Mind the Gap, Measure the Gain.

It is the first week of March and for many of us, this month marks the beginning of the vernal equinox when winter turns to spring. But for my clients, it is almost universally a difficult time as they eagerly ?and anxiously await results of the National Residency Matching Program.? Once rank order lists are submitted, it can feel like an interminable waiting game during which everyone’s self-doubt surfaces.?? The journey to residency in this country is hard, and while nearly 60% of IMGS are expected to match this year based on current trends, many outstanding applicants will not be rewarded with a position.? I am not an IMG and therefore can only experience the joys and disappointment of the match vicariously.? Nonetheless, I do think that I have something to offer at this time which may provide some guidance for all applicants – whether successfully matched or unmatched.

We measure ourselves constantly. We compare our achievements to those of others and measure ourselves against some hypothetical standard or result which we have decided is required for success.?? I have witnessed a myriad of such comparisons arise in applicants during the residency interview season. And often, such comparisons end up bearing disappointment as applicants believe themselves to have “fallen short” of expectations they have set and stand convinced they may never achieve their goals.? ??They focus on what they didn’t achieve as opposed to what they did.?

Several years ago, I read a book by Dan Sullivan called “the Gap and the Gain” which is promoted as the “high achievers’ guide to happiness, confidence, and success". ?It’s an easy read with a great deal of wisdom contained within its pages. The underlying message of the book is to reflect on how we measure progress and whether our typical measurement process is helpful or harmful, and ultimately whether such promotes happiness, confidence and success. ???I will try to do my best to explain.

We are always trying to get from one place to another. If “A” is our current state, “X” is a state sometime in the future – a destination or self-defined goal we’d like to reach.

There are often many “stops” along this route, but for purposes of simplification, I’m going to take these out of the equation.? For IMGs , “A” typically represents some time prior to obtaining a residency position and “X”, a successful residency match.? On a more micro level, “A” might be the date one commenced studying for the USMLE Step 2 CS and “X” might be having reviewed every question in the Q-bank twice.? I'm sure you get it. ?As physicians, we are driven individuals and are commonly setting goals.? Goal setting is, generally speaking, a positive thing as it helps us to map out a path forward.?

But no one consistently meets all their goals and we often fall short in some fashion.?? Sometimes such shortfall is minor and does not particularly concern us, but other times, our lack of goal achievement is met with seemingly enormous consequence and emotion.? I’m assuredly not going to deny that fact.? But what I want to explore, is the fact that we often rob ourselves of the very real potential to experience positive emotions and success when our self-proclaimed goal is not achieved.??

Quite commonly, our journey toward a goal may look like this: ?we get from “A” to “B” – a point along the route”, but miss our intended mark (“X”).?

And when this happens, what do we do?? What do we measure??

All too often we measure the GAP.? The gap between “B” and “X” – the distance we didn’t quite travel.? And we berate ourselves for not closing the gap and frequently decide that we have failed.? It may not even matter to us how close we came to our goal or how far we travelled.? We look at the future state which we didn’t achieve and ignore our successes along the journey. ?

What if instead of looking forward, we looked backward?? Decided to take stock of the distance that we travelled and gave ourselves credit for the hard work, dedication, sacrifices and resilience that such journey required?? What if we measured our GAINS?

It’s such a simple yet profound idea – the benefits of which I’ve personally witnessed many times over.

I believe that making this shift, measuring our GAINS instead of focusing on the GAP --- even in the midst of disappointment, provides a dose of much needed perspective. ??Shifting our thinking in this way can help us to take stock of real accomplishments and progress we have made, despite the fact that our eventual goal has not YET been met. ??

I decided to write this in consideration of what a portion of IMGs will experience in the coming weeks as grave disappointment when they do not receive a successful match outcome.? While I know that grieving the loss of this much-hoped-for-result is indeed expected and required, I would invite you to consider your tremendous progress and many achievements – both small and large – over the past months/years and give yourself the credit you deserve for such gains.?

I hope that this in some small measure you find this helpful.