Friday, July 9, 2010

Try all you want, you'll eventually fall into the trap of comparing yourself to others

The best advice I can give you as a medical student is the hardest to follow. Don't compare yourself to others. It is a horrible thing to do, but we all do it. I, for instance, will stand in front of the list of scores for each test and count the number of people who did worse than I did. I will then count the number of people who honored and secretely hate them. Or not so secretely, considering most people know my feelings. We are all so used to competing and being better than everyone else that it is hard not to do the same thing in medical school. Although I truly believe the outcome is far worse. In undergrad if someone was doing better than me in a class I couldn't stand it. I either hated them if I couldn't be smart than them or kicked my ass into gear until I was doing better than them. Slyly asking people how they did on the test to see if I got a better score, asking how long they studied. Feeling smug to be better than everyone else. And to be honest, that is part of how you get into medical school. It's a competitive world and to get in, you have to be the best. And you think you have to stay the best.
It becomes very hard when you get into medical school to remember that you are on an individual journey that is not the same as everyone else's. We all sit around comparing study methods, talking about how we studied thirty hours in two days for this test, then honored the crap out of it. We talk about the awesome things we get to do with our preceptor. Anything to make us stand out. We even have people who will come in dressed in suits and when asked why they are all dressed up they say "oh, I'm meeting with the director of the residency program I want to get into, just to chat a bit, and I figured I should look my best." Bite me. That's a different story though.
The point is, all of us have a different set of struggles, and we all have a different set of experiences and priorities and everything else. And all of it is going to get us to our endpoint of being fantastic doctors. For instance, I do not get to do many procedures with my preceptor. It just isn't something I got a lot of exposure to. So listening to friends who worked in the ER and got to stitch people up or do some other awesome procedure used to make me really jealous. And then I realized what I was getting from my preceptor. I, unlike many of my classmates, learned early how to write a history and physical exam, give an oral presentation, participate in rounds, and other things like figuring out hte computer system, learning how to put in orders, learning how to write things up, find old X-rays, get to the ER, etc. All mundane seeming things, not nearly as exciting as stitching or pericentesis or anything like that. But let me tell you, I was at such an advantage my first week of internal medicine because I did it at the hospital where my preceptor worked, so I already had computer access, knew how to get to the ER, knew where all the paperwork was and how to fill it out, how to do a history/physical and give an oral presentation, and know what was expected of me at rounds. So I oculd work on the things that everyone else found so easy, like knowing what to do with a patient or the details of the disease process they were suffering from.
We are all so obsessed with being the best that when we can't be the best we try to make everyone around us think we are the best. I've said that before, I truly believe it. So if you are constantly comparing yourself to other people, you are always going to seem like you are coming up short, because very few people are truly honest about what they are going through. All you see is that they study and get good grades, or they don't study and go play golf and still get good grades, and you are spending as much time in the library as you can and still not getting good grades. And then you start to doubt yourself. And that is when the struggle becomes too hard. Because no matter how hard you try, there is always soemone better than you who doesn't seem to be struggling as much as you do, and then you fall into the whirlpool of dispair. When in reality, those other people may see you and think you are always so together and never struggling and they always feel like they are having trouble but since you aren't, they don't want to tell you about it.
It's a vicious cycle, a culture of competition that needs to be broken so that people can get back to remembering that they are on a noble journey towards being a physician, a healer, not some guy that everyone thinks is a badass. If the only reason you are in medical school is for fame/prestige, you are an idiot.
I have come to the conclusion that 85% of the time, people are lying to me. It is actually kind of comforting. It used to drive me crazy to have a friend tell me he studied for like three hours and then went and played golf and still did better on the test than me. And it used to make me feel like a complete failure when a friend said they studied for 10 hours a day and I only study for like 6 or so and maybe that is why I'm doing so poorly. And nothing filled me with anxiety quite like someone saying they were studying for Step 1 during the first year. Pulling out their first aid or talking about doing practice questions.
I slowly realized that a lot of people were just full of shit. A friend of mine told me a story about how one of our classmates told her he was probably going to honor anatomy, no big deal, and she had just gotten comfortable with the idea in her head that no one really honors anatomy and passing is just fine. And she started freaking out, wondering why she wasn't even working towards honoring. What was wrong with her that she had already gotten comfortable with just passing? Turns out that guy actually failed anatomy and had to remediate. I once was studying in a room with a classmate when another one came in and said "tell me you've been here all night studying" (it was now 730am, I was early for class). So I said "okay, I've been here all night studying?" And he asked if I really had and I said "hell no, I just got here a little early this morning." And he was like "oh damn, I've been here all night studying and was just hoping someone else had been suffering as much as me." Really? First off, I don't care that you've been here all night. I've been sleeping and taking care of myself. Secondly, don't throw what you think as of a major accomplishment in my face. And third, you probably werent' studying all night.
People know I tell it like it is, and I think they realize that I'm not living in a happy world of success in medical school, so I am often privy to information that I'm not sure people are willing to share with others. I have numerous times heard people say "oh man, Joe Schmoe told me he is not only studying for class, but also has started studying for the boards, and I can barely accomplish the one, I really don't have any more hours in my day!" My general response is that Joe is LYING to you. He needs to feel self important and if he's not doing something fantastic at least wants you to think that he is. Sure, maybe he is "studying" for the boards. MAybe he carries his First Aid around in his backpack and pulls it out and puts in on the table, and sometimes opens it and reads something in there. But he has no clue what he is doing. So don't let him get to you. Don't compare yourself to him, because maybe you only put in three hours of studying a day, but it is three hours of real, hard core studying, and Joe puts in ten hours a day but most of it is sitting staring at the wall.
Everyone has their own way of doing things, and that is the hard part to remember. It may not work for you to not study ever and then pull an all nighter and memorize everything. It may not work for you to study a little bit every day. Class may be your idea of hell, or it may be the only way you can learn. Don't worry about what other people are doing. Figure out what works for you, and don't let anyone else tell you that their way is better. In fact, don't even ask them about their way, unless you really are in search of a different way. Because everyone's journey is different. We are all going to get out of medical school, some of us will take a little longer, some of us will have no souls, some of us will feel like rockstars all the time. It doesn't matter about everyone else, it only matter that you are going to get through this.
When it comes right down to it, there are some people that just don't have to struggle as hard as you do. There are some people who just get it, who just feel great all the time, and know how to study really well, and do well on the tests, and seem to have their lives totally together. Good for them. But that doesn't mean that everyone is like that. And it sure as hell doesn't take away from your value as a person or from your ability to be a doctor because you do struggle. I honestly believe that the people who have the hardest time but are able to persevere are the ones that are going to really really succeed in life. Or at least I only hope that because it makes me feel better about struggling.
It's the hardest thing to do, to say "I am me, I'm doing my best, and I don't care what others are doing." And it is even harder when you are in a place where the culture of competition leads people to always be showing off. But take comfort, you will be an amazing doctor in your own way, your journey and experiences will be gifts that help you succeed in the world, and we are all going to get through this. And if nothing else, remember that I struggle too, so now you know someone else is struggling as well.

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