Objective: Produce timely documentation and communication that is clear, concise, and organized, in a way that optimizes patient care and minimizes medical errors.
Communication is my greatest strength, but it is also my greatest weakness. In fact, communication is the very reason I became a doctor. I suffered tragedy in the early years of my life that left me with a great deal of existential dread and communication difficulty. I understood the reactions of the people around me but I did not understand my own non-reaction and why I chose to hid it by mirroring the behaviors of others. I sought to understand the world around me because it did not seem to understand me.
Fast forwarding to medical school I have learned more about behavior and emotions, I believed I had a better understanding of myself and how to help others. I would soon come to learn that my efforts while significant required a more nuanced approach. I was now entering a world where the margin of error is slimmer, and where clear and timely communication is the hallmark of a good professional. Professionalism is about showing those around you the proper respect and for this communication is key.
In my first year of medical school I began to encounter difficulties with focus and efficiency leading to medical knowledge failures requiring me to repeat my first year and professionalism failures that persisted throughout my clinical years. The primary difficulty was maintaining an accurate and consistent schedule to address important deadlines and tasks. After some very thorough soul-searching, medical visits, and neuropsychological testing, I discovered that what I was dealing with was consistent with ADHD. While surprising to me, it was also clear to me how this explained other difficulties, I have faced throughout my life. This was the first step for me in recreating myself and developing a process to overcome my deficiencies. However, despite having this knowledge I struggled to develop a regimen that worked for me.
Neuropsychological Test Summary
Late or missing assignments and inadequate focus while studying continued to plague my efforts. Gradually, I learned that prior to the start of a rotation sitting down with the syllabus and making a list of important dates and deadlines was an effective strategy for keeping track of task. I also noticed that I had a great deal of anxiety surrounding task completion and keeping track of a list was paramount to decreasing this anxiety. However, the regular structure of a planner did not work for me. I was too distracted, so doing my own research I invested in a bullet journal which many people with ADHD and trouble completing tasks have used successfully.
Bullet Journal
A year later, things had settled down and being on the right medications, as well as, daily practicing anxiety reducing activities would allow me to meet the goals of decreasing late assignments. I took on yoga and even started a tai chi class to reduce stress and maintain better focus. That’s when COVID turned our world upside down and the house of cards I had built began to crumble. The daily coming and going from clinic to home and other places kept me moving with a physical framework for structuring my daily activities. Without this, I was lost in the minutia of the many distractors I have at home leading to difficulties over the following year with the residency application cycle, step 2, rotation assignments, and personal relationships.
My most recent deficiency during my EM rotation allowed me to further reflect on how to develop myself into a better professional. Prior to understanding its inner workings, professionalism has been a sense of duty. This was how I pushed myself to achieve the standards necessary to advance and assert my sense of responsibility. However, my process was un-refined. Professionalism is a consistent process of procedures, actions, and behaviors that decrease risks, mistakes, provides efficiency, and mitigates contentious or superfluous social interaction. It is a process that enshrines the sense of duty for the professional and communicates to colleagues and the consumer that their time is important.
Working with my ADHD coach has helped me to be more specific at developing a plan that won’t break down the next time external pressures arise. This includes creating weekly and monthly schedules and goals, designating specific spaces in my home for specific tasks, and soon developing a system to keep track of all these interventions for maintenance. A great example of this has been my use of an organization module to map out my process. This as well as finding a good support system to help and keep me accountable. Continuing this process over the next 2-3 months before the start of residency will propel me forward to having a successful transition and allow me to meet the increasing demands of residency. My immediate next steps however are to complete the assignments for my previous rotation and talk to the EM coordinator to communicate a better understanding of why I had these deficiencies and that I am working to prevent future situations like this.