I remember sitting in the classroom on my first day of medical school. I was excited, scared and still a little bit in shock that I was really there. However, only one thing said to us that day has stuck with me all of these years.
“Look to the right and left of you. Statistically speaking, one of you won’t make it through the next four years.”
I think back on that moment often. It was at then that I realized that I really hadn’t “made it” yet. I still had to prove that I was good enough to be a doctor.
It is unrealistic to expect medical students to learn everything there is to learn about medicine in two years sitting in a classroom. I suppose it does make sense to teach us Biochemistry, Pharmacology, Histology and Microbiology, but I’d be lying if I told you that I retained or currently use any of that information as a practicing Ob/Gyn.
Now that I have had seven years to settle in to being an attending, been through burnout once or twice and left the job that I thought was my forever career, I know with certainty that I did not get taught what I really needed in medical school.
These are the real lessons that medical students need to hear. These are the foundational elements that should be modeled for them in order to mold the next generation of physicians.
1. How to have strong boundaries.
As medical students, we are taught that we must seize every opportunity to learn, especially during our clinical rotations. We are told to be the first ones there and never ask to leave. I understand the sentiment behind these rules, but what they actually do is create unconscious beliefs that carry far beyond our training.
We learn that our needs aren’t as important as the job. We learn that to be good doctors we should be the hardest working one in the room. This creates doctors who fear laziness, link their worth to their productivity and feel immense guilt for having desires that compete with medicine.
If medical students learn to create strong boundaries, they learn to have awareness of their values. They learn how to balance their values with their careers. They learn how to uphold their boundaries respectfully. This creates future doctors who know how and when to say “no”. These doctors would know that their worth as a human does not rely on their performance as a doctor.
2. Fulfillment requires not relying on external validation.
Throughout our training, we rely on someone else telling us that we are doing a good enough job. After 6-8 years of this, it’s no wonder that many attending physicians are addicted to the feedback of others. The problem with this is that doctors who rely on external validation to feel good enough will never be validated enough to be satisfied. They become perfectionistic people pleasers in search of validation from their patients and peers. This leads to chronic self doubt, overworking and a deeply unsatisfying career.
3. Work-life balance is subjective.
So many physicians are seeking this elusive balance. The problem is that balance is subjective and no one ever taught us how to define it for ourselves. So instead of taking the time to define it, we get stuck in the assumption that we don’t have it. Couple this with the fact that there are so few mentors who would say they have balance, and young physicians continue to struggle to find it for themselves.
4. How to be in integrity with your core values.
Having personal integrity is a journey. Ideally, this journey begins as a young adult and unfolds as we mature, find a partner and start a family. As medical students, we are instead encouraged to forget everything that we value for the sake of earning a medical degree. Being honest about what we want is replaced with doing the best thing for our patients. Once we become attendings, many of us forget what our core values even are and we are hypnotized to follow in the overworked and burned out physicians who came before us.
These four lessons would change the culture of medicine as we know it. Physicians would truly define the health that they want for their patients; in body, mind and spirit. For now, the attending physicians who know and live these lessons are the rebels. We are rebelling against the toxic culture of medicine with weapons of integrity, authenticity and self love.