Daniel Ortiz, M4, Class of 2020
You are more than just a number.
But of course, you already knew that… right? Unfortunately, the reality is harrowing. Throughout our curriculum and challenging gauntlet of test after test, we discover that complex clinical reasoning is not submissive to the 3-digit score engraved onto our transcript for residency directors to see. In fact, we know from rounding with our classmates that the phrase “medicine is an art” is much more accurate than “medicine is a number”. I honestly believe that the best path to becoming a competent physician lies with balancing your strengths and weaknesses, and maybe that is what these tests are trying to accomplish. I have, on multiple occasions, come across colleagues who find it to be taboo to even talk about test scores at all. We might first see this through the lens of humility – and I sincerely doubt my colleagues are so inclined to brag about their accomplishments. We did not come this far to engage in such behavior, so perhaps it is out of a sense of inadequacy that we avoid the discussion altogether except while in the company of our closest of friends.
That is not to say that I am not surrounded by brilliant people. Imposter syndrome is a very real thing. Even the top 5% of our class suffers from it. As someone who is a strong advocate for mental health, though, is there really a need to suffer at all? I have heard numerous attendings remark that our scores do not define us – that we are all more than just a number. I have heard on many occasions that examinations do very little to elucidate exactly how effective a provider we eventually become. I have seen students who are averse to becoming a surgeon that demonstrated excellent surgical skill and precision. I have seen students who are great with their hands and even more amazing with people. So, dogma aside, our clinical training and constant testing is obviously not a testament to our skill as a clinician.
Is it knowledge, then? I would argue no. How else can you explain twenty or thirty-point increases in practice scores over a short period of 1-2 weeks? Knowledge is acquired in time, but it is perfected by experience. We will all acquire the minimum background necessary to graduate and begin our training as physicians. We all have the potential to be a resident in any field if we are willing to work hard enough and sacrifice enough of our time and energy, and perhaps that is what these tests are a true representation of. Sacrifice.
I look at my children every day, knowing that the time on the clock keeps ticking whether I study or whether I take them out on a random bike ride. I know I must work hard to achieve my goals, and I hope to instill that work ethic into them one day as well. But I believe this recurring theme of sacrifice in medicine has very little to do with how much of your time you are willing to sacrifice and much more to do with how much of your self you are willing to sacrifice. Time always keeps moving forward. I have aged enough and watched my kids go from baby to toddler for long enough to know that. I have seen colleagues grey their hairs (much like mine) over the stress of academic success.
So as you undoubtedly become the best physician you can be, just remember – you are more than just a number. You are a person. Numbers are infinite. Time is not, and neither are we.