Tuesday, August 21, 2007

Insecurity

There's an infamous scene that plays out in the minds of all budding physicians. It goes like this: It's your first day of medical school. The stern dean approaches your class at the podium, and says, "Look to your left, look to your right. One of the three of you will not graduate."**

Times have changed. Medical schools spend a lot of time and money admitting students now, and don't like to flunk anyone if they can help it. So we didn't get that talk.

On my first day of medical school, we all sat, fresh-faced and nervous, in the auditorium that would hold our tushes for countless hours over the next year. The Dean of Students approached the podium beaming, and said "Some of you can't believe you are here. You're certain that someone is going to come in and tap you on the shoulder and say 'We made a mistake, you don't belong here.' But you all deserve to be here."

I've thought of that moment often through my career. I certainly felt that way, on my first day of medical school. I certainly felt that way again as an intern, as a newly minted second year resident, seeing my "own" patients in clinic during training, and as a young new attending physician. Sometimes for significant reasons, sometimes for just more of the daily grind.

So I've been an attending for almost 4 years now. When will I stop having that thought?

**I can't remember anymore - is that scene from House of God?

7 comments:

Anonymous said...

In my opinion some humility makes a good physician and not thinking that you know "everything."

hlnc

Ten out of Ten said...

Our dean of students gave us the same talk. How interesting! Those were important words -- we both remember them clearly several years after the fact -- because like you said there are so many opportunities for failure along the way.

I continue to feel inadequate my fair share of the time as well. I think being in primary care amplifies this. Any consult puts me in a position of speaking with someone who is an expert in said area. The breadth of their knowledge pales compares to mine, but unfortunately I never get to discuss pediatric fevers with the orthopods.

I also think feeling somewhat inadequate is healthy, it drives me to continue to read, learn, and strive to become a better physician.

PalMD said...

I think it's from "Paper Chase", but I could be wrong.

Anonymous said...

One of our professors said exactly the same thing. Of course this was over 30 years ago.

creaky15 said...

Dr. Smak, Thanks for a great blog. I have added you to my blogroll.
creaky15

Dr. Smak said...

Sounds like a lot of us get the same speech...

Thanks for the kind words, Creaky.

The MSILF said...

That is a GREAT dean. I still get that feeling...