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Tuesday Jul 05, 2016

Breaking Point Offers Med Students Chance to Grow

Saying goodbye to people you care about is rarely, if ever, an easy task. "See you soon" didn't really work on our last day of medical school because we had no idea when -- or if -- we might be reunited. Although we celebrated our graduation, we said our farewells slowly. As the night progressed, each goodbye hug seemed to last just a little bit longer than the previous one.

The past five years in medical school (I spent an extra year to get a master's degree in public health) taught me not only about my future profession, but also a lot about myself. As I transition to the next chapter of my life, I often think about how the people around me have impacted my personal growth.

Johns Hopkins University School of Medicine students, including me, celebrate our graduation May 16 in Baltimore.

The most distinct memories that come to mind are of the happiest, most lighthearted moments of medical school. My classmates and I have numerous memories we all look back on and laugh at: the awkward times we practiced physical examination on each other while trying to maintain personal space, the random food adventures we managed to pull off at the last minute or the study sessions filled with ridiculous mnemonics.

But medical school was not all joyful times. I grew more during the times of stress, during the times I allowed myself to be vulnerable. Instead of associating these memories with shame, failure or rejection, I have learned to embrace them as wonderful learning opportunities.  

The clearest defining moment of growth occurred on my medicine rotation during third year, but I never thanked the classmate who helped me through it for being so supportive during my lowest point in school. As my medicine attending was providing me with feedback on my morning patient presentation one day, she called me insensitive. I was shocked. I racked my brain for reasons, but I couldn't figure out why. My attending said I labeled the patient as a drug addict by overemphasizing the patient's heroin use, which she thought wasn't relevant to the patient's chief complaint. But actually the patient's drug use was the root cause for her presentation. My failing was that I had not made a strong enough case to clarify the connection. Tired, stressed and frustrated that I had not explained that it took me hours to get the patient to open up and confide in me, I surprised even myself when I broke down and cried in front of my attending and classmate.

As medical students, we constantly had to prove that we were worthy of becoming physicians. Residents and attendings constantly evaluated our performance on each rotation. We continually felt stress and the need to shine during morning rounds, and we mentally prepared for a series of followup questions. Simultaneously, we needed to learn the particular style each attending had while digesting the most up-to-date, evidenced-based guidelines or research studies relevant for the field. The pressure on medical students quickly builds. Ultimately, most of us reach a tipping point and we learn how much we can handle before we shut down.

My attending's reaction to my tears caught me off guard. Her stoic exterior immediately melted into a more maternal response as she recognized my distress. She had seen it numerous times in the past, among both students and residents. We spent the next hour discussing the stressors I had encountered on this rotation and clarified expectations. Although the following two weeks did not get easier as our team cared for incredibly sick and complex patients, this became my most memorable rotation because our team grew as a unit. The attending ensured we had a safe learning environment by deconstructing the traditional team hierarchy. Thus, she alleviated several layers of stress and allowed us to focus more on providing quality patient care.

Despite ending inpatient medicine on a positive note, I did not share my powerful experience with anyone until several months after the rotation ended. I still felt embarrassed about crying in front of my entire team. Slowly, my brave friends shared times they, too, broke down on a rotation. Looking back now, we realized how these moments of vulnerability enabled us to gain incredibly valuable experiences for both patient care and personal growth. During these low periods, we grasped and validated our passion for medicine. We had physically and mentally invested in the care of our patients, and we had to understand that we had this safe space to make mistakes and learn from them.  

Although I am sad to leave an incredible group of friends, I am also excited to start residency. Instead of constantly feeling the pressure to prove myself, I know I can focus on my personal growth as a family physician. I look forward to the joyous, comical memories I will share with my cointerns. Instead of trying to wish vulnerability goodbye, I hope to embrace it to grow into a stronger, more compassionate family physician.

Tiffany Ho, M.D., M.P.H., is the student member of the AAFP Board of Directors.

Posted at 05:12PM Jul 05, 2016 by Tiffany Ho, M.P.H.

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