Throughout my life I have been introverted and suffered from some mild social anxiety. I recall dreading having to ask professors for recommendation letters, pushing it off as long as possible so I wouldn’t have to talk with them in person. I would worry about mis-speaking or saying something incorrect in an embarrassing fashion and usually found it easier to just attempt to avoid activities that would take me out of my comfort zone. While I was fortunate that my anxiety didn’t stop me from matriculating into medical school, I knew that one of the more difficult adjustments I would have to make was being able to talk to people I had never met before as an “expert”. Interpersonal Communications CEO 4.3 states, “Use effective listening, observational and communication techniques in all professional interactions.” I am quite proud to say that this is one particular aspect I feel as though I improved upon the most throughout my medical school education.

Starting LP in first year was one of my most memorable and anxiety provoking experiences in med school. I remember going to my first day in clinic, knowing on the very basics of asking HPI questions, not really knowing how to do a physical exam properly, and not really knowing much medicine at all to tailor the questions I would ask the patient. I observed the first patient encounter with my preceptor, and once I had the opportunity to observe, I was prompted to see the next patient on my own. I recall standing in front of the patient’s door psyching myself up, running through the questions I would ask the patient- “what brings you in today? how long has that been happening? does anything you’ve tried made it better or worse? have you had these symptoms before?”. After running through all the scenarios in my head, I entered the patient room. I nervously went through my checklist of questions, barely able t listen to the answers over my own anxiety. As the year went on and after seeing several patients, the questions flowed much better. As I learned medicine and how to do proper physical exams, I found myself asking better and more relevant follow up questions as I narrowed my differentials. I noticed that I didn’t have to spend a moment in front of the patient’s room just thinking about all the questions I would ask, as the questions had started to become second nature to me. Of course, I would still have some awkward encounters with patients, especially if the patient was dealing with an ailment that was uncomfortable to talk about. My skills at talking about issues such as sexual health or aspects of a patient’s social or psychiatric issues would take significantly more time to develop, and did so mostly during my third year clerkships.

During third year, we had our first inpatient experiences, a completely different beast from the outpatient half day clinics I had been doing for the past 2 years. I again had similar anxious moments when I had to see patients for pre-rounding. I would constantly run every scenario through my head- ‘ what if the patient asks me about her condition and i don’t have any answers, what if something goes wrong while I’m in the patient room, what questions is my attending going to ask on rounds’. My strategy to counteract my feelings of self doubt and nervousness was to take meticulous pre rounding notes, going as far as the rewrite the patient’s entire hospital course for my pre rounding notes on the off chance I would be asked about it. Luckily, as time went on I found myself becoming more efficient and confident in my skills in both talking to patients and talking to other medical professionals. As I learned what information was important I began to make my pre rounding more efficient. I was especially proud that my bedside manner had improved throughout the course of my inpatient months and that was one aspect particularly mentioned in one of my neurology evaluations:

“Farhan’s presentations were concise and he asked thoughtful questions. He was able to formulate rational differential diagnoses and thoughtful management plans. He always had a reassuring bedside manner with his patients. He displayed clear evidence of outside reading.” -IM ring narrative

He has a very nice, calm, and reassuring bedside manner and patients like his approach. -Neurology

While there are still occasions where I find I struggle with some mild social anxiety, I’ve found that these moments have become few and far between. As I carry a larger patient load on my sub internship and during intern year, I hope to continue to improve on communication skills I have gained throughout med school. Interpersonal communication is the trait I feel as though I have most improved on during my 4 years of medical school.

Interpersonal Communication CEO 4.3: Use effective listening, observational and communication techniques in all professional interactions.