Jeremy Branzetti: Clinician. Educator. Scholar. Coach.

Shortly after the European discovery of the New World, Spanish Conquistador (probably better termed plunderer and murderer, but that’s another topic altogether) Hernán Cortés landed in Mexico on an exploratory mission. Upon landing, his exhausted soldiers resisted setting off into the unknown. In response, he burned all but 1 of his ships. The message was clear: there is no going back, only forward.

This story is somewhat apocryphal – in reality, he sank 10 of his 11 ships. But the takeaway is still the same: there’s no way we can all go back, so we must commit to the task at hand. And while we should all have reservations glorifying such a character for bold leadership, the action is something highly relevant to anyone undergoing a career change in academic medicine — or any profession, really.

How so? Fundamentally, humans are comforted by security and consistency. Uncertainty between two choices lacking a clear “right answer” results in significant anxiety and avoidance. Thus, for someone considering a change in their role, practice location, or academic focus, it can be incredibly hard to move forward. Heck, even when your gut tells you something is necessary, it can be incredibly hard to pull the trigger and move forward.

This is particularly true if you’ve met with some success in your current role, or the title/status of that role provides a benefit. On one level, we hold a scarcity mindset. We collect roles and titles, and then hold onto them. Sure, part of that is the sweet sweet FTE buy down that comes with such roles. But deeper than that is the need to demonstrate our value to others.

Don’t believe me? Listen how people introduce themselves at a professional conference – the string of jargon can sometimes be impenetrable. Then, try introducing yourself in a professional meeting of people who don’t know you, and not reference your role, title, position, etc. You’ll be shocked how few words you can come up with, and how quickly you feel “unimportant.”

This begs the question of personal identity and self value. What actually determines your identity? What is your yardstick of self value? To whom do we care to put ourselves up for validation? The risk of using external trappings – titles, roles, reputations – to define our identity can be that they indeed trap us in that identity. If you identify yourself as a Residency Program Director or an Assistant Dean, then, by definition, you need that role to maintain that identity.

Try contrasting that with an internally derived identity: “I’m someone who loves bedside teaching” or “I am someone who strives to give great feedback to learners.” Neither of these require a title. They are entirely self-determined. They require no one’s validation. You can be a great teacher, or great deliverer of feedback, in any place you choose to work. Note, I didn’t say “I’m seen as a great teacher” or “Students say I give great feedback.” Both of those require external validation in order to be true, and as you can imagine, awards, feedback systems, etc. are incredibly inaccurate. Should you search for objective markers of your self-professed identity? Yes. But should you hang you identity upon external validation? Absolutely not.

So, when facing the need to change, consider where your identity draws from. Better yet, consider talking with a coach; they are trained to help you reflect to gain the necessary insight into your true, authentic identity. Then, go ahead and burn those ships. Free yourself from the title, the role, the sources of external validation. Unshackled, you can move forward to new experiences, new opportunities for growth, and new insights into your true identity.