What I Wish I Knew in Medical School

Lessons in sustainability and surviving the medical culture.

Here’s a photo of me taken during what should’ve been a career high. I had just started my dream job: core faculty at a family medicine residency program, shaping the next generation of doctors and sharing the elusive art of how to practice medicine.

Instead, 7 months into my new role as Director of Inpatient Medicine, the world shut down. COVID hit.

I remember sitting in my office on a Zoom call with the doors closed, all of us quietly afraid of dying from a disease we didn’t yet understand. My face looked tired. Scared. We were trying to decide: Do we pull our residents out of the hospital? Or do we stay and help?

What you don’t see in the photo is that I had just drafted a 5-page contingency plan for our hospital and inpatient team, drawing from my Masters in Public Health and sheer panic. I stayed up late every night creating sample models for new team structures, patient flow, disaster preparedness, and safety precautions. In my mind, doing something was better than doing nothing and feeling helpless.

I wanted—no, needed—to stay and help. To me, it was the right thing to do. I had trained my whole life to be a doctor, to care for patients in their most vulnerable moments. And boy, were there a lot of patients.

Through the thick of COVID, I’d wake up every day at 3 a.m. to check for updates, comb through emerging studies on COVID, and memorize NIH guidelines. I was desperately searching for any new clue that might help save my patients.

And yet, I’d ask myself questions that no research study could yet answer: Would my patients survive the night? Would my husband, a hospitalist, be ok? Would our parents survive? I told myself that If I pushed harder, read more, did more – it would be okay.

But deep down, I knew that wasn’t true. We were all learning about this pandemic at the same time, making the best decisions with the information we had. My “doing more” was a way to soothe my feeling powerless in the face of uncertainty. In reality, there was nothing I could do to control the outcome.

The Culture We Inherited

While Covid was an extreme situation, it exposed something bigger about the culture of medicine: Our Hippocratic Oath calls on us to serve others ethically and with integrity, but the message got distorted somewhere along the way. We are now conditioned to believe we’re only “good” doctors if we push beyond our limits and sacrifice endlessly.

From the beginning of our training, we’re taught to override our most basic needs. Eating, drinking water, resting—things that should be essential—become suppressed. We bargain with ourselves: I’ll go to the bathroom after I see this patient. I’ll grab food once I finish charting. I’ll rest when this project is over. But the truth is, the work never ends. There’s always another patient, another chart, another urgent demand. Our medical training essentially teaches us to disconnect from ourselves.

I often found myself having not eaten or used the restroom at the end of the day, and operating on very little sleep. Part of it was imposter syndrome, the relentless need to prove I was capable as a new inpatient attending. And part of it was driven by my deepest fear of not being enough. Overworking became my way of avoiding the feelings of inadequacy.

The problem is, when physicians constantly push past our limits, patients don’t get the best of us. They get what’s left of us: doctors who are exhausted, numb and apathetic. We entered this profession with pure intentions of wanting to help others and make a difference. Yet in today’s medical industry, where medicine is treated like a business, there is no finish line. The demands are endless, and survival mode becomes the default over time. There are too many doctors living like this, mistaking survival for what being a doctor is supposed to be.

What Sustainability Really Means

For me, the breaking point was when I became a mother. Suddenly, I could no longer push through the way I once did. My choices were affecting my child, whom I loved more fiercely than anything in the world. That’s when I hired my first coach, who asked me one question that changed everything: “What needs to change so I can be the best mom I can be?”

That was when I began to understand what sustainability in medicine really means. It’s not about working part-time or stepping away from clinical work entirely. It’s not about taking more vacations, or clearing out your inbox messages. Those things might help, but they don’t reach the root of the matter.

Sustainability is about aligning your career and life with your values, needs, and the season of life you’re in.

What’s sustainable at 29 may not be at 39. What’s meaningful when you're child-free may shift after parenthood. What fuels you early in training may not serve you a decade later. And that doesn’t make you weak or less committed. It makes you human, constantly course correcting toward what feels right and what matters to you most right now.

My priorities had changed, and in that season, what I needed most was to be present with my daughter and watch her grow.

Part of sustainability is also learning how to rest. Just as our patients need time to heal, we need time to recalibrate and reset. Rest gives us clarity to make sound decisions, and allows us to show up more present, offering better care rooted in empathy instead of fatigue. When we model appropriate rest for our colleagues and learners, we redefine what “good” medicine looks like. We lead by example, showing that caring for ourselves is essential when caring for others. Rather than a sign of weakness, rest becomes a way to make medicine sustainable, and is the foundation of excellent, ethical care.

A New Kind of Legacy

Learning sustainability for myself was only the beginning. Once I saw the truth—that medicine doesn’t have to be built on self-sacrifice—I recognized how many of us were struggling the same way.

The industry of medicine has evolved dramatically, but the culture shaping physicians has not. What may have worked in a different era, when patient loads and administrative burdens were lighter, no longer fits the realities of modern medicine. We aren’t broken; the system is. Yet we continue to endure silently, hoping it will change on its own.

I realized that if we want something different for ourselves and the generations of doctors to come, we have to start rewriting the narrative now.

That begins with giving ourselves permission to question the norms we were handed, to say no when the cost is too high, and to design careers that honor not only our patients but also ourselves. It means creating spaces where physicians can be both competent and vulnerable, both skilled and human.