Five Lessons Learned From Fellowship

Medscape

16 hours ago

This transcript has been edited for clarity.
Hi, everyone. I'm Alicia Muratore. I recently completed gastroenterology fellowship at the University of North Carolina. I wanted to take a few minutes to share five lessons I've learned along the way. Whether you are just beginning training, navigating the middle of fellowship, or looking back from the attending side, I hope these reflections resonate with everyone.
Lesson number one. Growth lives in the gray. When I started fellowship, I thought confidence came from knowing the right answers. I came to find some of the most meaningful growth came from situations where the answers weren't clear or when clinical guidelines did not quite fit.
As you all know, the field of gastroenterology is full of nuance. You'll get plenty of consults that don't fit the algorithm. It is here that the growth will happen. It's in the gray zones, when you ask for help and when you challenge your assumptions. You build your clinical judgments with every consult, every scope, and especially every time you say, I'm not sure, but I'll find out.
Lesson number two. You don't just learn the scope; you learn yourself. Technical skills improve over time, but growth as a proceduralist is as much about mindset as it is the mechanics. Early on, I learned to celebrate the small victories, such as finding the ileocecal valve, troubleshooting loops, and yes, getting out of a difficult sigmoid.
Progress was never linear, and that's okay. It was about learning when to slow down, how to adjust when your scope was looping, knowing when to call for backup, and being okay with the fact that, some days, the valve wins. There will be a day during fellowship when your hands will finally just get it, but until then, celebrate the small wins.
Lesson number three. Your co-fellows will carry you. Let them. Fellowship is intense. There are long hours, emotionally heavy cases, and personal sacrifices, but the people around you can make all the difference. My co-fellows became close friends and confidants. We covered each other on call, debriefed after difficult consults, and celebrated every milestone together.
Their support was just as vital to my success as any textbook or training module could be. If you are entering fellowship now, invest in those relationships. They will certainly shape your experience and stay with you long after graduation.
Lesson number four. You are more than your scope. It's easy to let fellowship consume your identity, but I challenge you to make a conscious effort to remain connected to the parts of yourself that exist beyond your clinical role.
For me, academically, I pursued areas that aligned with my interests and my passions. This entailed earning board certification in obesity medicine and, as a nutrition specialist, completing the nutrition fellowship with Nestle and further studying clinical informatics.
Outside of medicine, I ran marathons — six while in fellowship — and became a world marathon majors finisher. Running marathons around the world while training in gastroenterology taught me that endurance, focus, and recovery matter, whether you're chasing a cecum or a finish line in Tokyo.
These pursuits didn't distract from my training. In fact, they enriched it. They reminded me why I chose medicine in the first place.
Lesson number five. GI is a privilege. Stay grateful and stay curious. You'll have days where you're exhausted, undercaffeinated, and very behind on notes. Even on the hardest days, remember, we get to do something that matters. In GI, we get to diagnose early, intervene meaningfully, and restore quality of life. Whether it's preventing cancer through a screening colonoscopy or helping a patient with their chronic disease, we are invited into some of the most critical moments of people's lives.
What I saw in my mentors and what I hope to carry forward is a mindset of curiosity, compassion, and humility. Wherever you are in your journey — starting fellowship, deep in the middle, or looking back — take a moment to pause, reflect, and look at how far you've come. To those of you still in the thick of it, hang in there. You've absolutely got this.
Thank you for watching.