Doctors are by nature both goal-setters and high achievers. Just getting into medical school is a long journey that requires you to not only get the best grades, but also be organized, take hard classes, ace the MCAT, and fill up any remaining free-time with volunteer activity or work experience that will catch the eye of the admissions committee and set you apart from the tens of thousands of others that are doing the same thing. In other words, it is not enough to just be smart. You also have to be well-rounded, personable, a good communicator, and have a noble reason for wanting to become a doctor. For most people, just being allowed to walk through those hallowed medical school doors can seem like a lifetime of achievement.

But for those who have succeeded, it is merely the beginning. Soon, you may discover you are no longer the smartest person in the room. In fact, you may be, dare I say it, quite average among your new peers. That can be difficult to accept emotionally but is also a major problem—because the competition hasn’t ended, it's only just begun. Your relative performance now carries additional significance. It is no longer about just getting into school but about the direction of your career, maybe even your life.  Specifically, If you aren’t near the top of your medical school class, you might not be accepted to your specialty of choice. 

So, you put your nose to the grindstone once again and work even harder, spending long nights in the library, being first to complete rounds in the wee hours of the morning, constantly practicing surgical knots so that you impress your preceptors in a skill that has become second nature to them, all the while being careful never to be unprepared for a question during rounds. It is a constant cycle of goal-setting, accomplishments, and failures. But it does underscore the need to achieve. 

What happens next? We become doctors. Most of us gravitate to the specialties that best fit our interests and personalities, most of us match into a residency that is reasonably high on our list, and few of us, despite our striving, finish at the top of our medical school class.

We can now take a collective breath and just carry on with our lives, right? We have arrived. Well, that’s not exactly how it stacks up for those of us who have been conditioned to be the best and brightest, society’s highest achievers. That’s a hard function to eliminate. 

Although we may no longer find ourselves in that cut-throat medical education environment, we continue to manifest our competitive drive in other ways. It continues into our fellowships, our academic appointments, our administrative positions, and in the trenches of patient care, or is manifested in hospital turf battles. Maybe we also need to scratch an itch outside of our careers—who drives the best car, goes on the best vacations, runs the fastest marathon, or raises the smartest kids? Regardless of the avenue, it continues to be a recurring theme in our lives:  Competition. Achievement.

Being driven is not a bad thing. It helps us reach higher, do more, and be better. But is there a point when it can become destructive? The answer, I think, is yes. 

As a soon-to-be retired physician (I have given my notice) morphing into the life of a full-time certified financial planner, I get to have conversations with my clients about what brings joy and meaning to their lives. And no one has ever said that it is beating someone else at a given task. Being the best version of themselves? Yes. Being a great doctor and taking good care of patients? Sure. Spending time with family? Absolutely. 

I think at some point we all discover that while worldly achievement and financial success can be gratifying, it is a fleeting pleasure. It does not provide sustained happiness or joy. Despite this, we continue to look for the next big thing. This is called the achievement trap.

As physicians, we need to take a hard look at our motivation. What are we looking for?  Meaning? Identity? Acceptance?

Many studies have been done looking for the Holy Grail of happiness. Consistently, the findings point away from money, success, position, or even purpose. Instead, lasting joy and meaning comes from the quality of interactions we have with those around us. It comes from lifting others up and sharing what we have—whether that be wisdom, time or money—to make the world a better place, at least in our little corner of the world. That requires us to stop comparing our accomplishments to others or constantly looking for the next big thing, and, instead, to slow down, look around, and reach out to those who we can most impact in a positive way. That is when life becomes wealthy, when we realize that the reason that most of us went into medicine can extend well beyond clinics, operating rooms, and medical careers. It is not the next big thing that should drive us, but maybe the next smallest thing that we keep bypassing or overlooking.  A smile. A gentle touch. A kind word of encouragement. A piece of our uninterrupted time.

As I stand on the precipice of retiring from medicine, I look back mostly at the patients I have been able to impact and the relationships with my colleagues and team members.  There is no retirement from that, just a shift to a different focus. And yes, I still struggle with the achievement trap. It is in my nature. But now I am purposefully focused on adding meaning to my life as well, and meaning comes from giving and building relationships. I propose we let that be our goal—a goal which you don’t have to wait until retirement to achieve and one that doesn’t end when you hang up your white coat for the last time.

Bryan Jepson MD, CFP®, ChSNC® is an emergency medicine physician and financial planner who works for Targeted Wealth Solutions (www.targetedwealthsolutions.com), an independent fee-only advisory firm focused on physicians, special needs families, and former members of the military.  He is the author of The Physician’s Path to True Wealth: 12 steps to gaining control over your time and your money, available on Amazon.  He also has a blog called Financial Grand Rounds with more personal finance content at www.bryanjepson.com