An interesting commentary appeared in the Wall Street Journal the other day. The author wrote about the difficult experience of calling her previous superiors by their first names as a rite into adulthood. Reading the article brought back awkward memories for me too. Medicine is a very hierarchical profession, almost equivalent to being in the military service. Not to disparage anybody, but at the bottom of the pyramid are the interns (medical students are actually held in higher esteem because attendings want the students to like their particular field and encourage them more so than interns who are already captive). One step up is the resident followed by the senior resident, and depending on your specialty, the Chief resident, Fellow, and finally the Attending. Everybody has his place in this business. Attendings are always addressed as Dr. So and So. The residents relax and talk shop with other residents. The interns are too busy (at least in the old days) to fraternize with anybody except their own.
The awkward moment comes immediately after completing the residency. You're suddenly a full time attending of your own. The instructor you have always addressed as Dr. So and So can now be called by his first name. But for me it felt extremely uncomfortable to do that. Some other residents who were bolder or had social interactions with their attendings outside of work or were more blatant brown-nosers seemed to transition through this quite easily. For me, I literally had to spit out the first names of my new colleagues. I had to remind myself every time not to call them Dr. So and So and talk to them as an equal, which was expected. It was a difficult transition. I even had to learn to call the Chief of my department by his first name. After of 20+ years of education, where I've always called a superior by a title, now there are no more titles. I am the Man. Now if I can just convince my wife and kids to treat me as the Man, not as their Workhorse.