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Faculty Reflection: Transitions by Dr. Gary Tithecott

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Monday, September 14, 2015

The events of our White Coat Ceremony, our Foundations Week for Medicine Class of 2019 hosted by faculty, guest speakers and students, the return of classes and the start Clerkship, brought me to reflect on how this month will transcend careers.

While it is one of many similar events in each student’s career, I realized how extremely meaningful this time is and the impact of it when I spoke with our students. The realization of how powerful this time truly is was the obvious anticipation of a new part of their career on a life-long path moving towards defined and yet undiscovered goals.

In medicine, we strive to advance ourselves, our peers whom we are privileged to work with, the care of our patients and health of society and our world to a higher mark. It is a career of life-long learning and adherence to long established guidelines – as recited by our Associate Dean of Learner Equity & Wellness (LEW), Dr. Terri Paul, in the Hippocratic Oath at our Convocation and White Coat Ceremonies. It is a privilege and a trust to learners and families at each event – as Dr. Strong stated in his addresses.

It was great to welcome the Medicine Class of 2016 to Clerkship, the Class of 2017 to second-year studies and the Class of 2019 to curricular studies. As I looked across each class – in person and by videoconference link to our Windsor Program - I was struck by the smiles, interest and anticipation of what lies ahead in the new academic year and careers as future physicians and clinical scientists.

But as I looked out at the faces in our lecture rooms, at the Meet and Greet in Windsor and recall our first combined Medicine-Dentistry White Coat Ceremony earlier this month, I realized there was more.

The pride, anticipation and engagement in each eye I surveyed were beyond palpable. In everyone, resided excitement for what lies ahead this year and beyond. This was truly the result of another key transition in their lives – as individuals, future physicians and professionals.

Transitions – positive for some and tragically adverse for others – happen to untold numbers of people worldwide each day. For clinicians, they are a significant part of delivering care to patients and families. We are humbled as a profession, to share the personal moments of patients’ lives that are driven by anticipated or suddenly unannounced transitions.

As a pediatrician, transitions are common in the patients and families to whom I am entrusted to support and deliver care. My field transcends from birth to the end of the second decade of life. I reflected on what I have observed in the countless transitions I was part of while delivering care or in medical leadership. These thoughts became meaningful as I looked out over Alumni Hall on our White Coat Ceremony and later that day spoke with the Medicine Class of 2019 on their new world. Transitions can build personal strength but are also stressful.

What do we know about transitions and how they shape resiliency as a person and professional? While I commonly cite to my patients that two of the more challenging transitions you face are entering secondary school and post-secondary education, it is clear that we learn from, and grow with, each milestone throughout our lifetime – regardless of age or reason.

While there is much written on transitions – little is rooted in medical literature.

To ground this discussion, what is meant by “Transition”? The Merriam-Webster dictionary defines this term as: “a movement, development, or evolution from one form, stage, or style to another.” [1]

Entering, re-entering or moving to a new stage of learning – as our students have experienced this month - is a time that stirs excitement, emotion and anticipation. If handled well, transitions build personal growth and move lives forward.

As a student, when you approach or are immersed in a significant career transition, what should you expect? Taibbi cites transition promoting feelings of anxiety as it is a new era in your life. [2] What helps you succeed in moving to a successful next step? His review suggests the power lies in thinking positively and having multiple levels of support – from families and close friends to colleagues. [3]

To each of you preparing for a transition, I have the following to offer. A recent article citing transition from medical school to residency identifies security in your knowledge and the presence of a network of support – personal, peers and the learning environment – as foundational to success. [4]  Key factors to drive forward with positive outcomes include: mentorship by others, security in self-confidence, empathy and a strong self-awareness. [4]

We know from studies in Australia on students entering university studies from secondary school that key transition success factors lie in: high levels of optimism and personal adaptability. [5] Having the background of strong support systems (social, personal and family) believing in you and addressing any anxiety arising with or escalating from the event is paramount to positive results. [5]

As you move through a transition, some talk of success coming from your adaptability. What can we learn from this? A recent report cites successful, adaptable people as having personalities that strive to demonstrate or explore: experimenting, always looking for opportunities, being resourceful, planning for the future, staying curious, amenable to what arises, able to reflect on the beliefs of others and standing up for what they believe in. [6]

The later sound much like our curricular objectives or competencies – derived from the CanMEDS competencies of Canadian medical education. [7] [8]

So where does this leave you as a student? First – it is okay to feel anxious. You need to share these feelings with partners, friends, peers and family. If necessary, access resources we offer in our Learner Equity & Wellness (LEW) Office.

Secondly, there are many areas you can grow from in knowing more about transitions. One is to use reflection in better understanding yourself and others now and throughout your career. Our program supports you to adopt this skill in many courses throughout your four years – especially the Professional Portfolio course.

Thirdly, seek and establish a strong peer and mentorship network – for life. Start now and always work on it, as you would on other personal goals. Many who care and understand surround you. Reach out and don't stop connecting.

You will experience many transitions in your career. Each will be meaningful and offer a different twist. All will have the same issues I have offered to you today. Take each moment to learn, support others and grow as a strong professional and work always as a team – in your class and with peers. Enjoy every minute.

Welcome back and every success for the 2015-16 academic year!

GT




Bibliography

1. Merriam-Webster Dictionary. 2015, Encylopedia Britannica.
2. Taibbi, R., Keys to Handling Life's Transitions. Psychology Today, July 31, 2013.
3. Taibbi, R., Keys to Handling Life's Transitions. Psychology Today, July 31, 2013: p. https://www.psychologytoday.com/blog/fixing-families/201307/keys-handling-lifes-transitions.
4. Cameron, A.M., J.; Szmidt, N.; Hanlon, K.; Cleland, J., Can new doctors be prepared for practice? A review. The Clinical Teacher, 2014. 11: p. 188-192.
5. Morton, S., A. Mergler, and P. Boman. Managing the Transition: The Role of Optimism and Self-Efficacy for First-Year Australian University Students. Australian Journal of Guidance and Counselling, 2013. 24(01): p. 90-108.
6. Boss, J. 14 Signs of An Adaptable Person. Forbes, 2015, September 3. http://www.forbes.com/sites/jeffboss/2015/09/03/14-signs-of-an-adaptable-person/?utm_campaign=Forbes&utm_source=TWITTER&utm_medium=social&utm_channel=Leadership&linkId=16767964.
7. Education, U.M. Curriculum Competencies. 2014  [cited 2015 September 4]. http://www.schulich.uwo.ca/medicine/undergraduate/about_us/curriculum/competencies.html.
8. Frank, J.R.S., L; Sherbino, J, The Draft CanMEDS 2015 Physician Competency Framework. The Royal College of Physicians and Surgeons of Canada, 2015. Ottawa.





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