Volume 18, Issue 5 p. 373-374
FROM THE EDITOR-IN-CHIEF
Open Access

Who do you want to be?

Samir S. Shah MD, MSCE, MHM

Corresponding Author

Samir S. Shah MD, MSCE, MHM

Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA

Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA

Correspondence Samir S. Shah, MD, MSCE, MHM, Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, ML 9016, Cincinnati, OH 45229, USA.

Email: [email protected]; Twitter: @SamirShahMD

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First published: 26 April 2023
Citations: 1

Graphical Abstract

I was recently reflecting on a work-related dinnertime conversation where someone was asked “What do you want to be doing in 5 years?” I've asked some version of this question countless times while interviewing candidates for residency, fellowship, and faculty and during numerous conversations with mentees: “In 5 years, what do you want to be doing?” “Where do you see yourself in 5 years?” “What would be your ideal job?” At some point along the way, I realized that while these types of questions are easy to ask, they're extraordinarily difficult to answer.

Life is complex and complicated. We navigate so many circumstances, predictable and unpredictable, both at work and at home. It can be challenging to think that far into the future. There are days when I can't figure out what to have for dinner, let alone think about what I'll be doing in 5 years. In moments of deep introspection, I'll play a game where I ask myself whether I would be content doing then what I'm doing now. The answer, to quote the musical group They Might Be Giants, is almost always “Yes. No. Maybe. I don't know. Can you repeat the question?”

Phrasing that emphasizes the “what” yields a (fairly) easily measurable and inherently results-oriented response. In theory, this approach to questioning provides insight into our motivations and future goals, and whether we might desire to remain with an organization in the long term. However, these types of “what” questions place a lot of emphasis (too much, I think) on the outcome. You're forced to concoct scenarios where progress can only occur when a specific outcome is achieved. This transaction, of sorts, places us on a narrow path where alternate possibilities may not be explored, or offered. And, often, the path may not align with the person we eventually become. Ultimately, the “what” question feels rhetorical, and the answer speculative. Neither party benefits.

An alternate approach, one that focuses on personal growth and development, might be more useful in some circumstances. This alternate approach can prompt reflection, raise awareness, and inspire.

Early in my career, I struggled to balance the dual challenges of developing a research career and raising young children. On the research side, I was studying hospital-acquired infections. I enjoyed asking and answering important questions in this domain. I felt reasonably competent, and I felt confident that I was developing the subject matter and methodologic expertise to succeed as a clinician-investigator. What prompted me to move away from this established line of work, however, was frustration that my publications only appealed to a niche audience. My work did not cross disciplines or sites of care. The influence of my work seemed small and the advances incremental.

My existential crisis was not about what I wanted to do but rather who I wanted to be. I realized that I wanted to be a person whose impact was felt on a day-to-day basis, and this was much more important to me than the details of any condition I studied. This realization prompted me to shift my scholarly focus less than a year before my planned career development award submission. In sports parlance, this change would be the equivalent of a coach giving his or her team a new playbook minutes before the start of the championship game. My career development award focused on improving care for children with pneumonia and my work eventually led to providing hospitals with tools to compare performance. As my career continued to evolve, my day-to-day impact has been made in different ways, as a mentor, committee chair, division director, and now as a department vice chair and journal editor.

I also very intentionally changed my approach to parenting. I wanted to raise healthy, courageous, and empathetic children. This meant that I needed to be a persistent presence in my children's lives. The implication of this conscious decision means that sometimes I decline speaking invitations or rearrange my conference travel to minimize conflicts with events in my children's lives. It also means that I volunteer as a soccer coach and as a member of the school board though time is scarce. You'll also occasionally see me editing a manuscript in between quarters of a lacrosse game. It's not easy but this is who I want to be.

Now, when I interview or provide guidance, especially to those finishing their training, I will often ask “Who do you want to be in 5 years?” This question shifts the orientation away from destination and toward development and exploration. When I ask this question, I'm not expecting them to name a person but rather seeking to understand—and help them better understand—what they value. Our values provide purpose and working toward this purpose leads to fulfillment.

Sometimes it's important to think less about what you want to do and more about who you want to be.

CONFLICT OF INTEREST STATEMENT

The author declares no conflict of interest.