Selection of a niche within a specialty is a complex issue on which to generalize, but most training programs, through mentors who play key roles in this regard, deal effectively with this aspect of career development. I intend to focus on the steps that fellows and residents must take to minimize the long-term risk of professional dissatisfaction and burnout, while maximizing contentment. Taking the lead from a prominent late night television host, I offer my list of the 10 best strategies for finding and retaining satisfaction and fulfillment in a career as a medical specialist. These suggestions, which were made to Canadian fellows in Gastroenterology at a recent national meeting, probably apply to most specialty trainees.
Work hard to develop strong consultant skills; they differ significantly from those required of a fellow or resident. If you have not already done so, begin now to think and act as if the “buck” stops with you. As a consultant you will be expected to provide clear, decisive advice on diagnostic and management strategies. It is not just about good case presentations at rounds. Also, for your sake, the patient’s sake and the referring doctor’s sake, it is very important to communicate well with the referring doctor and with the patient. The sooner that you apply these principles to your clinical training, and they do need to be learned, the better a consultant you will become.