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The Journey of a Trainee

There are a couple of ways to go about accomplishing this aim, but all of them include graduating from medical school, followed by completion of a residency in obstetrics and gynecology with a fellowship in reproductive endocrinology, a urology residency and andrology fellowship, or internal medicine with an endocrinology fellowship. I think it really pays to enter a fellowship with a strong laboratory research program to get a good understanding of molecular biology. Some of you will consider entering MD/PhD programs, which I believe is a great option if you know early in your life that science is your way of life. For me personally, entering the Polish equivalent of an MD/PhD program and struggling to finish my PhD thesis while doing a residency in urology was a great opportunity to learn the craftsmanship of biostatistics, molecular biology techniques, and designing and analyzing clinical trials.

Perhaps the most important part of this experience was that it exposed me to great mentors, without whom I would not be where I am today. I will repeat it over and over again: mentors are the most important ingredient in the recipe for success in medicine and science. Thus far, I have been very fortunate in this regard, and I will always be very grateful to the people who mentored me. Sometimes it took years to understand what they meant, but I never regret listening to their advice. One of my mentors told me: "Well, son, I can help you to stay here, but sooner or later you need to have the guts to grab your banner and carry it into the battlefield of science and research like a brave hussar would do." For non-Polish readers, Poland has had a long history of hussars (soldiers on horseback) carrying a banner and going into battle against all odds. At this early point in my education, it did seem that the odds were against me. I was a foreigner dreaming of becoming a urologist and working with the best reproductive professionals in the United States. At that time, I felt very uncertain about my future, but looking back, I realize that my mentor was closing an easy pathway for me in order to push me further and further in a more challenging direction. As things turned out, his efforts were successful.

I came back to Poland and started to work hard in the lab. I designed clinical research on adolescent varicocele, did my best in medical school and in my PhD program, and studied hard to pass United States Medical Licensing Exam. It was really hard work, but it paid off. I presented an award-winning paper at the American Academy of Pediatrics meeting, and it helped me to get into urology residency at Oregon Health Sciences University, in Oregon. This success is thanks to the guidance of my excellent mentors, Dr John M. Barry and Dr Eugene F. Fuchs. No, I am not just offering flattery—I have experienced this firsthand. You need to find good mentors very early in your career. They are essential all through medical school, in your PhD program, or in your residency. Those people will not only help you open the doors to many places (postdoc laboratories, fellowships, etc), but they will also give you a better perspective on life and what is important in science. You don't have to agree with your mentors all the time, but try to understand what they mean—it really helps.

My residency was very tough. It was before the controlled work hours for interns and residents, so I was at work all the time. The research progress was a second priority but never out of my mind—I knew that I wanted to get into a good fellowship, but without publications (and a good mentor) it would be almost impossible. After the 6 years of residency, I was getting tired (and poor) and my friends were questioning my sanity. "Why would you now begin a 2-year fellowship, suffering through the financial hardship and waste of potential income just to have a fellowship paper?" they asked me. There were and are plenty of jobs for urologists without fellowships. Well, I never looked at things this way. I have always wanted to be a clinician scientist, teaching and working in an academic institution. I have learned from Dr Gene Fuchs and Dr John Barry that "money will always come," and that you need to do "what is the best for you and your career." So at the age of 36 I moved to New York City to start a fellowship in andrology at the Weill Medical College. Age should never prevent you from reaching your dreams. This has been the best decision I have ever made. Training is about being exposed to people who can inspire you, give you new ideas, and just be there for you when you need someone to listen. The three people I have met here, Dr Peter N. Schlegel, Dr Marc Goldstein, and especially Dr Matthew Hardy, have each been all and more than I could ever have wanted from a mentor. If you don't share this type of invaluable connection with your boss, I suggest that you change the boss or move to a different institution. It is not worth your time and effort to be working in place where you aren't both challenged and inspired every day.

So what is the recipe for success? I think that it is important to have a dream and a general sense of one's life's goals. Once you make this decision, be persistent and flexible. Write, read, work hard, and don't feel jealous of your friends who are already making hefty salaries, buying houses, and starting families. Feel confident that you are different. Science can be very rewarding, despite the fact that it takes a lot of time to reach your career goals. So don't give up. There is always a light at the end of the tunnel. Nobody wants to be a PhD student forever. Although it may sometimes feel that long, have faith that you will graduate one day.

So here I am, 6 more months—was it all worth my time and the gray hair I've acquired? Yes, I think it was. I have 4 job offers from really good universities, I feel more confident about my own skills, and I have learned that as a physician scientist you become very special and unique. You will be the one to take the clinical question to your other basic science colleagues, you will be able to work on the bench answering clinically important questions, and you will be able to see a smile on your patients' faces because you were able to bridge the gap between science and the practice of medicine. I don't think that there is a better job, calling, or way of spending one's life. Although the adventure you will undertake is long, the fruit of this work is very rewarding.

Acknowledgments

Dedicated to my mother, brother, and John W C.

Footnotes

As you are reading this issue, you should all be making plans to attend the American Society of Andrology's 30th Annual Meeting, to be held in Seattle, Wash, from March 30 to April 6, 2005. This meeting always provides the perfect opportunity to mingle with fellow trainees and to network with other andrology professionals. This issue's segment showcases Darius Paduch's own unique journey as a trainee. We encourage you to approach him and any of the other authors who have shared their experiences and wisdom in Trainee Page articles. These individuals are ideal resources and are always happy to answer any questions that you may have regarding your career goals and plans for the future.

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