There’s a swamp out my back door in Gainesville, Florida, and a small dock that juts out into a lake that I am grateful to enjoy. Most mornings, before I cycle into the hospital, I go out back and stand on the dock and look into the dark water. Most evenings, after I’ve come home and showered, I’ll go out again and listen to the sounds of the swamp in my backyard. When we first moved to this condominium by the lake, I was excited for the view and the quiet. Through this morning and evening repetition I’ve learned things about this place that no visitor could know. I’ve learned that there are three baby alligators that live near the dock, and that their mother cruises 60 yards out beyond the dock at 8 a.m. and 7 p.m. I’ve also come to know that as the sun sets, the wind shifts and blows from the east and dozens of white ibises fly from south to north. I’ve learned that an hour later, after sunset, about once a week several hundred bats will fly toward the south.
Through walking outside every morning, I’ve learned that it’s usually quiet. Occasionally though, the mother gator will be sleeping on the shore and erupt with a loud splash as soon as I exit my house. I’ve learned that there are five raccoons — two of them young — that climb the palm trees and freeze when I startle them. They don’t run.
Most days though, I walk outside and don’t see anything interesting besides a nice view, and the same is true for any visitor to our place who walks out back.
During my third year of medical school, my outpatient pediatrics rotation happened to fall in late July, and I was initially miffed when I looked at the schedule and saw wall-to-wall school physicals for weeks. Internally, I groaned and protested, thinking to myself that it was an inefficient use of my time and would be spent completing the same standard exam repeatedly without exposure to higher yield topics for my Shelf. I did complete the same exam repeatedly. By the end of two weeks though, I had completed physical exams on well over 100 patients, and was tuned to picking up sinus arrhythmia, anticipating positioning difficulties, and hearing the heart sounds change as the stethoscope crawled across the chest. I didn’t hear many murmurs, but I noticed when I did. That experience has served me well as I’ve moved onto sicker patients, adults and children alike.
In the frenetic pace of medical school, there’s plenty of talk about optimizing study techniques to maximize testing performance. I’m also aware of significant discussions regionally and nationally on adjusting criteria for determining medical student competency, and even changes to the length of medical training. I am unqualified to comment on educational outcomes, and somewhat ignorant to the context of these discussions. I am growing in awareness, however, of the enormous benefits of repetition and routine. For something as complex as medicine, there is depth beneath the surface that reveals itself to those who look every day.
This sort of self-education demands consistency, repetition, and a tolerance for the mundane from its trainees. Engaging in stereotyped encounters with an attentive mind requires discipline. However, I am increasingly convinced that it is a worthwhile pursuit, and that time is, to some extent, an irreducible input for competency in medical training. Great athletes and musicians demonstrate this, and the best know that mere repetition without a willingness to focus, reflect, and repeatedly bring fresh eyes is not enough. Whether it is a standard physical, the daily ritual of reviewing lab values, reading yet another chest X-ray, or introducing oneself to the patient’s family, careful attention to seemingly routine tasks presents an opportunity for learning and instills diligence that may be important in practice. While athletic and artistic practice are helpful examples, medical training is inherently complicated because its subject is human beings. No composition is played the same on the hospital floor. Similarly, I could never have learned about the peculiar activities in my backyard without walking out there each morning because I can’t control the weather or what a raccoon decides to do on a Tuesday. I wouldn’t have encountered these things if I wasn’t standing out on the dock. Repeating the mundane errands of the day is beneficial not only despite the time cost, but because of it. Most days, it’s quiet and there are no ripples. A keen ear might make all the difference.
What medicine-related lessons have you learned from repetition? Share in the comments!
A. Hayes Chatham is a medical student in Gainesville, Florida. He is a 2025–2026 Doximity Op-Med Fellow.
Illustration by April Brust and Jennifer Bogartz
