A single quote can have an impact for years. I have a habit of writing down proverbs from coaches, books and podcasts so that I can draw on them as sources of inspiration. They are on notecards on my wall, the top lines on my daily to-do lists and backgrounds on my laptop.

Almost a decade ago, during my senior year of high school, I was sitting in my own basketball team’s locker room at halftime of a home game against a conference rival. I do not remember the score, but I know we were losing a game that we should have been winning. As if it happened yesterday, I still hear Coach McCoy’s voice. He should have been frustrated with us—he probably was—but I remember him calmly giving us life advice, ignoring the fact that we were struggling to make a free throw. He said, “This goes for life, too; if you just keep doing the right things, things will turn around and go for you. It might not be today, or next week or next year. But, if you just keep doing the right things, they will.”

Long after my life as a competitive athlete ended, I held on to quotes like this one from my coaches. They were in my head during dedicated study for USMLE Step 1, a challenging transplant clerkship during my fourth year of medical school, the anxiety of a pandemic and difficult family situations. They will always stay with me, but I have also found more words of wisdom to hold on to that come from an increasingly relevant source: surgeons.

When I started listening to the Behind the Knife (BTK) podcast, they had just begun publishing episodes. The structure and content of the show has evolved over time, but the early episodes focused on interviews with well-known surgeons with a consistent set of segments. The last segment was the “Final Five,” where the hosts asked their guests a set of questions that were designed to give listeners insight into the personalities of some of the leaders in surgery. The last question of the set of five was always my favorite. They asked, “If you could go back to your first day of intern year and tell yourself one thing, what would it be?”

There were a few answers that stuck with me from the time I first heard them. One of them was from an episode with Dr. Thomas Scalea from Shock Trauma, in Baltimore. His advice to his former self was simple and blunt: “Don’t take yourself so goddamn seriously.” I wrote it down back in 2018 when I first heard it, because it was so relatable on a personal level for me. It felt good to know that even some of the most prolific surgeons had the same mental challenges as me.

During my fourth year of medical school, I relistened to some early episodes. I realized more of the answers were going to be helpful during intern year, so I started writing more of them down. It felt like they could stick with me during residency, in the same way that my coaches’ quotes had stuck for years. Writing a few of them down turned into writing all of them down. The final total was 96 answers from 85 guests. After compiling them, several themes emerged that are great insights for new trainees, as well as valuable reminders for surgeons at later stages of their careers.

These are the general themes derived from the answers to the question, “If you could go back to your first day of intern year and tell yourself one thing, what would it be?”

1. Stay hopeful.

Many surgeons wanted to tell their younger selves to be hopeful. Even the advice that ultimately fell into another category often still had an underlying tone of hopefulness. It is no secret that surgical training requires grit and resilience, but be reassured that it gets better. There is a light at the end of the tunnel, and it is worth it.

“This too shall pass. It’s painful. The gap between what is expected from you and your skill set probably is never as wide for the rest of your career. Just have the long view.”

—Dr. Hasan Alam, Episode No. 125

2. Relax.

Closely related to the theme of hopefulness, there was another persistent message of the surgeons’ answers: Relax. This advice makes sense when considering that most highly successful surgeons are high achievers. They wanted their younger selves to know that they didn’t have to take themselves so seriously all the time.

“Take a deep breath. Relax. Your heart is in the right place. You’re trying to do good things for people. You’ll be OK.”

—Dr. Mark Welton, Episode No. 100

3. Learn all you can.

Although there are a lot of other factors that get tossed into the conversation about surgical training, the bottom line is that the trainee’s primary purpose is to learn. It is appropriate then that many of the surgeons gave advice related to learning. One takeaway was that the intern should learn all that they can, every day, from each patient. Another repeated idea was that spending time in the OR—even as a young trainee—is valuable.

“Keep asking questions. Keep reading and keep being curious about your field. I think sometimes you lose sight of that during residency, where you become kind of tired of the grind, and you start to lose a little bit of the perspective of the love of what we do. I think it’s important to hold on to that.”

—Dr. Al Beekley, Episode No. 64

4. Invest in relationships.

Learning through participation in the care of surgical patients is the purpose of surgical residency programs, but such learning cannot occur without an entire team. That team is both diverse and expansive. Therefore, it is no surprise that many surgeons’ advice to their intern selves was focused on the importance of relationships with attendings, nurses and staff, co-residents, and patients.

“Listen to the people around you. Almost everybody’s there to help you. And for crying out loud, ask for help whenever you need it.”

—Dr. Michael Zinner, Episode No. 49

5. Find a balance.

Relationships are important outside of surgical training, too. Actually, all of life outside of surgical training is important. Even the most prolific surgeons are people when they leave the hospital, too. Invest in your physical health, spend time with family and friends, and foster healthy habits outside the hospital.

“You need to approach your profession with passion. You have to like it; if you don’t like it, you probably ought to find something else to do. But it can’t be everything you do. You have to balance your outside life with your professional life.”

—Dr. John Devine, Episode No. 53

6. Just do your best.

Some of the most valuable messages from senior surgeons did not necessarily fit into an overarching theme, but some of the ideas were related to working hard, taking responsibility and having integrity.

“A major part was showing up, and showing up on time, and being ready to work.”

—Dr. John Holcomb, Episode No. 7

The less serious answers by hosts, usually preceding or following a more sincere answer, have been appreciated, too. Looking back at the list of quotes, encouragement and helpfulness are the primary sentiments, but they were also fun. The founders of BTK are deeply thankful to the surgeons who have generously given their time to be guests on the podcast. I hope their messages can be sources of encouragement, inspiration and wisdom for the next generation of trainees.

Over the last several years, the BTK podcast has grown and evolved to become an influential source in surgical education. You can find the episodes and much more by visiting www.behindtheknife.org.

Dr. Gongola is PGY-1 in general surgery at the University of Kentucky in Lexington.