A Green Patch Between the Rock and a Hard Place

Recently, I have been reflecting on what it means to be a good physician. It’s a silly thing, but I have realized that the components that make a good physician and a good physician-in-training can be quite different.

Without a doubt, physicians are by no means the smartest working populus in civilization, but we’ve generally got enough cranial “muscle” to get this far and survive. Up until now, my working assumption has been that the most successful physicians correlate with their intelligence. After all, to get to medical school required many of us to adopt the notion that being the best meant being the smartest. After two grueling years of pre-clinical learning, I still find myself repeatedly kicking my metaphorical rock of self-doubt when I experience intellectual inferiority amongst my peers and my seniors. Despite my interest and enthusiasm in nearly all my rotations so far, I continually feel that weight of incompetence that many of us wear like an invisible sweatshirt by now. It seems that I will never be smart enough, and I will always know less than those around me.

However, slowly, like the subtle way seasons change on you, a new understanding dawned on me. What makes competent physicians isn’t necessarily sheer intelligence. In many ways, the lone wolf mantra utterly fails in the world of medicine. Working alongside the team of interns, residents, and my peers, I truly began to understand that it wasn’t about standing out; it was about advancing together. The residents that commanded the most respect were often the ones most efficient in time management and appropriate task allocation. It didn’t matter so much anymore that you came to the clinical diagnosis all on your own; it became more about juggling the complexities of lists of patients while engaging in intellectual critical thinking. Residency is a learning process, and when I looked at it, sure there were brilliant individuals, but most of the time, what took place was dynamic exchange of information and learning.

As I tumbled in the giant machine of cogs and wheels named Medicine, I started to realize that being able to assess and understand one’s role in the team and being cognizant of each other’s progress are facets that allow for maximal contribution of each member and thus the whole team. A well-fitted cog, even if tiny, can make a heavy machine sing - much more so than the ostentatious cog that only chafed and attrited the greater whole.

True collaboration is what really makes a physician-in-training excellent.

Because, knowledge comes with experience. Essentially, students become physicians through pattern recognition and seeing the whole gamut of medical conditions; that comes with nothing but time, and it is something out of my control. I cannot compare what I know to the decades of patients that my seniors have seen. Even by the difference of one year (between a MSIII and MSIV), the gap is comparable. What I can control is my integration and ability to learn/contribute to my team. What I can affect is my responsibilities and image that I present to my team. My observation and my attention can make me a great worker, and in the world of medicine, that is what makes a student powerful.