Congratulations, Class of 2012

The last weekend was a bittersweet one; we drove 3 hours north to see my sister- after 3 years of postgraduate medical education, she graduates from residency.

Showing much perseverance and grit, she made it through 3 harrowing years, including that character building/destroying internship.

Only to graduate from one of the top medical institutions in the country and arguably the world.

As a big brother, I could only beam with pride as we went to celebrate with her.

But yet, with the end of this academic year, comes the start of another, for her as well as the thousands of medical trainees. The medical students. Residents. Fellows.

And so, this week, she moves to sunny California to continue the next chapter in her professional life, at yet another leading institution. While we are excited for her, a part of my was saddened. Saddened to have my only family here outside of my wife and daughter, to move so far away. And knowing that after she is done with the next step, she moves back permanently to Malaysia.

It was nostalgic and sad too, to revisit the familiar sights and sounds to those of us who have spent 6-7 years at the same Alma Mater, and to relive those memories. To visit Buddy's old apartment, or the same restaurant we must have had at least 100 meals there over the years. To recall the things we, he, had to go through in those final years there.

Yes, this will be a busy week; the thousands of trainees would transition from one program to the next. Often, this will involve physically moving to a different city or even state. Goodbyes are said to classmates, comrades, colleagues and perhaps even soulmates, as paths start to diverge.

As they take one step closer to leaving their academic motherships and to stepping out to the 'real' (medical) world, what advice would I leave these gallant learners?

• Don't lose yourselves. It's easy to lose sight of what's really important in life. We have all had the priviledge of sharing a dying patient's last moments on this Earth: No one has ever said they wished they spent less time with their family. No one has ever told me they wished they made more money, or spent more time at work
• Stay true to your principles, whatever they might be. Whether is is "First do no harm", or "The needs of the patient comes first". And no matter what, stand firm by those principles. Eventhough you may sometimes encounter a patient who attempts to threaten or bribe you to do something that goes against what your beliefs are
• There will always be patients who will frustrate you. Or deceive you. Or talk or cry too much. While you might not have the answers for their ailments, they are still people. And everyone deserves at least respect
• Yes, out in the real world, you finally get to make real money. You finally start to pay off your loans, or are able to afford a mortgage, or to save. But never let that guide your actions. You are a doctor, and you priority is the health and wellbeing of your patient. Not how many tests you can put him through, or how many patients you can see in a day
• It's OK to not have the answer. The 3-7 years of post medschool training might have taught you much, but it's not going to teach you everything about the human body. It's humbling to admit, but doctors really don't have all the answers.
• It's also OK to be afraid. The first time you treat a serious problem with no real supervision. To realize, "I'm it?? I don't have to staff this with my consultant? I AM the consultant?"
• The learning never stops. I hate to admit this, but after 2 years of college and 5 years of medical school, and 3 years of residency and 3 years of fellowship, the learning ain't done. Medicine is dynamic, so should you. But don't fall into the trap of feeling the need to read every journal. Find a few that is relevant to your field, and peruse it periodically. Thrash the rest
• We are in the business of saving lives. Unfortunately, there will be some patients you will lose. Some, perhaps even because a decision you have made as his doctor. But remember, you are not God. You cannot win all battles. And there is a huge difference between losing someone because of the wrong decision, versus losing someone because of neglect or malpractice.

It's not an easy next step. And the journey is probably far from being over. But for now, take a moment to reflect on how far you have come. To remember those without whom you could not have made it. And take a moment to recognize your work, and be proud of yourself!