Like many medical students, I was vastly underprepared for the emotional turmoil that the nature of the third year of medical school can create. Even with reminding myself that “this rotation is only six weeks” or speculating that “today was just an ‘off’ day,” a pervasive sense of inadequacy loomed. Relying on support systems to combat these patterns was a fallible strategy; I knew I would need to change my mindset, whether it be about my performance, my role in medicine or my vision of an uncertain future. The end of each rotation presented an opportunity to critically assess both my performance and my state of well-being, both of which improved with developing emotional resilience. To combat the sense of inadequacy and temper the turmoil, I had to acknowledge and validate my emotions, then allow them to pass.
Even the most pragmatic person will at times find themselves wondering if they made the right choice — was medicine the right career for me? The volatility of the work and turbulence of cramming knowledge day in and day out is enough to make the most sure-footed feel unstable. Trudging forward allows us to ignore these feelings and dismiss their legitimacy; I have certainly fallen victim to that. Learning to healthily engage with my feelings had served me better on all fronts than simply disregarding them.
Readjusting my vision of success was another aspect of training that felt like a revolving door with each rotation. The pool of high-achieving students that have always risen to the top feels much more condensed when we find that our academic company is others that have always risen too. Beyond that feeling, there is a ubiquitous sense of doubt that plagues students as we bounce from specialty to specialty, eventually finding a groove in the rotation only to abruptly start anew. As soon as I “got good at something,” it was onto the next rotation. This “starting-from-scratch” feeling challenged my mental health; however, I have come to accept that this is the reality of being a “life-long learner.” Shifting from preceptor to preceptor across different specialties, attempting to integrate clinical information across fields, and studying not only for shelf exams but ultimately the Step 2 Clinical Knowledge exam was emotionally taxing, to say the least. It is hard to reconcile our education process when it is not something that comes naturally at times. Learning medicine is hard, but applying that knowledge is much harder, and it challenges you in a way that many years of traditional learning could never prepare you for.
Particularly on rotations where I did not thrive (re: the time a supporting staff member in the operating room told me I suture like a hospitalist, which I found more entertaining than insulting) — I had to readjust personal expectations of my performance and what qualified as competency and quality. If ever there were a space that forces you to look within it is the operating room. There are many lonely occasions of wanting to be better, helpful or just out of the way that punctuates your experience. Understanding tools and techniques may be a matter of repetition yet learning to navigate the unspoken politics of the OR takes awareness, humility and finesse (undoubtedly something that you will fumble on as well). Every toughened figure in the room has felt this same flustered frustration you are feeling now. At some point in time, they likely had to furiously bat away a few tears because if they touched their face and broke the sterile field all hell would have absolutely broken loose. Their competence and confidence were earned, and you will want so badly to achieve their seemingly effortless assuredness but recognizing your place in the room is the first stride towards that goal.
I may not have developed an envy-provoking suturing technique, but I rose above the expectations of my preceptor simply by working as hard as I could. Even then, I remind myself that sometimes hard work is enough and sometimes it is not. That is the brutality of this path and I try to be cognizant of that reality. Survival requires giving grace to your small victories and recognizing that you do not have to be the best at every aspect of this tortuous journey. Accepting that truth is often harder than the many moments that manifest it — though there is undoubtedly a place for each of us within the greater world of medicine — and a less-than-perfect suture will not convince me otherwise.