How we respond to failure says a lot about who we are. In business, failure is often seen as a good thing. World-famous motivational speaker Tony Robbins likes to say, “You’re either winning, or learning,” putting an emphasis on the fact we should learn from our mistakes when we fail. Failing allows us to move forward in life, to grow into something better. Why is failure treated so differently in medicine?
It starts even before medical school. Premed classes are highly competitive. If you don’t get straight A’s and a high MCAT score, then you can’t get into medical school. If you’re smart enough and work hard enough to get into medical school, then next up is getting into a competitive medical specialty. You’ll have to outperform your classmates in order to get a coveted spot in the residency match. You’ll need excellent grades and boards to get your top choice. Once you’re in residency, there’s a good chance you’ll be competing for a highly competitive fellowship spot. This time you’ll need to beat out your co-residents to get into fellowship. You can see where I’m going with this. If you don’t succeed at any of these steps, then you’ll feel like a failure.
Failure during medical training doesn’t stop there, though. The time and energy it takes to get into medical school, residency, and fellowship takes a toll on the student. It leaves little time for other endeavors like family, health and interests outside of medicine. Medical training prepares us to take care of other people, but not necessarily ourselves. We may succeed as doctors, but could be failing in our own lives.
The traditional medical training model frowns upon failure in any form. Failure has only one meaning, and there’s no room for it. We’re taught one mistake can cost a patient his or her life. If you’ve ever been to a morbidity and mortality (M&M) conference, then you know what I’m talking about. Failure truly takes center stage during what is simply known as “M&M.” The point is to prevent the same medical error from occurring in the future. It’s clearly important, but also brutally honest. The mood is tense. It’s sometimes advertised as a non-judgmental method of reviewing medical mistakes, but it usually feels more like a way to figure out who to blame for what went wrong.
This mentality needs to stop. Blaming ourselves is not fair, especially when you consider the nature of disease itself and the millions of acts that come before a patient’s final breath. Avoiding bad patient outcomes caused by true medical error should be prevented at all costs, but fostering a culture where failure is acceptable in other ways also needs to be considered. Failure in medicine should be appreciated for what it offers, an opportunity to learn how to do the right thing next time. In my previous article, I discussed how medicine would be better served thinking more like startups. How we treat failure is an example of this idea. Next time you bomb a test, or place the wrong order, don’t beat yourself up: ask yourself what you just learned instead.
Dr. Matthew Bloom, DO (@DrBloomDO) is a PM&R resident and co-founder of Docs of Tomorrow (@docsoftomorrow). He is passionate about helping future physicians dominate their medical training, from medical school to residency and beyond.