When I transitioned from a PGY4 to a PGY5 I was hit by a sudden existential crisis. Up until this point in my training, I had everything figured out one or even two steps in advance. But after just having finished a year studying for my PGY4 Royal College exams, I emerged from the other side with no idea in which direction to take my career. I had one short year to figure it out before I would be thrust into the world, a real, independent doctor. I spent the next several months freaking out and imagining a lot of different possible scenarios: should I do a leukemia fellowship? Thrombosis? Go to the community? Start my own clinic?
At its essence, QI is all about realizing there’s a problem, then making small, but well-thought-out changes and measuring to see if they work. If they work, you create a new system to make sure you sustain these changes; if not, try something else. As it turned out, this was essentially the personal improvement mantra that I had been using for my entire adult life. I’m a bit scatterbrained and naturally disorganized, so I have to construct very robust systems to counteract these two weaknesses. I’m a bit of an app geek, and I’ve incorporated multiple apps like OmniFocus, Monday, and Streaks into my personal system as ways of forming and sustaining good habits and clearing the mental white space necessary to do creative work. I’m constantly on productivity/personal development blogs like Mark Manson, James Clear, and Juliet Funt (Whitespace @ Work) to get new ideas and fine tune my system into a well-oiled machine. My pleasure reading list (yes, pleasure reading) includes books like Getting Things Done, The Seven Habits of Highly Effective People, and Start With Why. Don’t worry – I toss in a good dose of Lord of the Rings, Game of Thrones, and Tom Clancy for good measure :)
If you’re inspired by the same sense of methodical tinkering, clever systems design, and practical outcome focus, then give quality improvement a try – you may just find what you’ve been looking for!
As fate would have it, the University of Toronto sent out a call for its inaugural Masters of Science in Quality & Safety just as I was in the midst of all this angst. I had done a really enjoyable quality improvement project in PGY2 with my mentor Dr. Don Farquhar, who was also kind enough to introduce me to another one of my mentors, Dr. Brian Wong. Unlike conventional research, quality improvement came naturally to me, and I applied & was accepted to the inaugural class. The rest, as they say, is history as I’ve been doing QI ever since.
Alan Gob, MD, MSc(QIPS), BScPhm, FRCPC
And QI Geek