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How My Boston Marathon Strategy Helps With Residency

Emily S. Goncalves, MD, MBA

Disclosures

October 26, 2021

Nerves and adrenaline were pumping through my veins as the bus pulled up to the starting area of the Boston Marathon. The event represents the Harvard of all marathons; it is the oldest marathon, one of the most difficult to qualify for, and elite athletes also toe the starting line, hoping to win one of the best marathons in the world. It is an honor to be accepted, and many runners dedicate their entire running career to qualifying for this race.

I was familiar with this feeling of nerves as I have been racing throughout most of my life. But what with COVID-19, racing has been on a 2-year hiatus for me. My stomach was in knots as I walked up to the start line.

Residency also makes you familiar with nerves. You're being tested every day as a resident and it also seems like there is a new "starting line" every day. Despite being very familiar with high-pressure situations, my anxiety was high the morning of the race. As expected, the nerves dissipated as I began running, and I could feel the energy of the crowds and other runners which turned nervousness to excitement. I tried to run conservatively down the first hill but I went out faster than I wanted. I settled down and hit the splits I was aiming for in the first 10k. My confidence increased and I felt like I was running relaxed.

The marathon is long (26.2 miles) and I knew I needed to run a smart race in order to survive.

Passing 13.1 miles in the marathon was a nice benchmark of how I was doing in the race. It felt similar to finishing my second year of residency: There were rough patches, but my skills and confidence grew as a psychiatrist and I was confident of the career path I wanted to dedicate myself to. My time in the half-marathon mark was perfect and I felt like I could really run a great race. My confidence grew and I raced through 20 miles pretty comfortably.

At mile 21, I started to climb the infamous Heartbreak Hill. This comes as the last of a series of four hills in the race and is a never-ending climb. Many marathoners state that the race begins after 20 miles and wow, they are right. Previous hills did not seem to affect me, but I felt my breathing quicken and my quads firing. My pace slowed but I remained steadfast that I could still race strong.

As I got up the hill, I was greeted with a long downhill at mile 22, but the pounding my quads took was significant with such a steep downhill and I was unsure how I would conquer the last 4 miles. The effort required to maintain my goal race pace was significantly harder than early on and each step was a challenge. I tried to focus on the mile I was in rather than thinking about how much longer I had to go. I find that focusing on the moment I am in has also helped me in my residency. Being present in the moment makes the arduous journey of being in residency doable.

I finally got to mile 25 and tried to give it my all. My pace picked up and I felt like I was sprinting to the finish. In reality, it wasn't a sprint but I was able to run my best time and finished the marathon in 3 hours and 17 minutes.

The marathon is symbolic of a career in medicine: It is long, painful at times, and may seem impossible, but conquering the marathon makes it seem like finishing residency is possible and worth the hardships. I'm looking forward to my next marathon and am hopeful about the rest of my third year of residency being an opportunity for growth.

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About Dr Emily Goncalves
Emily S. Goncalves, MD, MBA, is a psychiatry resident at Delaware Psychiatric Center in New Castle. She is a competitive runner and ran for Syracuse University. She continues to live an active lifestyle and has competed in eight marathons, including the Boston Marathon. Emily hopes to share her passion for running with her patients and is interested in pursuing a career in consultation and liaison psychiatry. She also enjoys writing about her running adventures.

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