Welcome to this week’s edition of Dear Dr. Horton! Send the anonymous questions that keep you up at night to a real former Dean of Medical Student Affairs, Dr. Jillian Horton, and get the perspective you need with no fear of judgment. Submit your questions anonymously through this form, and if your question is appropriate for the column, expect an answer within a few weeks!
Dear Dr. Horton,
It seems everyone is always talking about the importance of having a strong support system around you. While I’ve managed to make casual acquaintances among the pool of colleagues and co-learners I see from time to time, these relationships feel fairly superficial. Yet no one seems to have the time to forge deeper connections…
How do you build your “tribe” in medicine, given how busy everyone is?
Dear Lone Wolf,
My first day of med school, there was a lot of screaming. I was doing mine on the inside, but everyone else seemed to be directing theirs at long-lost friends from private school/undergrad/boy scouts/cooking class as they threw themselves at each over the registration table, squealing, “Oh my Gosssshhhhhh!” I wondered if I was the only person in the class who literally knew no one, until I met another girl who also literally knew no one, and then at least we could say that we knew each other from “before” — “before” being defined as a few minutes prior to our first class officially starting.
I can still remember how, in my first tutorial that week, one of the guys in my group said casually, “We’re going out with a bunch of our friends tonight, if you want to come.”
A bunch of your friends? How could this guy have already made “a bunch of friends” in the time I had spent wandering around campus trying to find the registrar’s office so I could get a crummy stamp entitling me to 20 percent off my monthly bus pass?
My undergrad years were different from his. I never made a group of friends big enough to be compared to grapes. In fact, I found some of the Grapes in various bunches that were forming around the med school very annoying. These Grapes were often the ones submitting infinite clusters of photos of themselves hanging out together to the Yearbook, going to Mexico for Spring Break, or shopping for stethoscopes together — and the message always seemed to be, “Look at us!” Sometimes, I had the feeling that they were declaring themselves as the alpha friend group, and I thought I’d left that behind in junior high.
I didn’t find my tribe in those first few years, Lone Wolf. I did find a few friends who laughed at my stupid jokes, and I found a fantastic study group that included the Girl Who Didn’t Know Any One Else whom I’d met on the first day. But we weren’t Grapes.
I’d like to tell you that clerkship changed it all. It certainly mixed things up; clerkship can be a bit of an equalizer, insofar as you end up working with people you might never have exchanged two words with beforehand. But it wasn’t totally transformative in the way I hoped it would be, and — in the end — while I finished medical school with some good friends, they were not my tribe.
If you think of med school as a process of differentiation, then it will make sense to you that you are more likely to find a tribe in residency. The people who gravitated towards the specialty you chose will have more in common with you than all the people who chose something else. And since residency has broken apart all the bunches of Grapes, it gets easier to see the other lone wolves. And sometimes, by nature of our aloneness, we become close.
But here is how I really found my people: every time somebody on the ward did something brave or awesome or compassionate, I spotted a member of my tribe. They weren’t just doctors; they were also ward clerks, nurses, and pharmacists. Their actions told me that they shared my deepest values and motivations. I got to know these people, and I came to like them as much — and sometimes more — than some of the doctors I worked with.
This takes years. It feels like an eternity, and the irony is that you need that network before you can possibly have it.
What can you do to expedite the process? Counter superficiality with realness. Counter arrogance with humility. Counter indifference with compassion. Counter cynicism with openness. Repeat, repeat, repeat.
That is how your Tribe will recognize you as one of their kind. When you find each other, you can begin your life’s work. And if you’re lucky, it won’t always feel like work, because you will have found your calling.
Dr. Jillian Horton is a graduate of McMaster Medical School and completed her residency and fellowship in general internal medicine at the University of Toronto in 2004. She was the Associate Dean of Undergraduate Student Affairs at the University of Manitoba from 2014–2018 and now directs programs in wellness and medical humanities at the Max Rady College of Medicine. She has won awards for mentorship, professionalism, and teaching at the undergraduate level. She is also a mother, musician, and writer. As an Associate Dean, she cared so much about undergraduate students because she never forgot what it felt like to be one of them.
Thank you for sharing this. What a great question and great response.
I also felt like a “lone wolf” in medical school; the endless competition, the cliques and other “high school antics” was frustrating and isolating. In residency, I felt this way much less so; but it is really only as a staff physician that I felt like I was forming the connections one needs to thrive in medicine.
Keep in mind that it takes time to form these connections. The statement “This takes years” is absolutely true. The people around you will take the time to get to know you once they know you will be around for a while- which is impossible to some degree as a medical student and resident where there is no sense of permanence. Look for an environment that welcomes and supports new physicians- when you are a locum, but also as a resident. Then settle in and be that person who welcomes and supports others: colleagues, staff and students.