As I prepare to make the transition from medical student to intern, I find myself reflecting on the past four years of my life. In doing so, I am filled with gratitude for the teachers, hospital staff, and patients that enabled an intimidated, know-nothing student to become a self-assured, know-a-little-bit intern. I also take pride in realizing that I accomplished something as challenging as an MD. degree. Despite these positive emotions, however, I would be lying if I said that within the gratitude and pride there isn’t a dose of regret.
During medical school, I was often overwhelmed by my perceived lack of knowledge compared to those around me. As an M1 and M2, I was intimidated by my classmates who came from prestigious universities, carried advanced degrees, or were already experienced in the medical field. Because of this, I rarely spoke up when I had questions and tended to take an observing role during group learning activities. Furthermore, during my third year, regardless of how much I studied or prepared, virtually every night (sometimes mornings) I came home feeling discouraged by how much more I needed to know in order to be fully responsible for patients. Only after I opened my letter on Match Day and found that a residency program I coveted “liked me too,” did I realize that, despite continually feeling like I didn’t stack up, I was actually a competent and successful medical student.
After speaking with colleagues and mentors, I now realize that the intimidation and hesitance I carried throughout medical school were more the norms than the exceptions, as a majority of medical students are plagued by feelings of incompetence and doubt. This doesn’t have to be the case. Medical school should be a supportive space for students to jump into challenging tasks, take chances, and make mistakes under safe supervision. Unfortunately, this is all too often smothered by the acute pressure to achieve a high test score or to impress a stoic attending.
The phrase “learning medicine is equivalent to learning a new language” is probably used too often when describing the difficulty of medical school; however, one of my favorite attendings improves this simile by extending it a bit further. According to him, the process of learning medicine is similar to not only learning a new language but also to traveling through and becoming a citizen of a foreign country. The early years of medical school are indeed like learning a foreign language, but clinical rotations provide an opportunity to practice this new language in a variety of specialties. These rotations are thus quite similar to visiting various countries that speak the same dialect yet have vastly different cultures. To continue with the simile, residency is like packing up and permanently moving to a country of choice, and attendingship is equivalent to finally becoming a citizen of that country.
I like this comparison because it puts each stage of medical learning in context. Similar to a traveler attempting to navigate the complex streets of a new country, no medical student is expected to handle the intricate details of patient care without making mistakes. Help is welcomed, and fascinating experiences arise daily when visiting a new country — medical school should be no different.
If I were to do medical school all over again, I would approach each day with the sole objective of growing my ability to take care of the clinically ill. This is all that really matters. Patients don’t care if their provider asked a “dumb” question as an M1. Patients don’t care if their provider missed wildly when presenting a care plan on rounds as an M3. Patients do care about their provider’s knowledge base, their compassion, and their relentless pursuit of optimal care. The only way to maximize these skills as a medical student is to jump in headfirst and learn from the mistakes. There will certainly be embarrassment and humility along the way, but there won’t be any regrets.
Robert McRae is a graduating fourth-year medical student at the University of Utah School of Medicine. He will be attending a residency in pediatrics at OHSU in July 2019.
