7 things I wish I had known when starting my neuro-oncology journey.
By Frances Chow, MD
Neuro-oncologist, USC Brain Tumor Center
Keck Medicine of USC
Many of us go into medicine because it’s a constant learning process. We know we’re always going to be developing new science and treatment approaches.
One of the reasons why I chose neuro-oncology as a specialty is that, even though we know so much about the human brain and brain tumors, there’s still so much more to learn.
In the course of my career, I have learned several lessons from my clinical and research experiences, which may benefit younger physicians, residents and medical students currently beginning their journey into medicine.
- Embrace learning as your core philosophy.
Looking back, medical school was such a wonderful time. I wish I could tell myself back then to enjoy all that learning. It seemed like never-ending knowledge and exams at the time, but every day, I do go back and use that foundation.
That body of knowledge is what sets us apart and manifests daily as the ability to explain to patients the pathophysiology of their disease; the insight to understand our therapies, side effects and potential interactions; and the ability to push the envelope to develop new treatments.
- Every phase of training is a growth process.
As you finish residency, you are on the brink of independently practicing medicine. It can be daunting to think that you will be making all of the medical decisions without someone overseeing your work.
There will be a learning curve, but with a strong foundation and a fire to continuously learn, things are going to get much better from here.
- Success does not come easily.
In terms of grants, or research, it can take several applications and rejections before arriving at an award. So do not be disheartened if you have a setback. Instead, learn from each challenge and equip yourself for the next one.
- Age is not necessarily an indicator of wisdom.
I have seen the best and brightest ideas coming from early-career faculty. Do not be afraid to speak up, because you have something special to offer. Continue learning, continue thinking and continue making your footprint on medicine.
- It takes a team to treat patients.
Develop collaborations by being friendly and speaking to colleagues in your department, at your institution and beyond. Conferences are an excellent way to develop collaborations with others in your field. Fields are small — you will see and work with these people again.
I’m very fortunate that, at an academic center like Keck Medicine of USC, I am every day working alongside other great scientists, physicians and leaders in our field. It inspires me to keep moving forward and to keep learning, because collaborating with them really allows us to strike into the future.
- When it comes to self-care, doctors can make the worst patients.
Our training instills in us the principle to always put the patient first and to push through challenges. When we are with patients, it’s right to put them first, but we are not shown how to turn that mindset off in the rest of our lives. We continue to push through challenges, like when a co-resident asks how we are doing — we show strength and instinctively respond, “I’m okay.”
These qualities that helped us succeed in medical school and residency can lead to burnout in the long run — the cardinal signs of which are exhaustion, depersonalization and lack of efficacy. Psychologist Christina Maslach defined burnout as “an erosion of the soul caused by a deterioration of one’s values, dignity, spirit and will.”
My mentors have taught me that we have to take care of ourselves in order to properly take care of others. It’s a daily task to consciously rebuild the erosion of burnout — to shift my mindset and help improve the culture of medicine.
- Remain inspired by your initial spark.
The last couple years of medical school and residency are tough training, and it’s easy to lose sight of why we went into medicine. Having spent a few years as early-career faculty, now I feel that I am able to make the differences that inspired me to go into medicine in the first place: I can see patients, I can do research and I can offer them therapies that we’re developing in the lab.
I would urge you to remember the essay that you wrote to apply to medical school, stating why you wanted to be a doctor. Hold on to that, because on those darkest days, when you’re exhausted, you can remember your bright voice, and that will lead you through.
Frances Chow, MD, is a neuro-oncologist for the USC Brain Tumor Center, part of Keck Medicine of USC. In addition to treating patients, Chow conducts translational research to develop clinical trials featuring novel treatments, with a particular interest in immunotherapy and its effects on cancer and the body.
The USC Brain Tumor Center offers comprehensive care for adults and children with all types of brain tumors. Our multidisciplinary team focuses exclusively on brain tumors, and we have deep experience from treating a very high number of complex brain tumor cases.