like you're increasing the depth of that river. If you keep increasing that depth, then you'll sink and you don't want to sink.

So while you're still trying to get your feet under you, limit your responsibilities. Because you see some people, they get into medical school or they are transitioning to third year or they are studying residency. And they want to be the exact same people that they wear before they started those things. It's kind of hard to be able to do that. Because think about it. Say, for example, you join the army. You can't have the same lifestyle you had before you join the army. The army literally will purge you of certain habits of certain just low yield things you do. I mean, not be very profitable for you long term, right? So I will encourage you, simplify your life, simplify your life, whether you like it or not, the transitions, they're busy. So you can't live exactly the way you live before you have fewer commitments, right? So I'm not saying you should not relax. You should relax, right? You should hang out with people, you should have fun. But the thing is, be select, just try to be more high yield. Because the thing is, if you don't overload yourself, then you can have time to rest. You can have time to reset. You can have time to reprogram your mind so that you have the right perspective on life. Now, what is the sixth point I want to make? The sixth point I want to make about dealing with transitions is organization. Organization, organization, organization, right? There is nothing like being organized. There's nothing like being a good planner, right?

There's nothing like having an almost like robotic approach to transitions, right? The thing is, it's very important to have a plan and to structure your day-to-day tasks, right? So that you can get them done in an effective fashion. One of the most effective ways, one of the best ways of dealing with chaos and difficult tasks is standardization. In fact, this is almost like a quality improvement principle, right? The thing is, what do I mean by this? What I mean by this is, pretty much take your most common tasks of life and try to have like an algorithm for it, try to have like a checklist for it, try to have like a protocol for it, right? The thing is, even hospitals have caught on to this, right? Hospitals have caught on to this because they're like, you know what? Wow, there are many ways something can go wrong in the management of a DKA patient. So how about we do this? Why don't we go ahead and create a protocol, create an other set, create an algorithm that is used, whenever we have any DKA patient. So when that chaos comes in, you know how to deal with it. It's not like something that is completely foreign to you, right? So start from your most common tasks and then walk your way to your list common tasks, right? You can take the fear out of many scary things in life if you can reduce that thing to a checklist, right?

Because think about a flying plane, I'm sure it must be like a Gotter engine experience, especially for a new pilot, but that is why they have checklists. You follow the checklists, it's almost like you are plugging and playing, you get good result, you'll get a safe flight at the end of things, right? In fact, in ICU settings, this concept of organization of planning, of standardization is used a lot, right? In fact, I tell you, in my personal life, I use this a lot, right? In my teaching, I use this a lot because you see one, one of the biggest components of students not doing well on exams, it's just a lot of testing and anxiety, a lot of testing in fear, right? So the thing is, if you can suck the emotion out of those processes and make it a standardized process, why it doesn't seem like something nebulous, but it seems like something where you know what, if I just do ABC every single time with every single question, I will get a good result, or I will give myself the best chances of getting a good result. Then many times, that thing almost like cures a person's test taken anxiety, right? So I will encourage you, be standardized, be standardized, because I remember like when I did my first ICU rotation as an intern, it was really scary because it was an ICU where we dealt with many different kinds of patients like surgical patients, cardiac patients, patients that had just really, really bad problems, right? And I saw how overwhelming the work would be. So what did I do?

Literally my first three, four, five days, I came up with checklist for how I write my notes, checklist for how I round, checklist for how I pre-round, checklist for how I, basically like most tasks, most of my common tasks that I knew that I had to do well and do with high fidelity, for extended periods of time, pretty much every day, I created my own checklist for them. And I, you know, I fine-tuned those checklists as time came along. And once I had checklist for everything then I was like, oh, divine, you're gonna be a good master in this ICU, doesn't matter what happens, you have a checklist, just follow your checklist and you'll be good, right? So build a good checklist, right? Look and the way to build a checklist is look at someone that has basically overcome, successfully, right? Successfully overcome what you're about to go through, right? And then take those things they did and break it up into a series of tasks, make it as thorough as possible and use it consistently and you'll get very good results from it, right? I mean, like when I do like my NV Me test-ticking strategies, that's literally what I'm doing with people. I'm just teaching them, organize their approaches to going through questions so that they don't feel like, wow, the NV Me is trying to get me. Oh no, this is gonna go poorly, blah, blah, blah, blah, no, you don't have to be in those situations if you're organized, right? If you're organized.

It's almost like, the thing is whenever you're organized, whenever you make a checklist for things, it's almost like you're making a study guide for your life, you're making a study guide for that task, right? So that's very important. I'm telling you, when you have rules, when you have structure, when you have checklists, it helps a lot. There's this show that I watch a lot, 9911, right? For those of you that are looking for something great to watch that is relatively wholesome, it's actually a pretty good show, the thing is, many times when you see a dysfunctional home, a dysfunctional family, it's a home where there are no rules. Most times, if you want to bother what these man is that come and intervening in this home, these dysfunctional homes, you want to bother what you do to one principle is that they bring in some structure, some rules and some organization. And once you get buying into those rules by every member of the family, including the parents, you see that that family just takes a complete 360 turn for the better. That's why it's very important structure, organizational rules. If there's anything I've said today, it's probably one of the most important principles that I've discussed. Now, the seventh point I want to discuss is it's very important in dealing with transitions to have a wholesome anchor, to have a wholesome anchor, right? The thing is, the fact that I'm saying wholesome anchor, that means there must be on wholesome anchors, right?

You see some people, they are anchored for dealing with transitions is alcoholism, right? Or is the use of drugs and things like that. Again, those things are not very wholesome. Guess what? Because they just mask the problem, they don't deal with the underlying pathophysiology of the problem, right? It's almost like memorizing factors, but you don't understand the factoid behind what you don't understand the thought or the reasoning behind that thing you're memorizing, right? It's very important to find wholesome anchors. Again, and there are many different kinds of wholesome anchors. For me, again, many of you even just knowing the website, Divine Intervention Podcasts, right? You can tell I'm a Christian. For me, my anchor is God, my anchor is my faith, right? I really came to my faith. I try as much as possible to be involved in church, to go to church, to do my personal devotion every day, to read my Bible every day. Because the thing is, it keeps me grounded, it keeps me on solid footing as I navigate many of these transitions of life, right? Really helps you keeping me grounded. Another thing that also helps is just my family. Another thing that helps are my mentors. I have many good mentors, right? So the thing is, don't cut off, like the thing is, when people are going through a transition, they feel like their life is being swayed from one direction to the other.

So the thing is, one of the best ways to not drown or sink whenever you're going through a stormy time is to have an anchor, right? So I'll encourage you, even before you start this transition, define what that anchor is and stick with it, right? Those things will keep you going through the tough times and the tough situations of life. Now, the eighth point I want to make is the importance of keeping calm, even in the midst of chaos. Keeping calm, even in the midst of chaos. The thing is, again, deciding to become is not a passive process. Deciding to become is an active process. Because the thing is, when you go through scary situations of life, if you can tell yourself calm down, literally repeating your mind over and over again, calm down. I have a quiet spirit. I'm going to calm down. Many times you notice that you then begin to see situations for what they really are and then you begin to have constructive, creative responses to those situations, right? Like, for example, I remember again, my ICU experience as an intern is very enlightening here, right? I remember the first time I had to do central lines or I mean, I had intubated in med school, but getting to like, intubate a human being in a trauma situation, in an emergent situation or doing like ACLS, right? Like when I had to again, resource it to that patient and things like that.

These things, when you look at my face, you don't seem like, you don't see like, no, no, no, no, no, no, no, even if my heart may be racing, I'm telling myself in those moments, divine calm down, divine just become the quiet on the inside. Everything will be okay, all will be well. And I noticed whenever I do that, it's almost like that situation slows down to my own speed. I don't feel like I'm trying to catch up with that situation. I feel like that situation is slowing down for me. And once your mind perceives the situation as being slowed down, then your mind begins to get constructive. And you notice that you start doing amazing things. Quickly, even if your mind is in slow to you, right? So it's very, very, very important. That was actually one comment I got from quite a number of people that worked with me as an intern. I worked with as an intern. They were like, divine, your face always just exudes a lot of calm, calm and calmness in these court situations or these terrible situations where everyone is running, like something terrible is happening. Obviously, something terrible is happening, right? But again, I want you to convince yourself that you have control. You have control over that circumstance. You can stand strong in that circumstance. That circumstance will not consume you, right? It's not the circumstance that this is the one that I tell people later, 101. It's not the kind of exam the MBME throws at you that makes the difference.

It's the individual taking that exam that makes the difference, right? So the thing is, if you have that perspective again, it can really, really help you in life. Now, the ninth point I want to make, again, I'm almost done here, is to keep your head down, right? Don't be loud. Again, just tell yourself, these are the things I want to do. This is my checklist. These are the principles I want to follow and just stick with them. Just keep your head down. Don't be loud. You see some people, they want to make waves from the get-go with a transition. No, you don't have to be that person. Why don't you be the person that is a discrete champion, right? The thing is, when you're a champion, people will recognize you. You don't have to be the one two thing your own horn. So that's one thing I will say. Like, many people that get into residency, or that get into like 30-year rotations, they don't keep their head down. They want to be loud. They want to be the populist person. They want to be the loud voice. But the thing is, there's this saying that empty barrels make the most noise, right? Empty barrels make the most noise, right? But people that are full, people that are actually doing great stuff. They don't make noise about it. So I'll encourage you, just keep your head down. You don't have to be involved in every single thing. You don't have to bring in your thoughts and your final word on everything. No, keep your head down. You don't have to control every conversation.

Keep your head down. Now, the final thing I want to say is to seek help in the right places, right? So the thing is, at the end of the day, there are some transitions that are just too overwhelming that people cannot handle on their own. You need help. Find help in those circumstances. And the thing I will encourage you, because many times, don't wait until you get to a crisis situation to have a plan of attack for that crisis. No. Think about it. When people do alcoholics and nonimus, or narcotics and nonimus, or whatever, one of the cornerstones of therapy is that you talk about a crisis situation. And you have a plan in place. You have a sponsor. You have someone that you're like, oh, even if I'm not presently going through a crisis situation, if I were to go into that crisis situation, I know exactly what I need to do, right? So the thing is, before you get into these transitions, have a plan. Oh, if I start feeling like I want to hurt myself, I want to kill myself, or I feel like life is over. This is what I will call. This is what I will do. This is how I will extract myself from this situation. Have those plans in place. The thing is, depending on the transition of, like, you're ready, if you're, for example, like a resident, depending on the transition of your residency program, your residency program, you actually not be the best place to get this kind of help, right?

So if you get really bad, if you get to that really bad point, you're like, oh, man, I'm going to commit suicide. I'm going to end my life. Speak to someone trustworthy, right? Call the nationals to decide hotline. There are people on ground that are able and willing to help you, right? The thing is, if you need to take a leave of absence from work and spend some time with your family, do that. Do that. Again, remember, it is a person that is alive that can practice medicine. Again, the current setup of many things in medical education is to almost like induce mental health crises in healthcare practitioners, right? Remember, there is a lot to life. There's a lot more to life than the practice of medicine. I will tell you that, right? There's a lot more to life than the practice of medicine. Medicine is a calling, but sometimes many people, especially people in authority positions in medicine, right? They use this thing. Oh, medicine is a calling to begin to abuse participants in healthcare, right? So again, remember, keep your priority straight. Everyone has different priorities in their life, but I will tell you this. Do you know what my priorities are? Number one, my number one priority in life is my fifth. That is the number one thing to me. It matters more to me than anything else in my life. Number two is my family. Guess what? These are my top two things. Medicine is no one of it, right? One is my fifth. Two is my family and then the third on that list is my career.

My career does not come over my faith. It does not come over my family, right? So again, it's very important to have the right priorities, whether you like it or not, they're not going to be able to practice medicine forever. At some point, you will stop practicing medicine. You will stop practicing medicine. What is left off after that? You see some people after they stop practicing medicine, then it's almost like their lives are over. No, it shouldn't be so. You should have the right priorities for your life. Again, your mileage may vary with some of these things I'm saying, but I'm just saying things based on my perspective and what I think personally for myself makes the most sense, right? Because many times in the US, it's almost like a badge of honor for you to be worked to the bone, right? The thing is, we're a profession that is supposed to be healing other people. But what we're actually doing is we're pretty much killing our own. Because really, I really hope that at some point, major reforms I'm eating in this country in medical education and medical training. Because we have pretty much come to normalize just being worked to your breaking point, being worked to the bone, right? Because think about it. We have said, oh, you know what? An 80 hour work week is normal. We have normalized an 80 hour work week. But let me tell you this, an 80 hour work week, there is nothing that is normal about an 80 hour work week, right?

The thing is, there are many countries in this world, where the healthcare systems are far better than what obtains in the US, right? Far, far better than what obtains in the US. And guess what? They don't work the physicians don't work 80 hour weeks, right? The physicians may work like, oh, 40, 48 hour, 50 hour weeks, right? Again, some of you may be like, oh, divine, are you trying to promote laziness here? No, I'm not promoting laziness. I promise you, for those of you that listen to my podcasts and stuff, I work really, really hard. I don't lazy about every, no, no, no, no, no, most days I am up by 5 a.m. and I go to bed relatively late at night. So I work pretty hard. I will tell you that. I work really, really hard, right? But the thing is again, there is just more to life than the practice of medicine. So I will just tell you this, prioritize yourself and your mental wellbeing, right? The thing is, the Bible says, love your neighbor as you love yourself. The Bible did not say, love your neighbor more than you love yourself. So it's very, very important. Again, this is a topic that I'm extremely passionate about because I know that this is something that really, really, really affects many people in healthcare, more people than I will into admits to it. So hopefully you found this podcast to be helpful and I will encourage you again, if you're going through these transitions, have a plan, take the right steps and all will be well with you.

So as I do at the end of every podcast, I do offer one or one tutoring for many exams. Step one, step two, CK, step three, pre-clinical med school exams, 30-ish off exams. And then I also help with ER As applications. Again, I've worked with many people that have applied to many competitive residency programs that are now currently residents. If I've some people I've worked with, actually either graduating or have graduated from from residency. And then I also have this website, divininterventionpodcast.com. If you go there and subscribe, you'll get an email notification whenever I make a new podcast. And then I also have these podcasts on Apple podcasts, on Google podcasts, on Spotify. At least the most recent 150 episodes. If you want everything from episode one, then you want to make sure you go on the website. You always find those things there. Basically, it's a Word Press role. I can really put more than the most recent 150 podcasts on these podcast apps that exist. And then I also have a You Tube channel, Divine Intervention, USMLE podcast and videos. It's basically a channel where I put all the videos that I make. I can please subscribe to that every little bit of support. Definitely helps. And then I also have this website, divininterventionlifelessens.com. In fact, because I've got, I've got in tons and tons and tons of emails from people that have listened to many of my life lessons. And many people have said, oh wow, divine, I found this to be really helpful.

It has helped me a ton. So I started a podcast. I call it Divine Intervention Life Lessons. I believe right now I have like maybe eight podcasts or there about eight or nine. I make a couple every week. And I'm going to start being more aggressive on making those. You know, it's just really short podcasts about like less than 10 minutes long for each podcast, like Bible-based teaching that just kind of talks about a life lesson that applies to like a common situation of life that many people encounter, that many, many people experience. In fact, I actually have it on an Apple podcast. It's called Divine Intervention Life Lessons. So thank you for listening to me. I will see you in the next podcast. God bless you. Have a wonderful day. Thank you.

A high-risk period of change that can be very distressing, especially in medicine.

Going from college to med school; taking USMLE exams (Step 1, Step 2); transitioning into residency rotations.

Suicide.

Your internal perspective on those circumstances.

Faith (or spiritual belief), Family, and then Career.

Developing a detailed plan of attack or "plan in place" for potential future crises.

To reduce anxiety and remove emotion from processes by creating predictable, repeatable protocols (checklists).

A stable source (e.g., faith, family, mentors) that keeps one grounded and on solid footing during turbulent transitions.

Thriving requires actively adjusting behaviors and maintaining a positive perspective, rather than just surviving or managing symptoms.

It is an active process; one must consciously watch inputs (media/people) and replace negative thoughts with good ones.

To limit non-essential, low-yield responsibilities to conserve energy and prevent being overwhelmed.

You must prioritize yourself and your mental wellbeing; medicine is not the only defining aspect of who you are.

To reduce anxiety and remove emotion from processes by creating predictable, repeatable protocols (checklists).

A stable source (e.g., faith, family, mentors) that keeps one grounded and on solid footing during turbulent transitions.

Thriving requires actively adjusting behaviors and maintaining a positive perspective, rather than just surviving or managing symptoms.

It is an active process; one must consciously watch inputs (media/people) and replace negative thoughts with good ones.

To limit non-essential, low-yield responsibilities to conserve energy and prevent being overwhelmed.

You must prioritize yourself and your mental wellbeing; medicine is not the only defining aspect of who you are.