Find Your Niche

“You must define yourself as a hospitalist.” I smiled uncomfortably at my colleagues across the table as I pondered how best to respond to this statement. This seemingly innocuous comment had me perplexed, despite the fact that I aced the “What I want to be when I grow up” question as a fifth-grader. What had changed in all these years?

It was my first job as a hospitalist. I was two months out of residency and had accepted a position at the large academic hospital where I’d spent the previous three years of my life. The comfort was alluring and the transition appeared mundane. However, I naively did not realize that the difference between residency and the launch of a professional career was far greater than a miraculous transformation of paychecks.

Don’t get me wrong—throughout residency, I knew that I had a wealth of untapped energy and ideas; I was just too exhausted from patient-care duties to put action and plans into place. But as I vaulted into my career, I realized I now had the opportunity to act on these ideas and transcend the physician-in-training stereotype.

And so here I was, sitting with colleagues, attempting to define what would occupy the nonclinical portion of my upcoming career.

You might be wondering, “Isn’t great patient care enough for me as a hospitalist?” Indeed, in residency, we are praised, ranked, and valued almost solely on clinical acuity. As a hospitalist, however, we have the unique opportunity of defining ourselves in ways beyond bedside skills. While we are all astute clinicians, an important secret was kept from you during residency: You can choose another hat to wear and—unlike during your training years—you will have the time to do so.

Not buying it? It’s true. Simply pause and reflect on the hospitalists or general internal-medicine physicians you once admired; odds are they weren’t just clinicians, but they were also clinician-educators, clinician-researchers, clinician-administrators, clinician-fill-in-the-blank. In essence, they found a niche, a path that defined their careers.

And now, it’s time you did the same. But how, you ask? Here are a few pointers to get you started:

No. 1: Take Your Time

Before you go off trying to find your claim to fame, keep in mind that the first few years out of residency are a time of transition. Simply put, taking on too much, too early, could capsize your vessel. Learning to become an attending comes with a myriad of diverse responsibilities and a slow march to confidence in your clinical skills. This is a full-time position and one that requires diligence, both to ensure that you gain a strong clinical footing and fully understand the dimensions and nuances of potential “niches.” Get secure in your new role before beginning the search for your new calling. Once you feel comfortable with the resident-to-attending transition, you might find yourself itching to take on that new role in the hospital.

No. 2: Identify Your Passion

My mentor in residency was Dr. M, an all-star attending who had the energy to inspire by building an effortless bridge over the intern-resident-attending communication gap. As I studied her actions during my intern year, I found myself asking, “Could I ever be that successful in my career?”

As we shared experiences, I realized Dr. M genuinely was happy and passionate about her job every day. Her ability to effectively communicate to residents, nurses, and patients was a simple segue to her niche. So what is her niche? Dr. M is a clinician-communicator. Whether it is blogging about a recent patient experience on the wards or appearing as a physician correspondent for an Atlanta news affiliate, Dr. M’s strength is effective communication. Despite being a great clinician, it was her drive outside the wards that helped me understand she had found, and was living, her passion.