I choke down my overdone cafeteria cheeseburger, bite by bite, hoping some extra ketchup will make it go down. I passed over everything else, nothing looking or sounding good to my weary soul as I haunted the cafeteria before close. Not even the fryer can save me tonight. It’s time for a final embolization of the night, a hemorrhage that needs me. Or at least, needs me to try. I need to just take the next best step, again and again, as I always have.

Depressed? Take the next best step

As I’m normally a good eater, this signals that something is wrong. Depression is likely. Somewhere between depression and rage is where I live, the last 15 months having descended into a hellish battle for everything I’ve worked for. I’m being taken advantage of in every way possible, and it’s legal. 

Altruism kills, or maybe it could. It’s killing me. Like arsenic, it’s all around us, and okay in small doses. But not the amount I employed. Some people take, and some people give. It’s just the way things are. 

In times like these I plod, one foot in front of the other. There will be times like these, in which you have to simply look at the options in front of you, and choose the best one. It’s like those multiple-choice tests you’ve groomed yourself for, in the process of becoming a doctor. 

Overwhelmed? Take the next best step

So my morning of making the next best choice looks like: inserting a tunneled catheter, a few ultrasound-guided procedures, and filling out locum proctoring forms. Saying hi to my colleague, and running to medical staff headquarters. Grabbing extra water and tea for my office, and seeing a consult. Every time I regroup in my office, I decide on my next best step. I prioritize. I’m running out of time to review committee documents before noon, but left my cell phone in the car. I run to the garage to retrieve it, so I can retrieve a pin to access a quick 45 pages of peer review notes. It’s a juggle well known to anyone who runs in circles for a living. 

This works at work and in life

It’s a parallelism in IR and in life. In the moment, there are tasks and options in front of you, and you make the next best choice you can. I repeat that throughout my day, and in my life as an image-guided specialist. This “just make the next best move” mentality keeps me from getting overwhelmed, as the phone rings, and case requests pile up on the desk. I complete administrative tasks in a time frame balanced between avoiding complaints and letting them take over completely. 

And in my personal life, I feel the landscape shifting and wobbling forward, jolting me, and keeping me up at night. 

My little boy wakes me at midnight, having spun around in the bed. He’s lost, upside down and backward and I huff, tucking him back in beside me. It’s not his fault I’m battling my own personal bogeyman. He drifts quickly back to sleep, his rhythmic breathing a comforting, grounding sound beside me. He’s so beautiful. We are here together, and in this stressful moment, that’s what matters. 

Do you want to squeeze all you can out of life? I do. That’s why my motto is “save lives, enjoy your own.” As a physician, I spend a lot of time serving, and I want to live well too. To me, that’s the balance. I want to live with purpose, to contribute to something greater than myself. At the same time, I’m not living for others, and I want to experience all the best life has to offer. That’s why when I heard of the idea of writing down 50 aspirations during a leadership seminar, I absolutely loved it. What better way to brainstorm all your biggest dreams? Writing them down makes them one step closer to becoming a reality. So here’s my list, and I dare you to create one of your own. Don’t hold back as you come up with 50 aspirations for your life! 

The prompt: what does it mean to have 50 aspirations?

If money were no object, and if you were to eliminate limitations of any kind, what 50 things you would like to do, try, accomplish, or experience in your life?

Experience

Live in Spain

Visit Italy and eat everything

Stay in a magical Italian villa

See Argentina

Soak in Japan, culture shock and all

Take a camper van around New Zealand

Have another baby

See the Galapagos islands

Spend a month on a houseboat in Seattle

See Alaska: the mountains of ice, the wildlife, what the cities are like 

Snowboard with my son

Snowboard at Whistler

Experience the Kayakapi Premium Caves in Turkey

Swim with whale sharks

Lope around the West including Glacier NP in an RV or van

Accomplish

Publish a memoir

Speak to over 500 people on a stage

Become a multimillionaire

Get 10,000 pageviews a month on my website

Inspire 1000 women surgeons

Get paid $5k to speak 

Get paid $10k to speak

Write a children’s book about women in male-dominated fields of medicine

Acquire a new income property every couple of years to create a nice portfolio

Own valuable land or a mountain as a potential future homestead or to flip

Indulge

Get a teak cabin in the jungle in Thailand with a personal chef to feed my fam

Rent a big ski cabin with friends

Rent a lake house in Idaho or WA

Enjoy a trip to Hawaii again

Be comfortable in my skin

Become more and more myself

Fly first class

Have someone buy me a first-class ticket to speak or contribute

Laugh every day

Curate a fantastic loungewear wardrobe

Try a personal stylist

Value & treat myself like a pampered pet

Health aspirations

Eschew sugar

Get help optimizing my diet

Maintain my skin/ age well

Maintain a steady weight

Experience every kind of love 

Master the art of setting boundaries

Spend as much time on a catamaran as I damn well please

Trust myself implicitly

Develop my intuition and connection with myself through reading, learning, & exploring

Even as you assemble 50 aspirations, recognize how great your life is now.

As I sit in my hot tub typing this on a sunny California afternoon, I’m already living the dream. Even as I go through a massive personal transition, my life is perfect in so many ways. I recently engaged a life coach to help ease the transition. She’d challenge me, asking, “What is perfect about your life right now?” I love this question because it turns on all kinds of light bulbs for me! Try it out for yourself.

1. My job is secure
2. I have options
3. My friends are beautiful, interesting, and big hearted
4. Life is full of joy
5. I ran today (and I’m grateful that I’m able to run…)
6. I live by these incredible mountains
7. There are Japanese orchids blooming in the trees
8. My family cares about me
9. My little boy is healthy
10. I have free time
11. I can create
12. There’s more to explore

I think you get the idea. 

I hope this inspires you to get out a pen and paper yourself– or at least the notes app on your phone!

I’m sending encouragement your way. As you march through life in a male-dominated field, don’t forget to dream. 

Want to thrive in a male-dominated field? Jump on my mailing list for blog updates and periodic inspiration from a fellow tired superheroine (that’s me).

It can be a roller coaster, folks. This life of putting your hands, needles, and scalpels on people. A week in the life of a superheroine can be trying.

One week I am lauded for saving a life, and the next week, I can deeply disappoint patients and colleagues. That’s the way it is.  

A week in the life of a superheroine won’t destroy you… or will it

I just need a mantra at these moments: “I can’t destroy my reputation with one procedure.” 

That’s my hope, at least. 

No pressure, right? 

Of course, there is pressure. It’s peoples’ lives and limbs at stake here. 

Superheroines fall

So I messed up at work. Like I really made a really stupid, thoughtless mistake. I haven’t made this exact error ever before, and I haven’t made a comparable error in years. But when you do a thousand procedures, you might make a dumb mistake in there somewhere. It sucks, but it’s true. 

This error is something I did, and I did it alone. I confirmed the plan with the nurse in the room, and then 5 minutes later proceeded to do the procedure on the wrong side, and my assistant let me. It’s not his fault, he lacks experience, and probably couldn’t even see where I entered the skin, with the fluoroscope blocking his view.

I didn’t recognize my error until hours later, as I went to dictate the case. Right. I worked on the right side. The pain was on the left. My face flushed, and my head slumped into my hands. Fuck fuck fuck fuck fuck. No no no no no. Not on this patient. She had already been through enough. Why would I do this, when I should have been paying attention? Everyone matters and is theoretically equal, but if anything, I should have been hypervigilant in this case. This patient trusted me implicitly, and I let her down.  

Shame permeates a week in the life of a superheroine

I felt nearly incapacitated with shame for the rest of the day. I notified the department manager, who entered an incident report. Will they take my license over this? I don’t think so…

As often comforts me in these cases where the outcome is short of what I’d hoped, I tell myself, if no one died it’s going to be okay. The thing is, I told the patient there were serious risks, and then I proceeded to work on the wrong side as if I didn’t take it seriously enough. I stated the gravity of the rare (but real) risk and then disregarded it with my actions. 

I spent the afternoon trying not to hate myself for making a mistake. Trying not to blame anyone else, because that’s my go-to move when I feel vulnerable or hurt, is to blame. It is certainly not a tendency I’m proud of, and it’s one I’m actively working on. Blaming fills some kind of need in the moment, in a maladaptive way. 

No matter how you’re feeling, the day keeps moving on

I felt horrible making a mistake. Later that night, I was called in emergently to care for someone who was bleeding to death. I selected the bleeding vessel instantly as if driven by some sort of dumb luck. Incredible fortune, I thought. I was lauded by the vascular surgeon who came in for an update, just as I’d finished. I did my show-and-tell, pointing to my angio and embolization on the screen, as he admired my work.

“Great job,” he boomed. “You saved a life!”

I muttered, “After the day I’ve had, I guess I had an easy select coming to me…”

My new colleague and I exchanged phone numbers and parted ways. The patient was coming off blood pressure support. A victory, but in the shadow of my mistake. 

Putting one foot in front of the other

The next day, the victim of my error returned for her procedure: for another chance to get it right. She was gracious and listened to my apology. The case went well. I think it will help her. 

I returned to the ICU and the person I ‘saved’ the previous night is now on four vasopressors. She stopped bleeding but her heart couldn’t take the insult. Does this feel like whack-a-mole to anyone else? 

And riding the emotions of a week in the life of a superheroine can feel like being on a roller coaster. I’m not going to lie. In one way you’re up, in another way you’re down. It balances… sort of. If you’re a good doctor, you care… and people are sick. Outcomes can be good, bad, and everything in between. 

A rollercoaster of a week

And this is to say nothing of those who greet you at home, from your fur babies to your partners and children. They add other (mostly) wonderful variables to your life: they can make the roller coaster ride sharply turn left or right, as it coasts wildly up and down. 

Back at work, you can be a savior, a dunce, and everything in between. But this is the life we chose- a life of one challenge after the next.

“Why not?” we probably thought at some point. We are talented and bright, and we can do so much good. It’s just that in these moments– and in these tough weeks– the challenges overwhelm. The shame stings. We try to help people as doctors, and we’re not perfect, no matter how hard we try, or how much we wish we were.

I’m just being transparent. This is not a boring, stable life. Not for me, not this week. This is a week in the life of a superheroine.

If you are feeling some similar way, I’m sending my solidarity and hugs to you, superheroine. 

Motherhood as a female physician has been an incredible journey so far, overall. It’s gratifying, joyful, and exhausting. It’s a rolicking sort of balance. I love it. But I’ve noticed that working moms get a lot of subversive messages that can make us wonder if we’re doing a good job or not. There’s a lot of talk about overwhelm and mom guilt in the media. It’s true, I work more than 40 hours per week as a surgical subspecialist. And I’ve felt “cheered on” at times as a working mom. But many times, I have felt pressured to be as close to a stay-at-home mom in my free time as I can, and that’s a recipe for burnout. I’m here to tell you that if you choose this life– the life of a doctor mom (or dad), you will need to decide how you feel about it, ideally without the interference of others. You can’t let those societal messages hijack your brainwaves. It’s way too easy to let others’ opinions steal your joy, and you don’t have to let that happen. I’ve decided to reject parts of the societal narrative on mothering in order to create my own definition. And I’m a great freaking mom. Here’s my perspective on how my being a doctor really affects my kid. 

He’s learning about a profession centered around helping others.

As my kid transitioned from diapers to the potty, and words to sentences, I wondered when he’d come to know what I did for work. He’s four, and I thought this revelation might come later, at 5 or 6, as he gained some awareness of different occupations in the world. But it happened earlier, when I introduced the book, “Is Mommy a Doctor or Superhero?” by Dr. Amy Faith Ho, an emergency physician. It has really helped him get him acquainted with the idea of having a doctor mom. This book explains why mommy sometimes has to leave late at night to go to the hospital, something he’d started to notice happening. Sometimes his dad has needed to take over for bedtime, as I’d head out to embolize a bleeding organ. Wes was fascinated by the scenes in the book, and excitedly asked to read it again and again. 

It warmed my heart to see relatable scenes in the book, like mom getting patient related calls at the playground. The book illustrates nurses and patients on the other end of the phone. This helps explain the doctor-mom life so well, in simple terms that kids can understand. 

One of Wes’ favorite parts of the book is when the little girl can tell if her mom had a good day or a bad day. There have been times I came home and cried after a hard day. Through seeing my emotion, and with the help of our reading, Wes is able to cultivate an understanding of his own emotions, and hopefully, empathy. 

Our social circle really affects my kid. 

Being a physician exposes my kid to a network of amazing people he might not otherwise know. One of them is his pediatrician, who is a friend we get to see on a regular basis. She is part of a special group of kind, brilliant, and understanding moms, all of whom are physicians or married to one. Were it not for my line of work, I might not have assembled such a group of friends. We were brought together by the common lifestyle of the physician/ professional mom. 

It’s true that my current position occupies more hours of the week than I’d like right now. I plan to tweak that in the future, especially as Wes needs me more. But for now, I don’t dwell on the hours we are apart. I can see countless benefits of his spending time with the various people in his life. They are his whole village, and he’s learning more from all of them than he could from me alone. We have our own special bond as mother and son, and that bond doesn’t require a certain number of hours to maintain it. Nightly bath time, bedtime, and so many other times are ours. Consistent quality time and an amazing community really affect my kid. 

I provide, and that affects my kid

As the breadwinner in the house, my work not only helps others, it helps us too. My kid has a roof over his head, and chicken nuggets in his belly. Because of my toils, my son will grow up with a level of privilege experienced by about 1% of kids in the world. Is that a good thing? I think so. We have a lot to teach him about the responsibility that comes with that privilege, and we will have the resources to put toward the effort as well. This will have a massive effect on my child as he grows and enters the world as an adult. 

One day, I hope he’ll be proud as the son of a doctor

I was inspired by this tweet from a fellow interventional radiologist, proclaiming his love for tumor ablation, and his pride in sharing his win with his teenage son. I can imagine such an exchange with my little boy in the future.

Cryoablation of renal cell carcinoma. Nearly always curative, this is one of my favorite #irad procedures.

These patients are thankful their urologist referred them to my clinic.

Telling my kids I cured a person’s cancer today? Priceless. @AmerUrological @SIRspecialists pic.twitter.com/1OxM7VeeN7

— Peder E. Horner, MD Interventional Physician (@IR_Doctor) November 9, 2021

My little sprite doesn’t yet know what cancer is. But I look forward to the day when I can tell him I killed someone’s cancer. Doctoring is worthwhile work, and seeing us live this way benefits our kids and their development. So if you have kid(s), or would like to someday, don’t let a medical career stop you.

You may not be room mom, or make cupcakes from scratch– or maybe you will, if you choose to prioritize those things. Through your actions, you will model one of the many ways in which to live with purpose and meaning.

Loving your kid(s) doesn’t have to conform to a schedule. You can love them in a thousand of ways, and it’s okay if some of the traditional moves don’t fit into your doctor-mom schedule. There are so many ways to love my son, I know I’ll be doing them for the rest of my life. 

So I ask you to consider this: what if it’s not just mom guilt, heaviness, and sacrifice, the way it can be painted sometimes? What if what we do during the day inspires our kids? No matter the path they take, our example will stick with them for years, maybe through their entire lives. My being a doctor really affects my kid, but not in the way some would assume.

When I stop to think about it, what more could I want for him?

As an interventional radiologist at a trauma center, I also happen to be a human and a mom. You might wonder, how do I balance the sometimes demanding, unpredictable schedule of emergency call with the rest of my life? Well, I take a week off nearly every month, for a total of 10 weeks per year. That might sound like a lot, when you’re used to 3 or 4 weeks off per year as a trainee! So what does a momma doc actually do with all this time off? Here the top 10 things you’ll find me doing in my spare time. 

Extended a.m. routine

1. I’ll extend my morning routine. This might involve sleeping an extra few minutes, but I don’t sleep in like I used to pre-child. I get my little man ready and off to pre-school by 8:30. We have some time for coffee, breakfast, and potty. This gives my husband a break, since he does toddler mornings when I’m working. 

Self-care for a momma doc

2. On a week off, I’ll head to some appointments. Whether I need a skin check at the derm, new tires, or a sit-down with my accountant, it’s all part of self-care as a mom who also works outside the home! And every week off is an opportunity to see my therapist, who helps me with relationships and stress management.

3. Eat healthy food. I fast until 11, then fill up on some eggs and avocado toast. If I crave something sweet or feel like a bottomless pit, I might make a protein shake from Body Love. 

Strategy for the momma doc

4. Whether I’m working or not, I blog. When I’m off, I have more time to brainstorm upcoming topics to share here. I’ll also write drafts, edit, format, and publish posts. I used to plunk down at a coffee shop for a few hours at a time to do this, but I’ve gotten more efficient with practice. 

5. Manage the finances. I look at all our accounts, and make sure the money is going where it’s supposed to. How is my 401k balance doing? Do I need to reinvest some dividends? How’s our progress toward savings goals? Or do I have excess cash lying around, looking for a job?

Family matters

6. Most days, I aim to get outside with my little dude, who is three. Whether we head to the park after school, or visit our equine friends at the local stables, we make it a point to get out for some desert sunshine. 

7. Hang out as a family. This can involve a trip to the local air museum, bubbles in the backyard, or recording the latest musical sensation in our little studio. 

Sharing the message of the empowered doc

8. In the evening, I’ll sign and send some copies of Save Lives, Enjoy Your Own. I love my label printer, which reminds me of my play cash register as a kid. Any chance I can feel like I’m playing is a win!

9. Strategize how to reach more people with my book and its message. This involves researching people of influence like medical school Deans and podcast producers, so I can introduce myself.  

Mind the timeline

10. Though most weeks during the pandemic involve staying home, my list had to include checking off a bucket list item. A recent example: I’d been dreaming of seeing Grand Teton National Park for a decade. So I convinced my husband to get on board, and we piled in for our first socially-distanced RV adventure, traveling from Palm Springs, California to Jackson, Wyoming.

Was it worth the drive? Heck yeah, it was! I relished the change of scenery in a whole new way I don’t think I could have pre-COVID.

Medical training teaches you to put your nose down and work for long-term gains and delayed rewards. But after training comes the rest of your life, and it’s finite. So don’t forget to assemble your own Grand To-Do List, and start checking things off!

What’s on your bucket list? 

What are you most likely to do on a week off, once the laundry is done, and you’ve called your mom?

Tell me in the comments below!

I’ve been so busy promoting my book, my head is spinning! In the midst of planning the launch of Save Lives, Enjoy Your Own, I was asked to join the 5th Annual Northeast Vascular & Interventional Radiology (VIR) Symposium at my home institution of Brown. So despite the book launch, I was excited to take part in the symposium. It was an honor to join other outstanding women in my field at the event, which happened on September 27th. The questions from the Northeast VIR Symposium were so good, I thought I’d share them here on the blog.

Tell us about yourself & your path to VIR

• I’m a private practice IR in Southern California
• Now 6 years out of training
• I’m Chief of my IR section
• I’m a wife and a mom to a little cherub
• In the last couple years I’ve become a blogger and author!
• My path to IR was via diagnostic radiology. I did residency at Brown and IR fellowship at UCLA. 

What other fields/specialties did you consider going into and why?

• Family med- because of the breadth of practice, which is similar to radiology. You need to know about a lot of different things, and that keeps it interesting. I envisioned a role in primary care in which I’d do procedures– which is more common in the western part of the country. 

How did you go about seeking mentors during your training? What does mentorship mean to you as a woman in IR?

• I found the process intimidating. 
• Ultimately, the process of finding my mentors was somewhat organic. My 1st mentor was a woman in radiology who lectured us in med school. After her talk, I went up to her and made contact.
• Later: it happened organically. Some people are more supportive than others. But I learned from all! 

What do you think are some of the misconceptions that may deter students from pursuing IR? How can we change that?

• The idea that it’s not for women
• That it’s not for women who want to have kids
• That it’s so competitive that you have to be from an elite physician family
• The idea that radiation is bad for women
• How to change it? By being an example of what is possible
• Showing the positive aspects of the field for women
• Correcting misinformation regarding radiation and specifically, radiation in pregnancy

How have you been able to balance your career in IR with other interests/non-medical pursuits?

• I strongly believe everyone has a choice in how they spend their time. Everyone has free time if they care to find or make it. Once you find time, you can harness it with passion and focus. That has allowed me to write my blog between patients, or to apply for a leadership position as I’m waiting for a trauma patient to be prepped. I used to fritter these moments away, but I’ve found satisfaction in using them more intentionally.

Can you speak to your time in leadership roles and give advice on making leadership a part of your career?

• I like to talk about the messiness of learning to lead, because we all think of leaders as exemplary specimens of perfection. In order to learn to lead, you need to embrace the messy imperfection of leadership in medicine
• I talk about my own experience and lessons specifically in the context of early career leadership in a private practice environment. 
• Beyond local leadership, there are countless opportunities to learn to lead in our societies. These can be great places to find leadership opportunities. 

Have you had a particular challenge which you had to overcome on your path to IR that has left you with a lesson you could pass on to students or trainees?

• Learning to listen to myself as I entered an elite hierarchical world where everyone knew more than me. I needed to learn I still had a valid guiding voice inside. 
• Learning to nix the naysayers. It’s a skill to parce through advice which may be tinged with baggage or bias. Sometimes you need to discard the advice if it doesn’t suit you or your situation. 

Can you talk about any experiences you have had with imposter syndrome in medicine? What strategies have you used to overcome these experiences?

• When you enter IR, it’s so foreign. Some students and trainees act like they may understand everything that’s happening, even if they don’t. Sometimes, it takes learning a ton of a field for everything to fall into place. So if it feels that way in IR, that’s OK. It doesn’t mean you can’t do it/ will never get it. 

What words of advice do you have for those interested in VIR and other male-dominated fields?

• Don’t settle on a career just bc someone tells you it’s “more woman/ family-friendly” 
• Follow your interest, and your work will always be enjoyable. 
• Working with your hands in these procedural and trad male-dom fields is some of the coolest most gratifying work in medicine!

Those were some highlights from the Northeast VIR Symposium, which normally takes place in person. The virtual version was the next best thing!

What questions do YOU have about being a woman in VIR or in a male-dominated field of medicine? Leave a comment below!

And if you have a chance to attend the Annual Northeast VIR symposium in the future, I highly recommend it.

I also wanted to let you know about a new podcast called Marriage, Money & Medicine, started by my friend and fellow radiologist Dr. Kate Louise Mangona. I’m one of her inaugural guests! In our episode, we chat about how we came to form our families, and the finances of physician families, specifically as it relates to being a female bread-winner! You can check out that podcast anywhere you listen to podcasts. I’ve been enjoying Overcast, if you’re not totally happy with the medium you’re using. Link to the podcast page and show notes by clicking here.

This is a guest post from a blogger who is doing some good in the world. Catherine Burke helps those who’ve been suckered into payday loan schemes to find their way out. When she asked the kind of content she might write for you, I liked the idea of covering the emergency fund. It’s a bit of a loaded topic for residents, who are often saddled with educational debt. Does a resident actually need an emergency fund? Here’s a breakdown from Catherine.

-Barbara Hamilton, MD

Does a Resident Really Need an Emergency Fund?

You could call an emergency fund the backbone of your personal finance strategy. If an emergency arises suddenly, you will have the emergency fund to support you. That is why personal financial specialists have always endorsed having one.

In this article, the focus is on demonstrating how such a fund will work for medical residents who are getting an annual salary of $45,000 to $60,000.

“Keep the emergency fund intact in case you lose your job or income.”

Michelle Singletary

What if you’re a resident earning $60,000 per year?

For a medical trainee, directing an amount of money towards an emergency fund may not seem a practical option, but it is really important.

You don’t know what is going to happen with you tomorrow. Maybe you need money suddenly, like in the case of a sudden accident. Then the money you’ve saved in an emergency fund will come in handy.

That is why you need to save at least 3 months to 6 months’ salary in your emergency fund. Suppose, as a medical resident, your income is $60,000 per year. Then you should aim to save $15,000 to $30,000 for an emergency.

Believe me! Creating an emergency fund and saving at least 3 to 6 months’ savings is necessary for a medical trainee.

What if you are repaying your student loans?

The Student Loan Hero website states that on a standard medical student loan repayment plan where the payment duration is 10 years, you have to pay a regular monthly payment of $2,300 per month on a $196,250 loan amount and 7% interest rate.

In addition, you have to pay for your food, utilities, rent, etc. You may feel like you don’t have enough money left over to save.

So, try to save some dollars in the emergency fund slowly but steadily. The amount of money is not important here. The important matter is to maintain the Emergency Fund and continue to save dollars in the Emergency Fund regularly every month.  

Where should a resident keep her emergency fund?

You can say that online banks are currently a good way to store your savings. Online banks currently offer higher interest rates compared to brick and mortar banks.

So, the ideal account for keeping the money for Emergency Fund purposes is an online account.  

According to the Bankrate.com report and our estimation, if you want to open an online bank account for emergency savings purposes, you can rely on 2 online banks.

These are Citibank and Vio Bank. Citibank is offering 0.90% APY (Annual Percentage Yield). You don’t need any minimum balance to open a savings account in Citibank. You’ll get access to the ATM with Citibank.

Vio Bank is offering 0.83% APY and you need a minimum of $100 to open a savings account in the Vio Bank. (Editor’s note: Ally, CapitalOne360, *Etrade, and many others offer high interest rate savings accounts. Mine is at *Etrade.)

What’s the difference between a savings account and an e-fund?

Financial experts always suggest that you should create a separate account for emergency purposes if you already have a savings account.

The thought may arise in your mind that if you already have a savings account then where is the need to open a second bank account?

Well, the 2 accounts have different purposes. In the savings account, the money you’re going to save is for your future. The savings account will provide you financial security.

The bank account you’ll open for emergency purposes will serve your emergency purpose needs. In case, you need some money suddenly, you can instantly withdraw the cash from your emergency account.

That is why you need to strictly follow the rule that you’ll only withdraw money from the emergency fund just for emergencies that arise.

What if you have other debt?

With the emergency fund, you should take care of your debts too. As a medical resident, maybe you have unsecured debts like credit card debts or a payday loan, in addition to your medical student loans. In an emergency, it is easy to depend on credit cards and payday loans to control the situation instantly. But in the long term, you’ll face problems while paying off the credit card and payday loan balance with a high-interest rate.

If you end up in this situation, you might consider consulting an expert on the repayment of credit card and the payday loan debt. You can use options like debt consolidation, card balance transfer, or payday loan consolidation to solve your problem.

What do personal financial experts say about the emergency fund?

Personal finance experts like Suze Orman and Dave Ramsey are quite vocal about the emergency fund.

Dave Ramsey has advised that all Americans should start by saving $1000 in an emergency fund. Once you have saved $1000, then you can aim for the larger goal of saving 3 to 6 months of your annual salary.

Suze Orman states you will be in a better position if you save 8 to 12 months of your annual salary.

So, the personal finance experts have supported the emergency fund quite vocally. 

A final word on emergency funds

Your emergency fund is the test regarding how much you’re prepared to face an unexpected scenario. If you are generally living a paycheck-to-paycheck life, start by saving $100 each month. The best option is to use a high-yielding savings account, as previously described. You’ll be glad you have it in case of an emergency.

As Greg McBride, Chief Financial Analyst for Bankrate.com has said, “Nothing helps you more than knowing you have money tucked away for an emergency.”

What is your experience with the e-fund: do you have one? Where do you keep it? Does it help you feel financially secure?

Catherine Burke is a financial writer for Online Payday Loan Consolidation. She provides resources to help people get out of predatory debt. She lives in Kansas and has hard-won knowledge when it comes to payday loans. 

I don’t actually talk about personal finance in my book, Save Lives, Enjoy Your Own. I allude to the fact that as a physician, you will be able to make a living that allows you to make choices that suit you and your family (if you choose to have one). You’ll have the resources to get help as your career makes demands on your time. I left personal finance out of the book because it’s a huge topic, and will likely be the subject of its own book. So as we prepare for book launch, and the important task of finding your place in medicine, here are some financial considerations for you, the budding physician. And read through to the end to find out how you can learn more about setting up your finances with my friend, Dr. Bonnie Koo, a.k.a. WealthyMomMD.

1. Your career choice should not be made based on financial factors.

Most of us incur educational debt on the path to medicine. But it should be kept low/ manageable enough so as to NOT affect your career choice. I know, six figure debt a huge amount, but you can do it. Even if you choose a lower paying specialty with a high debt burden, you can always go for a student loan forgiveness program. If you want to read about the different kinds of student loan forgiveness programs available, The Physician Philosopher’s Guide is a great resource. TPP delves into these programs in detail, in an understandable way.

So what should career choice be based upon? Well, I did a deep dive into that topic in my new book. My approach is tailored to those who think they might want to work with their hands, in a procedural or surgically-oriented field of medicine. Check it out!

2. You’re learning to tolerate debt right now, but you can regain control of your finances, once you have the tools. 

As you accumulate student debt, it can be really anxiety provoking. I know this first hand. As you work and study so hard, and push yourself to exhaustion at times, you just can’t afford to lose sleep thinking about your loan balances. It’s not good for your well-being. As a defense mechanism, professionals in education debt become numb to it. As you do the best with what you have, know that you’ll have more resources to deal with your debt when the time comes.

Basically, you have a mortgage on your mind. It is a valuable investment, even if there isn’t a lot of tangible evidence of its value just yet. Hang in there. One day you will have a paycheck large enough to make real decisions about where the money should go. Whether you decide to tackle your debt head-on, or refinance and let it simmer for decades, that’ll be up to you!

3. Lifestyle creep is a practical financial consideration!

As you make your first moonlighting paycheck, or that first sign-on bonus, you might be wondering when you’re ready for a lifestyle upgrade. This can be an incremental process. It’s enjoyable to increase your lifestyle, after all. It’s part of why we work so hard!

One mistake I see is people making a lifestyle leap. They get their first job and lease a luxury car. They make decisions based on a lack of financial goals. 

Speaking of financial goals: Do you know how to setup your finances? You might even feel the pressure of being the breadwinner of the family. That’s what prompted me to start learning all about personal finance. 

Let me know what personal finance questions are on your mind.

To your health, wealth, and happiness!

TiredSuperheroine

Writing a book is like giving birth again. How did this even happen? Where did I find the time? I thought I’d write a little e-book on finding your place in medicine. Then, I stumbled upon a book coach in a physician Facebook group. My coach is a neonatologist, preventive medicine specialist, and social entrepreneur who is making the world a better place through the cultivation of first-time authors. And as a coach, she delivered. She told me where I needed to add a story here, or clarify something there. That’s when Save Lives, Enjoy Your Own started to look like a real book in the making.

Who it’s for

This book is for those in medical school, who are staring down one of the biggest decisions of their life– choosing a medical specialty. That’s why I focused on medical students as I wrote and edited (and edited… and edited) this book. Yet I also wrote the book as a person who found herself at a fork in the road mid-way through residency. I had to decide whether I’d be a diagnostic radiologist, or dive into the ultra-male-dominated, adrenaline-soaked field of interventional radiology. That’s why I understand that some residents may need the book when they’re in the midst of their training. And still others may find the book as a pre-medical student or non-traditional post-baccalaureate student. There is value in the book at each of these stages.

Many women entering medicine will identify with the messages in the text. As they begin to encounter some of the more traditional and even outdated ideas about gender in medicine, I hope this book helps to light the way. Others who want to learn more about what their female colleagues face as they become physicians may read the book as he-for-she advocates. Finally, students and trainees who identify as underrepresented minorities may find guidance and comfort in the pages of Save Lives, Enjoy Your Own. For aspiring and training doctors finding where you belong in the medical field, I’ll show you how it’s not easy, but it’s worth it.

We are a month out from book launch in October. In order to tease some of the contents of the book, here are the foreword and mini-bios of the amazing physicians who contributed.

Foreword

Sometimes the phone rings just after the first precious hour of sleep. The trauma surgeons need my help. When I rush into the hospital for an actively bleeding patient, I might not return home until dawn, but as I work, I’m in the zone. This work is a part of me. Being able to save a life is worth it every time. And I want you to find the kind of work that engages and fulfills you, too. 

But how do you find the right field of medicine, in which you can harness your unique talents and skills? How do you find your calling while drinking from a fire hose? I’ll address these important questions, with the help of some colleagues in various medical specialties.

What’s keeping some women from saving lives?

Unfortunately, the male-dominated atmosphere, outdated ideas about what constitutes women’s work, and concerns about work-life balance can discourage some women from surgically-oriented fields like my own. If your desired field is a boy’s club, how do you figure out if you truly belong there? How do you navigate a sometimes foreign environment and succeed, despite the lack of female representation there?

If you dream of transforming from an uncertain student or trainee into one who confidently pursues her career path, you’re in the right place. From the decision to work with your hands, to finding the right balance and learning to lead, this book will light the way. I’m so excited for you to join me as a physician who saves lives and enjoys her own!

Contributors for Save Lives, Enjoy Your Own

I would like to thank the women who contributed to this book. It’s a privilege to call them my friends and colleagues. They know it’s possible to save lives and still enjoy your own. The following are abridged biographies, which highlight some of their many accomplishments.

Theresa Caridi, MD, FSIR 

is an interventional radiologist who was named a Washingtonian Top Doctor in 2018 during her time at the MedStar Georgetown University Hospital in Washington, D.C. At the time of this writing, she is transitioning to her new roles as an Associate Professor of IR, IR Division Director, and Vice-Chair of Interventional Affairs at the University of Alabama at Birmingham.

Hannah Clode 

is a third-year medical student pursuing an MD/MBA degree at the University of Miami Miller School of Medicine. She aspires to be efficient, autonomous, and joyful throughout her career. Her specialty choice is yet to be determined, and she plans to take a year off to consider her options, which include IR, surgery, family medicine, and OB/GYN.

Laura Findeiss, MD, FSIR, FAHA

is a Past President of the Society of Interventional Radiology. She is a Professor of Radiology & Surgery at the Emory University School of Medicine and the Chief of Service for Radiology at Grady Memorial Hospital in Atlanta, Georgia. She’s passionate about leading patient-centered change in healthcare and is an avid cyclist, skier, and snowboarder.

Anna Gasparyan, MD 

is a board-certified vascular surgeon in private practice in Southern California. She specializes in endovascular & vascular surgery including the treatment of venous disease. In her free time, she enjoys quality time with her son, Bikram yoga classes, and long-distance running.

Anne “Annie” Gill, MD

is an Assistant Professor of Pediatric Interventional Radiology at the Emory University School of Medicine. She is a leader within the Women in IR Section of the Society of Interventional Radiology, in which she works to increase the gender diversity of selected speakers at national meetings.

Lara Hasan, MD

is a board-certified obstetrician-gynecologist in private practice in Southern California. She’s a world-traveler, outdoor adventurer, burgeoning cook, and trivia geek.

Aneesa Majid, MD, MBA, FSIR

is an interventional radiologist who has spent the majority of her career in private practice. She continues to find her balance with the help of entrepreneurial endeavors since completing her MBA at the Kellogg School of Management. A leader within the Society of Interventional Radiology (SIR), she led the development of the first Women in IR Champion Award.

Natosha Monfore, DO

is an early career IR in private practice. She is a passionate advocate for mentorship, with countless projects completed with the Residents, Fellows, & Students (RFS) Section of the SIR. As a leader within the Women in IR Section and as a SIR delegate for the Young Physicians Section of the American Medical Association (AMA), she continues to lead into early attendinghood.

Lola Oladini, MD, MBA

is a rising PGY-3 IR/DR resident at Stanford Hospitals and Clinics. She aspires to be compassionate, creative, and relentless in the pursuit of leaving her community a better place than how she met it. She likes improv and baking cookies.

Arghavan Salles, MD, PhD

is an academic bariatric surgeon. A former Scholar in Residence at the Stanford University School of Medicine, her research focuses on gender equity, well-being, and the challenges women face in the workplace. She is an internationally recognized speaker and an activist against sexual harassment.

Nancy Yen Shipley, MD 

is an orthopaedic surgeon in private practice. She is also a mother, half of a dual-physician couple, a writer, a speaker, and a podcaster (The 6% with NancyMD). Through these roles and her online content, she helps open doors for those that wish to be more and do more in their own lives.

Agnieszka Solberg, MD

is a practicing Vascular & Interventional Radiologist who is board-certified in Internal Medicine (ABIM), Nuclear Medicine (ABNM), and Radiology (ABR). She is a Clinical Assistant Professor at the University of North Dakota. A passionate advocate of women in radiology and informatics, she founded the Facebook community Radiology Chicks.

These women prove it’s possible to save lives and still enjoy your own. I’m inspired by them, and I know you will be too. They’ve found their respective place in medicine. From academics to private practice and beyond, they represent several different subspecialties. They share their experiences and career lessons to help you see that there are many ways to be a woman in medicine.

You can still purchase a signed special edition of the book by clicking right here.

This week’s blog is a guest post from an allied health provider who has transitioned to an alternate career herself. With the ubiquitous concerns around physician burnout and the ramifications for our health systems, I felt this was an interesting share. Are you afraid of burning out early in your career? Let me know what you think in the comments below. -Barbara Hamilton, MD

Working in a healthcare environment is intense and demanding. The epidemic numbers of physicians experiencing burnout has grabbed the attention of third–party payers, legislators and professional organizations.

As the level of technological advancement in medicine rose, healthcare leaders hoped it would improve the levels of physician productivity and satisfaction. Yet digitizing processes had the unintended consequence of producing alienation and disillusionment in even medical students, residents, and early career doctors. 

Knowing the factors that contribute to burnout can help keep you from burning out yourself. Just knowing the viability of alternative career options can reduce the risk you’ll feel stuck, should you experience burnout in your career.

Burning out by the numbers

The Medscape National Physician Burnout Report for 2020 surveyed over 15,000 doctors. Results showed:

• Urologists, neurologists and nephrologists experienced the highest level of burnout.
• Women were 11% more likely to experience burnout than men. 
• Bureaucratic tasks, hours at work and lack of respect from administration topped the list of reasons that contributed to burnout. 

The report also found that reported coping mechanisms ranged from constructive to destructive. The strategy most used was isolation, which can perpetuate burnout. However, the second most used strategy was exercise, which is a constructive method of reducing stress.  

Slightly more than 50% of women were willing to take a pay cut to have a better work life balance. But, isn’t there a better option?

Consequences of Physician Burnout

According to Dr. Dike Drummond, author, speaker and consultant on physician burnout, “There is an epidemic of physician burnout in the United States, and it has a pervasive negative effect on all aspects of medical care, including career satisfaction.”  

Burnout is directly linked to striking number of consequences:

• Post-Traumatic Stress Disorder 
• Depression
• Lower patient satisfaction
• Lower quality of care
• Higher number of medical errors
• High turnover
• Increased risk of malpractice
• Physician substance abuse
• Physician suicide 

A survey of doctors in 2014 found that 54.3% had symptoms of fatigue. 32.8% reported excessive fatigue, and 10.5% reported a significant medical error in the last three months. It’s no wonder we are afraid of burning out. The price paid by physicians and society is steep.

Contributing Factors

After completing hours of one-on-one coaching with physicians who experienced burnout, Drummond determined that the five biggest causes are: 

• Interacting with people who are sick, scared and dying. 
• The stresses of on-call rotations, hospital politics, and personality clashes at work.
• Inability to balance one’s personal and professional life.
• Character traits such as being a workaholic, superhero, or perfectionist.
• Poor-quality leadership.

Like factors named by Gagné and Deci, who study intrinsic motivation in the workplace, these factors increase a doctor’s risk of burning out. The pillars of intrinsic motivation are autonomy, competence and relatedness. Each has suffered as a result of healthcare restructuring.

Physicians experience a lack of control over their time, contributing to burnout. They are forced to check off boxes to meet billing standards, leaving them less time to develop therapeutic relationships with their patients. These factors are related to the three top contributors to burnout found in the Medscape 2020 report: bureaucratic tasks, hours at work and sensing a lack of respect from administration.

Treating Burnout

While work-life balance may not have been stressed during medical education, it’s critical to foster a personal balance as a physician. The characteristics that supported great grades during medical school should also be channeled toward personal wellness. Finding balance starts with identifying physical and emotional areas that may have been overlooked in the pursuit of a rewarding yet often demanding career.

Self-care basics: exercise, nutrition and sleep. Under the stress of work, maintaining relationships, and growing a family, basic self-care can fall to the wayside. However, prioritizing physical and emotional health is key to avoiding burnout in the long term. This means adequate exercise, healthy eating  and getting 7 to 8 hours of quality sleep each night. These basic strategies improve a physician’s ability to withstand external stressors.

Set boundaries. Doctors who don’t uphold personal boundaries may be at increased risk of burning out. A lack of boundaries between work expectations and down time can create tension and stress, in turn raising the risk of burnout. It is vital to deliberately set boundaries and then protect them as a physician.

Knowing and practicing these simple strategies may help you reduce the potential for burning out in the future.

Career Alternatives for Physicians Who are Burning Out

The skills gained during medical education and practice are remarkably transferable to different career options. Yet a physician’s education is highly specialized. Here are several alternative options that may allow a physician to return to clinical practice later if they are burning out.

Clinical Practice Outside the Specialty

Physicians may not consider clinical practice outside their specialty but it is a viable option. Physicians from a variety of specialties find wound care challenging and rewarding. The subspecialty has less stress, a predictable environment, a competitive salary and keeps physicians clinically and procedurally active. Family practice, plastic surgery, internal medicine and vascular and general surgery are just some of the specialties that involve skills that transfer into wound care.

Hospital Administration

This is a long-standing option that physicians have taken over decades. Physician administrators may be more apt to initiate change based on the challenges and frustrations experienced by clinical staff. Physician administrators often have the respect and goodwill of other doctors in the hospital, which improves their ability to be successful. Hospitals are seeking a balance of clinical and administrative skill to more fully integrate the needs of physicians with the demands of third-party payers. One hurdle some physicians face is a lack of business knowledge needed to run a hospital profitably. Some have completed an MBA to overcome this challenge.

Academics

Teaching offers physicians the option of continuing clinical work while engaging with medical students. Most academic positions are seeking physicians who have published in peer reviewed journals and prefer doctors who have specialized. This is an opportunity for physicians who prefer a daily routine and have the background and clinical practice to support an academic career.

Medical Journalism

Doctors who enjoy writing and translating complex medical concepts into language the general public can digest may consider this alternative career. Pharmaceutical companies, research studies, and editorials all offer venues for physicians to help propagate medical knowledge.

Telemedicine

This is an option that allows physicians to continue to interact with patients through clinical practice, while benefiting from predictable hours. Telemedicine is flexible, allowing for a part-time or full-time schedule. In an environment where more people are apt to stay at home, the global market for telemedicine is growing.

Telemedicine and in-home visits are a hot topic and area of study, even in interventional radiology! So if you are afraid of burning out, take comfort in all the options at your fingertips, from preventative strategies to career alternatives in the future.

Author: Gayle Morris is a freelance writer who has written on health and wellness for over ten years. She spent over 20 years as a certified nurse and nurse practitioner before hanging up her stethoscope and picking up the pen. 

To hear my personal take on early career burnout and some strategies I used to deal, check out my recorded talk on balance. You can access it by clicking here.

And let me know what you think about this post in the comments below! Share your experience, or your unanswered questions. Are you afraid of burning out?