Post-Training Mistakes Residents and Other Professionals Make: Part IV by Clark Gaither, MD, MRO, FAAFP

At last. You’ve graduated and finished your training. You found the job of your dreams and moved to a city of your liking. You put your head down, got to work, and settled into a routine. The paychecks are coming regularly and, for the first time in a very long time, you have disposable income. You should feel on top of the world. Yet, something doesn’t feel quite right. There is a disquiet within you, an anxious fatigue you have not experienced until now and it troubles you. You can’t vocalize it at first but one day it comes to you in a flash. A cold, harsh, almost disappointing realization— “This is it‽ This is how it is going to be from now on‽”

This is the fourth post in a series on common mistakes I have seen residents and other professionals make just out of training, mistakes with long-term, often severe, consequences. This particular mistake is rarely talked about or even acknowledged, namely ignoring the unexpected feelings mentioned above when you realize there is no “next.” It is a feeling of finality. Through high school, college, medical school or other professional programs, and on to post graduate training there was always the next academic quarter or semester, the next set of exams, the next block of courses, the next internship, the next rotation. We lived our lives in blocks of time according to someone else’s schedule.

We raced from one hurdle to the next until finally the last one was surmounted. The perception that no more hurdles remain can be very demoralizing. In fact, it can become paralyzing. If you are experiencing or have experienced this feeling of finality after completion of your training, take heart. Here are five steps you can take to eliminate finality fatigue and prevent any of its unwanted consequences.

  • Acknowledge the feeling and talk about it. It’s important to realize almost everyone has this post-graduate feeling of finality fatigue to one degree or another. By talking about it you’ll realize you are not alone. You will hear what others have done to get past it. Or, you will see how others who did not get past it became entrenched and enslaved by it.
  • Realize there is definitely a next. That is, if you choose. No longer is someone else in charge of your schedule. You are. Know your education has not ended. It has just begun. You can choose to continue to strive for excellence or even genius. You can continue to learn and acquire new skills inside or outside your chosen career. You are now the sole arbiter of how far you will advance.
  • Set goals. Continuous improvement in what you do and who you are should become your new goals. Continue the habit of goal setting—3, 5, 10, 15, 20, 25-year goals and beyond. You arrived at where you are by setting goals and achieving them. Become the preeminent expert in your field. Climb the corporate ladder. Create. Invent. Innovate. There is no reason to stop now just because you are out of school and working. Your next level up awaits you.
  • Experience life. We spend one third of our adult life sleeping. This means we spend one half of our adult waking hours or more at work. Don’t just be all about work. Take on as many new experiences outside of work as you can handle. They will continue to shape you. You need different perspectives. (Bingeing on the latest boob tube series is not type of new experience to which I’m referring.)
  • Periodically, ask yourself the hard questions. Each year, for a few days at least, you should get away somewhere by yourself, shove aside the noise and distractions in order to give yourself the margin to think and ask yourself, “Am I where I want to be in this season of my life?” If not then, “Where do I want to be?” This kind of self-assessment is fundamental to keep you in control of your own destiny to the extent it can be controlled. Lao Tzu said it best, “If you do not change direction, you may end up where you are heading.”


Every end of something is a beginning for something else. The same is true for the end of your formal education and training. It is the beginning of your informal education and training, potentially your most thrilling and rewarding period of personal growth.