The Chair Closest to the
EXIT
by Andrew Ray, MD, MBA, MSc
The first thing I did when I walked into my first Kentucky Medical Association meeting was find the chair closest to the exit. I had come at the urging of a mentor, who encouraged me to simply show up and listen. So, I did. After surveying the room, I recognized many attendings I had come to respect from medical school and residency training – many of whom remain my heroes.
What followed was nothing like I had anticipated. I was introduced to parliamentary procedure: motions in precise formats, positions defeated through a process that worked deliberately backwards from the way my brain operated. The thought of approaching a microphone and saying something illiterate in front of many of my idols kept me firmly in my seat. I drove home with one clear thought: what the hell just happened?
As I reflected more, I began to think: why did the work feel so important? Something in that room had gotten to me. These physicians had given up an evening to argue carefully about things most colleagues would never think about, let alone act on. The work was invisible to nearly everyone it would eventually benefit. There was just the work, and the people willing to do it.
I went back. Not because I understood the process( I didn’ t) but because I wanted to be one of those people. What I didn’ t fully understand then was what going back would actually cost me.
What Nobody Tells You
Resident advocacy is not simply a matter of finding your confidence and showing up. When you step into these rooms, when you approach microphones, take Delegate seats and ask your peers to care about things they are too exhausted to care about, you voluntarily surrender something most residents don’ t realize they have: anonymity.
Most residents are allowed ordinary days. A mediocre rotation, an improving board score, a rough stretch of call: these things happen and are largely forgotten. When you are visible, nothing is forgotten. You are under a microscope that does not turn off between meetings. Every clinical stumble becomes evidence for attendings already skeptical that your priorities were in the right order. Some will tell you so( not maliciously, but clearly). Some attendings who trained differently will worry, sometimes to your face, that your generation is distracted, that
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