When I provide therapy for physicians after their residency, I assist new attending doctors as they navigate one of the most challenging and confusing transitions in their professional lives. These early attendings frequently arrive feeling unanchored. They’re rediscovering their identity, addressing anxieties that have long been sidelined, stepping into their roles with authority, and striving to establish lives that extend beyond the confines of medicine.

When I discuss the attributes that contribute to a new attending’s “success,” I’m not referring to their clinical abilities, diagnostic expertise, or efficiency. I’m focusing on the characteristics that enable physicians to find fulfillment both within and outside the hospital environment. These four qualities can facilitate the transition and establish a foundation for a life that feels both sustainable and complete.

1. Flexibility

A successful new attending embraces adaptability while determining what life outside of training should encompass. For the first time, their decisions are entirely their own. The clear path that existed since their pre-med days comes to an end, resulting in an occasionally intimidating void. There may be a stage of uncertainty. Questions like What does success look like now? or How does medicine fit into my broader life? frequently arise. Flexibility creates an opportunity for new attendings to explore options, accommodating shifting priorities.

2. Self-compassion

Self-compassion safeguards against the harsh inner critic that often emerges during this phase. Many new attendings envision the type of physician they aspire to be, yet lack the clinical experience and numbers to operate as seamlessly as established attendings. These comparisons to those with many years in the profession can be crippling without the application of strategic self-compassion to highlight the unfairness of these comparisons. Self-compassion enables that physician to think, “Sure, I realize they’ve been practicing much longer than I have. I need to grant myself grace as I acquire the necessary skills on the job. I will continue evolving into the physician I aim to be.” Others may find themselves measuring against peers who appear “ahead” in metrics such as relationships, home ownership, and travel. Without self-compassion, these comparisons can be overwhelming. Self-compassion permits the new attending to acknowledge their own circumstances and say, “It’s understandable to compare myself to others. It’s natural to feel ‘behind.’ And I will prioritize my own wellbeing without chastising myself for not being at a different stage.” The capacity to offer oneself grace, to accept that it’s acceptable not to have everything sorted out, fosters growth without unwarranted shame or stress.

3. Intentionality

Intentionality involves making choices based on personal values rather than instinctively responding to external pressures. Whether it involves selecting a job, a specialization, or deciding when to start a family, early-career physicians flourish when they stop to ask: What is truly important to me? Such deliberate decision-making results in a greater alignment between their work and personal lives. It lays the groundwork for enduring satisfaction.

4. Perspective

Perspective enables new attendings to understand that challenges are a normal aspect of development. The learning curves can be steep. It can be daunting to suddenly find oneself in command. It’s overwhelming to be the attending making the ultimate decisions regarding patient care. However, stepping back to contextualize this phase—envisioning what your future self might reflect on—can alleviate the pressure for perfection and promote increased self-acceptance.

The shift to attendinghood is not simple. Yet it can be transformative. By adopting these traits, and possibly with the aid of counseling for physicians, this phase can serve as a robust foundation for a rewarding and balanced medical career.

Sarah Epstein is a licensed marriage and family therapist.