Spencer C. Knox, MD

Internal Medicine Resident Physician, PGY-3

Category: General Thoughts

Goals for 2018

This weekend has been really relaxing and re-energizing.  Weekends are rare during residency, and are exceedingly sparse during the first and second years.  This year, my third and final of residency, has ushered in more weekends.  It’s been awesome for organizing and cleaning at home.  Today, I’ve been able to vacuum, clean the kitchen, and am in the process now of organizing my desk.

Goals for 2018

In taking a new approach to the prototypical “New Year’s Resolutions,” I decided to rename it “goals” for the year 2018.  Earlier today, while jamming out to music on my Bose Mini Soundlink, I did some thinking about my goals for this year.  I’ll share my big three.

#1 Studying with a fresh perspective

   I will study with a new purpose, as if I have a patient sitting right in front of me

Sounds strange just writing this, but I recently sat in on a lecture that drove this very point home.  I’ve been fortunate to have success on many exams utilizing the “study [x, y, z] material for the exam” approach.  I want to extend and improve on my success with a more diverse and more detailed working knowledge of medicine.  Also, I want even better exam scores.  How I plan on doing this will involve approaching reading and answering practice questions differently.  Starting in 2018, I pledge that I will study with a new purpose, as if I have a patient sitting right in front of me.  This will impart relevance to the study topic at hand.

Note to self when answering practice questions:  you may very well see a patient with the same presentation and be faced with the same problem.  Learn from it.

#2 Improve my communication

The hope is to improve on two fronts:  answering my text messages promptly and reaching out to family and friends more often.  Time seems to be accelerating the deeper I get in residency/training; I need to take pause and appreciate others in my life with a simple “Hi, how are you doing?”  Time constraints are often an impeding factor, but I plan on using breaks in the day to reach out more often to develop quality relationships.

#3 A focus on my well-being

Super complex and relating to a myriad of areas of my life, this is the year to enhance my health.  Despite eye-popping reports of physician burnout, I remain very happy with my choice of practicing medicine as a doctor.  Training takes a toll on everyone in residency, but I plan to stay ahead on the wellness curve.

Exercise, something I frequently recommend to patients and seldom do myself, is first and most important on this list.  I’m happy with weight lifting, elliptical/stationary bicycle/treadmill, or a walk outside even if for only 30 minutes, if that’s what I can do in a day.

Diet, another key element in my life, has suffered as of late.  Instead of reaching for pizza/fries/Lo Mein, my 2018 diet will consist of less carbohydrates and more protein.  When possible, I’ll make fruit smoothies with fiber and protein sources.  Lastly, looking forward to the future is super invigorating.  I will begin training in a GI fellowship, aka my dream career.  To be the best physician possible, it has to include personal improvement all of the aforementioned categories.

Let’s do this!

Consolidating Social Media Accounts

I recently came across a terrifically intriguing TEDx talk regarding social media.  The title?  “Quit Social Media,” by a self-proclaimed “Millennial, computer scientist, book author” from Georgetown University.  A short 13-minute video with over 1.5 million views (as of May 31, 2017), with that title, instantaneously piqued my curiosity.  I watched.  He also wrote an article for the NY Times on the same topic.

Transformative content on the internet is just that – potentially life-changing.  Think of educational YouTube videos (like TEDx), or other videos that teach specialized skills to allow the busy professional to hone skills for a beloved hobby.  Also easily obtainable online is a construct commonly known as “social media.”  Everyone and everything (e.g. dogs, businesses, etc.) have a social media presence nowadays.  Viral videos are commonplace.  Flashy color schemes and “sophisticated” new features including new platforms like SnapChat and Periscope (and countless others) seem to populate an ever-crowded space.

Professional success is hard, but it’s not complicated. The foundation to achievement and fulfillment, almost without exception, requires that you hone a useful craft and then apply it to things that people care about.
– Dr. Cal Newport

I recall the first Facebook days, around the time I was in senior year in high school; the primitive network was “semi-exclusive,” allowing only those with .edu email addresses to log in.  Today, Facebook remains a routinely visited website on my home laptop after a busy day at work.  I truly enjoy “catching up” with family and friends, mainly via photo sharing.

However, I noticed an unsettling trend amongst my social media practices – something I’ll call “social media bouncing.”  I define this as leaping across a multitude of networks, from Facebook to Instagram to SnapChat to Twitter to LinkedIn while aimlessly browsing news feeds.  I know I’m not alone.  A 2014 Pew Research Center poll showed that approximately 50% of people use at least two or more social media services (I suspect more people participate in multiple social media services in 2017).


In a capitalist economy, the market rewards things that are rare and valuable. Social media use is decidedly not rare or valuable.


I love this quote from Dr. Newport’s article and TEDx talk.  I find that some people look to social media as a way to attract attention, thereby bolstering their own personal brand.  The endpoint?  Perhaps the thrill of attention; however, I posit that the same people feel it will further their career or in some way generate money/fame.

Considering my own social media involvement, I decided to free up more time to learn new skills, become a better physician, and enjoy more leisure time.  To do this, I deleted some of my accounts.  The only accounts that remain are Facebook, Twitter, and LinkedIn.

Even more fascinating was the multi-step process required to delete a social media account.  In May 2017, I began deleting my social media accounts.  I’m technologically adept, yet I could not find the page to delete my account.  I enlisted the help of Google to point me to the page/form needed to actually delete (not “suspend” or “deactivate”) my account.  The services are so concerned with keeping their valued customers (“friends”) that they ensure you give them more data entry points before you leave.  I reminded myself that every single data entry point on social media is a source of revenue for these companies.  This only hastened my desire to leave Instagram and SnapChat.


I want to be the very best physician possible.  However, I desire leisure time just as much as the next human.  Filling this leisure time is made exceedingly more useful by watching top-rated movies, learning new skills via online videos, reading textbooks, traveling, and spending time with friends/family.  I needed to be reminded of how social media is not as useful as I once thought it was.

Millennial Doctors and Social Media

I’m part of the “Millennials” class of physicians.  Depending on the source you read, it’s generally characterized as people born between the years 1982-2004, give or take a couple years on either end of that date range.  We’re learning a great deal from our senior medical professionals, also known as Attendings.  These are our predecessors – the mentors we look up to, to learn the bread and butter techniques as well as secrets of the trade.  Like many other resident doctors, I still rely heavily on traditional methods of learning, including textbooks and question banks, but there is another movement afoot.

That movement – albeit a slow movement – is physicians learning and discussing healthcare topics online (examples on Twitter:  #meded, #hcsm, #FOAM).  Hashtag it whatever you want, it’s essentially anyone in healthcare who spends time disseminating information about the trade – online.  Physicians play a key role in healthcare, however I still feel (anecdotally speaking) that we are lagging behind a bit.  There are but just a few active residents and fellows on Twitter.  This leaves a large void in the social media world.

Prominent online physician presences like KevinMD illustrate why it’s important for doctors to at least establish a footprint online, and I agree.  It’s the norm; people look to our social media profile(s) for more about us.  The articles, comments, photos, and videos we post today may influence a patient to come see us in hospital A or clinic Z; a high school student to consider pre-medicine; a premed student to continue on the grueling path and get accepted into medical school; a medical student to choose a specialty and strive for the residency program of choice; and a resident to learn more about a sub-specialty field.  The opportunities to influence are numerous and far too many for me to account in one simple blog post.

I actively search and link to other young physicians on Twitter.  I enjoy reading posts in my spare time, whether those are micro-updates on Twitter to full-length articles and blog posts on reputable websites.  It keeps me updated on things that are happening within my profession across the U.S. and World in real-time.  The beauty of the modern world is that we have so many efficient ways to talk to one another; it is unprecedented.  So, let’s use this powerful technology to help other people.  It can be other doctors, PAs, NPs, registered nurses, or the general public – physicians should feel comfortable in their own professional online presence to educate and assist.

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