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PM&R Alumni Social @ AAPM&R

Date- October 23, 2025

Information and Registration Available Soon!

2025 Graduation Keynote Speaker: Gabriel Gorin, MD

We were honored to have Dr. Gabe Gorin as this year's keynote speaker. Since joining VCU PM&R in 2020, Dr. Gorin has been a trusted mentor to many residents and fellows, and was thoughtfully chosen by this year's graduating class to deliver the keynote address.

2025 Keynote Address:

Welcome everyone!

A few weeks ago, Dr. Hupe reached out to me asking if I would speak in today’s graduation. I was surprised to be honest but honored and a little scared at the same time. I have never spoken in public in a situation like this, ever!! Immediately my instincts screamed at me, just say NO!! It is easy, I have done it a million times… I consider myself pretty good at the art of saying no, but NOOOOO, I didn’t this time. (I’ll tell you more about saying NO later). So, here I am, in front of you, speaking in public. Therefore, I have to start off by thanking Dr. Hupe and the graduating residents for thinking of me for this task. I thank you because I feel appreciated, but also because you prompted me to step outside of my comfort zone. I am grateful to be able to be here and be part of your lives. So again, thank you. Also, I would not be here, amongst you, if it wasn’t for Dr. Cifu, so my eternal thanks go to him for helping me join the VCU PMR team, especially at a time when COVID threatened me with unemployment.

I was asked to speak to the graduates about things I have learned along the way in practice. Maybe about career advice. Maybe what I will say next is just my interpretation of what I was asked to do here today. English is obviously not my first language, so you will have to excuse the possible “misunderstanding” (wink). Career and practice, those words got me thinking, what do they actually mean. The Merriam Webster dictionary defines career in several ways, first a profession for which one trains, and which is undertaken as a permanent calling, such as a career in medicine. But it is also defined as a course or passage and also to go at top speed especially in a headlong manner. Its origin comes from Latin, and in turn, sounds a lot like the same word in Spanish: carrera. The word immediately brings to mind a race or raceway, and in fact, some roads are even called that way, Carreras (come on, say it with me, Carreras; gotta roll the Rs…). So, maybe it's a path, hopefully not one where you have to rush through, but one with twists and turns, surprises, maybe unexpected side paths, abrupt ends, slides, maybe even a nice waterfall and hopefully good companionship for the road.

What about practice then? Here we find the definition that fits best as the continuous exercise of a profession. But it also means systematic exercise for proficiency. Note here that mastery is not mentioned. Maybe the word is trying to tell us something, something about staying open to learning, to continue growing, to practice medicine and always recognize that nobody knows it all, and we are and should be perpetual learners.

As your friendly neighborhood PM&R attending, let me tell you something, you might think the residency and fellowship mountain is the Everest of your careers. That was just the training climb! The real ascent? The career, that’s the next part. It’s steeper, the holds are smaller, and sometimes, the only belay you’ll have is your own grit and maybe a well-timed text to a former attending or fellow resident when it’s least expected!

But, fear not! You are rehab/pain physicians! You can fix anything with a well-placed injection (ask Dr. Cifu!!), a meticulously crafted exercise program, and the unwavering belief that movement is medicine. Remember that! While the surgeons are busy playing Operation with scalpels, we are empowering people to reclaim their lives, one functional movement at a time. We can truly be the health span whisperers!

Now a little background about myself. As many of you already know, I am from Colombia, South America, or as I call it the true deep south! I am actually a second generation Colombian, descendant of Polish and Romanian immigrants that left those parts of the world looking for a better situation. Many immigrants at the time of my ancestors' departure, the early 1930’s, were intending to go to the United States, but entrance was denied to many, so they found their way to other places, like Cuba, central and south American countries, and in my case, Colombia. Now, here I am, about 100 years after the time my great grandparents were trying to get to these lands... talk about playing the long game! 

So, here I am, now an American citizen and part of this amazing, sometimes mind-boggling country. I am part of the working force, and VCU is my 4^th job since graduating from residency, so I have some experience with the ups and downs in the career path. I will say, every time it has been hard to leave the job, as it was to leave my homeland. Usually because of the human aspect of leaving people that I’ve learned to like and care about. But it has also been easy, because opportunity allows us to create moments of adventure, new beginnings with its unknown positives and negatives.

I suppose what I am trying to say is that life is filled with coincidences, strokes of luck or misfortune. Chance is a big part of our lives. That does not mean that chance is everything, but I think it is important to acknowledge that it plays a big role in everyone's existence. Where you were born and raised will change your views of the world. Who your parents are, where they're from, their stories will alter how they raise you and how you perceive what happens around you. Your friends, acquaintances, fellow countrymen/women, will nudge you in one direction or another. Circumstances push and pull to mold you into the person that is you! But we can still make our own choices, and hope that chance smiles at us, like I am smiling at you now! I smile, because I can see all of you, at a point of inflection in your lives: finishing residency or fellowship, about to start a new chapter in your lives....your careers, your paths! Change is the only constant and as such, it applies to the practice of medicine. Practice, seen as a process, more than a final destination. Always practicing, exploring and learning.

So……How many PMR docs stay in their first job? Google didn’t know. However, the AMA reports that most physicians stay in their first job for six years, but for those finishing residency or fellowship in the past 6 years, the average time is now less than 2 years. Is it failure to have to change jobs? I believe that’s a matter of perspective, even if it is a failed attempt, there is always something to learn from that, and hope that the next time, you don’t step on the exact path that led to that “failure”. Hey, “failing” can be great, otherwise I would not be here at this moment!

Remember that when it comes to career paths there is no right or wrong. It’s what you make of your experience that will matter in the end. What did you learn, how did you treat your colleagues, underlings, superiors, support staff, strangers, etc. ………You are following your own path, but you are never alone, and as long as you realize this, your career, your path will be better for it. In that path, remember that your personal growth does not have to suffer because you are now attendings. On the contrary, you should grow and be better every day, since we have the opportunity to make those decisions every day, every moment. And yes, as Forrest plainly put it in my favorite movie, Forrest Gump, “Life is like a box of chocolates, you never know what you’re gonna get”, we should always be prepared for the unexpected, be flexible like a strong bamboo, fluid like the water, and, hopefully …. Enjoy the chocolate!!

Your career and life require nurturing and attention, so I want to make sure I mention many things that I think are worthwhile for a good life, and work as part of life! 

Just bear with me a bit longer....

Your job is not you and you are not your job. You are many things, and your job is part of you, but IT should not define you. Remember that being a doctor requires dedication, persistence and courage, but it’s easy to forget that you also need to be dedicated to your loved ones, be persistent in your efforts to create bonds with your friends and family as well as your coworkers, and the courage to understand that your job is an important part of your life, but it should not be the only thing that matters. Your job is in many ways like any other relationship in that you can work on your side of things, but can’t expect to change the other person, you have to learn how to communicate, express your needs and grow, hoping that the other side grows along with you. But your identity should not be a reflection of your job, your success in it, or failure.

Build good relationships. Obviously with your close ones. At work, it should be just as important to find and nurture healthy, growing relationships. Work will likely be the place where you spend most of your waking hours, so you may as well make the most out of it. Having good work relationships will improve your sense of belonging and will make even a terrible day more bearable. I am thankful to the many people, docs, nurses, cleaning staff that I have been able to work with throughout the years, because they have helped me create a sense of belonging wherever I have worked, and I find myself “richer” in people that I care for and care for me no matter the distance between us. Having friends at work will improve your health and life, so work on it and don’t neglect this aspect in your careers. Nobody is an island. Humans evolved as part of groups, and we are better as a whole in functional groups. Find your tribe and your world and life will be better! Community and relationships matter at work and at home. Your relationships may be the most important thing that drives your happiness and health span. Take good care of them and they will take care of you! 

--Exercise, be active (take the stairs where possible) If there is something close to a miracle drug, it is exercise. Even a little is better than none. Strength and cardio (don't forget to include your feet). There is more to it, but that lecture is for another day!

--Breathe, most humans have forgotten how to breathe properly. Knowing more about your breath can help your wellbeing. We often forget those muscles, but as PMR we should also own them. 

--Prioritize Sleep. I know residency, fellowships and some jobs will still take a toll on your sleep. Life will keep throwing things at you that may interfere with this vital aspect of our lives. Do your utmost to make this work, create routines and the right environment, manage stress, don’t eat, drink or exercise too close to bedtime, make your room dark and a sanctuary for sleep, keep the room cool and more. And, if you have a cat like I do, good luck!!

--Dial in your nutrition. This may be boring and fascinating at the same time, but your mind and body will thank you in the long run. You have to play the long game here too and remember that it doesn’t have to be perfect.

--Mental health is just as important as your physical health. If you think you need help, reach out to your close ones or professionals if needed, it’s not a sign of weakness

--Caring for others requires that you care for yourself if you want to be able to truly “care”. Be gentle to yourself in words and actions. We are usually our worst critics. Words have power, including self talk, so use them wisely! Your thoughts and feelings are trying to tell you something, but they are not truly real, it’s how you interpret them and deal with them that matters.

--Learn to truly Listen. The world is all distraction and we have to work to not let it!

--Gratitude can raise your spirits, even in dark moments. Expressing gratitude will make you happier and more satisfied with your life.

--Self-reflection/mindfulness can lead you to a more fulfilling existence and relationship with the world around you. This is important in any situation in life, the more mindful we can be, the more likely we are to appreciate our situations and the situations of those around us and hopefully make us more likely to be present with them.

--Don’t let perfect get in the way of good

--Small changes can lead to great ones, so be patient and gentle with yourselves

--Enjoy the path. If you are only looking for the destination, you will miss a lot of great things!

-Watch your expectations as they may not always fit with reality. That's where flexibility comes to the rescue!

-Remember the power of NO (I told you I would come back to this). YES is a wonderful word, but if you say yes to everything, you may not be able to do what matters most to you. It means you may be doing things on somebody else’s agenda. One needs to say yes a lot, but you have to make yourself say NO at times. It may take time and practice, but eventually it gets easier.

-Know what you don’t know. Acknowledge this fact and life becomes simpler. It is wiser to say I don’t know than believe that you know everything.

FINALLY: --we are a miracle of chance, billions of years from the Big Bang, we are humans in this point in time, conscious beings made of stardust, a chance of 1 in trillions some say… and one day, after our path is done, careering down our lives, we will all be stardust again!

May your lives be full! Welcome to a new beginning! Congratulations!!

*2025 Annual John & Rosa Cifu Lecture & 4^th Annual Sheltering Arms Institute Research Symposium

Speaker - Anne McDonnell, Director of Brain Injury & Spinal cord Injury Services , Cantor Grana, Buckner, Bucci

Date: Friday, October 17, 2025

Time: TBD

Location- Sheltering Arms Institute -(More Information To Come)