Tag Archives: professional guidance

Should You Commit to Working for a Company in Exchange for Getting a Residency?

The Devil’s Advocate summarizes my feelings on this issue.

In my opinion: no.  If you want a more detailed, analysis, read on.

The first time I encountered this concept, UGA had taken a radiology resident from VCA.  We later took a surgery resident from the military. We also took a surgery resident from another university.  The essential premise is the same: the sponsoring organization (university, company, military, etc.) pays for the resident’s salary (including benefits) and then the resident contractually owes that organization a certain number of years of service after they finish the residency.  Why would anyone do this?

The training institution benefits because they get an ‘extra’ resident.  Resources to find residency positions are limited, but services need to meet their caseload demands.  Residents are an effective way to enhance service delivery. Universities see residents like this as “free” residents- they get the labor of a resident without having to pay for it themselves.  So it’s a good deal for the training institution.

The sponsoring institution benefits because they get a committed specialist for a certain period of time.  Institutions that have a hard time attracting specialists may choose this route so they have a guaranteed specialist at the end of the program.  One problem is that it takes 3 years to train a resident, so if they need someone NOW, this won’t help much. Another problem is that the specialist may not stay once their contract is up, which puts the institution right back in the same position they were before.  So it may be a good deal for certain sponsoring institutions, but may not be a long-term benefit for others.

The individual doing the residency benefits because they get a residency position which they may not have otherwise gotten.  For example, if someone does not get a position through the Matching Program, and they desperately want to do a residency, they could find a sponsoring organization and then get to do a residency.  These positions exist OUTSIDE The Match and are spots in addition to the existing spots offered by training institutions. They then HAVE to work for the sponsoring organization, usually for about 3 years, after finishing the residency.  So it may be a good deal if the individual would have wanted to work for that organization anyway, or if they are basically fine working for them until the contract is up.

Naturally, my idealism clashes dramatically with this free market approach.  I don’t believe anyone should have to sell their time as a specialist in order to get a residency.  It just strikes me as unfair. In an ideal world, these organizations would have to change so that people would WANT to work for them, rather than forcing desperate residency-seekers into a deal with the devil.  In an ideal world, those most deserving of residencies would get them, and those who don’t would be happy with a different life path.

I understand it isn’t an ideal world, and the free market allows for these kinds of contracts.  As long as there are applicants desperate to get a residency, who will do almost anything to get one, these kinds of contracts will persist.  I wish people wouldn’t make these deals, because then organizations would have to improve and actually ATTRACT specialists. But I’m not in charge of the world, and you’re an adult, so you can make your own choices. Just make sure you’ve taken all the benefits and drawbacks into serious consideration before making that choice.

Exorcising Demons

I wrote more than 70 posts for this blog in 6 weeks.  That works out to 1.7 posts per day or almost 12 posts a week. I didn’t set a particularly blazing pace- I wrote an article or three whenever I had some downtime.  I also didn’t set out to write that many that quickly. My goal was to be able to publish twice a week once the blog launched. I also wanted a sufficient backlog so that if a week or two passed without inspiration, there would still be posts for you to read.  I never expected to write so much so quickly

What the devil is going on here?  Well, the posts are generally fairly short- much shorter than experts advise for blogs seeking lots of search engine optimized traffic.  I could write longer posts, but I want to make these manageable for you. I am trying to change the way a large number of applicants function- the message needs to be palatable so you will adopt the changes I am recommending

I also get fired up as I start writing.  More ideas come to me in the middle of a post and I add them to an ongoing list.  I started with about 40 ideas, and as of this writing have 70 ideas in addition to the posts already written.  And more keep coming in every day- from my experiences at work, from my editors, from reading books and websites.

My editors are also an incredible source of inspiration.  My wife proofreads all the posts and occasionally makes suggestions.  One of my best friends also proofs them and contributes his own outside-of-vetmed perspective.  Both of these help tremendously, so it’s not only my brain working, but others’. I hope to engage several of my professional colleagues in the future so they can contribute their own vast knowledge and experience to the blog

But I think the most significant reason is I feel I am exorcising some horrible pent-up demon.  For god’s sake, how can it be 2018 and this material DOESN’T exist for veterinary applicants yet?  There are some good vet blogs out there- we’ll check in with them eventually- but no, I can’t find a centralized source where you can get all the information you need from someone who’s been there and done that already.

I see applications and interviewees all the time and just WISH they had found some of this advice before applying or interviewing.  I want to help, and I desperately hope this blog reaches applicants, so you can make your future career and life as successful as possible.

How to be Successful: Self-Reflection and Self-Honesty

One of my friends has told me she is interested in pursuing a residency because she wants to be respected by the community and be a Person of Importance.  In our study of senior students interested in internships, many of them expressed an interest in being The Expert. I applaud both of these sentiments because they come from a place of self-reflection and self-honesty.  They may not be motivations on par with “I want to help sick animals” or “I want to train better vets”, but that’s OK, because they are genuine. They are also not contradictory of such noble motivations; you can help sick animals by being a respected and important surgeon.  Having thoughtful self-reflection and being honest with yourself is essential to being a successful professional.

My friend who wants to be a specialist because of the social capital can make better decisions because of that knowledge.  Maybe she can get the same acknowledgement from being important in organized veterinary medicine (like sitting on the state board or being an AVMA delegate).  Maybe she can get it from doing a PhD in physiology and being a basic scientist. Or maybe she realizes that what she actually wants is the regard from pet owners and veterinary academics, which will funnel her more towards the path to a residency.  In any event, knowing exactly what is motivating her will make her career choices and decisions dramatically simpler.

Those students who acknowledge they want to be considered The Expert can use that self-knowledge in powerful ways.  Hopefully, they will realize that most Experts don’t put a big flashing sign saying “EXPERT” above their head; this knowledge will allow the students to Aim for Zero.  If they don’t get a residency, they may decide to find an area of clinical focus and drill down on that- maybe being the ultrasound ‘expert’ in their clinic. This insight will help them find professional fulfillment regardless of their career path.

And that’s the real key: what would you be happy doing and why?  I see countless people saying, “I HAVE to be a vet! It’s all I’ve ever wanted!” or “I HAVE to be a surgeon!  It’s the only thing I can imagine doing!” But… is it really? Why? “I want to help animals.” You can do that VERY effectively as a vet tech, wildlife biologist, or working in animal control for the county.  “I want to make lots of money.” Sure, then you should be an entrepreneur.  “I want to talk to clients all day.”  OK, a receptionist does that and is a key part of the veterinary team.

“I want the regard of my parents, who both have graduate degrees and expect me to excel in academics.”  Ah ha, good, now we’re getting somewhere. “I am scared of trying to make my way in the real world and need more time in school to shelter me and discover who I am.”  Excellent, excellent. “I want people to like me because my mother never hugged me.” Yes, yes! Once we get to this level of self-reflection and self-honesty, we can actually make some helpful, meaningful decisions about our life. Try not to be judgmental of yourself or fear others’ judgment of these motivations. You have a right to decide what to do with your own life; full honesty will help you get there.

I want you to be reflective and honest because I want you to make the best career decisions you can.  And you can only make the best decisions if you are able to decide exactly what you want and, importantly, WHY you want it.  You need to go deeper than superficial motivations. What VALUES of yours does this career path satisfy?

The easiest way to get to this is called a ‘laddering technique’.  We used it in the study cited above and it can work for you. Just keep asking “why?” until you get to a core, bedrock value which cannot be reduced.  I personally adhere to the Self-Determination Theory of core values, but you can adhere to other theories and get the same outcome. The point is that you need to know what MOVES you from a fundamental core belief level.

For myself, I wanted intense intellectual challenge, because that is a source of enjoyment for me, a decent salary, because financial insecurity was a source of anxiety growing up, a flexible schedule, because I am an iconoclast and don’t like being told what to do, and the opportunity to be in some clear leadership role, because I enjoy the regard of those whom I am in charge of as long as I do a good job.  This led me on the path to academia, but there are MANY MANY other people in academia with very very different motivations. I don’t care what motivates you, but you need to know the core values which motivate you.

What Mindset Should You Have When Applying to Faculty Jobs?

Opinions on this may differ, but I wanted to share with you my philosophical approach to applying to faculty jobs.  It can be summarized pretty easily: don’t bluff and be genuine. This can be harder to do than it sounds.

Academic institutions have interesting, but fairly consistent approaches to salaries and raises.  There is usually more money available for new hires than for existing hires. Existing hires have had to get raises through lean years and when the legislature (if a public school) is more conservative with education than other years.  As a result, salary compression occurs

Salary compression is when people who have been working at an institution for a while end up making less than a new hire.  Although uncommon, you can have a situation where a full professor makes less than a new assistant professor.  While you don’t need to make a lot of money to be happy, you DO need to make a fair amount of money to be happy.  Studies indicate that employees are generally happy with their salary if it is fair.  Unfortunately, salary compression can result in salaries not being fair among faculty members

The ‘solution’ to this problem in academia is, unfortunately, applying for other jobs, getting an offer, and then using that to negotiate with your home institution.  I put the solution in quotes because I hate this solution. I believe it is disingenuous. This may be where my sense of an idealized world conflicts with reality: you shouldn’t HAVE to resort to this, the institution should keep your salary at pace with others over time.  But I understand that isn’t always reality and this is how some people manage it

I had one colleague who was grossly underpaid at a large state school.  He was a full professor, had asked for an adjustment, and been told ‘no’.  As a consequence he began applying elsewhere. Once he got an offer from another institution, his home school was suddenly able to find money and pay enough to keep him.  Would he have actually left if he hadn’t gotten a retention offer? Maybe yes, maybe no.

What I would prefer to advise people instead is this: if salary means that much to you (I sure wish it wouldn’t), and you are genuinely unhappy because of the lack of fairness, then you should genuinely look for a job elsewhere.  It should not be a ploy or a bluff. If you are unhappy, you SHOULD look for a different job. But I believe you should only look for jobs you may seriously consider taking.

I feel that it is a disservice to the institution and, potentially, your reputation to interview somewhere you absolutely know you will not go.  Most schools dedicate significant time and energy to faculty interviews- you don’t want to waste those resources. Also, maybe there is another candidate who would LOVE to go there but doesn’t get an interview because you take up one of the slots.  We routinely interview only about 3 people on average for many faculty positions. If you know you won’t go somewhere, don’t take someone else’s spot.

On the other hand, if you believe you COULD go there, even if you’re not sure, then it is fair to apply and interview.  I have applied to institutions I wasn’t sure about and, after visiting, was favorably impressed and willing to consider moving if given an offer.  Some places I have interviewed and decided it wasn’t a good fit for me, but I didn’t know that before visiting.

My wife went on numerous interviews and got several offers, which helped refine her understanding of what she wanted from her career.  So I’m not saying don’t interview unless you’re certain you will accept an offer. You may need to go through an interview to decide if the institution or job is right for you.  I am saying: don’t interview if you’re certain you wouldn’t accept an offer. To do so is not being genuine.

Should you do a Residency?

The Vetducator - deciding on doing a residency.
Photo by Paola Chaaya on Unsplash

The residency is the path to specialization.  There are a handful of veterinary specialties you can earn without a residency, but, for the vast majority, a 2-4 year residency is the only path to specialization.  So, really, the question of doing a residency is: Should you be a specialist? Obviously this is a question you need to answer for yourself, but here are some considerations which may help.

Timing.  There are many paths to being a specialist, but the most common is straight from vet school to residency (pathology, lab animal medicine specialties), or from internship to residency (for most others).  Some people may be tempted to go into practice first, and then go to a residency. While possible (and even successful for some specialties- like radiology), read the post about taking time off before deciding on this path- it will be harder than a more traditional path.

Salary.  Most, but not all, specialists make more, sometimes considerably more, than general practitioners.  If you have chronic health issues or family obligations, you may be able to take care of them more easily as a specialist.  Otherwise, the salary shouldn’t factor into your decision-making.

Academia.  Although some universities are figuring out they should hire general practice vets to train general practice-bound students, the vast, vast majority of faculty are still specialists.  If you want to go into academic veterinary medicine, becoming a specialist is really your best bet. And academia is pretty great!

Expertise.  In a study we did interviewing senior veterinary students, those interested in specializing expressed the desire to be considered experts and sought after for their knowledge.  As a general practitioner, you become more knowledgeable and proficient in a wide variety of domains. As a specialist, you become an expert in a single field. Both can be intellectually rewarding, but if you want the social status that comes with being The Expert, becoming a specialist is an easy path to that regard.

Time.  Do you want to spend 2-4 more years of your life on your education?  Or do you need to get on with things? This depends on your own life situation, probably largely determined by your family life.  Along with this is the reduced income you will have as a resident relative to entering general practice. This is only relevant during the residency, though, as your salary will be much higher once you are done.

Flexibility.  As a specialist, there will be fewer places in the country you can work.  General practitioners are needed even in very small towns, but Americus, GA, does not need a board-certified veterinary surgeon.  In general, as a specialist, you will work at a university or in a private practice in at least a small city.

Dedication.  As a resident you will work long hours for little thanks and little pay.  Can you suffer through that? Are you OK being treated as a minion for more time in your life?  It is physically and psychologically tiring, so you have to be dedicated to the pursuit or you will be miserable.

There are a lot of great reasons to do a residency, but it is not without cost, and it is absolutely not for everyone.  Talk to your friends, your family, and your mentors. It’s a difficult, but important, decision.

How to be Successful: Kaizen

The Vetducator - Kaizen kanji.

I spent a tremendous amount of time preparing for my interview for a department chair position.  My talk was about the psychology of motivation, as I believe that is a core principle to understand when leading people. I focused on Self-Determination Theory, which states that people are internally motivated by autonomy, competence, and relatedness with others.  When discussing the competence domain, I wanted to try and express a concept I had been living my whole life, manifested most obviously in my martial arts training.

When you begin training in martial arts, regardless of your age or athleticism, you begin as a white belt.  No matter what talents you bring to martial arts, you start at the beginning because you don’t know about about this specific skill.  As you learn, you progress through clearly delineated ranks. Do this skill correctly, then earn this rank. It makes skill progression visible and tangible.

I have been training in martial arts since I was 12, so this process was largely invisible to me- it was just a way of life.  OBVIOUSLY, if you practice more, you get better at the skill. That is what a growth mindset gets you. But, to get really good, you need to not only train.  You need to identify what you need to improve, work on improving it, then evaluate your performance and improvement. This can be conceptualized in the plan-do-act-check cycle, which is a component of Kaizen.

Kaizen means “good improvement” and describes a cycle of continuous improvement.  The Toyota Corporation was an early adopter of Kaizen, and the principle became more widespread and accepted in the past few decades.  Although originally used in industrial processes, the principle can be applied to any human pursuit. Applying Kaizen speaks to the competence domain of Self-Determination: you get better at something, which increases your competence, which makes you want to do it more.

What can you do to continue to improve in life?  Here are some suggestions:

1) Learn a skill.  “I’m already learning a skill, Vetducator- how to be a vet! (or a better vet)”  Yes, but you can learn other skills, too. I prefer movement-related ones like dancing and martial arts, but maybe you like learning coding, or home repair/maintenance, or cat training.  This is valuable because you never know when learning something new will help you in another area, it keeps your mind sharp, and it keeps you in the HABIT of learning new things.  Find something FUN to learn.

2) Read a book.  “I am reading so many books already for school, Vetducator!”  Yes, but you need to develop non-veterinary skills and knowledge, too.  I prefer non-fiction books for this development, but fiction books can expand your vocabulary and provide other improvements.  I have been on a recent kick reading books about teaching, so I get to expand my knowledge of teaching.

3) Practice social skills.  If you’re already an adroit, socially-competent person, you can skip this.  For the other 99% of us, you can ALWAYS practice interacting better with other humans.  And I don’t mean acting more extroverted, bouncy, and outgoing. Maybe your focus is you need to listen more, maybe you need to think about treating people with more respect, maybe you want to smile more.  I think everyone can improve on this.

4) Diet and exercise.  This is a common trope today, but it is nonetheless useful.  Don’t know how to cook a vegetarian meal? Practice. Not good at making bread?  Practice. Can only do one pull up? Practice. Keep getting better, even if it is incremental.

This principle applies to being a better student/intern/resident/faculty member because you want to be the best one of those you can be.  The ‘best’ will look different depending on the individual, but the principle is to be constantly improving. You don’t need to push yourself every single day (unless you enjoy that!).  But you should always be looking at how you can improve. Don’t just tread water. If you want to be successful, if you want to be a +1, you need continuous improvement.

If you want to get better, it’s not enough to just want it and hope it comes to you.  You need to make efforts and you will achieve. Don’t stop.

How to Manage Student Loans

The Vetducator - CPI vs home prices vs. tuition costs graph.

Higher education has become incredibly expensive.  There are many reasons for this, including expanding administrator numbers and salaries, declining state support, schools expanding offerings to compete for paying clients (students), and a bubble for student loans.  Regardless, you want to go to vet school (or are in vet school) and need to figure out how to pay for it.  Assuming you do not have sufficient funds on your own or from your family, you may need to borrow money. Here are some considerations and strategies to minimize the amount you have to borrow, so you can be as free as possible once you graduate.

School Choice.  You want to attend your local state school if at all possible.  Don’t go in for expensive out-of-state, out-of-country, or private schools.  This is one of the most important decisions you can make with respect to your financial future.  Attend the least expensive school you can.

Frugal Living.  I know one vet who bought a brand new car during vet school and just added it to his student loans, which totaled more than $200k by graduation.  That is unacceptable.  You need to live a frugal life- which does not mean a life devoid of all pleasures.  Believe it or not, you can have a great life without spending more than all the money you have.  And you can get a great education at a fair price.

Avoid Interest.  When it is working for you, compound interest is amazing.  However, if you are taking out a loan you have to pay back, compound interest is the worst.  You need to make sure loans you take minimize your interest as much as possible. Ideally, you should find loans which have the interest taken care of.  If you take loans which immediately begin to accumulate interest, you will be much worse off after four years in vet school. Maybe even family can give you low-interest loans.  Whatever you can do to minimize accruing interest you should do.

Is it still worth it, economically, to go to vet school?  It depends a lot on where you go to school, how you live, and what types of loans you take out.  If you go to a private school or out-of-state school, live high on the hog and take out interest-bearing loans, you could find yourself $300k in debt with poor prospects- especially if the economy turns south.  Maybe you could be just as happy doing a Ph.D. in Biochemistry?  If you insist on going to vet school, be mindful of your decisions and how they affect your future freedom.  And for god’s sake don’t buy a new car in vet school.

How to Successfully Seek Assistance

The Vetducator - Be smart enough to know when you need help and brave enough to ask for it.

Do you have a hard time asking for help?  Talking to people? There are a lot of veterinary professionals out there who have a hard time with both of these.  Veterinarians are notoriously self-reliant and independent. Imagine the early days with the lone vet out there on house calls- you didn’t have a cell phone to call for a consult, you had to Figure It Out.  It’s built into the very bones of our profession. I think this must be why I see so many applications and interviews where the individual clearly didn’t ask for help, and it reflects in their work. Faculty are easy resources- they are being paid to teach you, after all.  You must ask for help. We’ll see why and how in this post.

Why you need help

1) This is a high-stakes event.  If you are applying to vet school, internships, or residencies, there are MANY others also applying for these positions.  At UGA we would routinely have 200 applicants for six intern positions, and I heard from a friend this year they had 190 applicants for a one surgery residency position.  You need the best possible application and interview in order to stand out from the crowd and secure a position.

2) You are not an expert at career progression through veterinary academia.  Heck, you’re barely a novice. It would be like someone with no training getting into a boxing ring- you’re going to get hurt.  You haven’t been through this process, so you don’t have the experience. You haven’t mentored others, so you don’t have the perspective.  Mentors and even peers can provide this experience and perspective.

3) I have evidence you need help.  I read materials all the time and think, “Did they even show this to their mother?!?”  Simple typos, bizarre sentences, odd flows of logic- all of these would be identified and helped by an outside observer.  Many applicants could dramatically improve their application and interview skills by working with mentors.

How to ask for help

First of all, don’t just limit your editors to faculty with whom you have had a long-standing relationship.  If they have supervised you on a clinical rotation, or even in a didactic course, you can ask for their help.  It’s possible you won’t get a response or will get a ‘no’, but remember: most faculty are there because of the students.  They WANT to help you, you just have to ask!

1) Ask in person.  This is usually whenever you see or interact with the faculty member.  You can also swing by their office. It’s not hard, just say, “Hey Dr. X, I’m applying for ThisKindOfPosition, would you be able and willing to give me some help with my application?”  That’s it! So simple! As always, if you get a ‘yes’, follow up with email.

2) Ask by email.  This requires less timing to figure out- you can send it at any time.  It is slightly less personal, though. Particularly if you don’t have a strong relationship with your mentor, email may be a little too impersonal.  They may not remember working with you and you may get somewhat tepid assistance if they don’t know you well. If you choose to email, take a similar tack to in-person: a short email along the lines of, “Hello Dr. X, I am applying for ThisKindOfPosition this <timeframe> and was wondering if you would be able and willing to provide advice on the process and look over my materials?  Any help you can give would be appreciated. Please let me know what you think. Thank you so much!”

Now you know why and how.  Go out there and get help! What obstacles do you experience in seeking out help with your career?

Making the Most of a Residency Interview

The Vetducator - residency interview image.

Your application is compelling enough for a program to spend the time interviewing you- congratulations!  Many residency programs conduct interviews, and it can be a significant variable in the decision making. Sometimes these are by phone, sometimes by video, and sometimes in person.  Obviously, you should follow the general guidelines for each of those interview types as well as prepare so you can present your best self. More specifically, here’s how to make the most of your residency interview experience.

This is not only a chance for them to learn about you but for you to learn about them.  If you get matched for a program but will be miserable, you may not finish. Every year there are residents who drop out of their long-dreamed-of specialty because the program wasn’t a good fit for them.  You need to make sure this is somewhere you can be happy for three or four years. Here are some questions to ask the program directors or existing residents to help you decide:

Both program directors and existing residents:

  • What’s it like to live here?  What do you like about it? What do you dislike about it?
  • What are the students/interns like?  What are the interaction with them and the residents?
  • What are the responsibilities of the residents?  Do they do general ER duties or call or only do specialty emergency duties?
  • What is the interaction with other specialties like?
  • What is the strategy for ensuring residents successfully complete a research project?  Are there opportunities to do more than the required project?
  • Are there opportunities or requirements to teach in lab or classroom or rounds room?  What kind of support is available to help nurture resident teaching skills?
  • If you could change anything about the program, what would it be?

Program directors:

  • What do you do to ensure resident success?
  • What are the plans for program improvements?
  • What have you learned from previous residents that has caused you to change the program?

Existing residents:

  • What have been your challenges with this program?  What did you like about it?
  • Would you have chosen this program if you knew then what you knew now?
  • What would you change about this program?

Asking incisive questions will ensure that the program knows you are serious and engaged.  What else can you do to impress them during your short interview time? Remember, their goal is to determine if you will be successful in their program.  You want to assure them you are competent, dedicated, and enthusiastic.

You need to have examples from your experience that demonstrate your best characteristics.  Are you willing to come in odd hours- tell a story during your clinical year or internship when you did and had a great time.  One of my best days in vet school was 22 hours long and started with a hemilaminectomy and ended with a GDV. The resident on duty said excitedly, “Well, what else would we be doing on a Friday night?” and I was in enthusiastic agreement.  Just saying, “Yes I work hard and I would love to be your resident” is not enough. Demonstrate you have those characteristics with stories.

Each residency program is different, but characteristics that are generally looked for include (in no particular order): curiosity, willingness to work hard and long hours (no laziness or cutting corners), detail oriented, compassionate, humble, teachable and willing to accept and use feedback/criticism, able to handle setbacks, good at managing stress, pleasant to work with/positive, ethical, good critical thinking skills, knowledgeable, effective at communication, enthusiastic, dedicated, and cooperative and helpful.

The residency interview is a difficult experience to navigate.  You need to get information to make sure you would be happy there while assuring them you would be happy there and a great catch for them in a very short amount of time.  Have a plan ahead of time. If you fumble asking questions or coming up with examples of how you’re awesome, you’re sunk. It’s a fairly high stakes experience. You spent undergrad, vet school, and maybe an internship to get here.  You can’t just hope it will work out. You must prepare.

How to Be Successful: Show Up

The Vetducator - success by opening doors by showing up.

Show up.  That’s it.  End of blog post.  You can believe me and stop reading or you can read on if you need more convincing.

Living in the South is strange in so many ways.  One which you would not expect is the approach service workers (plumbers, electricians, roofers, contractors, etc.) take to showing up.  That is, maybe they will and maybe they won’t. Not just being late- that’s any service worker. You make an appointment, and they never show or call to reschedule.  This is distinctly different than in other parts of the country in my experience. It seems like a simple arrangement- you show up to do a job, I give you money. Don’t you like money?  Apparently, laborers in the South do not. Every now and then you find one who actually shows up, and they get all my business and my friends’ business. Until they also eventually start to not show up.  It’s a weird way to run a business, but this was a huge sign I had of how important it is to show up.

Teaching martial arts for 20 years, I see this constantly.  Who are the black belts? The best students? The most competent, the stellar athletes?  Not at all. The black belts are the students who showed up. They came to class and kept coming to class, slowly learning and progressing.  The most amazingly athletic students- they were aiming to be a +1– they fell off because they actually had to apply themselves to progress rather than rely on their raw talent.  The slow, steady, quietly competent and attentive students were the ones who became terrific martial artists. They showed up.

The best vet student, intern, resident, or faculty isn’t necessarily the smartest.  Smartness helps, as does wisdom, but to be excellent you first need to show up. If you’re a student, be there before anyone else on your team and leave after everyone else on your team.  Offer to take extra on-call responsibilities. Study when you get home. One vet student with whom I worked answered a call to participate in a research project. She was so capable and engaged that she became integral to other projects, and now she has her name on three published research articles.  Those who put the time in, get the rewards.

This goes all the way up.  The most productive faculty aren’t necessarily the smartest or the most ruthless.  I know some faculty members who never come into their office when they are off clinic duty.  They’re fine faculty members, but they won’t ever be amazing until they start showing up.

We’ve talked before about how to avoid being a -1: aim for zero.  Here is where we start to see how you can go from a zero to a +1. Start by being quietly competent. Then show up.  The world is run by those who show up.