PCMS Member Corner: The Medical Hierarchy is Human

In March of 2020, COVID changed our lives and created chaos. At the time, I was a first-year family medicine resident. I had just found a groove in training and come to love my co-residents as family. I both felt and respected the medical hierarchy in those six months, looking up to my attendings as having all the right answers. Then, one after the other the pandemic hit and I became a mother. Ultimately, an epiphany: the medical hierarchy was human. Humans working to bring health to communities. Humans creating literal and metaphorical lives at home. Humans sometimes faltering for answers. It felt like a twin-demic – one viral, one humanitarian – from which my perspective shifted. In the end, I felt excited ascending the “hierarchy” to become (spoiler alert) an attending in the very place that good humans trained me.

Before ever thinking about who I might be after residency, I thought about transitions and goals. We transition from high school to college to medical school to residency. With each transition we hope to gain something. Yet for each transition, the goal is the same: to be a doctor. Once “doctor” is unlocked and specialization to “doctor of” happens, what does transition look like? Here is the question I found myself needing to answer after residency. Until now I had a map, like a Candyland board with its twists and turns. Now, I had a canvas. A vastness of opportunity to add my own sloppy signature all over. It was time to summon the achievements unlocked during all those transitions. It was time for some new goals.

Now, I am a few months into my role as faculty. This transition has been novel, exciting, and challenging. I enjoy working in a system I already understand. I maintained a panel of patients I love caring for. I have more work life balance and control of my time than ever before. Yet, one of the best parts of this transition has been getting the chance to connect with more humans. While moving from peer to attending has challenges, I hope that my unique experience helps blend medicine’s hierarchy. I hope that modeling lifelong learning and teamwork as I navigate my own imposter syndrome helps another doctor fill in their canvas. I am honestly in my dream(ed) job and couldn’t be happier. I am eager to evolve professionally alongside the humans I so respect both at work and in real life. I have wide open spaces now to dream the big, the small, and everything in-between in terms of my career which, for once, doesn’t just have one ending.

The pandemic helped me focus on the human in our leaders. Residency taught me to be a doctor, an advocate, and to check-in on others no matter your “level.” Motherhood grounds me and my life and actions are reflected via the eyes of a toddler (i.e., keeping me accountable!). Being a mom and an academic physician lends itself to advising so I’ll leave you with one bit of unsolicited advice that I’m working on, too—In a high stakes, chaotic, hierarchical system: be kind, share freely, and wear your personhood out loud.

Written by Dr. Karissa Wasiak, PCMS Board of Directors
January 2023