on excellence-an open letter to our incoming pediatric residents, and to graduating medical students everywhere

This is graduation season. I have given a number of graduation talks to residents beginning a new facet of their careers. I thought I would share parts of the last graduation speech I was invited to give to the finishing pediatric residents at the University of Maryland Medical System and School of Medicine, before I left there to start the newest facet of my career at Carilion Clinic Children’s Hospital. Excellence has been on my mind lately, as I contemplate the start of our new Pediatric residency. And so instead of waiting until they are going out into the world at large following their training with us, I would like to share my feelings about excellence as they get ready to start.

 Dear in-coming resident:

Why excellence?

Excellence, is in my opinion, the “it,” the “point,” the reason you have chosen to spend three years (and the rest of your life) learning the practice of pediatrics.

Excellence, however, takes work.

It does not appear because we want it; it comes because we work at it. It comes when we study for the boards, it comes when we look up the side effects of the medications our patients take; it comes when we stay up a little bit later, even though we are so very tired, in order to learn something new about the diseases or symptoms our patients exhibit. You are used to doing this in medical school. Some of you think you are doing it for the faculty, who will quiz you in the morning. You are really doing it for yourself, to develop the habit of excellence that will carry you throughout your lives. You are doing it for your patients, those precious lives that have been or will soon be entrusted to your care.

Excellence is achievable, and should not be confused with perfection.

Excellent physicians make mistakes but they are not afraid to acknowledge them. Excellent physicians may not know everything, but they always strive to know more. Excellent physicians put everything they can into the job of caring for their patients.

What about “work-life balance”?

Am I advocating that to be excellent you have to forsake yourself or your family? Of course not. However, you must in fact have a balance and not forsake your patients FOR your family either.

Patients and their families come to us in trust and with certain expectations.

As excellent physicians we must uphold that trust, and do for them the best we can possibly do. We must be trustworthy, we must keep their confidences, we must acknowledge what we do not know, and must strive to do what is right and what is best. We must treat them with the same concern, passion, understanding and dedication with which we would want our sons and daughters, brothers and sisters, mothers and fathers treated by their physicians.

We must not be judgmental, and we must make ourselves just a little bit better tomorrow than we are today.

Striving for excellence also applies in our relationships with our colleagues, and our students. We must not only tell people what to do, we must show them by our actions. We must strive to be the role model of excellence, no matter what. I have an incredible amount of faith in each and every one of you. I know you will  model the behavior that will identify you each as an excellent pediatrician, teacher, friend, husband or wife, father or mother, son or daughter. I wish you all the very best. I urge you all to do your very best. Be excellent