"What Do You Want Your Life to Look Like 10 Years From Now?"

This article is authored by Andriana Nikolova, MD, fourth-year general cardiology Fellow in Training (FIT) at Cedars-Sinai Medical Center in Los Angeles, CA.

It all started when my mentor and I met at the beginning of my second year of cardiology fellowship – right after I emerged from the haze of my first-year call schedule – and asked, “What do you want your life to look like 10 years from now? Think about it, talk it over with your husband and let’s figure out how I can help you get there.”

As simple as the question was, I never realized that “the beyond” after fellowship was a fast-approaching reality. There was always the carefully rehearsed answer prepared for the countless interviews we go through in our lengthy medical training. Of course, I want to be the triple threat: clinician-researcher-educator! However, as for the true implications for my day-to-day life, I truly had no clue and was not alone in this dilemma. Around me, my co-fellows were also coming to the overwhelming realization that fellowship was the last stop on the train ride that took us through an exquisitely well-defined path. Now it was time for us to learn how to sit in the conductor’s booth and take ownership.

The most exciting aspect of medicine is that it is a versatile and fast-evolving field, which offers countless possibilities for us to grow professionally. Yes, we can be expert physicians in our respective fields. However, we also face a wide array of other, out-of-the-box options such as medical advisors or executives for technology companies, clinical trialists, bench scientists, venture capitalists and more. How do we determine the true fit for ourselves when our life has been so strictly defined with little flexibility to leave the hospital confines, and explore other career options that intersect with medicine?

In my decision-making matrix I borrow from the lean and agile methodology adopted in the start-up world – fail fast and fail forward! In other words, think about the people you want your life to be modeled after, commit to that path with fervor and be honest along the way if it is not the right fit for you. And if not, change direction fast!

Choosing a mentor along this road, with whom you can have an earnest conversation about the concerns and doubts you have about making a particular career choice, is crucial. For me, research is one of the “non-negotiables” in my professional life. However, I was facing a branch point in my path – to choose a clinical research track where one can develop a skill set faster and demonstrate productivity early-on, or take the winding road of basic-science research, where one must commit a significant time to training in exchange for delayed rewards. My mentor was instrumental in that decision-making process as he helped create a PhD track for MDs at my institution, which alleviates some of the class pre-requisite burden and allows for a shorter training time. I joined a PhD program in biomedical sciences in the third year of my fellowship with the intent to try my best and, more importantly, be honest along the way if this choice was right for me.

Asking the question, “What do I want my life to be like in 10 years?” in a brutally honest way should be a conversation every FIT has early in fellowship with their mentor. Luckily, this phase of our training is also exploratory and we can dedicate time to developing additional skill-sets that help us get to our goal. Be it a formal degree in public health, health services delivery, basic science or a hands-on internship at a tech start-up or venture capitalist firm, it is worthwhile going out of one’s comfort zone and exploring the exciting possibilities out there. After all, failing forward is the only way to find the right path for oneself.