Reframing Success in a Holistic Way

By Ariela Marshall, MD , Adult Classical Hematologist, 美国明尼苏达大学双城分校

You are not the only architect of your success, but you DO need to be the only one to define what success means to you, and that definition can change throughout your life.

Like many in medicine, I previously had no definition of “success” other than that which I learned during my medical training — a very narrow version essentially encompassed by how well and how quickly one can climb the ladder to a title or set of accomplishments considered by others to be “the top.” Our model of stepwise progression from medical school to training to junior faculty, establishing a clinical/research niche, and moving through the academic ranks to full professor as quickly as possible was the only framework I had to work with as a young physician, because I did not know anything else. There’s nothing wrong with this definition of success, but I never considered there could be any alternatives and certainly never considered redefining it for myself instead of relying on how others defined it for me.

I began my career as a full-time academic classical hematologist with a plan to proceed?in a fairly traditional way: divide clinical practice between outpatient clinic and inpatient hospital service, build a career in clinical research, and go up for academic promotion as rapidly as possible. I was forced to redefine success when faced with life circumstances that no longer allowed me to pursue it as others had defined for me. When my husband and I decided we wanted to build a family, we struggled with infertility, and after multiple cycles of in vitro fertilization, we were lucky to have a healthy son in late 2020. This was at the height of the pandemic, and with no relatives nearby and child care falling through, we made the tough decision to relocate closer to family. I was thrilled to take a position at an institution where I had trained that offered me a title and leadership opportunities from the start — allowing me to continue to progress toward “success” in essentially the same way I had before. However, my husband, who had taken a chance on a nonclinical position he had always wanted to explore, quickly realized that he missed academic medicine. With the options available to us at the time, we made the tough decision to move yet again — and I found myself in the position of needing to work part-time at an academic institution located quite far from our home. (I could not work full-time or I would almost never see my family.)

It was at this point that I was forced to redefine success for myself. No longer was I climbing that academic ladder with the same speed and straight trajectory, and part-time work is often viewed as “bailing out” (or not even considered at all) in academics. Unwilling to view prioritizing the needs of my family as failing, I stopped thinking of success in external terms. I value my relationships with my family, my colleagues, and my mentees and trainees. As a part-time inpatient consultant hematologist, I am able to maintain my position in academic medicine, work with trainees, watch my mentees grow in their careers, and spend more precious time with my family. I have more time to work with my nonprofit organizations and advocate for gender equity and parental rights. My new colleagues and institution have been incredibly supportive and accommodating, and I feel a sense of tremendous satisfaction with my choice. I am successful in a way that I choose to define — a holistic combination of satisfaction with multiple domains of my life.

To all the trainees and early-career physicians: define success in your own way and let that shape your career, rather than letting someone else’s definition shape it. Ultimately, I believe being true to yourself is the best definition of success.

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