The future of rheumatology: Searching for joy
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This month’s roundtable features a group of budding rheumatologists, still in training, who share their thoughts on how to sort out, define and achieve their goals in the workplace.
I am very pleased to hear that these young professionals are generally espousing many of the things that I have long believed in, and still tell those who seek my counsel, regarding career planning.
First and foremost — for those who want my opinion — a truly successful career will not only support you materially, but more importantly bring joy to your life. Achieving joy in the workplace is, over the long run, worth much, much more than material wealth. So, as an addendum to their comments, I will briefly share my own top line recommendations on how to find joy in our chosen profession, because when work is accompanied by joy it is no longer work.
But first, please do not take my comments this month as evidence that I am unaware of or unconcerned about the threats of burnout and the loss of autonomy in our subspecialty. Rheumatology, like virtually all other specialties, is indeed under pressure. In fact, in a few months, I will be the first speaker in a plenary session at ACR Convergence 2024 on burnout, so I am clearly concerned and aware. For the moment, however, I want to specifically share my views on how a young rheumatologist might optimize their chances of remaining happy over an entire career. Yes, a career in medicine is not always a smooth superhighway but rather a road with ups and downs, as well as potholes and detours. These are a few of my personal pearls on how to forge and maintain a fulfilling career.
First off is choosing the right job. When looking for their first job, I tell my juniors to not only weigh salary, benefits and hours, but also — when they interview — to carefully examen the group and appraise just how happy their prospective new colleagues appear to be. Are they collegial? Do they have their colleagues’ backs? Do they enjoy each other’s company? This search for joy in a work environment is often ignored yet vitally important.
Secondly, for those not fresh out of training but perhaps in the early stages of their career, I counsel to continuously reinvent oneself over a lifetime in medicine. My career was enriched the most by my early experience in HIV care and research, by which I will be forever moved. I still feel great privilege and take great joy from my ongoing care of a much smaller population many decades latter.
Despite this, I was thrilled to pivot and immerse myself in the excitement surrounding the dawn of targeted therapy, and combine my strong interest and experience in infectious diseases toward the study of safety regarding these new agents, which grows more interesting by the year. Moving on to vasculitis and working with such a great group at the Cleveland Clinic was incredibly supercharging and remains so. Most recently, COVID-19 and long COVID are actively fueling my fire, and I am still looking for new challenges. New ideas and challenges can help keep you, as Bob Dylan says, “Forever young.” Please work on it.
Third, as counseled by Atul Gawande, MD, MPH, in his brilliant book, Better: A Surgeon’s Notes on Performance, try to be positive and try not to needlessly complain about the downsides of a life in medicine. Please, before you express any outrage that I am merely suggesting one wear rose-colored glasses and ignore injustice, I am certainly not. In cases of injustice, we must always speak up and act, but that is not what I am referring to. In a world with great suffering, physicians objectively have positions of significant privilege, and needless negativism, which is often fueled in group feeding frenzies, is a drag against achieving joy. In such situations, consider taking a deep breath and a step back.
Finally, as counseled by Stephen Bergman, MD, DPhil, under the pen name Samuel Shem, find a colleague or a small group with whom you can trust, and share your experience and feelings — and stick together. There have been analyses of why the other half of physicians are not burned out, and one of their common features is having trusted colleagues to talk to and share experiences, good and bad, in a safe and confidential manner. I truly believe in this and have a small handful of such people whom I trust and treasure.
I am sure some will read these comments and dismiss them as being overly aspirational and unrealistic, but I have been doing this stuff for a long time, and work is still not work to me.
This is my take, and I would love to hear yours. Please share your thoughts with me at calabrl@ccf.org or at rheumatology@healio.com.
- For more information:
- Leonard H. Calabrese, DO, is the Chief Medical Editor, Healio Rheumatology, and Professor of Medicine, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, and RJ Fasenmyer Chair of Clinical Immunology at the Cleveland Clinic.
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