I'm going to go ahead and I'm going to give it a few more minutes before we start, just maybe like a minute or two. Okay, who's on. So, Wilma's here. My senior fellow song is here Casey Roberts, Donald to break clear and Bertie Gabby Toby is here. So it's good so it's really going to be a small group. We had 12 people register for the webinar so it, it just kind of depends but again this lives on the website so people can access it at any time. How many did what's your name have 60 registered for her. Do you have. He had 12. Okay. All right, so why don't we get started. And good evening and welcome to the early career webinar series. My name is Dr. Christina the wiki gout and I'm going to be moderating tonight. The webinar is entitled your five year plan and interactive workshop and setting and meeting your goals. And our speaker tonight is Dr. Cynthia bring cat, Dr bring cat will present for about 45 minutes and then we have some time for questions in the end. Not only is Dr bring cat, a dear and near near and dear friend of mine but she's also a graduate of Loyola medical school and completed her residency and fellowship at the University of Michigan where we first met as co fellows. In February of 2018 she served on the faculty at the University of Wisconsin, and also the Loyola Street School of Medicine, and she presently serves as the john m Simpson professor and chair of the Department of OB guy and that rush. She's also the interim dean, dean of the Medical College. She's a practicing urogynecologist, who specializes in vaginal surgery surgery. Dr bring cat has received numerous awards for excellence in teaching she has an active research agenda has been on multiple NIH study sections and the PI or Co PI, and many NIH grants. So I'm very excited to hear this webinar, and the webinar is being recorded and live streamed for the participants, please feel free to use the q amp a feature on zoom to answer any questions which will address at the very end. If you have any technical difficulties, please use the chat feature and then our staff member will be there to address that. All right, on behalf of August, I present Dr bring cat. Thank you, Christina. It is kind of nice, you know after your co fellows with somebody and you share a small office and get yelled at by the same people. So, thanks to all, and thanks for the opportunity to present today. I'm hoping there's some fellows on here too, and some people at different points in their career. But before we get started, I just want to invite everybody to take a second. Turn off your phone, or put it somewhere else. Get a pen, a pencil, a paper whatever your favorite writing instrument is, and a piece of paper. Okay, get a beverage I have a Pellegrino, but get whatever beverage of your choice like just take a minute. This really is going to be interactive. I gave it to my family last night, and I, I received on a scale of zero to 100 I received 100,000 on the cheesiness score. I've already been warned that this is a cheesy talk, but it's something completely different. Right, this is a time for all of us to kind of sit down and look at goal planning and meeting. This came out of my work with graduating residents, their whole life. They're like, okay, it's grade school, high school, medical school, residency, and now what? And so we talked about the next steps. So with that, we're going to get into the next steps. I figure by the time I'm talking here, everybody has a beverage and pen and a paper. Okay, so I'm running two screens. So for my disclosures, the biggest thing for me to say here is that a bit about my background. It's not been quite a linear path. And thanks so much for saying the interim dean thing. So as of October 1st, I was named the interim dean of the Rush Medical College in the medical education platform there. Kind of with the focus on research and education. And if you had asked me about that six months ago, I wouldn't even have thought that to be the case. And so I'm going to be participating as much today as everybody else. And I don't have any financial disclosures. I don't have any connections to funding agencies or industry right now. But I do have a couple other disclosures that will drive a little bit where I come from. I'm currently the secretary and a member of the ACOG board of directors. This is the organization that I kind of speak from and speak to. This and OGS really are the representative part of my career and where I've had all my leadership training, mostly through ACOG, but also through the great mentors at OGS. And I am the other final disclosures. I am an aggressive proponent of professional coaching and self-awareness. And I just want you to think about this moment. So much of our life can be captured by eating over the sink. Right. So think about those days. You've had those long days and you come home and you find yourself, you're eating over the sink. We were talking about this. I had a meeting with the residents this morning. A third year resident said, but it's so efficient because if you spill, there's nothing to clean up. You can just eat over the sink and think about all the things in your life you do without awareness. Right. You maybe change a diaper, walk a dog, take some drive home, put in a Foley. Right. All the things in your life you do without self-awareness. And so this is going to be just one opportunity to not eat over the sink. Right. And take a chance to do that. And so, as I mentioned, this is the talk I've given before to ACOG junior fellows. And it's something for me that's near and dear from that place, because people want things or they don't know they want them. And then they get resentful and unhappy and dissatisfied and never in our careers and probably in our lifetime. Has there been such a crazy time of resentment and dissatisfaction? I think that I talked about this and, you know, right now in my institution, we have a 41 percent turnover in medical assistance. And I know in this and I can only see Dr. Lewis, but she's not. And that's like our claim to fame is we're still doing better than Northwestern or University of Chicago. Right. But it's still 44 out of 10 of our people leave. And so everybody we're seeing that in faculty, too. Everyone's looking for that first kiss moment again, where everything's fresh and shiny and something else. And this is a moment for you to kind of reevaluate your life and really figure out what you are looking for and make those decisions consciously and not eating over the sink. So this is an invitation or as I was thinking about another way, if it's a crummy talk, it's your own fault because it's an interactive experience for you. And so I'm really hoping that this becomes an opportunity for you that really is independent of me. So it's a chance to take about 40 minutes to share only with yourself what your most honest and sincere goals actually are. It may have nothing to do with AUG, with work, with your partner, and it may not be something prior to tonight you ever spent any time thinking about. So for one hour. We're going to sit down, we're going to get a napkin, we're going to pour, we're not going to drink out of a can. We're going to put it in a glass and think a little bit reflectively about our lives. And behind that is this idea of changing a habit, right? Making a conscious decision and then acting on a new behavior. So the objective, this is the official part objectives by the end of the session, you should be able to describe a date on goal achievement. We really are going to talk about goal achievement and neuroplasticity. Describe your personal, professional and spiritual goals. And I put those three buckets in there, your personal, professional and spiritual goals, right? So maybe you want to run a half marathon. Maybe you want to change a medical school curriculum. Maybe you want to spend time meditating or growing in one way. And so I try to put them in those buckets. Maybe you want to have a baby. Maybe you don't want to have a baby. Maybe these are all the different parts of your life that are important. So I also put down on here, if I have seen further than others, it is by standing upon the shoulders of giants. And that's something I've heard my whole career, standing on the shoulders of giants, right? Or as I like to say, I've been writing the greats in NeuroGuidance coattails for about the last 20 years. And I've had an opportunity to work with some giants in this field, great thinkers. But I've also worked with a lot of people that are great mentors, great sponsors, great friends. And, you know, I always say that some of the most difficult people in your life end up being your greatest teachers. And so those are the moments that we're kind of coming from. And so my journey to looking at these things was being riddled with FOMO or fear of missing out, mom guilt, imposter syndrome, all the things we all tackle and all the things we all face. But then one day I saw this really amazing TED Talk, cheesy as I'll get out, right? TED Talk called Draw Your Future. And I'll put some references at the end. So don't worry, they'll be there and you can see it. But it was called Drawing Your Future by Patty Dumbrow-Walsky. Right. And again, I'll put the reference up. But this was the first time I ever thought about how can you consciously form your future? How can you decide what you want and then move forward and get it? And this was the first time I was introduced to that concept. Other parts of my life or in all of our lives, we do this all the time, right? You're invited to a wedding and you're like, I want to go to that wedding. And then you think, well, what will be the consequences of going or not going to that wedding? I want to do X, Y or Z. What will be the consequences of going or not going? And I think very often in our careers, we're told every time you're asked to do something. But I swear under if I come back someday and say I'm going to write a chapter, you will know aliens have come and taken over my body because that is something that at some point in my life, I decided I'm never writing a book chapter ever again. Right. And being able to say no to things at different points in your career really just comes from knowing your goals, knowing that time is finite and how you'd like to move forward. So I'm looking at you, Christina, as I'm standing. If I ever say I'm don't ever ask you to do a book chapter, if I'm ever asked to do a book chapter. And I say, yes, aliens have taken over my body. OK, so thank you. So today we're going to articulate the concrete steps you're going to need to take to meet your goals in a realistic manner. I'm not going to say do anything or otherwise. And that's like liberating. Right. Like as a chair and now as a dean, I don't make anybody do anything. I don't make anybody feel anything. I really I don't have much control and I'm really a piece of that. But I can be present and offer opportunities. And that's that's really a privilege. So. Next slide. What is the data show? Well, as a field right now, we are worse off than we've ever been. Right. Physician burnout, suicide, really long term consequences of these things. Job dissatisfaction and taking things and just always looking for what I've thought of as like the next and best first kiss. Right. Everybody's looking for that other thing. So when we saw this happening in our own residence, I was doing my reading. Saw this article come out and it was the effect of professional coaching intervention on the well-being distress of physicians. It was a pilot randomized clinical trial. Now, can you read JAMA Internal Medicine Physician Work Environment and Well-Being? AMA now sends out a once weekly burnout, how to avoid and it's free, how to avoid burnout prompts. We're seeing this everywhere, right? We all around COVID tons of free food, free subscriptions to all these mind apps and doing these sorts of things. But in this, this is pre-COVID. They took 88 residents, mostly residents, a few attendings, and they did a coaching intervention and they looked at quality of life, satisfaction and overall well-being. Those who had coaching. And again, when I say coaching, living consciously. We all know those physicians in our institutions that were required to get coaching because they were naughty doctors. This is coaching and it's not therapy. And again, if you have issues with therapy, I encourage you to pursue those. But this is an opportunity and an invitation to live consciously. So 80 of the physicians, all their scores went up. Those who didn't in the other arm of the trial, their satisfaction went lower, their burnout went higher. So for this, the goal of the study was helping providers maximally access personal strengths and skills to handle work-related stressors, thereby reducing vulnerability to burnout and helping those who are burned out recover. And for me, I found that so compelling because what if we could have a department? And then now what if we could have an institution that could teach people or help people? Part of my work as a chair or as a dean would be to help people maximally access their personal strengths. Wouldn't it be just a crazy way to practice medicine and a crazy way to conduct things and then to give them the skills that they already possess to handle stressors? Again, the study, this is all from the quotes from the study, provide an avenue to assist individuals in their effort to navigate their professional life, work choices and career direction and build a capacity to influence systems that affect the wealthy. One of the saddest things I ever heard a resident say was they felt like they were in a press class. And that to me, after the reactivity was like, well, when I was a resident, blah, blah, blah, we all do those things. But after that, I thought, oh, my goodness, here's somebody who's really broken and feels so disempowered and is perfectly set up to leave, have burnout, do something stupid on Twitter or Facebook or something like that that's not in the long-term interest. Okay, so now what? Well, this is an argument for neuroplasticity. I'm going to talk about here, all these things. So if our circumstances are what they are, and if we can't control them, then neuroplasticity is hogwash, not hogwash, right? We all know these things. We know these things from spinal cord injury. We know these things from trauma literature. And we know these things from our own experience. And especially where I am at Rush, we have a huge Alzheimer's disease center, and it's the brain bank, right? We're the ones that we have a lot of brains from people that are donating brains. And we do a lot of like closed head injury work and Alzheimer's work and dementia work and all those sorts of things. So neuroplasticity is kind of in the air there. And you can see the definition and you can read the definition, right? But then how do you develop neuroplasticity? How do those things change? And if you have children, you watch neuroplasticity every single day. And if you ever practice piano with a child, teach a child a skill or teach an adult a skill, that's neuroplasticity. And it's that place in all of us where your brain hurts, right? Where you're exercising, you're doing something or you're doing that bad chest, and you really do get the ovaries. And you had to get the extra instrument or you had to get the endo loop or you had to do that extra thing where you really cleaned off that sacral promontory that was that thick, right? That's neuroplasticity, when your brain just stretches and everything changes a little bit. So how do habits work? Now, this is from a really kind of a pop culture book, but it's really accessible, called The Power of Habit. Your slide is still on what does the data show? Ah, ding, ding, ding, ding, ding. Thank you. Neuroplasticity, right? Well, in my mind, I just keep it coming, right? I have no pride. I just keep the cues coming that way. Thank you. So neuroplasticity, and is there the definition? And so how do habits work? That's how neuroplasticity works. Now, evolutionary biology kind of tells us that the human condition is to seek threats everywhere we look to see a threat. And the other issue is conserve energy. Right? And try and avoid pain and seek pleasure. Those are like the best that's kind of like the pop culture version of neuro of behavioral or evolutionary psychology, right? Avoid, avoid pain, seek pleasure, conserve energy whenever you can, right? Those are the issues. Now, if that's who we are, and that's what drives us, and and we can all think of plenty of behaviors of our own, probably, that do those sorts of things, how can we change that? Now, in doing all those sorts of things, we have habits, right? Everyone here gets up, goes to work, and follows through and shows up, right? That's a habit, you have a cue, you have an alarm, go off, you have a routine, you get up, you shower, you don't shower, whatever, you know, you do your thing, and your reward is you go to work, and it's a task completed. There are recent studies out that show people that make their beds in the morning, have lower rates of depression than people who don't. And the idea behind it is that you start your day with something being accomplished, right? And so if you get up, your cue is you see your bed, the routine is you make your bed, the reward is a sense of accomplishment. Every action we have has a cue, it's a trigger, it tells the brain what action to take. Think about really basic ones, pot on stove, that's the cue, right? Hot pad or whatever you use to grab the handle so you don't burn yourself. So all those things happen in a way that's automatic. And that's the routine. We don't take hot things off the stove. Without using a hot pad, you have hot coffee, you don't drink that first sip of the hottest coffee right away, you let things go. So what's the reward reward is you don't get burned. Or the reward is the coffee is the perfect temperature. And that's reference the reward is reference to a pleasure you feel after acting on your routine. And so in our own experience in medicine, I wouldn't just say the pleasure that we feel after doing our routine, I think oftentimes in our training, it's not as much pleasure, it's an avoidance of pain, right? So the reward in doing certain actions is just the absence of discomfort, right? And so you think about, I'm going to do a systole after hysterectomy to avoid the absence, or to avoid the discomfort of lying in bed at night when you get that call about low urine output. So that's your cue, your routine case is over, I'm checking for ureteral integrity, I'm going to do a systole, what's my reward, I know the ureters are safe, right? So taking a set of actions like that, and turning into habit is called kind of in the literature chunking, right, you chunk actions together. And if you do it enough times, it becomes a habit. And we think about these habits we have. And if you think for a second, reflectively, just think for about a habit you have. What's a habit you have, you come home, you make a martini, right? That could be a habit, or driving home, every day, I put my keys in the same place, all these implicit habits we have, or unaware habits we have. And I just think, think about all the things we constantly do without consciousness. And then I'll throw a couple others in there eye rolling, right? Like, like, I don't know, I said to a resident, you got to be careful, your eyes are going to be stuck like that, right? When you roll those big eye rolls, but things like driving home, changing a diaper, brushing your teeth, logging into your computer, think about how automatically you log into your computer, you see your keyboard, that's the queue, you type in your password, what's the reward, the computer comes up, it's really that simple. And that then becomes a habit. Now, it implies an urge or a craving there once we're faced with a queue. And I think our phones can be the biggest place that we can look at habits we form, right? The text goes off, that's the queue. What do you do? The habit is to open the text, what's your reward? Oh, the text is gone, or the to do list is checked off, or now you know what's going on, right? But that is all driven, it implies an urge or a craving behind every queue, but behind the action, the routine on every queue. So our brains don't last really until we receive the reward. And, and you can I think checking a text is like one of the perfect ones, right? Because because you get that thing or whatever it is, and you don't check it, right. And this is I always sometimes go into meetings now, because I spent a lot of time in meetings. And I just time each person. And I probably should say that I time how long it takes each person to go through the meeting before they check their phone, right? Because it's, it's a very interesting phenomenon, because we all feel so much safer when we touch our phones, we check our phones. It's like, do you remember when we just used to wait in line, instead of like, look at and all those things like, I don't even know if I'm capable of waiting in line anymore without a phone, because it's just what we all do. But so that's the curve. So how do we shift your routine, right? We shift your routine, the first thing we do is we have to believe something is possible. And that's what I'm asking you guys to do today, really, or we'll go into this is how do you shift your routine, move to a goal, and say, and we can talk about various goals, and hopefully, we'll get a chance to do that, believe that it's possible. So let's say, one of your goals is to be an unbelievable vaginal surgeon, right? That's the goal, you have to find the cue, that's going to put you in a routine for that reward. And you have to work backwards from that. And you can think about these things, like what are the necessary and sufficient conditions for meeting that reward? And so we'll look at it really basically, right? Like, let's say you want to be the President of Oggs. What's the necessary and sufficient condition to be the President of Oggs? Well, you probably want to be a member, right? So that would be one of the first steps to take, you probably want to be a volunteer, you probably want to be on the board. And then you probably want to do certain things on your CV to get there. And now if you know in your mind that it's 2021, and by 2028, 2026, you want to be the President of Oggs, all your actions, for whatever that goal is, work towards that, right? And that is that I know that makes it seem super simple. But there always is the challenge in there. And the challenge is willpower, right? So if you know, you want to be the President of Oggs, and the steps you're going to take moving forward to become the President of Oggs, step one, join Oggs. I don't want to join Oggs, right? Like I want to take that. I don't even remember how much it is right now, the $250 to join the $965 to go and be in the meeting. I'd rather spend that $1,200 and put a down payment on a Peloton, right? But you made a commitment, you made a commitment consciously, and you follow through on that. And so that's where your, your reward, what you really want to accomplish for your goal has to be compelling. And so we're going to talk a little bit about how to come up with compelling goals in the setting of kind of the literature on how our brains work. So I'm going to do my slides right this time. All right. Now, this is a picture of my, I think my last year in fellowship, right? And there, there are some faces in there, I'm hoping some of you recognize, right? There's Ronnie Thacker, Abdul Sultan, John Delancey, Dee Fenner, Carolyn Samsell, a lot of giants in our field. Now, I picked this picture, because this is the time in my life when I was probably professionally the most productive. I was in a community of people I really cared about and liked, I was active in various other things that my future, one of my future colleagues at Loyola is in the middle of thing next to D. And so I want you to think we're going to take a second, I want you to think what makes you happy? What makes you satisfied? What makes you aware? And I and this to me was a time where I was happy, satisfied and aware. And it doesn't mean I was perfect. There were a lot of, you know, there were a lot of squirrel monkey vaginas that got dissected, that wasn't particularly gratifying experience, or, you know, all the other things that that may or may not have happened. But when I think of that time, it was a personally a professionally and an emotionally fulfilling time. And so I want you to take a few minutes. And I actually this is where the music comes in, get your paper, get your beverage, whatever it takes. And answer these questions. What makes you happy, satisfied, aware, and then find a time in your life when you really were those things what worked and what didn't. So I'm going to do this. See here. And an exercise. Okay. So this is the next slide. We're going to take a look right now we're where you've been right down. I'm going to we're going to go back in writing down those things. I want you to take a look at where you've been over the last five years, up to July 2021. When was the last time in that time that you felt truly valued, rewarded, and then satisfied, completely disregarded? And what was the guiding principle there? And what about that? Would you like to preserve or avoid? So this is Beth Pink, who I just think is smashing. And then we're going to just let's do this for about four and a half minutes. Okay, and I'm going to stop my video for a second. And we're just going to look at pink. We are searchlights, we can see in the dark. We are rockets pointed up at the stars. We are billions of beautiful hearts. And you showed us down the river too far. What about us? What about all the things that you had to give birth? What about us? What about all the broken happy ever after? What about us? What about all the things that you had to give birth? What about us? What about us? What about us? We are brothers that want to be so. We are children that need to be loved. We were women, we came when you called. But man, you fooled us, and up in the air. What about us? What about all the things that you had to give birth? What about us? What about all the broken happy ever after? What about us? What about all the things that you had to give birth? What about us? What about us? What about us? What about us? What about us? What about us? What about us? What about us? What about us? What about us? What about us? What about us? What about us? What about us? What about us? What about us? What about us? What about us? What about us? All right, I was giving the signal maybe three minutes is enough, that it's a little too agitating to actually do this for four minutes. So we'll do it. Let's stop for a minute. And so if you take nothing away from that, right? What was the guiding principle there? What about that would you like to preserve and avoid? And I think we can all say that. And all the things where you've been and what's been going on in your life. Okay. So that's the first way to start. So this is a question, right? What emerged for you? It's a variation on a theme. And I left that blank, because I'm really hoping that you're able to fill that in for yourself. What emerged? What were the things that made you professionally and emotionally fulfilled in those situations? Or if you're if you're looking back on the last five years, or a certain time in your life, that was a disaster. And here's what was a disaster about it. And here's something I know that I know I want to avoid in the future. So now, now we're going to look at the future, right? And this is one of the, you can tell I, you know, I've been a chair now for the two years in January and 10 weeks into my 10 years of chair COVID hit, right. So 10 weeks in March 13th was the last full day of clinic I took over January 1. So I've been doing a lot of management books reading. And this is one of the things they talk about a lot is SMART goals. And this is how you also if someone comes if one of your bosses brings you into the office and wants to talk about SMART goals, that's how you know you're in trouble. Because SMART goals is what you do is a very specific, measurable, agreed upon realistic and time based. So if I were to tell you, my goal is my personal goal is in the next five years, I'm going to write run a six minute mile. Right? Not gonna happen, right? It's just not realistic. Or I'm going to fly not realistic things, right? But you do want something very specific. And then it's okay. So maybe you're not going to run a six minute mile, I'm going to run an 11 minute mile for 13 miles. It's measurable, right? 11 minutes and 11 minute mile for how long? 13 miles. Now, when you do SMART goals like that, especially in the professional environment, you want it to be agreed upon you want your goals, or we'll do another example like that. So you want to have a baby, right? If you're in a relationship, and you want to have a baby and somebody else doesn't want to have a baby or vice versa, or a puppy, that's the big one, we're coming into the holiday season, that's always the fun one, right? When the puppy shows up at the house, you want something that's agreed upon the situation, and then realistic, right? You know, I'm going to learn to do ureteral implants in two weeks, probably not a realistic, but then time based. So today, we're talking about goals in five years, what do you want your goals to be in five years? Do you want your commute to be longer? Do you want to be shorter? What do you want it to look like? And so this SMART goals are really big, important part of making things doable and piecemeal. Okay, so let's go up, we're going to go to the next exercise. Now, I have this done. And I actually carried around with me. Because this is the thing that it's the guiding principle of what I want to do. Do you want it and so I'm going to throw out these things. So this is I want you to sketch out the following. And for the most part, if you're at odds, or if you've been in school forever, which most of us have, year starts July 1 20. So this year, July 1 2021 to June 2022, put down your age, how old will you be at the end of that. And then here's the easy part, take all those goals. All those years, 12345 years and put your age down and make three categories. Professional, personal and spiritual. And again, spiritual is just that thing that's really 100% about you and not about anybody else. So we're going to take a few minutes and do that. And I get to take my, my, if I can get my, alright, and we're going to do that for about two minutes. And we'll do well that one, I get three minutes for that one. Okay, Christina. And so I just want you to spend a little time on those ones. Okay. Okay, so we're going to do that for about two minutes. And we're going to do that for about three minutes. Okay, so we're going to do that for about three minutes. Okay, so we're going to do that for about three minutes. Okay, so we're going to do that for about three minutes. Okay, so we're going to do that for about three minutes. Okay, so we're going to do that for about three minutes. Okay, so we're going to do that for about three minutes. Okay, so we're going to do that for about three minutes. 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know that I won't go I am right here Don't you know that I won't go I am right here Don't you know that I won't go I am right here Don't you know that I won't go I am right here Don't you know that I won't go I am right here Don't you know that I won't go I am right here Don't you know that I won't go I am right here Don't you know that I won't go I am right here Don't you know that I won't go I am right here Don't you know that I won't go I am right here Don't you know that I won't go I am right here Don't you know that I won't go I am right here Don't you know that I won't go I am right here Don't you know that I won't go I am right here Don't you know that I won't go I am right here Don't you know that I won't go I am right here Don't you know that I won't go I am right here Don't you know that I won't go I am right here Don't you know that I won't go I am right here Don't you know that I won't go I am right here Don't you know that I won't go I am right here Don't you know that I 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webinar

Five-Year Plan

interactive workshop

neuroplasticity

SMART goals

reflection

professional goals

personal goals

spiritual goals