Some Medical Students Could Use Lessons From kindergarten

I peruse the Student Doctor Network on occasion. I can honestly say, from the physician’s side of things, that many could have learned a thing or two in kindergarten. Hubris runs rampant, entitlement is endemic and many are Machiavellian and narcissistic. The trolls are always at the ready to descend on you if you ask for any kind of advice. Many on here are suspicious of you for asking simple questions.

I had a question about getting back into a residency a couple of weeks back. In 2010, I had to pull out of a residency for personal reasons and remain good friends the program director (he recently wrote a letter of recommendation to a residency program for me). The question was simple: If I do not match for a residency spot, am I able to practice with only an internship, and if not, did anyone have any advice on what kind of jobs I could hope to find.

The posts were brutal. Putting it lightly: ‘”You should quit now.” “Leave residency spots open to those who actually want to finish.” “Let me get this straight; you left a residency five years ago, and now you want to restart?’’ “Oh woe-is-me, nobody will interview me.”

The other comments are not fit to post here. Their arguments seemed to hinge on my failure of Step 2 and removing myself from a previous residency. This despite the fact that I had very good reasons for leaving and have been practicing primary care since with a full medical license. For these reasons, they would argue, I was not fit to practice medicine. I closed my account after seven years.

The hostility towards others I have witnessed makes me ashamed to be a physician. Many go there because they are anxious about the state of medicine, feeling burnt out, or because they are worried about getting a residency, etc. What most need is a sympathetic ear or some inkling of solidarity among their chosen profession and maybe a few kind words of encouragement. There is a lot of performance-based anxiety among residents and medical students. I suspect that many medical students and residents rely on some amount of performance-based esteem. I would surmise that some need only realize that they are not alone in feeling inadequate. However, it does not take long for the wolves to inevitably pounce all over their colleagues. Go see for yourself sometime, it’s alarming. What is more, it is an anonymous site, so there is no accountability.

Medical school is no different. I once left my books in a study room for a short period to get something to eat, and when I came back, they were gone. I left my ophthalmoscope and otoscope in an unlocked locker during cadaver lab, and when I came back, they were gone. Some students would argue incessantly about questions they got wrong on tests. I witnessed some debates become quite heated. Rather than taking responsibility for lack of studying, many students would criticize and deprecate professors until they got their way. I had witnessed hostility and one-upmanship on rotations among students on more than one occasion.

I remember distinctly an acute appendicitis patient. The attending had asked a fellow student what types of history she could expect and what physical exam findings she should be looking for. When she stumbled and couldn’t answer the question, other students snickered and laughed behind her back. These same students took it upon themselves to bully her every chance she got until she came crying to me one day saying that she should just quit. She told me that I looked so sure of myself all the time, and she wondered why she felt relatively inadequate and inept. I told her that we shared many of the same insecurities and talked her off the proverbial ledge. Many have not been so lucky to find a compassionate ear. Unfortunately, years later when I needed her to reciprocate she opted not to.

I went into medicine because I felt that it was a higher calling, where individuals were held to a higher standard. For the most part, what I have found is a culture of suspicion, privilege, and temerity full of fawning sycophant’s intent on seizing every opportunity to make they look good at the expense of others. There are a few diamonds in the rough, so all is not lost.

However, there has been a recent disturbing trend: medical students and physicians committing suicide. I’m almost positive that some the suicides we have seen among health care workers are a direct result of the bullying both on this site and out in the trenches.

So colleagues, take a lesson from kindergarten and treat others as you would like to be treated: Someone’s life could depend on it.

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