Up until medical school, my life was relatively smoothing sailing. I did not really have too many challenges before this point. Once I got the hang of college, I had good grades, participated in the right extracurricular activities, and worked in a medical research lab. Never did I imagine that the next few years would hold so many obstacles.
I had gotten into my dream medical school. I could not imagine a place I would rather be, but was completely unprepared. I had exceled in undergrad, but now I was surrounded by people smarter and more accomplished than me. Not only were my classmates some of the most impressive people I had ever met, but I was at an institution that I had no idea how to navigate. This became very difficult during my third year clerkships. Up until this point, I had not spent much time in the hospital. I had no idea what I was walking into. I knew this was probably my most important year of medical school aside from taking Step 1.
What caught me by surprise during third year was the amount of interpersonal skill and self-confidence I would need to excel this year. I do not have a very aggressive personality and it takes me awhile to get the hang of things. I struggled during my clerkships and had no one to talk to about it. I did not know where to go to ask for guidance. All my grades suffered during my clerkship year, and I was mediocre at best. I started to doubt if I was built to be a doctor and whether I would get into any residency. I did not have the best letters of recommendation and had no advocates to help call residency programs I was most interested in. My worse fears bore out, and I matched at one of the programs at the bottom of my list.
I arrived at my residency very distraught. I was still holding on to resentment from my medical school experience and was discouraged by my lack of success. I was not emotionally ready for all that intern year required. Intern year was by far my most challenging year of training. I was nowhere near prepared, and this was evident in my work. I got a terrible evaluation on my second rotation. My attending said I was the worst intern he had seen in his 10 years of practice. Shortly after this rotation I worked more hours than I thought possible—up to 120 hours per week because of my complete inefficiency, and I was still not finishing my checklist at the end of the day. Because of my severe duty hour violations I had to meet with my program director, who told me that I would need to shadow another resident for a month and repeat the rotation. I was yanked from my current rotation and remediated. I felt humiliated and did not have the courage to tell people why I was pulled off service. This was my all time low. It took me 4 months to get out of this.
I felt alone and lost. I did not understand how I had gotten here. I went from being at the top of my premed class to now being remediated. I knew no one and had no other people to talk to. I was alone in a new city, and my friends from med school were absorbed in their own internships. I let myself wallow in self-pity and gave up. Then I started to think: I can’t let myself fail here. I will become the best doctor I can be if it is the last thing I do. This is something I have wanted all my life and I can’t give up on it now.
When I finally began to see the positive that came from all of this, it changed my perspective on what had happened. I had focused on all the negative and had not seen the beauty in all of it. Medical school and intern year were the best times for me to be challenged. These were very formative years, and the things I learned at the beginning would help make me the doctor I am today. The things I considered setbacks had actually taught me valuable lessons and have helped to shape me. I previously thought I was perfect. That I could learn everything I needed to without the help of others. As I started to see that there was so much I didn’t know, I took my studies more seriously. I took the feedback others had for me and tried to improve in these weaknesses. I learned to ask for help when I needed it and that medicine is a team effort.
I tackled each comment on my evaluations one at a time. Assertiveness was one of the first things I was told to work on in medical school. I needed to say things with conviction and be able to support my ideas. The conviction I would need to be able to speak up would only come from really believing what I said, but that meant more reading and more learning. I would not be willing to assert my opinion if I had not taken the time to read about it beforehand. I continue to work on this, but because of my new found voice, I have been able to speak up when something does not seem right. It has even given me the courage to start writing.
Next I needed to work on my organization and efficiency. This was a difficult one in residency because I was required to be on top of everything while I was learning how to do it. I knew that these were important skills because they would allow me to take the best care of my patients. Plus, being efficient would allow me to spend less time on documentation and more time with my patients.
Finally, I still struggled with attention to detail. I would miss things buried in charts or glance over important labs. This was detrimental to the care of my patients. I could not miss anything. I needed to know my patients better than anyone else. It is better to take the time to learn every detail than to rush to see more patients. So now I focus on the task at hand and try not let my mind race to the many other things that I still need to do. It does a disservice to the patient I am taking care of at the time and in the end does not really save me much time because I have to go back and relook at things.
Even though all of these challenges have been a blow to my ego, they have greatly improved the type of physician I am now, and I would never change the chain of events that have gotten me to this point. Don’t be so hard on yourself. Let these experiences shape you and make you a better person.
About the Author
The author is an early career general cardiologist in private practice who blogs at Medicine Pathways.