Studying for my second set of board exams (step 2/level2), I am ready to finish up this study period and get back in the hospital where I feel I belong. It’s time for me to apply the knowledge I have been gathering, and time to stop wasting away at a desk, completing the never-ending list of practice questions. The feelings I have now are in stark contrast to what I was feeling last year at this point. This time last year, I was on my very first clinical rotation. A brand-new, baby third year, I was starting with surgery, and I was terrified.
The intermittent, fleeting moments of Imposter Syndrome that I would feel in the lecture halls of my med school were suddenly persistent. I felt as if I had forgotten everything I learned those first two years – or worse yet, as if I hadn’t learned anything about medicine at all. I hadn’t learned anything at all about hospitals, that was for sure. This was confirmed by my complete inability to keep from getting lost. Constantly wondering what was appropriate – wondering which computers was I allowed to use, when and where to refer to utilize the binders with the patients physical chart, how to obtain information from the nurses, decide which labs were pertinent to report. Filled with self-doubt about my ability to do anything at all, I was reluctant to assert myself. Scared of being an inconvenience or being in the way was all consuming, to the point that it was almost paralyzing.
Nothing that I practiced on my practice “standardized” patients at school seemed applicable now. Entering a patient’s room with a fourth year, my mind was blank. I watched as she introduced herself, said she was with the surgery team, and asked a couple pertinent questions. After listening to the heart and lungs, she examined the abdomen, told the patient we would be back later with the attending, and we left.
After watching her see a couple more patients, I went in to see one on my own. I felt like an imposter now more than ever. Who was I to be examining this patient? A real patient with real problems, with real pain. Oblivious to my inexperience, vulnerable to my inadequacies. I asked the patient to remove his gown so that I could perform a physical examination. He had no problem doing this. He trusted me. But why? Because I wore this short white coat? He must not know the difference between the short and long coats, I thought to myself. I asked to see the lesion, and he was eager to comply, no questions asked. He was grateful. As I examined the first perianal abscess I had ever seen, I was struck with unexpected feelings of honor and privilege for the role I played.
Today, I still have difficulty finding my way around the hospital, and it’s difficult when I have to learn a new EMR system. However, I am able to get oriented within a matter of days, instead of weeks. I don’t struggle with feeling like I am in the way or an inconvenience, I know that everything I do, I do for the patient – now and in the future. I have learned to be a contributing team member, and I no longer feel like an imposter in my short white coat. Shoulders back, head high, and proud to wear this coat, I walk the wards with confidence. I don’t feel bad when patients have to answer the same questions or tolerate the same exams an extra time. I am capable, and I might just pick up on something that no one else did. There have been many small events and moments of success that have built me up to be the confident student doctor that I am today.
Studying for my second set of board exams has given me the opportunity to reflect on everything I have learned these last three years. Concepts start to come together with a clarity that would have been invaluable when I was studying for step 1. I’m not surprised though, knowing myself, knowing that I learn best by doing, it makes sense that I have learned more in my third year of medical school than I have at any other time in my life.