An excerpt from Career & Life Planning Guidebook for Medical Residents: The Best Part of Your Journey Is about to Begin.

Life is a journey. Where is this journey of life taking you? Do you know? If I asked you where you will be in seven years, could you tell me? Do you have goals you are in the process of achieving? Have you written them down?

There are two ways to sail through life. One is in a boat that has no rudder or sail; content to float wherever the wind and waves take you. If this is your plan, you are not likely to be happy with where you end up, especially if it is in the rocks.

The second way to navigate through life is with a rudder, sail, map, compass, and a plan. In this case, you are very likely to end up exactly where your plotted course leads. This chapter is all about making that plan. Deciding where you are going in life is the first step to getting there.

What do you really want in life?

Maps are a great tool. They help you get from here to there.

But even the best map in the world is useless if you don’t know where you currently are and where you want to go. Without both pieces of information to plot your course, the map becomes just another pretty picture.

You most likely know where you are, but do you know where you are going? Controlling the direction you are headed is a function of setting goals. Goals are the things you plan to do to get you where you want to be. The goals you set should align with your priorities in life. Priorities are the fundamental philosophy and rules under which you will live your life. If you have a mismatch between your goals and priorities, you become unhappy.

What if spending evenings with your family is one of your priorities. Occasionally something may come up that prevents you from being home for dinner as planned. An important meeting or an emergency may extend your workday. If your family sees you at home most nights, they can tell this is your priority, even when an occasional event prevents you from being at home.

But what if you announce that your new goal is to be the highest producer in your clinic? To accomplish this, you will extend your clinic from 5 p.m. to 8 p.m. to accommodate people who can’t get off work earlier. What will your family feel about your priorities? How will you feel about the mismatch between your goals and priorities?

Before you set goals, first establish your life’s priorities. Then don’t ever set a goal or accept a responsibility that will conflict with these priorities. If you have firm priorities in place, you will find it easy to say ‘no’ to something that goes against one of your priorities.

Have you ever really thought about what is important to you? Have you ever listed your true priorities? Today is the day. In this exercise, you will need to listen to your heart to establish what is truly important in your life. There are many areas in which to establish priorities, but for this exercise, we will concentrate on only three of them. Now you have established the general direction you want your ship of life to sail. Next, let’s begin to define the specific things you need to do in order to get there and what course you will be using on the map.

Put your family first

I have heard so many doctors state their highest priority is their family, but when I look at what they do on a day-to-day basis, it’s obvious that their family is not even on their priority list.

It is easy to say that you will put your family first, but it’s hard to do. That is why you must establish your priorities and examine each goal or commitment to see if it fits within your priorities before obligating yourself to it.

Things will constantly come up to challenge your priorities. If you know your priorities well, you will have an easier time sticking to them.

One of my priorities was to spend time with my family. So when I learned that the youth soccer league my kids played in needed a coach, I could easily say yes. Coaching my child’s soccer team gave me more time with my kids and matches my priority.

When I took on that responsibility, I made some changes in my work schedule to accommodate soccer practice. One doctor asked me how I could possibly have time to be a soccer coach. We were in the same specialty, and he knew he would never have the time to coach soccer. I told him two things: First, spending time with my family was a priority. Second, I’m the boss at work. If I want soccer practice to be on my schedule, I put it there. I’m the doctor, and I’m in charge.

The most expensive mistake you will ever encounter is to destroy your marriage. It’s an instant loss of 50 percent of your wealth and probably more than 50 percent of your happiness, and will negatively affect your children for years to come. Do everything you can to cultivate your family relationships by making them a priority, and you will enjoy a wonderful future with your partnership at home.

Define your dream job

You are on your way to becoming a physician with a great life; I know that because you are reading this book! There are many different paths you can take in choosing your job as an attending. If you don’t figure out which path is right for you and your family, you will likely be unhappy.

Too many residents don’t think through what they want out of their career before they accept their first job. They just take the first high salary they’re offered. That’s one of the many reasons why about 50 percent of all new attendings leave their first job within a few years. I don’t want you to be one of the statistics who realize their job is heading in the wrong direction after just a year or two. Your happiness level, satisfaction level, and financial standing will all flourish out of the residency gate if you pick the right job the first time. It is very expensive, stressful, and unnecessary to go through another job search. Choose well the first time.

Meagan W. Vermeulen is a family physician and Todd Skertich is founder, Adventures in Medicine. They are the authors of Career & Life Planning Guidebook for Medical Residents: The Best Part of Your Journey Is about to Begin.

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