How to Get Better: Some Not-So-Medical Advice for Med Students
- Oct 04, 2017
During training, we want to improve our own capacity to deliver excellent healthcare for patients in need. Our professors and attendings have the same goals for us, and aim to be instrumental in our successes. We here at MST thought long and hard about the essence of self-improvement during medical training, and managed to distill years of practice into paragraphs of wisdom. The path to getting better at all things medical is predicated on three important factors, and we will discuss them here individually.
For the most part, our ambition is within our control. It is fueled by motivation, and almost single-handedly, separates the good from the great. It goes without saying that getting into medical school is effectively impossible without major ambition. Once one has arrived, the daily necessity is to study everyday, read whenever possible, and strive to maximize patient encounters. One can get by on the bare minimum of lecture notes and following their requisite one patient per day. But, as history reminds us, “Greatness is reserved for the great.” The ambitious student is at home reading nightly and picking up extra patients to advance their own learning. They are using free time to get involved with extracurricular activities, leadership roles, and health clinics. Ambitious residents are trying to cram as much learning as they can into their training phase of employment, all the while teaching their medical students instead of sending them off to handle menial tasks. There is no substitute for ambition, and in order to be successful, students and residents must do what it takes to foster it.
Confidence goes a long way in medicine. In our phases of training, whether as medical students or residents, we find ourselves in an interesting place. We are eager to learn as much as possible from every clinical experience, yet because of our titles (or perhaps insecurities), we feel absolutely compelled to let patients and colleagues know how capable we already are. In many ways this is a good thing. Being assured in our abilities, both cognitive and procedural, can lead to greater successes as we visualize positive outcomes; mental success begets actual success. In addition, patients are kept at ease by our lack of waffling and unsurety. But, if we lean too far in the direction of having it all figured out, it can have a devastating effect on our learning.
It is paramount to approach your own knowledge and ability with a sense of humility.
What? Practice humility to improve oneself? Shouldn’t pride in one’s work be the centerpoint of their practice? The humility that we refer to here is Socratic in nature. One of the wisest men in recorded history was humble enough to proclaim, “I know that I know nothing.” Despite your “knowledge,” this is an important attitude to maintain during medical school and residency. Believing that you know all there is to know is a recipe for circumscribing your ability where it stands today. Remaining humble expands the limits of your abilities, and will accelerate your growth far more than being over-confident.
Let me explain. Let’s say you are able to recite the recommendations from the NICE-SUGAR trial on rounds. Or you perform a lumbar puncture that feels flawless. You have affirmed your abilities and built confidence, important aspects of any clinical success. While you might rate your performance as outstanding, take a step down from your high horse, and think about how much better you could be. Work harder to internalize the finer points of landmark trials. Think about how you can be more streamlined in your procedures, down to absolute patient comfort, informed consent, and your own ergonomics. There is always room to grow.
This is the other side of the humility coin. Despite medicine being an ever-changing field, it is easy to fall into dogma, guidelines, and institutional patterns. No matter what field of medicine you practice, there are multiple ways to approach clinical decisions and procedural technique. A huge tenet of training is to experiment with multiple ideas from multiple providers, and combine them with the evidence to create a technique or thought process to call your own. An open mind will allow you to become greater than the sum of your teachers.
Even more importantly, keeping an open mind makes you a better receiver of feedback, a skill which is absolutely essential in training. With so many brilliant people working together, egos at the hospital can be large. Often times, our first response to constructive feedback is the voice of your ego, saying something along the lines of, “I’m great and infallible! What you could possibly have to say as a critique?” Triumph over your ego, squelch this voice, and give your full attention and sense of humility to your mentor. Doing so will maximize the chance that you learn something from the experience. Letting ego triumph will guarantee that no growth occurs.
Perhaps we can sum everything up as balance. It is up to you to balance your time between your personal life and your own intellectual advancement. Combine that with the balance between pride and humility, and you will be in an optimized position to improve yourself as a doctor.