Stephanie V. Blank, MD
Do you love what you do? Do you do what you love?
I have recently been thinking about purpose for many reasons: conversations with inquisitive students as well as frustrated gynecologic oncologists, my own shortening temper and, of course, the impending fellowship interview season.
I know I am in the right field. I absolutely love what I do. I get to use my mind, charm and hands, be a leader, detective, advocate and writer, meet new people constantly, hear their stories, get them through difficult times, share in their most personal thoughts. I can ask and answer questions through research, and I have been able to see the results of that research drive progress in our field and result in better, longer lives for our patients. I work with amazing teams, watch people whom I have trained succeed and have the most inspiringly brilliant colleagues.
We all decided to work in this field because we had to—there was not another field that drew us in quite the same. We did not pick gynecologic oncology for its easiness or laid back/comfortable lifestyle. This field is extremely challenging in many ways that I do not have to itemize for anyone who has chosen to read this.
A recent survey of the membership presented at the 2022 Annual Meeting on Women’s Cancer showed that 49% of the SGO members who responded were experiencing low professional fulfillment.i In the past, the shocking SGO burnout numbers had been tempered by overwhelmingly high personal accomplishment and evidence of satisfaction with the gynecologic oncology career.ii Of course there is bias in here, imperfect sampling, different measures and a cross-trial comparison of sorts, but still, this does not sound like a good trend.
Why? Is it all of the benign surgery? The pelvic pain? The race to amass RVUs? The cesarean hysterectomies late Saturday night or the peer to peer at 4:30 p.m. on Friday? Having to see more patients in less time? Compassion fatigue? We can’t be blaming this on COVID or EPIC any longer.
What do we do?
Think back to that place where you were when you wrote that essay for admission to school, program or fellowship or what you said when you interviewed for your job.iii Do you remember just how much you wanted that opportunity to work in gynecologic oncology? That (hopefully) is your authentic reason for being where you are. And that can bring you to your purpose.
It is your purpose that will keep you professionally fulfilled, personally accomplished and sane. Remember that essay. Find that floppy disc filled with metaphors and adjectives. You have a purpose and you need to find it again.
If you, like me, can’t find that essay, another tool is the concept of Ikigai, which is more about the now and requires introspection. Ikigai is what gets you up every morning and keeps you going. It is finding joy in life through purpose. The diagram below explains it better. When you realize or remember that you sit right in the middle of that diagram, you can appreciate your purpose. For example, while I am stewing about the inefficiency and inequity of the OR, I remind myself that I will never tire of sentinel lymph node mapping or the mystery of the large pelvic mass, that my patient is getting the highest quality of care, that she and her family have entrusted her care to me, and I have the privilege of caring for her. Even if you do not find specifics to fill in the Ikigai circles, just looking at the diagram may center you as it does me.
We deal with a lot of guff daily, and it is distracting and at times overwhelming. It is imperative that we remember the big picture and the why.
An optimist by nature, I am not at ease when bogged down with day to day annoyances and disappointments. If I could not recognize my impending fate and center myself, I would have imploded by now. I have purpose, and I have the best job in the world. I promise this is not magical thinking. It is the truth and it works.
Stephanie V. Blank, MD, is the Director of Gynecologic Oncology for the Mount Sinai Health System in New York, NY, and the 2022-2023 SGO President.
i Carr et al. We can’t just wait this out: Burnout and fulfillment among SGO members over the first two waves of the COVID-19 pandemic. SGO Annual Meeting on Women’s Cancer 2022.
ii Rath KS, Huffman LB, Phillips GS, Carpenter KM, Fowler JM. Burnout and associated factors among members of the Society of Gynecologic Oncology. Am J Obstet Gynecol. 2015 Dec;213(6):824.e1-9. doi: 10.1016/j.ajog.2015.07.036. Epub 2015 Jul 29. PMID: 26226551.
iii I personally recall describing myself as tireless, but do not remember much more.