By Martina Murphy, MD

This spring, my family and I took a highly anticipated trip to Zion National Park. The moment we committed to this trip months earlier, I promptly purchased several guidebooks and shot off emails to friends who had taken this trip seeking bulleted itineraries and packing lists. My husband, unpacking an Amazon box full of travel guides one evening, innocently questioned my approach. “Why don’t we just figure it out while we are out there?” He quickly read the look on my face, a mix of horror and confusion, and carried on in spite of it. “If we plan the whole thing out, we’ll probably miss things we don’t even know about and would love.”

The concept that best laid plans may leave much to be desired has become a recent theme in my life. While attending the AAMC Early Career Women’s Leadership Conference earlier this year, I learned that my husband had unintentionally offered up some highly applicable career advice. Sitting in a room full of 150 brilliant women academicians from across the country, I did what one is supposed to do at conferences like this—I gained heaps of practical advice on topics like negotiation, conflict resolution, and effective communication as a leader. These workshops were full of wisdom that was immediately impactful for my career as a clinical investigator and medical educator who recently assumed the role of program director of our heme/onc fellowship program. Late one day, I watched as a panel of highly successful faculty, all in senior leadership roles at their various institutions, offered advice following a common theme: the importance of staying open to opportunity, embracing the possibility that your life and career may lead you in directions you never once considered.

This particular bit of advice struck me, as it has been a highly salient feature of my early career path and yet something I had never really heard spoken of. As a medical educator, I spend a great deal of my time mentoring trainees at various stages of their own career development. They all ask the same question in one way or another—"How did you end up in your chosen profession?”—as they consider they plans and the choices they make, certain that each one will have a clear and definitive impact on the physician, the person, they are to become. The planner in me, the one who swears by her bullet journal and Outlook calendar, now smiles with an understanding that has only come with years of learning that all the careful planning in the world may not lead you where you want or need to go. I smile with a sense of irony for all the times I’ve asked my own mentor this same question, pining for a sense of certainty that will help me make sense of my own trajectory.

I started my faculty position in an academic medical center as a medical educator clinically practicing non-malignant hematology. Through a variety of career plot twists fueled by the collision of personal and professional passions I could not have appreciated earlier, I now practice medical oncology caring for women with gynecologic malignancies. In addition, I recently became the program director for our heme/onc fellowship program and am immersed in the development and implementation of curriculum aimed at addressing and reducing health disparities and bias. There is no cookie-cutter, one-size-fits-all path for the career I am building—and I have begun to get the sense that I am not alone.

 In her poem “Evidence,” Mary Oliver implores the reader, “Keep some room in your heart for the unimaginable.” More poetic than the advice from my leadership conference, yet they are one and the same. It is, as I’ve learned to see, the greatest lesson of my early career and yet one not frequently shared. I entered early career with a bit of naïve assuredness about what exactly it was that I had gotten myself into and have found the experience full of lessons that I was only truly able to be learn while on the trail.

Here are a few I’ve gathered on the journey:

Interests evolve. This is, hands down, the most important lesson I have learned in early career. While not applicable to all, I hope that those with whom it resonates find solace in knowing it is a truth for many like me. It is not a sign of failure or that you’ve gone in the wrong direction. The job you take when you graduate from fellowship may be a far cry from the career you find that you’ve built a few years in. “Follow your passion” is a great piece of career advice except that, for some, those passions may not make themselves immediately clear. It has taken me almost 37 years to truly find my passion at work and it took a willingness to be open to change and opportunity.

Let other people’s expectations go. Managing other people’s expectations of what you plan to do with your career is not your responsibility. For me, my evolving interests have left me at times feeling as if I had let certain people down. I now have the following words from Brene Brown written neatly on an index card, tacked to the bulletin board in my office where I can see it every single day: “Do not think you can be brave with your life and your work and never disappoint anyone. It doesn’t work that way.” This is a hard but necessary pill for a recovering people pleaser to swallow. Mine is not a simple upward trajectory of a career path—it is mired in twists, turns, sidesteps, and many moments of being propped up by those around me. I wouldn’t have it any other way.

Practice saying no, but also say yes a lot. A popular piece of advice given to early-career faculty is, “Learn to say no.” This is well intentioned and aimed at ensuring we don’t take on too much or get distracted. But saying yes to enough of the right opportunities can help dramatically with career development. Meeting those engaged in work you find interesting (think collaboration!), access to data sets, and the chance to share your great ideas are only some of the reasons to say yes rather than no. Learning to discern when to say yes is hard—I’ve reached out my trusted colleagues and mentors countless times to help hone this skill.

On the first day of our family trip to Zion we ventured into The Narrows, an understandably famous hike through the Virgin River gorge with rock walls over a thousand feet high on either side. The path is usually closed at the time of year we visited, as the water current is too high and swift resulting from spring snow melt, but we got lucky. Although I had another hike planned for us that day, I threw those plans away and, along with my husband and 9-year-old daughter, donned a dry suit and grabbed a walking stick. It was spectacular from start to finish. The water cuts a winding and stunning path through the rock and life gets quickly put into perspective thanks to the incredible views. As we navigated the current, I glanced at my daughter making her way on uneven and uncharted ground. I saw a flicker of myself in her eye—happy, proud of herself, and thoroughly enjoying the adventure.

Dr. Murphy is a clinical investigator and medical educator with a passion for women's health within hematology/oncology. She specializes in gynecologic cancer. She is particularly interested in the study and reduction of health care disparities and is interested in multidisciplinary approaches to improve access to care for women with cancer. She serves as the program director for the hematology/oncology fellowship program at the University of Florida. She tweets at @DrMMurphy.