It started on the first day of orientation. I remember coming into Meiling Hall and seeing a sea of faces. By the time we were through orientation I can remember thinking to myself numerous times, “Why am I here?” I met students from John Hopkins, Harvard and Cornell and students who’s family members were physicians, engineers and scientist. “Why am I here?” I was an average student from a state school in Indiana raised by a single mother who was an accountant before she had to quit working. “Why am I here?” it became a constant refrain for the next several years of medical. I was an average medical student until my life got complicated. I never struggled to understand the topics, I never felt lost but I was just average. A fact that underscored and gave more power to that constant refrain in my head.
When I began to struggle in school with my medical knowledge it was from sheer exhaustion and its what promoted me in a large part to take a LOA. I got to the point where I was overwhelmed, exhausted and burned out fro everything else in my life that medical school took a back seat. When it came to dealing with studying and learning I was going through the motions and it started to show. I knew that the first two year were about building foundation and that this knowledge I would need in the future to be the best physician I could be. So I took a step back. Outside of the amazing tutor, Dr. Covington, I sadly remember much about studying for Step 1 just feeling like I wanted it to be over. I finished my score back and did just okay. “Why am I here?”
We had Dr. Capers as a speaker for SNMA one evening and I took far more from our talk than I thought I would. He came in and said, “Let me just start by saying none of you are here by accident. You didn’t sneak in the back door unnoticed or fly under our radar and might get caught eventually. We specifically chose you. You’re here for a reason.” He went to explain that this was called impostor Syndrome. ‘Oh my God it has name and I am not alone ‘- my most clear thought at that moment. I remember a friend of mine turning to me and saying, “Well that explains a lot. I definitely have that.” I grinned and replied, “Me too.” He went on to discuss how it was common in minorities especially ones like me. Minorities who have no family members in medicine and who grew up in lower socioeconomic groups. More importantly he also discussed the ramifications of Impostor syndrome and how it affected performance, stress and well being.
I could see this affected my life and my medical school experience. Now I loved third year it was a great experience for me. Actually using the knowledge I learned from the first tears and using it to apply to my patients problems was and still is one of my favorite parts of medicine. But if questions were asked during rounds I would stay quiet. You see I thought I might know the answer but that person beside me they definitely know the answer for reasons X, Y or Z. There were very few times that I came up against a patient and couldn’t generate a differential or was completely lost. It was just having the confidence to speak up.
I had to change my attitude. It wasn’t enough to just know what I needed to know I need to speak up and to challenge myself to use my knowledge and clinical skills confidently. I found that even when i was wrong I learned something – being wrong and being taught why actually taught me ore than my silence ever did. I realized in order to be a good physician my patients need me to be confident in my knowledge and in my diagnosis. It would be pretty hard for a patient to trust me if I was so unsure that I barely trusted myself. And while I always did good on clinical rotations they got better, they felt better. And step 2 was considerably better – both due to the lack of chaos and dysfunction of my life and due to the change in view. Going forward I know there are things that I need to learn and ways I will continue to grow. But intern year will be considerably harder if I spend half of my energy doubting what I know. I’ve wanted to be in medicine since I was a kid and more importantly I belong here.
Medical Knowledge & Skills CEO 2.1: Demonstrate a broad working knowledge of the fundamental science, principles, and processes basic to the practice of medicine and apply this knowledge in a judicious and consistent manner to prevent common health problems and achieve effective and safe patient care.