COMMENTARY

High Achievers on What Their Failures Taught Them

Don S. Dizon, MD

Disclosures

March 17, 2020

I was sitting with my 17-year-old daughter recently, discussing her future. Naturally I couldn't help but recall being 17 myself, with all of the self-imposed pressure to apply to the right colleges and then go to the best one I could get into. I can't blame that on my parents; I was always driven to do well: National Honor Society, advanced classes, achieve the best scores.

Don S. Dizon, MD

I worked hard for two reasons: to leave my home on Guam for the continental United States and to become a doctor. The latter would consume me in college as I continued striving to do well enough to get into medical school. Once there, I worked hard enough to get into a good residency and then into a good fellowship.

The path certainly wasn't easy. I applied to multiple medical schools and got rejected by all but two. I really wanted to get into one particular residency, but I ended up not matching there either. These circumstances were humbling, but I persevered. I worked non-stop, all to achieve a goal, intent not to fail.

Although I have no regrets—I am where I have always wanted to be, doing what I always wanted to do—I do wonder whether I had to rush through life to get here. I will never get a chance to teach English in Japan, do a year abroad in college, or design my own clothing brand, but sometimes I wish I had taken those detours. In a way, these missed opportunities haunt me. So when I had kids, I was determined to raise them with as little pressure as possible: Work at your own pace, do your best, and remember to stop and smell the roses.

As my daughter grew up, I didn't force school on her. She was naturally gifted and took to lessons well on her own. I didn't press her about grades or inject my vision for her future. I wanted her to be happy in the moment, freed from the self-imposed demands to succeed that I had. Mostly, I wanted her to see that life wasn't a destination but a journey. So, as we sat there, I told her in my most sincere voice, "Sweetie, don't feel obligated to go straight to college. Think about taking a year off to find yourself."

She looked at me like I had two heads. "Dad, if I don't go to college now, then I'll be further behind than my friends, and I really want to get on with my life," she said.

In that moment, I felt I had failed as a parent. I had been trying to liberate her from the framework of my own expectations, yet she had developed them internally: a set of deadlines and markers on the road to adulthood. More acutely, she had developed a sense that were she not to hit these milestones, she might be left behind.

Getting Your Foot in the Proverbial Door

In looking back at my own experiences—and looking forward to my daughter's—I decided to ask three of my incredible colleagues at the SWOG Cancer Research Network about their experiences with rejection, which I have included here in their own words.

Sarah Mougalian, MD

Sarah Mougalian, MD, breast oncologist at the Smilow Cancer Center in New Haven, Connecticut; assistant professor at Yale School of Medicine

Prior to college, I was used to being the best—or at least close to the best.

At Harvard, however, I found myself a tiny fish in a sea full of amazing people. I shied away from speaking up in class or in small groups. School work was harder; distinguishing myself took immense effort. Nearing graduation, I realized that I needed a break from academics. But my requests to join a variety of 2-year programs that would look good on my eventual medical school application were all rejected. (I surmised that I wasn't "special" enough, nor had I successfully differentiated myself.) After several grueling rounds of recruiting, I ultimately landed a job as an analyst with a management consulting firm in the pharmaceutical and medical device industry. So, off into the real world I went.

I decided to go to medical school a year and a half later but wasn't even granted an interview at Harvard Medical School. Later I didn't match into my favored residency program. These experiences colored my choices for fellowship, particularly because I didn't want to face the possibility that I might fall short yet again, so I ended up not ranking higher the one fellowship program I loved most; I was certain that stronger candidates from my program would match there.

While these rejections (or "failures") were tough, I ended up learning far more than I probably would have otherwise. My residency had a robust quality-improvement curriculum and I completed a number of quality-improvement projects. As part of my fellowship, I collaborated closely with my institution's quality division, obtaining a certificate in healthcare quality. These experiences helped shape my interests in optimizing quality and efficiency—and here I am, an administrative leader of ambulatory operations at Yale, a National Comprehensive Cancer Network–designated cancer center.

Heloisa Soares, MD, PhD

Heloisa Soares, MD, PhD, co-physician leader for the Gastrointestinal Cancers Clinical Trials Research Group at the Huntsman Cancer Institute at the University of Utah

I went to medical school in Brazil and dreamed about completing my training in oncology in the United States. Ultimately at age 23, I moved to Florida to work as a research assistant at the Moffitt Cancer Center. During this time, I was also working toward my Educational Commission for Foreign Medical Graduates (ECFMG) certificate but failed Step 1 of the US Medical Licensing Examination (USMLE).

I cried a lot and had many sleepless nights. I felt that I was not fit to be a doctor. Perhaps the universe was trying to tell me something.

Some people advised me to give up patient care and stay in basic research. Fortunately, others gave me hope and told me to be persistent. I clearly remember one of my colleagues telling me, "Heloisa, I see the light at the end of the tunnel for you; you will get there. You don't need amazing scores, just get into the system."

I eventually passed the USMLE tests and I got my ECFMG certificate. I was offered only three residency interviews and matched at a community hospital program. While I feared that I would not match at a good oncology fellowship, I allied myself with great mentors and worked hard both clinically and research-wise to make myself competitive. I received 17 invitations (including from some top-notch places) to interview for fellowship and ended up choosing UCLA, where I also pursued a graduate degree in molecular biology.

Zeynep Eroglu, MD

Zeynep Eroglu, MD, practices cutaneous oncology at Moffitt Cancer; assistant professor in the Department of Oncologic Sciences at the University of South Florida Morsani College of Medicine

As a junior faculty member, one of the most challenging aspects of my career has been opening clinical trials through the National Cancer Institute's (NCI) cooperative group system, which allows a trial to run simultaneously in hundreds of sites. I've been working on a research concept in melanoma for nearly 3 years. The melanoma committee expressed interest and we had the support of SWOG, but the trial was rejected by the industrial sponsor, a major pharmaceutical company.

Instead of letting it go, however, I reworked the concept with the help of others over the course of an entire year and led it through the approval mechanisms at SWOG and the pharmaceutical sponsor—only to see it rejected at the NCI.

As frustrating as this was, I learned the importance of perseverance. I was also part of a really great team. We went back to the drawing board, and over many months we went through further revisions, rejections, and reapprovals. The process was exhausting. Many times I entertained thoughts of quitting.

At long last, though, it paid off and we received NCI approval. Now, nearly 3 years later, we are finally—albeit cautiously—optimistic that the study will open.

What Does Personal Growth Look Like?

I learned through these stories from my colleagues that despite adversity, we as human beings are stubborn and will always persist—both in life and in the practice of medicine. Even as doors close, the human response is to open new ones—or in Dr Eroglu's case, to keep trying the same locks.

There will be success. But be aware: What success looks like may be very different from what was initially envisioned. There will also be personal growth, a realization echoed by my colleagues.

Dr Mougalian. I still feel twinges of jealousy when I see my former medical school, residency, and fellowship colleagues on the podium, but I now realize that there are different paths to success. Give me a complex analytical problem—I have the skills to solve it. Need to optimize a process? I'm your woman. I've been told by other hospital administrators that they have never seen a physician "so engaged" in clinical operations. Had I followed the path that I thought I wanted, I doubt that I would feel as fulfilled in my career as I do today. Through a series of what I perceived as "misses," I hit my bullseye.

Dr Soares. In my eyes, my academic career has been great. Yes, I could have more investigator-initiated concepts, and sure, I could use more grants and publications. But I am happy and doing what I love! Experience has taught me that if you are persistent and choose good mentors, you will get there. There is always a light at the end of the tunnel—you just have to find the right path for you to see it.

Dr Eroglu. I have learned that my goals include not only my own professional success. They also include expanding options for our patients in hopes that we can find something new that will be of benefit to them.

Bringing It Back Home

These stories from my colleagues helped inform my own next steps at home with my daughter. I realized that as a parent, my job is to provide her with a core set of values to carry her through life—not my life, but her own. Each of us sets our own goals and ambitions, and with each marker met comes a new set of circumstances to navigate.

So I stopped talking to her about a gap year. I now spend my time listening rather than lecturing. I realize that she will have failures along the road to independence, as we all do. But I also hope that as my three colleagues have demonstrated, every experience allows one the opportunity to grow, and with it, evolve.

How has a perceived failure shaped your career in a positive way or led to unexpected growth? I'd love to hear your experiences in the comments section of this article.

Don S. Dizon, MD, is an oncologist who specializes in women's cancers. He is the director of women's cancers at Lifespan Cancer Institute and director of medical oncology at Rhode Island Hospital.

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