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Joshua J. Goldman, MD

Bio Advanced CMF and Microsurgery Fellow; Medical Innovation*Evidence Based Medicine*Quality, Patient-Centered Care. Views are my own.

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. [volume up for pure joy] . Its 3:30 am, raining, and lightning in Michigan and I just fed a hungry baby. Karen picked me up from work (I usually walk) on her way home around 7 pm after a difficult, humbling Friday in the OR for both of us (the gods are not always kind or generous, and for her, ortho chief resident things). I had/have studying to do, work to catch up on, opportunities to take advantage of, writing to start, research to finish. But first…this. Always this. . If you’re goal-oriented, in the truest sense of the word, it’s easy to forget to breathe. Five months and three days ago this tiny human changed my perspective, my temperament, my passion for life, my direction, but more than anything and part of everything, he enhanced my appreciation of seemingly mundane moments of the most infinite import. Now, I try to live in them. . In addition to the sheer exhaustion of being a new parent and a physician in training, I’m more efficient than ever with my time, my efforts are focused, I’m more compassionate, more sensitive, and infinitely sillier (less self-conscious). I can read board prep questions in a wide range of ridiculous voices, I know The Very Hungry Caterpillar by heart and I’m pretty sure he knows the Gustilo and Sunderland classifications, I can type and do bicycle leg pumps, I can rock a baby and wash a bottle/make dinner/take call/jot notes. I can officially , but there are moments, like these, where there is value to putting everything else down, on pause, and just being present. I see that more clearly than ever when he laughs…and I melt. . Lesson to myself: Go ahead and do both, together, but don’t forget to let yourself fully enjoy both, separately. . . . . 😊

 image by Joshua J. Goldman, MD (@goldstandardplasticsurgery) with caption : "With 1 in 8 women diagnosed with #BreastCancer over the course of their lifetime, nearly everyone has been touched, in o" - 1883007715381236551
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With 1 in 8 women diagnosed with over the course of their lifetime, nearly everyone has been touched, in one way or another, by the disease. Much of my plastic surgery residency focused on reconstructing aesthetically pleasing breasts after mastectomy or lumpectomy, after radiation and/or chemotherapy, immediately or delayed. My fellowship is about 70% cancer-related and 50-70% of that is microsurgical breast reconstruction. It is an honor to be part of the journey and a pleasure to restore form and enhance quality of life and sense of self. . Some Breast Cancer and Reconstruction facts from the ASPS website: . Today there are more than 3.1 million breast cancer survivors in the United States . The total number of reconstructive procedures by ASPS member surgeons has remained relatively stable at 5.8 million annually since 2015 . Less than half of all women who require mastectomy are currently offered breast reconstruction surgery, and fewer than 20% elect to undergo immediate reconstruction. Studies have revealed that 23% of women understand the wide range of breast reconstruction options available. . The Breast Cancer Patient Education Act (BCPEA) was signed by President Obama in December 2015 and implemented in October 2016 to inform breast cancer patients about the availability and coverage of breast reconstruction and prostheses. [Provision of education regarding availability remains a major obstacle to providing optimal breast reconstruction to patients.] . Did you know? . The Women's Health and Cancer Rights Act of 1998 (WHCRA) is a federal law that protects patients who choose to have breast reconstruction in connection with a mastectomy in terms of insurance payment. It also covers procedures for symmetry in the case of unilateral mastectomy. . . .

 image by Joshua J. Goldman, MD (@goldstandardplasticsurgery) with caption : ".
Education must not simply teach work; it must teach Life.
- W. E. B. Du Bois
The first few months of fellowship have" - 1878546459979150523
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. Education must not simply teach work; it must teach Life. - W. E. B. Du Bois . The first few months of fellowship have been an adventure. Occasionally, I feel like an odd bird standing awkwardly between who I am and who I will be, but the advantages far outweigh any potential down sides. I have had unique, quaternary-level experiences, achieved new skills/techniques and refined previous ones, gained confidence in every aspect of patient care (preop, surgical, post op, advocacy, career development, business logistics, etc), expanded my knowledge base exponentially, made new contacts, colleagues, and friends, and have grown as a physician and as a person. Every moment, has been an opportunity to advance personally, educationally, and professionally, and it has been nothing short of incredible. . If you're a out there wondering where you are in this picture, you are a little seedling. Congrats on the exciting growth and journey ahead. Residents and fellows, get ready to bloom. Attendings, here's to not wilting too soon! ; ) . . . . Photo by KT on Unsplash

 image by Joshua J. Goldman, MD (@goldstandardplasticsurgery) with caption : ".
No act of kindness, no matter how small, is ever wasted.
- Aesop
I drove to #flintmichigan (over an hour away; a pla" - 1877655803853041527
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. No act of kindness, no matter how small, is ever wasted. - Aesop . I drove to (over an hour away; a place that's been in the news quite a bit) at 5 AM yesterday morning to do cleft palates and attend the Mott Children's Health Center Craniofacial Clinic. I worked with physicians, therapists, dentists, social workers, nurses, and other tireless, inspiring healthcare advocates volunteering their time and effort to help kids who need them. There are people, all around us, who are in need of human kindness. While a lot of humanitarian interest focuses abroad (an important endeavor), there is work to be done domestically as well. . Days like yesterday make me wonder what we would be capable of if caring was our priority. Sometimes we get caught up in the hustle, sometimes our efforts get displaced, sometimes entitlement gets the best of us. Sometimes we build just to build, even if it takes us further away from the purpose of the project. But we can always change course, even if just for a moment, and give back. . Some questions to ponder: Why isn't helping people the coolest thing we can do? Why isn't the number of lives positively impacted a widespread, agreed upon, measure of success? Why do large portions of the population know the names of all the Kardashians but not a single contemporary scientist? Why are our leaders (elected officials to hospital admin) not chosen for combined competence AND compassion? When did pride in work and sharing become aspiration for fame and finance devoid of productivity or purpose? Discuss below . My medical ethics mentor told me, "Ethics is easy. Just do good and be good." We don't have to agree on the path to good, but we should aspire to it. . . . . . Photo: Matt Collamer

 image by Joshua J. Goldman, MD (@goldstandardplasticsurgery) with caption : "My new article is out on Op-(m)Ed (link in profile)! This one is a little different, and it's certainly an outward chall" - 1875754517343999609
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My new article is out on Op-(m)Ed (link in profile)! This one is a little different, and it's certainly an outward challenge to the reader to read, digest, ponder, and repeat. I firmly believe the key to fixing healthcare lies in reconnecting the patient and the provider experience, and to do that, we have to tap into each others perspective and our shared humanity. . The article stemmed from the saying "A boil is no big deal...on someone else's neck." . What does this quote say to you about healthcare perspective? . Excerpt: "Perhaps a major distinction between the noble art of medicine and the stripped-down “healthcare provider” lies in the distinct ability and obligatory, if not altruistic, quest to better perceive health from outside oneself." . What is the role of the humanities in improving the quality and efficiency of healthcare? . . . . . . . . . . . Image: Justin Schüler on Unsplash

 image by Joshua J. Goldman, MD (@goldstandardplasticsurgery) with caption : ".
Trimmed Beard. ✔️
Unapologetic Man-bun. ✔️
Board Eligible Plastic and Reconstructive Surgeon, CMF Fellow, Microsurgery" - 1869876706364143541
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. Trimmed Beard. ✔️ Unapologetic Man-bun. ✔️ Board Eligible Plastic and Reconstructive Surgeon, CMF Fellow, Microsurgery Fellow. ✔️✔️✔️ Fortunate partner to a brilliant, beautiful orthopedic surgeon who made me a proud dad. Big ✔️. Baby ✔️. Researcher and Scientist. ✔️ Pop-Philosopher. Writer (@Doximity Fellow). ✔️✔️ Cautious Optimist, Secular Humanist, Social Progressive. ✔️ Nature-lover. ✔️ Music and Film Aficionado. ✔️ Theme-party enthusiast. ✔️ . All day, everyday…Me. ✔️ . Credentials make you a competent physician and surgeon () but individuality () makes you human, and it’s important too. Once you have all the certificates and experience that make a competent physician (these are the foundation), what makes a great doctor is personality, compassion, drive, individuality, and sincere desire to connect with and care for patients (this is the architecture). . Half-way isn’t in my vocabulary or my character. For some, “drive” means playing the game to climb the ladder. For me, it means taking my own path in my own way, even if that means building an entirely new ladder. When someone says “Denim-Themed Party,” I say “Challenge accepted!” And then I try to win a competition that nobody else seems to know is happening. That excitement translates to medicine. For some, “professionalism” means clean shaven, buttoned up, and character and job compartmentalization. For me, it means advocating for patient and physician wellness, involvement in professional societies, scientific pursuit, engagement in quality improvement, giving back, late nights studying for tomorrows, really knowing the people I work with, making the hospital and OR home, and going the extra mile to provide care to people (patients) I care about. . Professionalism and individuality are not mutually exclusive, and both have a place in Medicine. Staying well rounded keeps you human. Being human allows you to connect with patients and colleagues in a meaningful way. .   

 image by Joshua J. Goldman, MD (@goldstandardplasticsurgery) with caption : "Real Plastic and Reconstructive Surgery training is a long, competitive, rigorous model. Here is my training:
Health C" - 1868976957733907392
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Real Plastic and Reconstructive Surgery training is a long, competitive, rigorous model. Here is my training: . Health Careers High School (2003) - A magnet high school for kids interested in a career in medicine . Stanford University (2007) - Major: Bachelor of Science in Biological Sciences; Minor: Philosophy; NCAA Scholar-Athlete; Varsity Gymnast . Texas Tech University Health Sciences Center School of Medicine (2012) - Medical Doctorate (MD) . University of Nevada Las Vegas School of Medicine (2018) - Integrated Plastic and Reconstructive Surgery Residency (6 years of Plastic Surgery Training); 2018 Chief Resident. (Note: Integrated PRS is generally the more competitive and direct route to plastic surgery, the Independent pathway requires 5 years of General Surgery followed by 3 years of Plastic Surgery. Both are recognized by the American Board of Plastic Surgery) . Beaumont Hospital, Royal Oak - 2018-2019 Integrated Craniomaxillofacial and Microsurgery Fellowship (Advanced Pediatric and Adult Congenital, Trauma and Oncologic Reconstruction) . The importance of this campaign cannot be understated. If your physician does not have complete transparency regarding their training, credentials, and board qualifications, it’s time to get a new physician. @plasticsurgeryasps has recommended that patients for years now, and this campaign makes it even easier. This is especially an issue in aesthetic surgery, where physicians take advantage of confusing wording and substandard certifications to confuse patients (ie every Plastic Surgeon is trained as a Cosmetic Surgeon, but NOT every Cosmetic Surgeon is trained as a Plastic Surgeon; ya dig? It's confusing, I know) . Board qualifications are complex, but a good place to start is to check a physician’s qualifications online and see if their board certification comes from an organization recognized by the American Board of Medical Specialties. . People don’t go to dinner or order a new brand of sneakers without doing thorough research, why would you take a risk with your healthcare provider? . Thanks to @austinchiangmd for starting such an important campaign for patient awareness.

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One morning a month, as an Integrated Microsurgery and Craniofacial Fellow (), I lead the Ian Jackson Craniofacial Clinic (developed by and named after one of the CF greats). I learn how to take care of some of the most complex and difficult pathology that exists from amazing physicians and an entire interdisciplinary team. I also see everything from indifference and neglect to the highest forms of care, love, concern and patient advocacy from the patients, friends, and family. I’m not sure I’ve experienced anything more humbling than a child with a severe anomaly noting that he gets made fun of at school, but its him who feels bad for the bullies…”because they just don’t get it.” It’s grounding. The resilience and adaptation are inspiring, but the precocity and evolved thinking is what always astounds me. These kinds of patients force perspective, which is something I’ve considered a lot lately. . Every morning, I kiss my baby goodbye before work. Most mornings, I wake up early so I can play with him, watch him explore gross and fine motor skills (wrapping clumsy fingers around an owl with a bell in it), help him learn to stand and bounce and fly with my hands around his chest, teach him to laugh and play and not take life too seriously as we exchange funny faces, noises, and he drools the most drool anyone has ever drooled in the history of drool. I’m fortunate to have him (and his drool). I know I am. So I’m trying to better understand my own perspective and to practice taking others, so I can better teach it to him. . My next essay (on perspective in medicine) will be going live soon. And my next few posts are going to be on being an individual (in medicine and life), professionalism (my version), the constructs of success in medicine, and some of the art I’ve collected over the years. . . . . .         @stancesocks                    @aldo_s

 image by Joshua J. Goldman, MD (@goldstandardplasticsurgery) with caption : "What happened to the things we loved about clinic as medical students? Clinic was a limitless forum for learning. It’s w" - 1865907664934724391
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What happened to the things we loved about clinic as medical students? Clinic was a limitless forum for learning. It’s where I honed physical exam and history-taking skills, refined diagnosis and treatment algorithms, and first translated my passion for the science of medicine into meaningful care for patients. As a resident, it’s where I first really saw the toll taken by pathology and the vital role sincere treatment plays in alleviating suffering of all types. . Now, clinic is mostly exhausting. If it was exhausting from changing so many lives, and helping so many people, I doubt I’d be bothered by it. But the fact is, the exhaustion is mostly emotional, a subconscious dissonance, I think. Nobody went into medicine to spend more than half their time doing various forms of paperwork. Externalities, imposed by the healthcare bureaucracy, have built a divide of opposing vectors between the patient and the physician, and, tragically, convinced both parties that these are necessary, insurmountable evils. . They aren’t, and here’s the mind blowing part - they mostly don’t come from each other even though they so efficiently keep us apart. The interaction between physicians and patients is what made clinic great. Period. As neither of us have gone anywhere, I know we can take that back. I’m adamant about taking it back. Not just in the clinic, but in every aspect of healthcare. . Doctors, we are not breakable mannequins. Patients and physicians are not enemies. Medicine is not a chain. Health doesn’t belong in a machine. And healthcare bureaucracy is the man. As Lucas says in the classic 1995 film, “Empire Records”: “Damn the man. Save the Empire.” And, “In the immortal words of The Doors, ‘The Time to hesitate is through.’” . . . Photo Credit: Edu Lauton on Unsplash

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“You know you're in love when you can't fall asleep because reality is finally better than your dreams.” ― Dr. Seuss . Had an incredible weekend, celebrating in , , with all of our best friends. I cannot imagine two counterparts more deserving of a lifetime of happiness together. . The perfectly charming, historic, Manor House Inn , lobster, the uninterrupted sleep, living our best , lobster, a picturesque wedding, hiking , and, of course, , all offered a welcome reprieve from real life. Good conversation with a seemingly bottomless supply of laughter, beautiful people both inside and out, and humbling views of nature that quiet the mind as intensely as they incur wonder, have all nourished the soul, and it feels like there could never be too much of such a good thing. . On the way home, I reorganize notes and make to do lists, study for cases and boards, re-arrange childcare and examine schedules for mistakes and unforeseen conflict, address administrative duties, prepare for the week, the month, the year, write, read, worry, repeat. The reality sets in that I’m facing away from care-free and back towards the grind, heading away from friends and family and back to colleagues and peers, that mornings will once again be punctuated by battles with the snooze button instead of homemade baked goods, and the sun will soon be replaced by fluorescent OR lights. . In the middle of it all, we look at pictures from the weekend. We laugh quietly to ourselves about silly jokes and stupid moments that made us forget the seriousness that usually surrounds. More importantly, we remind ourselves of the beauty in our daily, less decadent lives, and take a second from preparing for work to start planning for the next adventure…and maybe the one after that. . “Don't cry because it's over, smile because it happened.” ― Dr. Seuss .

 image by Joshua J. Goldman, MD (@goldstandardplasticsurgery) with caption : "Such an honor to be named a Medical influencer by @happydocpodcast 
Looking forward to collaborating! Lots of big stuff " - 1856163456690731179
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Such an honor to be named a Medical influencer by @happydocpodcast Looking forward to collaborating! Lots of big stuff in the works. @drneel1973 ・・・ Our latest @happydocpodcast Medical Influencer of the Week is @goldstandardplasticsurgery & is an avid writer 4 @doximity @medium & writes about the flaws in the current medical education & healthcare systems. Just 4 the record, I enjoy working with Millenials (you can close your mouth now) and think it’s time we start working with next generations of physicians to practice, teach, & learn in the century we live in. Dr. Goldman believes the same & we @happydocpodcast are looking forward to collaborating in the future. Check out Dr. Goodman’s series in @doximity @medium 2 see his insights and perspective on changing medical education & healthcare.

 image by Joshua J. Goldman, MD (@goldstandardplasticsurgery) with caption : "My partner-in-crime/love/life knows I HATE taking muscle on perforator flaps. She's Ortho, and if she didn't care about " - 1852607346603998209
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My partner-in-crime/love/life knows I HATE taking muscle on perforator flaps. She's Ortho, and if she didn't care about me, she probably wouldn't even know perforator free flaps exist. We woke up at 4 am and I played with the baby while she got ready for a long operative day, and then she got the baby ready for a long tummy time day at a friends house. Before rushing out, she took the time to write this note for me to see before leaving for my day of microsurgery. . If I had only one piece of advice to give to medical students, it would be to build a strong support system of people, medical professionals or otherwise, who get you, who understand your passions, and support the lifestyle tied to those pursuits. . I have not good, but amazing, friends who have done incredible things. I share in the excitement of their successes in the same way they do mine. And when we get together, the gaps in time since we've seen one another disappear. My mom calls me several times a week even though she knows I'll only answer a couple of them. It's been that way since college, and she's never hesitated to just keep calling. My dad never fails to send a message telling me to breathe at just the right time, even when we haven't talked for a bit. My siblings are always there with unconditional love for a largely absentee brother. For six years, my co-residents and I looked out for each other in the trenches with unwavering commiseration and support. And the girl who got through it all with me, while doing it herself, the one who has written me little notes and left them in hidden places, she's been a rock. . You will let people down in your pursuit of medicine. You will miss funerals and weddings, baby showers, and baby milestones. You will be a bad friend and a weak partner. But if you built your life around people who get it, people who see that you are attempting to change the world in small and big ways, to save lives or improve them, and see that you are doing your best to balance work and life (assuming you are), you will succeed. And in the end, the people left will be the best kind: the kind you can count on, the kind who count on you.

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It’s no secret that @kdaws309 and I are so proud of this tiny human we made together (ok, she did most of the work). There is nothing easy or simple about two surgeons at the end of their training raising a baby. Long hours and sleep deprivation have turned into longer hours and sleepless nights, but it’s amazing how a smile and a coo, a new thigh roll, a drooled on shirt, and an achieved milestone can make it all melt away. . Thanks @drshawnakleban for the most thoughtful onesie and sound bar image. He obviously loves both and I wish he fit into things long enough to wear more than once. . We definitely have gotten by with help, support, and love from friends and family. Cute clothes, heartfelt texts, books, and music have enriched the first few months and imbued them with overwhelming love. So grateful for all of it. . Now back to studying for written boards, reading Avett board questions while he laughs, him on my stomach, Avett Brothers playing softly in the background, while Mom watches videos on ACL repairs and sneaks secret pictures of us falling asleep. . @theavettbrothers

 image by Joshua J. Goldman, MD (@goldstandardplasticsurgery) with caption : "When you meet a person for the first time, inevitably, even if subconsciously, you judge their face. Your brain scans fo" - 1837625587399403326
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When you meet a person for the first time, inevitably, even if subconsciously, you judge their face. Your brain scans for asymmetry, missing parts of subunits (portions of the face that are defined by 3-dimensional anatomy that causes light and shadows to fall in certain ways), scars, blemishes, wrinkles, skin tone and color and other imperfections and qualities. These features can tremendously affect others' impression of you as trustworthy or dangerous, tired, elated, and a bevy of other emotional states and personality characteristics, true or not. The importance of your facial structure (bone and soft tissue volume and placement) and skin health can not be overstated in its impact on how others perceive you. . But what happens when the very basic structures of your face begin embryologically abnormal or are ravished by traumatic or oncologic processes? . My fellowship integrates principles of craniomaxillofacial surgery and microsurgery (borrowing tissue from one part of the body to repair another) to provide patients with congenital facial anomalies, rare clefts and syndromes, cancer defects, and complex traumatic injuries with the best possible reconstructive outcome. By that, I mean, restoring or creating normal anatomy in an aesthetically pleasing way. Success, in that respect, starts with math and ends with art. . Tomorrow I start a weekend of Craniofacial Boot Camp to learn the math and art of complex facial reconstruction from some of the masters. Could not be more excited! . , , , . Photo Credit: Mathew Schwartz on Unsplash

 image by Joshua J. Goldman, MD (@goldstandardplasticsurgery) with caption : "From exams that each singularly determine your fate to a curriculum that absconds with the overwhelming majority of your" - 1817354740789190580
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From exams that each singularly determine your fate to a curriculum that absconds with the overwhelming majority of your time and energy, medical training has the nearly unique ability to pigeonhole its pursuers. Like many educational systems, the rigors take a hammer to creativity and innovation and smash them into little pieces of conformity. Pathways close themselves off, shine red, say, “don’t go here,” specific doors open at specific times, turn green, beckon, “yes, this way is okay.” The path is laid before you, the one of least resistance, but the reward is specific en mass, not individualized. . If your passions outside of medicine are true, you will never be fulfilled without maintaining some semblance of them. I let reading fall by the wayside throughout my medical training, exchanging philosophy and dystopian fiction for anatomy and operative techniques. But between medical school and residency, I picked up copies of as many classics, the ones we ‘read’ (SparkNotes’ed) in high school, and took them in with a fresh, more mature, perspective. Now, I pepper my academic texts with history, philosophy, and fiction. Staying intellectually well-rounded has been extremely important to me my entire life. Why would it change as a physician? . Last month, I motivated myself to step out of my comfort zone by entering free short fiction, creative fiction, and poetry competitions. I better acquainted myself with the limitations and qualities of my writing through the simple exercise of performance. While I have no expectations of winning, I surprised myself often and shed some of my fear of the unknown, of failing, of rejection - a different win altogether. . The lights should not be green and red, yes and no, go and stop. In the middle, there is a “Sometimes Entry.” The algorithms have tiny offshoots that are too thin to see and their non-linearity makes them difficult to assess in terms of endpoint. Maybe, as these webbed paths wind, the bends obfuscate the destination, directing your attention more squarely to the joy of the journey. .

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Cheers to all the interns who embarked upon their first day of residency yesterday, with their first long white coats, to all the residents who started the next year of 21+ grade with the new responsibility of seniority, and to all the fellows, like myself, who chose to keep on going as professional learners, to the chagrin of their bank accounts and loan officers, in the pursuit of sub-specialty knowledge and skill. . A little advice: . For interns - Ask as many questions as you possibly can, no matter how “dumb” you think they are. They will never be as well tolerated as this year. The caveat: make sure they aren’t easily google-able and you are asking the right person, at an appropriate time. . For residents - Don’t forget two very significant populations as you get exponentially more busy. The first, is the people below you (med students and juniors). They rely on you for teaching. Give many, mini-lectures and, in lieu of lectures, lead by example. The other, is patients. You are overworked and underpaid, but they are the reason why you started and why you’re here. Don’t be afraid to connect while you examine, diagnose, and treat. . I’ve gotten nervous before the first day of school/work since I was 5. The anxiousness is exacerbated when its a new place, new hospital, new attending, new EMR, etc. You feel the need to, once again, prove yourself to onlookers. Inevitably you question yourself and confront some form of imposter syndrome. But for some reason, this year, fellowship, feels different. I feel confident and excited. It’s my last year of formal education and I’m going to make the most of an amazing training opportunity. . Accepting fellowship advice. . Awesome stories and surgical experiences to follow! . . . . .

 image by Joshua J. Goldman, MD (@goldstandardplasticsurgery) with caption : "You think residency is tough, then you have a baby during residency/fellowship, and you learn the true meaning of surviv" - 1811906716541855014
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You think residency is tough, then you have a baby during residency/fellowship, and you learn the true meaning of survival mode. You find out how strong you are, your partner is, and what your relationship can withstand. You push old limits while you strive to achieve new goals. Your bar for success doesn’t necessarily change; mine hasn’t. But your measure of gracefulness on the way there certainly might. . Multitasking is a must because your time is shot. Systematic planning is vital because everything takes 25-100% longer than it used to. A security net of people who love you is invaluable. Flexibility and understanding are indispensable. . So far, deep breaths in stolen moments are the sine qua non of psyche maintenance. The exhaustion is beyond compare, but so is the reward. . From Scrubs (Turk and Carla to JD): “-Having a kid changes the way you think about everything. -Hell yeah it does. Before Izzie was born if I saw a half eaten meatball sub in the trash you’d better believe I would dust that bad boy off and go to town on it. But now, I’m not risking my health eating trash food. I mean, unless it’s a corn dog. -Newbie, the point is, when that kid comes, you…you’ll start seeing the world a whole lot differently. You’ll develop patience. You’re going to forgive easier. -If you got baby poop on your thumb, it’s no big deal you can just wipe it off on your jeans like that. . Never been more worked. Never been more happy. Worth the coffee burns, the milk stains, the varying degrees of sleep torture, the missed meals, parties, and showers. Worth everything. . 💪 . Photos from Unsplash: (Left) Nathan Dumlao, (Right) Tyler Nix

 image by Joshua J. Goldman, MD (@goldstandardplasticsurgery) with caption : "Excerpt from my new post published by Doximity’s Op-(m)Ed (Link in profile):
‘Who are Osler and Cushing in a world of " - 1810123407306274091
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Excerpt from my new post published by Doximity’s Op-(m)Ed (Link in profile): . ‘Who are Osler and Cushing in a world of Zuckerbergs and Musks? Why aspire to wear an over-starched white coat when you can don a broken-in hoodie? . Whether you want to classify them as millennials or demean them as snowflakes, there is a palpable change in the attitude of incoming medical students and residents…there is an unprecedented sense of entitlement based on prior accomplishment, or sometimes just potential, and an unwillingness to “pay dues” simply because their bosses did before them. They pay limited, if any, heed to tenure and offer minimal deference to title. They truly do not care if you hiked uphill, both directions, in the snow. In fact, they want to know why you chose not to reverse commute and walk downhill both ways or why you did not simply build a tunnel through the snow, whichever is more cost-effective. In a society that swiftly traded a “time-served” promotion system and reward model, for one of “value-added,” who can blame them. Medicine has lagged in this respect and many others. . The downstream effect: we are losing the recruitment battle for the greatest minds of the next generation.’ . Keep reading the full article at (copy and paste or go to link in profile). This is an article I’m particularly proud of and an issue that has personally challenged me to regain footing on multiple occasions. A must-read for anybody who is or works with millennials (aka everyone) in the healthcare industry and beyond. . Share your challenges and successes working with a new generation of up-and-coming providers. . . . @doximity . Photo by Helena Lopes on Unsplash