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5 Mistakes I Made in Med School (So You Don’t Have To)

It has been nearly a year now since I walked across the stage at Carnegie Hall to accept my diploma. Now approaching the end of internship – let’s say that again, one more time, with appropriate emphasis: the end of internship – I can look back with a little more objectivity on my four years of medical training. As with everything else, hindsight is mostly 20/20 and, while there are a lot of things I did right in medical school, I now realize I made some mistakes, or, if they weren’t outright blunders, at least things I would do differently if I had to do it again. Let that these not be your mistakes:
1.  Worrying too much about looking foolish: I have a tendency to avoid doing things that I don’t do well. Call it well-ingrained perfectionism compounded by being quick to blush. In third year, regardless of what I was doing, I felt that I was constantly being watched. The worry about getting it right could get in the way for getting it at all. If I had a dollar for the number of times I thought to myself, I think the answer is x and it was right, but I didn’t say it aloud. . . well, I wouldn’t exactly be rich, but I could certainly afford to eat out more often. Throughout medical school, but particularly during those third year clerkships, it can feel like “All the world’s a stage” and all the residents and attendings are harsh critics, constantly passing judgement. Now as a resident, let me let you in on a little secret. You can relax. Yes, sometimes we make judgements, I won’t say we don’t. However, as residents at least, we barely notice your incorrect answer – we are secretly very happy that the attending is pimping you and not us, as we have forgotten much of what we learned in medical school. You will remember your mistake far longer than anyone else. Having been occasionally asked the same pimping question twice from the same attending in medical school, I am fairly sure many of them forget as well whether your answer was correct or not. We are far more interested that you come with a positive attitude and a willingness to pitch in on the team than the correct answer to where hydrochlorothiazide acts in the kidney (spoiler alert: it’s the sodium chloride transporter in the distal convoluted tubule).
2.  Not moving past step 1 of the See one, Do one, Teach one algorithm: It can be easily to constantly say “I’ll get the next one,” particularly if you are hung up on step 1 above. You can get through medical school not doing a lot of things – if you don’t step forward, there is almost always a more aggressive classmate at your shoulder who is happy to put in the foley, throw a stitch or two, draw some blood, etc. If you wait until you feel comfortable with a procedure to do it, you never will. Better than just volunteering when the opportunity arises, let the team know if you have a particular skill you would like to work on. As residents, it can be easy to forget to offer you the opportunity to practice your skills and just chug through it ourselves. If you ask to practice your phlebotomy skills, we’re more likely to seek you out when we need a blood draw on Mrs. Smith.
3.  Failing to figure out the expectations: This is particularly true at the beginning of third year. Some attendings and residents are excellent at establishing expectations. They sit you down on the first or second day, check in, and lay out your role on the team. This is, however, not universal, some of it depending on the individual and some on the culture of the specialty or hospital. Regardless of specialty, learning to be part of a team is not always intuitive or straight forward. The resident often doesn’t know what clerkships you have already done and may expect you to know what your roll is even when no one has told you. My first clerkship of third year was surgery at a community hospital where things were a bit, shall we say, unstructured. I still remember the resident berating me for not having a wound bucket. I had not a clue what he was talking about. The following day, I was again lambasted for not having a properly stocked wound bucket. The fact that no one had told me what a wound bucket was or what materials should be in it was completely lost on the exhausted, sleep deprived resident. Ask – on the first day, “How can I be helpful? What do you want me to be doing each day?” It puts the onus on them to articulate what they are looking for, rather than expecting you to read their mind. Although it can feel uncomfortable at first, it will save both you and the resident a lot of stomach acid.
4.  Assuming what worked before will work again: As an undergraduate, I tended towards a solitary study system, working away deliberately at home or in the library. I thought this was how I studied best, plowing through texts, making flashcards, re-writing my notes. It worked in college, why not in medical school? So that was the system I started, and it held up well through my first set of exams mostly covering material I was already familiar with – the fundamentals of genetics, biochemistry and biology. When we began anatomy and physiology, I plowed ahead through my piles of textbooks and notes, alone in my room. Then the first test came and I got my score back – I think it may have been my lowest score since a rather disastrous middle school algebra quiz. I panicked, convinced I was about to fail out medical school. While my initial impulse was to just study harder, I realized that I needed to change something. I reached out to a few friends who I knew studied together and asked if I could join. Now I had people to bounce ideas off of, clarify difficult concepts, and help me realize when I may have had a gap in my knowledge. It made a big difference and the next exam, while not perfect, was much better. If the data suggests something isn’t working, even if it has worked before, change it.
5.  Sticking to academics: If all you get out of medical school is what’s in the curriculum, you are missing out. Medical school is so much more! My first two years, I mostly worked hard at whatever was going to be on the exam, not seeing past the next multiple choice test. I participated in some club events, went to the occasional interest group, but when more of a commitment was involved I tended to think I’m too busy, I have to study, I’m not right for the job etc. I was impressed by my classmates who managed both. Then I joined the leadership board of our student-run free clinic and my world opened up. I got to know not just my own classmates better, but also those in other classes as we worked together to keep the clinic doors open. I had the opportunity to meet faculty and administrators in the medical school and hospital that I would likely have known by name only otherwise. I learned new skills – the complexities of grant writing and putting on charitable events (both far more complicated than they appear on the outside). I found, when I made the clinic a priority, I did have the time. Whether it’s working with your student government, leading an interest group or organizing a public health project, getting involved in extracurricular activities is fulfilling and greatly adds to the medical school experience.
Mistakes are an inevitable part of life. Theodore Roosevelt remarked, “The only man who never makes a mistake is the man who never does anything.” Give yourself permission to make your own mistakes and learn from them – just don’t repeat mine. Best of luck!

M
Megan Riddle, MD PhD, is a psychiatry resident at the University of Washington. She is a graduate of the Weill Cornell/Rockefeller/Sloan-Kettering Tri...