As I finish my 21st year of clinical practice, I have been reflecting a lot about my career. Several friends asked me for advice as their children begin medical school. Instead of repeating myself, I decided to make a list. Here are the five things I would tell my younger self.

1. Just apply. Recently, I attended a luncheon and sat next to a female physician. I hadn’t met her before. I learned that she was the CMO at a nearby hospital. She was very young—a few years out of residency. I asked her how she got the job. She shrugged her shoulders, “I just applied.” I was confused. What did she mean she just applied? Did she have healthcare administration experience? No. Did she have an MHA or an MBA? No. Did she have some connection that helped her get the job? No. She told me that she had confidence in herself. If she could master a job as hard as medicine, she could certainly figure out a job in administration. A commonly quoted business statistic states that men apply for a job when they meet 60 percent of their qualifications. Women only apply when they meet 100 percent of them. So, go out there and apply for things that interest you. You may not get everything you try for, but you’ll never know unless you apply.

2. Find new ladders to climb. Think about that ladder we call medicine. It goes something like this: Get straight As. Ace your MCATs. Get into medical school. Do well on your rotations. Apply to residencies. Then, one day, become an attending. Perhaps, it’s different in the academic world. But, in the community where I work, once you become an attending, you have reached the top rung. I remember my first day of work. I looked over at my colleague. She had been practicing EM for 24 years. Yet, we were equals. We were seeing the same patients. We were doing the same things. She was an attending. I was an attending. I was confused. Wasn’t there supposed to be some sort of reward? What should I strive for next? What was the next rung on the ladder? Among the goal-oriented people who go into medicine, I don’t think I was alone. It took me a few years to realize that I climbed to the top of the “physician ladder.” Now, I needed to stop and look at what other ladders I wanted to climb. So, explore what else might interest you, and then start climbing that ladder.

3. Remember why you went to medical school. Even though my medical school interview was over 20 years ago, I vividly recall one question: “Where do you see yourself in 10 years?” I had prepared for this interview but had not anticipated this question. I answered with the first thought that came to mind: I wanted to change the world. Despite being embarrassingly naive, my response seemed to come from within. Fast forward several years into my career; I was feeling blah. I remembered my impromptu response from many years ago. Perhaps there was something there. I decided to take the summer off. I traveled to rural Nepal. I practiced in a resource-limited setting. I treated diseases I had only read about. I cared for grateful patients. This changed my perspective and my love of medicine. Since that summer back in 2014, I have been back many times. I started a women’s cooperative that focuses on entrepreneurship and nutrition. These few months every year fill the void I feel practicing medicine in the U.S. Although I am not changing the whole world, I am changing the lives of a handful of rural Nepali women. So, think about your earlier dreams, no matter how far-fetched, and see if you can make them a reality.

4. It is a marathon, not a sprint. In medicine, we have a distorted view of time. Go faster. Be the first. We blast through years of training at breakneck speed. Even after we complete our training, we never even consider slowing down. We commit to more things. Early in my career, I did something very unconventional at that time: I decided to work part-time. Did I feel guilty about it? Absolutely. But I decided I wanted to enjoy what I had worked so hard for: motherhood, hobbies, and life in general. Spending time on these outside interests completely filled me up. They made me enjoy my time at work much more. I worry when I see young doctors, fresh out of residency, working long hours. I’m saddened to see them completely tapped out three years later. Many are looking for their exit from medicine. In medicine, “slow and steady” truly wins the race.

5. Think of your hyphens. One of my favorite books is Paula by Isabel Allende. It’s a memoir she wrote at the bedside when her daughter, Paula, was in a porphyria-induced coma and later died. Allende was married to three different husbands throughout her life. She writes that she was a different person in her 20s than in her 40s, than in her 50s. Her interests and ambitions changed as she got older. Think about this. Were we really supposed to be the same person and do the same things for 30 to 40 years straight? Perhaps in the olden days, it was normal to go through life working at the same company, doing the same tasks. But now, times have changed. It’s healthy to think of your “hyphens.” Are you a physician-entrepreneur? Maybe a physician-writer? I began to find my voice when I embraced my hyphen as a physician-artist. I started to spend time doing things I felt passionate about. As you get older, your interests change. This is perfectly okay. Remember, being a physician is only one part of your identity, not your whole identity.

Reflecting on these pieces of advice has been quite enlightening. It has allowed me to reflect on who I am as a person and what I want to continue for the next stage of my career.

Sapana Adhikari is an emergency physician and artist.