#815 “I failed, big-time, a few years ago, and even though I’ve bounced back it’s still affecting my self-confidence.”

Ahoy Captain,
I was hoping you could give me some scripts for internal use only.

A few years ago I was in medical school in city A. In my final year, I failed my exams & had to repeat the last semester – and know this sounds ridiculous (“the worst thing to happen in your whole life is failing an exam, you lucky, over-privileged jerk?”), but I have never felt worse, more devastated and humiliated, in my life before or since. I was the only failure in my year, & all my friends graduated without me. Ultimately, I graduated at the end of the semester, have been a doctor for several years, and my supervisors give me satisfactory reports. My self-confidence was not-so-great for a while and I have issues with anxiety. But a year ago I moved away to work at City B Hospital. It was a natural progression based on my experience, but I was entrusted with more responsibility, less supervision, learned a lot and people tell me my confidence has noticeably increased.

This year I’ll be moving back to work at City A Hospital, for many excellent reasons, not least because they will be giving me a type of position I’ve been trying to get for the last 2 years, and necessary for getting onto the training program for the speciality I’m interested in. I’m looking forward to this move on the whole, but I’m worried about how I’ll deal with seeing my old friends, many of whom still work there. They are not the problem – they were and still are great to me. But most of them are registrars now (kind of a middle-management position) while I’ll still be a junior. I’m worried that, working with these guys, probably being told what to do by them sometimes (as part of our jobs), I’ll start thinking what a loser I am again. I already feel a little depressed when I hear about one of them passing an exam or getting a promotion (because I am a terrible person). I mean, I try to tell myself stuff like “They know more than you because they’ve been studying for specialty exams / they’re further along because they had a head-start /it’s not a crime to take longer to progress in your career – that doesn’t make you a loser”. But then I go “Yeah, but they didn’t fail and you did, therefore all of that must be interpreted in the worst possible light – so you kind of are.”. 

Captain, have you got any other suggestions for how to convince my self-doubt to STFU?

Thanking you in advance,

Doc With Doubt

Dear Doc With Doubt:

The exams were just a progress report, a marker of how well you knew the material at a specific point in time. Slowing down until you knew the material was the only right thing to do, and because of your past failure, you will never forget that particular piece of your education when it matters to the health of human beings in your care. You also know something you didn’t know how to do before and something that many of your peers might not know how to do: You know how to fail, you know how to assess what you need to do to succeed, and you know how to apply that knowledge and do the thing to get where you want to be. You know how to do this in spite of shame, in spite of negative feedback, in spite of cost and delays in time. You are a doctor and have been one for some time, yes? People are healthier and better because of you and your work, yes? Then you have succeeded in the ways that count.

So when the mean tapes start playing in your head, ask yourself, “What do I serve? What is my work? Is my work about being seen to be perfect or about winning a secret competition with other people (who aren’t thinking about me and my relative status to them all that much), or is my work about the people I treat?”

Your patients do not care whether you failed some tests four years ago. They care about whether you know your stuff now. They care about whether you listen to them and about whether you really see them. They care about how you apply the knowledge that you have for their treatment. If you are replaying old failures in your head, or worried about what the doctor in the next room down thinks of you, or thinking about the bullshit of prestige and competition, these things will distract you from the actual work of treating patients and working well with the nurses and other colleagues around you.

And if your peers underestimate you, let them for now. Being anxious and at pains to prove how smart you are is the hallmark of the sophomore. Being underestimated and then letting your work elicit “Damn, you’re great at this!” responses is a very particular kind of pleasure, reserved for the older and wiser.

You know what I’m going to say next, right? I’m not really set up to provide ongoing mediation between you and yourself. If these self-doubts are really messing with your happiness and ability to function, there are pros who will be happy to help you sort this out over the long-term.

Finally, if you are lucky enough to have trusted mentors, try asking them:

  • “What’s something that you really screwed up when you were just starting out?”
  •  “How did you bounce back?”

Everyone who has done anything for any length of time makes mistakes, everyone fails sometimes, everyone carries secret “ooof I could have done that so much better” doubts and memories. People who pretend they haven’t are kinda scary.

Best wishes in your new position. You can do it!

 

 

 

115 comments
  1. Anna said:

    I still wake up in the middle of the night shaking from nightmares of failing a history test in high school…. and I’m 41… so I think I feel your pain (hugs!).

    However, as a patient, I really wish my doctor was, well, more human. Or maybe just more aware of her humanity and fallibility. Because, yes, it’s great that she’s uber-confident of her medical knowledge, but that confidence seems to routinely get in the way of listening to anything a lowly person like me has to say. She’s made some major mistakes as a consequence, and caused me a huge degree of unnecessary worry, as well as a lot of frustration.

    I wonder whether that one setback might have been something that actually made you a better doctor from the patients’ point of view, or even a better person all round, because you know you’re not perfect, so you question yourself.

    • stellanor said:

      I mentioned that I still had these, several years out of school.

      My dad told me HE still has them. He’s in his 60s and hasn’t been in school for FORTY YEARS.

      I think those nightmares are unfortunately forever. Although I did find that after the first couple years the frequency dropped off as my brain finally realized that I didn’t go to school anymore and I wasn’t going back — for a while there it was like, “What do you MEAN we don’t have exams every 4-6 weeks??”

      • if you really love these nightmares and want more, go back to school in your late 30s. FUN DREAM TIMES.

        • Sneakys said:

          Can confirm. I am 30 and went back to school. Organic chemistry haunts my dreams now.

        • My mom went back to START AND THE FINISH highschool when she was 54, now she is doing a career :D. instead of thinking about it like a nightmare/whatever, think of this as a great way to accomplish or IDK, complete some unfinished business??

          • Also, Captain, in my opinion, I don’t know if it’s a good idea to go around asking “What’s something that you really screwed up when you were just starting out?” to other people/”future mentors”/etc, less in a professional environment in which LW is a newie…

            In the same way that LW feels bad about her failure, I think that maybe you/LW/etc have to put yourself in another’s shoes and think that maybe the other person feels the same as LW and they have experiences that are painful or uncomfortable for them and they don’t want to talk about it…. And asking this kind of questions, even for a familiar person, is a delicate matter, and it could result in an very unpleasant or awkward time (to put it in the best way) therefore, asking such questions would only be like putting the finger in the wound.

            Empathy should come from both sides.

          • JenniferP said:

            Fair enough, though there is a difference between asking a mentor (someone with whom you have a close relationship with over time, someone who is invested in your success and has agreed to talk frankly with you about the ‘unwritten rules’ of rising in your profession and be open to questions) and polling all the people above you on the org chart willy-nilly.

          • I think you are misreading these comments, which are talking about ACTUAL AND LITERAL BAD DREAMS that people are having, about school, long after they are out of school.

      • lilisonna said:

        I thought mine were gone, but I had one a week or so ago. They’ve dropped in frequency, but for the year after I graduated, I kept my diploma on my nightstand so I could look at it when I woke up from a ‘you didn’t graduate’ nightmare.

        • boutet said:

          Last night I dreamt that I showed up late, naked for an exam for a class that I never attended… and the chairs were all toilets. I don’t know what my subconcious was on about last night but it seemed like they were working off a checklist!

          • RedinSC said:

            Oh, Boutet! I’ve had that dream without the toilet, BUT I also can’t remember my locker combination and I have to get in there to get something for the test.

            I’m in my late 40s, and yes, they aren’t as frequent now, but I still get them in times of big stress. My dad, probably when he was in his 60s tole me he still had them. Le Sigh.

          • Kitai said:

            I’ve had a dream similar to that! I was naked and late and didn’t know the content and it was that bizarre dream thing where I became hyperaware of the fact that I was naked, but everyone kept going about their business, completely throwing me off.

          • Jane said:

            My tediously stereotypical dreams usually combine 1. not being able to close the stall door in a public restroom 2. showing up at a piano recital or dance recital for which I have not practiced 3. discovering at the end of the term that I failed to drop a class that I didn’t attend and now must take the exam, in roughly that order of frequency.

      • twomoogles said:

        I had mostly stopped having those nightmares…till i started working in a school! That seemed to restart all the school anxiety dreams.

      • Frankie said:

        I’ve more or less stopped having test dreams, but they’ve been replaced by “oh shit, someone stole all my costuming half an hour before the show” dreams.

        • thepaintedlady said:

          Ha! Before I quit professional theatre for good I used to get “It’s opening night and you seem to have forgotten our big expensive plot-driving prop which we told you about many times and clearly you’re a total failure” dreams. Now I have “Good lord did you really go on vacation and forget to have someone take your classes?” dreams. At least they’re topical to my life?

        • Hah, yes! No test dreams but I have the occasional “Guess what, you’re fired and we never really liked you anyhow!” dreams.

      • Panda Bandit said:

        I used to get test nightmares a lot but they stopped after about four years of therapy. Now I have calm dreams about school. I think finding the root cause will stop the nightmares.

      • sophylou said:

        I still have those school nightmares, except that now they’re “professor” nightmares; I’m *teaching* naked while trying to keep a towel around me; I have to give a final exam and I forgot to write one up; I’m teaching a class but I forgot to go after the first day of class. (I apparently will never stop having the dream where I’m carrying a huge amount of stuff and can’t find my high school locker OR remember its combination. That one just lives on and on….) When I was in grad school, during a particularly hard TA assignment, I had a recurring nightmare that I was back in my 8th grade math class where we were all in our thirties and everyone was making fun of me for not having kept on doing my math homework since 8th grade… in other words, I was YEARS AND YEARS behind. No matter what I said (you know, like, “but we GRADUATED!!!!”) they just kept making fun of me.

        • daffodil said:

          I had some of those teacher nightmares too! Most recently it was a real concern, I was cutting it close with test composition, but I did manage it in real life.

      • gmg said:

        When I was in the home stretch of grad school, I dreamed (during an afternoon nap the day I turned in a paper after pulling an all-nighter) that I had uncovered a scandal in which my fellow students were being falsely accused of cheating, and that the penalty for cheating at my school was … DEATH BY ELECTROCUTION. They had an electric chair set up in a secret basement room in the school and people were just disappearing. I was running around trying to warn my friends and they were saying “Just shut up, don’t rock the boat and you won’t die,” and then I was calling my parents and telling them I was dropping out and going into hiding but I couldn’t explain why. Yep.

        • bjane said:

          Oh jesus, I switched to this tab and read your post having forgotten we were talking about dreams.. I was all like “whaaaat where does gmg live?”

        • If it helps, I find writing about these dreams – and discussing them with others about how they piss me off, stupid brain – has greatly reduced the frequency of their reoccurrence.

          I hope this thread means you’re all setting yourselves free too. 🙂

      • Kaz said:

        This conversation is making me grateful for once that I have the world’s most boring dreams. Me failing an exam I passed already would be too much of a stretch for my unconscious mind – I only get exam dreams if it’s right before an actual exam, and then it’s more immediate stuff like oversleeping and running late.

        (Most of the time, I admit, I go “I would like some actually interesting dreams for once, I think the REM on this brain is defective does it have a warranty…”)

      • duaecat said:

        Weirdly on the nightmare thing, I used to regularly dream that I’d shown up at a show and forgotten everything to sell and everything was ruined forever.

        And then it happened. The big tub full of displays made it into the van. The smaller tubs full of actual merchandise did not. This wasn’t discovered until we arrived at the hotel at around 10pm. We ended up driving the whole way back, getting the forgotten tubs, and driving back to arrive in the wee hours of the morning just in time to set up.
        It really stunk. I would not recommend it. We spent that first day sleep-walking through sales.
        But strangely enough since it happened I have not had a single nightmare about it.

        Sadly, I don’t really think there’s a way to do this to stop the school ones!

    • peardi said:

      Seconding this so hard. I have had doctors straight up tell me they don’t know much about a particular topic, and then try to tell me what to do in that area anyway. I don’t expect any one Doctor to know anything, medicine is huge and that’s why there’s a million types of specialists, but I do want them to know the limits of their own knowledge, and that it’s okay if they don’t know everything.

      • misspiggy said:

        Agreeing so hard. Doctors who are completely comfortable with their own knowledge are dangerous in my experience.

    • RSVP said:

      I still have these dreams at age 57 and they all have to do with math classes. Math was my worst subject. Even now that I’m working my way through “Algebra For Dummies I”, I can’t shake them.

    • Angiportus said:

      Get a new doctor, Anna–stat. And best of luck. With me it isn’t nightmares, just flashbacks. Relieved to know I’m not alone.

      • Anna said:

        Hi Angiportus, yes, I finally did. It was when I found myself in a specialist’s office, getting a carpal tunnel syndrome test after an injury to my sacroiliac joint that I finally decided enough was enough :-). It’s not so easy in this area, which is probably the only reason that particular doctor is still in business.

        • Hlyssande said:

          WTF. In what world is a carpal tunnel test appropriate for an SI joint injury? Pelvis/hip != carpal tunnel!

          • Thneed said:

            The spine is all connected, and things at one end will affect things at the other end. So here, sacroiliac pain leads to pelvic muscle tension, leads to spine tension, leads to shoulder tension, leads to arm/hand tension leads to pain.

            Not trying to defend that doctor, honest! Just pointing the connection out. People can get chronic pain in their hands or arms from a variety of root causes. My wife’s hand pain was eventually traced to “thoracic outlet syndrome” which essentially meant all the tension was coming from her upper spine. The acupuncture on her arms did help, absolutely, but it couldn’t truly fix the problems (except the secondary ones that constant muscle tension created).

    • Kate said:

      I didn’t finish university, so my recurring nightmares are having to try and complete university, living in the dorms, while also knowing that I have to attend work full time 2 hours away, and trying to figure out how to fit it all in… sometimes for extra élan my brain decides that I have to *secretly* attend school so no one will realize I don’t have a degree yet, even though I’m totally open about that with my bosses!

      Brains are weird places to live I tells ya!

    • Solestria said:

      Word. I routinely fire doctors who can’t seem to listen to me and relate on a more human level, or seem to think they’re infallible and my preferences for treatment don’t matter. This sort of “failure” can be a huge asset in a career where working directly with people is so intrinsic.

  2. Jen said:

    Hi LW. Not an MD, but I’ve got a Ph.D, so I know how exams/testing goes. There are many, many reasons a person can fail an exam, and only one of those many reasons is because the test-taker wasn’t prepared. Shit happens, as the saying goes, and the majority of reasons are something other than your own knowledge. The reason why people are given more chances to take such exams are because people realize that not everyone tests well, is ready to move on, or had a brainfart.

    One thing Captain didn’t touch on is that you’ve got an advantage over the others: you know how to fail. This is huge, speaking as a fellow Type A overachiever. I didn’t learn that until I got to grad school, where it was a really painful lesson to learn.

    Asking one’s mentor is a GREAT suggestion, because odds are good everyone’s bombed something at least once in their lives. If they balk at the question or blow you off/judge you, then they aren’t the mentor for you. From the people I know who’ve been through med school, you’re hardly alone, either. I think every physician (if they’re honest) has at least one story about belly-flopping something major.

    Another thing to keep in mind is that you’re junior, but you’re also a colleague now, know what I mean?

    • When She Was Good said:

      What, did CA amend her answer? Because she did bring up knowing how to fail in the answer I’m reading.

      • peardi said:

        First paragraph: “You also know something you didn’t know how to do before and something that many of your peers might not know how to do: You know how to fail, you know how to assess what you need to do to succeed, and you know how to apply that knowledge and do the thing to get where you want to be. You know how to do this in spite of shame, in spite of negative feedback, in spite of cost and delays in time. ”

        Honestly, being able to fail and then get right back up on the horse is an amazing skill and I understand where the doubt it coming from, LW, but personally I think that was awesome and you should be proud of yourself. There were numerous times in my academic career where I failed, and instead of trying again I ran away and assumed that meant I could not do it. It was true I couldn’t do it… because I didn’t even try. Being able to fail and handle failure and try again is an extremely important skill that I think not enough people know.

    • Smithy said:

      When I was 16, I failed my driver’s test. Three times.

      I have all of my reasons and explanations, but that was the reality. At the time, my mom kept on trying to tell me how great it was that I have having this chance learn what it was like to fail at something that really didn’t matter. Not that 16 year old me ever heard that and rather heard the voices of ‘all sorts of idiots pass this the first time, therefore exactly how dumb are you?????’.

      Years and years later, I still remember every single test that I failed, what the reasons were, what the context was and whether or not that really serves as an excuse. That being said, my first stint in grad school was a huge mistake for me and dropping out was absolutely necessary. I’ll never know what that experience would have been like had I passed my driver’s test the first time, but there is a large part of me that believes that the decision was easier because of that. For better or worse, these kinds of situations have a tendency to come up again – and being able to work through them, restructure priorities, know when and how to start over – that’s all really helpful.

      • Libby said:

        I failed my driver’s test the first time when another girl in my social circle was taking it the same day. So humiliating to walk in without mine while she had hers. Also? My husband failed his the first time too so fist up in solidarity! I think it has something to do with nerves – I mean, I ran a red light. 😛

        Excellent advice! These things do tend to happen again.

      • I passed on my 7 th attempt. Basically I got so nervous that I’d be shaking, dry retching, sweating, panting… Not in a good state to do anything let alone drive.

        Yes, I was embarrassed it took me 7 goes.

        So to prove to myself that I *am* a good driver, I joined the Institute of Advanced Motorists and passed the advanced test, first time. Now I know that I am better than most of the drivers on the road – certainly better trained and better qualified.

        Is there something like that which LW (and any of you who have failed tests) could do, to reassure yourself that you’re not just competent, but you’re actually really good?

  3. I second the point about knowing how to fail. It’s a learning experience, not a deficiency. Do you know how many people out there are not pushing themselves, not taking chances, not trying new things, because they’re so terrified of failure? If you never try, then you can’t fail. But if you’ve had the experience of failing and then still doing the thing and getting on with your life, then you’re awesome.

  4. B said:

    Let me just say, as a physician, I HATE HATE HATE EXAMS! And I’ve done okay on them but I still hate them and think they are antiquated.
    The exams are an extremely narrow view on your actual abilities as a physician. I don’t even think they are a “necessary evil”, I actually think they are half racket (at least here in the US, we are talking over a grand a test, and they keep trying to increase how frequently you take them – who is going to say no? Not the people who aren’t paying for it!). If they really were just about patient safety and making sure physicians knew a core set of facts, then they would give us a book with the core set of facts we had to know and let us retake the test endlessly until we had everything right. For free, or for minimal amounts of money. And periodically have us retake; but no high stakes, expensive exam.
    That would at least ensure we knew _____ if that was the goal.
    Tests do not measure
    — ability to interact with people
    — ability to take an accurate history
    — skill at procedures
    And most of all, medicine today is rapidly evolving and often it is /good and necessary/ to check yourself and look things up periodically.

    Ahem.
    Let’s say I have had my own setbacks as well – different ones but there were times when I did not meet some standard and had to go into some remediation. It sucked, it was a blow. I didn’t even really agree with it and it wasn’t in the field I was planning to go into (the opposite) but maybe I’m biased. I squared my shoulders and did what I had to do to get through those checkpoints and tried to take what I could from the experience.
    There have been other times when I had to say “no, enough, this is not working out and I’m not going to hit my head against it” and radically change gears (research, rather than medicine)

    So anyway the main point of all that was to emphasize that everyone has setbacks, it’s about getting up and getting back on track, or finding a new track if need be. Which it sounds like you have done, congrats!!!

    But LW, I don’t think the trouble is really with the exam. In your letter you are apologizing and belittling yourself in several places! Not sure where it comes from and the captain probably has better advice than I do regarding what steps to take to fix that. But I do think working on your confidence is necessary.
    Physicians have to walk a fine line between being confident, but not to the point of arrogance, and being humble but not insecure. It’s hard. I hope there are some resources in your area to help; but anyway, if it helps, know that overcoming a setback is something to be proud of, not ashamed of.

    • LR said:

      >In your letter you are apologizing and belittling yourself in several places!

      Yes! That jumped out at me too. I reckon some counselling/therapy would be handy to work on having a strong sense of self. LW, you’re apologising for having emotions and reactions, and belittling those reactions rather than enquiring into what they’re about.

  5. Kitts said:

    Hey, LW, I can so empathize. I’m in a PhD program, but I’m about 5 years older than much of my cohort, because I had to take year off from undergrad (for money and mental health reasons), and then I felt so inadequate that I didn’t think I would ever be up for academia, so instead of applying to grad school like all my friends, I went and taught esl abroad, and then worked various temp jobs for a while.

    A couple things I remind myself of, when the insecurity gets bad:
    1. It turns out that most people back at my alma mater didn’t think I was stupid, even though my grades were lower and I took time off. They thought I was a bit of a spaz (untreated severe ADHD will do that) and they could tell I was dealing with stuff, but when I got into Prestigious Ivy League PhD program, all my old friends and acquaintances were like “oh yeah, that makes sense.” The things I’d fixated on as huge embarrassments were remembered by my friends as “oh yeah, you were going through a rough time” or just “huh, I didn’t even notice.” My guess is that most people remember you as smart, hard-working, and dedicated enough that you didn’t give up on the face of a giant setback. The rest probably just go “oh yeah, I recognize that face.”

    2. Taking longer to graduate doesn’t mean that you’re less of a good student. Now that I’m a TA, I get to see the other side of this. One of my favorite students a couple years ago was a 5th-year undergrad. She wasn’t just my favorite out of solidarity, she was also much more engaged and better able to make connections between the course material and the real world. That extra time you took gave you a chance to learn things more deeply than just cramming them all into your brain as fast as possible, and that probably made you a better student to teach, and a better doctor now.

    3. I actually really admire you for sticking it out in need school through the embarrassment and self-esteem blow. Your clearly smart and ambitious and hardworking, because you need that to get into med school. But being the sort of smart, hardworking person who can hit a setback like that and not drop out? To me that says that you’re someone who is patient and tough and who cares more about medicine than about ego, and I really can’t imagine a better doctor than that. And it sounds like your career is advancing in the direction you want, so maybe the people in cities A and B both think so too.

  6. TJ said:

    This is extremely topical for me right now. I dropped out of graduate school during my PhD and (even though it was a good decision and I was even doing pretty well in school) I felt a lot of shame about it, because I’d bought wholesale into the academic track idea that getting a PhD and then a faculty position and then funding for my research was the only marker of worth for me. It’s been about 5 years, and I just went back to work for the same graduate school (in an administrative staff position that has nothing to do with the topic area of my degree). Being around that mentality makes it hard to keep from falling back into those feelings, even though I am more than qualified to do my job now and getting that PhD wouldn’t have made me any more qualified for it. It’s tough – setting-dependent feelings are real.

  7. gmg said:

    “Everyone who has done anything for any length of time makes mistakes, everyone fails sometimes, everyone carries secret ‘ooof I could have done that so much better’ doubts and memories. People who pretend they haven’t are kinda scary.”
    ———-
    YEP YEP YEP. I would add the following, though with the caveat that overall we know it’s best to avoid comparing yourself with your peers all the time. But because sometimes you can’t help it, also recall that some of them may have a failure of some kind AHEAD of them whereas you’ve already had to get over the hump and experienced the growth that you get from that. If that helps turn competitive negative feelings into some kind of empathy (or at least friendly detachment), so much the better.

    You’re going to do great, LW! Congrats on the new gig.

  8. Jane said:

    Woo boy, LW, I feel you on this. Woo boy, LW, I feel you on letting one big academic mistake crush your confidence. My circumstances are a bit different than yours, but I also ended up failing a class at the eleventh hour of my master’s and being pretty goddamn unhappy with myself for needing to take another term.

    You have ALL THE RESPECT from me for bouncing back so quickly to do what you meant to do. I am still struggling to even look at my research, because I associate it so strongly with failure.

    There are three things.

    One. If you have a thing outside of work that consistently makes you feel happy and competent, do a lot of that thing. I know being a doctor eats up the mammoth’s portion of your time and energy, but if you can have a reminder that your work is not all of you, it will go a long way to anchoring your sense of self-worth.

    Two. Consider that it is possible that other people don’t see yourself the way you see yourself. You got through motherfucking MED SCHOOL and you have been a motherfucking DOCTOR for YEARS, PLURAL. The vast majority of people do not get to work in an esteemed profession where your contribution to humanity is pretty obvious. This is where having friends outside your profession and your workplace helps a LOT, again if you can manage it.

    Three. Meaning and signficance come from particularity. You’re never going to be the best doctor ever, because no one is ever the best [professional] ever. What is significant is that you are the particular doctor who worked with your particular patients in this particular time. You said and did things that no one else said and did when helping those people, and all of your colleague’s professional advancements cannot erase those particular acts of service. Maybe they’ve done things which are similar to the things you have done, but your life is filled with people and encounters that theirs are not (and vice versa, of course.)

    Most of the words I have for you are pretty cliche, and for that I’m sorry. But to the extent you can, please realize that you are simultaneously filling a space in the world and creating a space in the world that no one else can.

    I can’t give you advice about how to feel confident in your professional accomplishments, because I haven’t really achieved that. I still struggle to look at my research because I am so ashamed of the failures that are linked to it. But —

    After I moved home from doing my master’s, I started volunteering at a humane society. And you better believe I am not the best volunteer there ever was, but it was probably the best thing for my sense of self-worth, because it doesn’t MATTER. It matters that I am THERE and I am doing what needs to be done.

    I think I can tell you how to feel steadier in who you are: and that is all about looking at each patient and saying: I am probably not the best doctor ever, but I am the one who is here helping you now, and I am showing up and doing my best.

    • Jane said:

      Gah, I didn’t edit this comment like I should have and repeated myself! OBVIOUSLY THIS SUBJECT TOUCHES A SORE SPOT.

      Summary: GO YOU LW, YOU ARE FINE AND DOING AN IMPORTANT JOB

    • Stephanie said:

      That paragraph about “meaning and significance come from particularity” is SO GOOD. I really needed to read that.

      • Isben Takes Tea said:

        THIS POINT IS AMAZING. Exactly everything I needed to read today. Thanks 🙂

    • Kelly said:

      “But to the extent you can, please realize that you are simultaneously filling a space in the world and creating a space in the world that no one else can.”

      I love this comment. I’m in the home stretch of my master’s program and trying to figure out “what’s next?” Finding meaning in the daily grind makes a huge difference.

  9. Celeste said:

    The thing with school and classmates is that you are in a group. It’s a matter of chance who ends up in the class, but you mustn’t let membership in it define your existence. You seem to be treating yourself like a failure for not graduating with the class. But there is more to you than an arbitrary graduation date. I had to drop out of college for a while for reasons. I graduated two years later than the class I started with. I get the feelings, but we really have to move beyond being part of a class, and being ourselves. Our lives are just bigger than some arbitrary grouping we started out in.

    As far as your former classmates, odds are they give way more though to themselves than they do to you. I think I can promise you that some of them are even in difficult times right now. There is surely someone who can’t find a partner, someone who is in a bad relationship, someone who can’t get or stay pregnant, and so on. The mind tricks us, saying oh they graduated on time so their lives are shiny-happy-perfect. But that probably isn’t true at all; the mind lies, hurtfully. You sound like you are otherwise pretty together, so I hope you will go forth and be awesome at this new opportunity you’ve landed. I hope it takes you to the next great thing, too. Congratulations!

  10. LeftWingFox said:

    This happened to me a couple of times. I was a smart kid who passed classes easily, and was not really used to failure. The first was failing out of my grad year in Biological sciences technology. I was already reconsidering my life choices at the time, and ended up transitioning into a career in animation.

    The second time was much much harder. I had been working in my chosen career for over a decade, and had built up a bit of a reputation as a troubleshooter, even rescuing a couple of struggling productions. I had been waiting on a freelance job to start back up again, and was running dangerously low on funds. Unfortunately, the production had been taken over by a new company, and the workload tripled.

    I wound up suffering the most catastrophic case of burnout I have ever experienced. I got so far behind that by the end of the first week, I was paralyzed. I spent every minute at my desk doing ANYTHING but work, and every minute away from my desk berating myself for not working. I quit after the second week, and had to go begging to my parents to help pay the bills.

    It was a devastating few weeks after that. I didn’t know how to continue in that career, and didn’t know what to do next.

    Fortunately, I found a job as a project manager for a website production company, using some of the skills gained at my old company as a director and supervisor. I’ve since gone back into the animation industry, and have received praise and appreciation for the work I do.

    My suggestion is that you’ve already done the hardest part, which is to keep going after failing.

    Even the greatest talents suffer from Imposter Syndrome, the idea that despite praise, we’re somehow fooling people into thinking our work is worthwhile. Knowing that talents I look up to feel they’re not worthy of acclaim is heartening. It’s a negative symptom of trying to better ourselves, and being dissatisfied with our output.

    And of course, being able to talk through those feelings with someone outside the industry, a therapist ideally, can really help offload some of the emotional baggage.

    Hope that helps.

    • RSVP said:

      I suspect that many of the people who end up in medical school fit the profile of the smart kid who never failed at anything before. It is probably a devastating experience to have it happen for the first time in adulthood.

      • I come from a discipline full of Smart Kids That Never Failed At Anything, and the ones that go on Not Failing until they hit grad school are usually insufferable until they reach the inevitable point of failure, at which point they almost always lose it. (It doesn’t help that many people in my discipline come from very wealthy families who can afford to sacrifice a studying child’s worth of income to a field of study that will, for most people, never really pay that well–the particular spin that socioeconomic privilege puts on SKTNFAA is pretty ugly when it manifests in people who also have a lot of intrinsic gender and race privilege.)

        I’ve noticed that the earlier most people fail big and learn those coping skills, the better they are at both failing and succeeding for the rest of their lives.

  11. Pinkie Pie Chart said:

    Wow. I hear you on this. 20 years ago I was stupid and it resulted in me dropping out of college without a degree. I had 1 month to go and it just wasn’t going to happen. My parents have PhDs and my brother is a doctor. Almost everyone around me has succeeded where I failed. So, I hear you. I’ve spent the last 20 years working on it. It took me 10 years to start over on my degree. So, 23 years and 3 colleges later, I will be graduating this spring with my bachelor’s degree. Finally.

    You, on the other hand, you kept going. You got it done. You are successful. You are moving up in the world. You sound your barbaric YAWP over the rooftops of the world!

    • Stephanie said:

      Congratulations! This comments section is filled with some great stuff and some great stories. I hope you enjoy the shit out of your graduation.

      • Pinkie Pie Chart said:

        Thank you! I intend to party like it’s 1999 (or something like that). Which will probably involve a nice dinner out and gaming, since that’s what I did back then. ^_^

        • That sounds awesome, Pinkie! And well done, you. 🙂

    • You’re not a failure. If anything, you’re being hard on yourself. Further, maybe the people who are currently in positions with more clout or cachet than your current one aren’t actually as good at those positions as you think, or maybe they are but they struggle with something personal rather than professional, like bemoaning the fact that they aren’t good enough or sporty enough or able-bodied enough at rugby to play casually in the park with friends on weekends, or maybe they can’t ever get their al dente pasta to come out right, or maybe they can’t seem to make lasting healthy relationships with good partners, or [insert thing here]. Very few if any people are perfectly satisfied with their lot in life, and often pin that dissatisfied feeling on themselves, and believe they are what is lacking. I’m guessing that you are the best You possible, and the dissatisfaction you feel about not meeting your former expectations and mileposts doesn’t have to make you feel bad about where you are right now. It can be a motivator to make new or different personal goals, so when you look back on today some time in the future, future-you will both be more gentle on now-you and, because we are human, feeling dissatisfied about some other thing you “should” have or do or be.

      Note, too, that the popular joke about doctors is that they suffer from a God complex, wherein they feel they can do no wrong. So I argue that your self-doubt is the perfect inoculation against that sort of thing, and that is good. You’ll be the doctor who doublechecks things and looks up things when you aren’t 100% sure. You’ll be the doctor who listens to what your patients say and asks the right questions. You’ll be the doctor whose observation skills are superior, and the doctor who checks everything you write down to be sure it is clearly phrased and legible so no mistakes are made by supporting staff or pharmacists or nurses. You’ll be the doctor who won’t expect everyone to read your mind or anticipate your whims. In short, what you see as a shameful failing on your part is really, really not. It’s when you think you know everything and never make mistakes and when you are loathe to correct your errors or apologize to others or work on improving your knowledge and skills that there is a big problem!

      My intention when I moved home to help with my grandmother was to get a MFA in a field I had almost zero prior experience with. Because I was always a good student, am pretty smart, taught myself how to code HTML by hand back in the early, early days of the graphical web (my time online started off as monochrome text-only interactions with others), and knew a bit about design and layout due to a BA in Fine Art and time logged putting together newsletters, newspapers and literary magazines (including via the olde skool wax cut-outs and blue pencil method), and I knew about content creation due to my BA in English and yet more time writing stuff and producing illustrations and cartoons and paintings and bla foo bar for money and publication on and off, I figured getting an MFA in Interactive Design and Game Development (emphasis on the former) would be a doddle. I ignored that I’d been out of school for nearly two decades, knew pretty much nothing about games that require electricity to work (I don’t even own a game system and had a dumb phone at the time), I was an unmedicated depressive who was actively struggling to brush my teeth, eat, and get out of bed every day, and my coding skills were with linear or WYSIWYG coding rather than nested/looped programming languages. I qualified for an MA fairly easily, but, Gentle Reader, I still don’t have my MFA. I hit a wall. And I beat myself up about it for literally years. This did nothing but make me forget that I earned that MA, make me feel like a loser, and exacerbate my (still untreated) depression. It did not magically earn me that MFA (and I still don’t have a game console or want to design games). I also do not currently have a personal website online, because I don’t feel like it after messing with that crap for a couple of years. (I do well to retain the URL.)

      What I’m saying is that I can choose to focus on the MFA that about 10% of my fellow MA classmates went on to get, and beat myself up over not persisting, even though I had excellent reasons (some financial) to opt out, or I can focus on that MA and feel good that I got that. Even if it didn’t help me get a job. (I had to go back and get my fourth degree in an entirely unrelated field to do that. I actually fought against anything to do with lawyers and the law for decades, as I have too many relatives and family friends who are attorneys or judges, who also disparaged my creativity while talking up law (which I thought would be beyond my abilities to grok, smart or not). Well, they weren’t entirely wrong. That’s painful for me to admit but 100% true–sometimes people on the outside looking in have insights about your skills/abilities/worth that you don’t, and it turns out I actually DO have a good head for law stuff. They figured that out from a few short polite conversations with me, and because I like to read (which is a lot of what legal stuff is all about–reading and retaining some really dry information and placing it into context). Also, now I can now afford to get depression meds and therapy, and my job is a pretty good fit. So, an unexpected happy result.) Would it have behooved me to keep pounding my head against the brick wall that was getting an MFA in this one particular field at this one particular school, with its upheavals in professor and dean positions every four months (and I could go on), at one particular time, even though I knew in my heart I had pretty much had all the joy and interest in the field wrung out of me at that point and was no longer LIKING Interactive Design (and I had never had great interest in working in the Game Dev field!), which was becoming all about programming shopping carts and catalogs, and smart phone widgets and apps, and moving from Director (which I knew how to do) into Flash (which I learned to do but I hated ActionScript) with Silverlight threatening to make both Director AND Flash obsolete (it was a while ago, and you know how that shook out)? Answer: No. And should I have spent so much time feeling bad about deciding not to deal with the extra hoops required between MA and MFA even after I had done 90% of them? That was likewise not productive or self-loving, though it took me a couple of years to stop feeling bad about the time and money I “wasted.”

      You can choose to focus on one test that you didn’t perform as well on as you’d like, or focus on the fact that YOU ARE A DOCTOR! That is a fantastic achievement! (Surely you know several people who bombed out on medical school, right? And you didn’t! YAY! A WINRAR IS YOU! Tiny cupcakes for everyone on Team You, with sprinkles!)

      You can focus on your peers who APPEAR to be a few boxes ahead of you on your personal LIFE board game, or realize that comparing them to you isn’t helpful because you have NO IDEA what they struggle with when you aren’t around to notice. (I guarantee that there is at least one person who looks at you and thinks you are amazing and wonders how the heck you do what you do, and how you did what you did, and who compares themselves to YOU and feels bad they aren’t as awesome as you. Everyone has self-doubts and compares. It just makes us all miserable.)

    • Pam Adams said:

      Hooray for you! I am a university advisor, and I love my returning students. (My oldest graduate to date was 78!)

  12. Stephanie said:

    Hey Doc, the part of your letter that popped out to me was the part about how everyone you know is in those management positions and you’re in a junior position. Perhaps you are more career driven than I am, and so you are perhaps indeed feeling like you’re taking a slower path. For me, I decided I didn’t want to get into management. So a lot of the analysts I have worked with over the years are now managers, senior managers, directors. They have progressed, and if I were to ever work with them again, it would totally not be as peers anymore. Everyone takes their own path in life. Sometimes you’re the boss, sometimes you’re not. Some people rocket to the top, others meander their way there. I hope you can come to peace with that.

    • SJ said:

      ^This.

    • The Awe Ritual said:

      Right. Did LW go into medicine to heal people and fix problems or to write schedules on whiteboards? I’m guessing the former. S/he/zie really don’t come across as someone whose primary motive is prestige.

    • Mary said:

      UK and UK-influenced medical systems terminology: when the LW describes a “registrar” “a kind of middle-management post”, they mean in terms of the level, not that it’s actually a management post. It’s the last 3-5 years before you take your consultant exams, and it’s definitely a clinical position. So if they are in hospital specialty training, then registrar is what they are aiming for.

      • Thanks, Mary, I was about to post something similar.

        Here in Aus (I assume the UK is similar) the hierarchy goes intern -> resident -> registrar -> consultant (equivalent to “attending” in the US system, IIRC) -> fellow. The odds that docs at the Fellow level see patients on a regular basis are pretty damn low, so there’s a certain tradeoff in deciding if one wants to prioritise doing the most good on the clinical frontline or ascending the ranks to influence institutional direction.

  13. Back in 2010, after a decade of animation career with a positive reputation, I suffered a nervous breakdown on a job. I spent every moment at my desk doing anything other than work, and every moment away berating myself for not working. After two weeks, I quit, and had to beg my parents for money to help pay the bills.

    The hardest part was dealing with the immediate aftermath. I found a job in a tangentially related field, and the change of pace helped re-energize me. I paid back my parents, and started digging myself out of the hole, and started to feel happy again. Since then I’ve gone back into the animation industry, and have been doing well ever since.

    It helps knowing that even the talents I look up to suffer from Imposter Syndrome, berating themselves for their performance even when they are at the top of their fields. It helps me recognize praise and criticism for what they are.

    Having a therapist, someone to talk to outside your industry helps as well. Just a way to dump out the negative emotional baggage once in a while.

    • Sorry about the double post. Thought it got eaten on login

  14. kamrynwhowanders said:

    Hey, Captain just wanted to let you know that this question isn’t numbered. (815, right?) I don’t know if this was intentional or not, but thought I’d let you know. (Feel free to delete this comment after reading it, since it’s irrelevant to the LW.)

  15. I know that feel, LW. Failing and mistakes make me feel like crap, too. I also get unnecessarily down on myself from time to time when my peers are progressing faster than me. When jerkbrain tries to take advantage of those situations, I do my best to stop it as soon as I catch it. Be reasonable and kind to yourself. Letting go and letting your ego heal is tough, but you deserve it. 🙂 Good luck with the new position!

  16. miss_chevious said:

    In addition to the many good suggestions of the Captain and other, one of the things that might help with your internal feelings is to practice failing by trying out something new that you’re pretty sure you won’t be good at (at least not immediately). Like you, LW, I am a high performer. I’m a lawyer, not a doctor, but I excel at schoolwork and my job and test taking and when that natural ability didn’t protect me from failure (because nothing can really protect you from failure), it was a big blow to me.

    What helped me, although I didn’t realize it at the time, was teaching. I was a T.A. while I was in grad school, and if you’ve never taught, let me tell you, teaching is full of failure. No matter how much you prepare, you are never going to be able to anticipate all of the questions that your students have, and you’re going to make mistakes, and you’re going to say or do dumb things, and your slip is going to fall off in front of a room full of eighteen-year-olds (TRUE STORY) and you’re going to have to recover and keep going. As a result, somewhere along the way, I got comfortable with failure.

    I don’t LOVE failure, and I don’t look forward to it, and I do my best to succeed, but I’m also confident in my abilities to bounce back and failure (or the possibility of failure) doesn’t have huge blowback for me. I can pick myself up and assess what went wrong without doubting myself or my abilities generally.

    So maybe pick something low stakes, like knitting or kickball or painting (or whatever else interests you) that has no job consequences, and get out there and fail your ass off. Getting comfortable with it takes some of the sting out of even BIG failures. You already have the skills to remedy the actual deficiency as you demonstrated by persevering after your exams (which took ENORMOUS strength, by the way. You are AMAZING), now all you need to do is take remove the concomitant self-doubt that comes with it, which you can do (like so many other things) through practice.

  17. Curlicue said:

    This may or may not be encouraging to you, but I share it as something that really helped me when I was finishing up a year later than I should and therefore I had, according to my jerkbrain, already failed at everything ever about the degree, as I could never possibly unfail (by graduating on time) from this all-or-nothing task. (hint: not actually true)

    Anyway, one day while I was shame-spiraling my brother told me this joke:

    [Bro:] Do you know what they call the student that graduates last in med school?
    [Me:] What?
    [Bro:] Doctor.

    • Hannah said:

      I want to preface this comment by saying that I am not trying to say that people who attempt advanced degrees are necessarily smarter or better than people who don’t. I’m just trying to talk about the way that in environments where a lot of people have or are going for advanced degrees, it can be easy to forget that grad school and med school are really hard things that not many people even attempt, let alone succeed at. But, it is equally (if not more) important to realize that exams, degrees, grades, publication rates, etc. are not measurements of one’s worth as a human being.

      Ha, I was just about to leave basically the same joke. LW, one of the things that makes higher education really mentally grueling is that your frame of reference is all out of whack. I’m in a PhD program (so I spend most of my time around people who are either getting PhDs or already have them), and both of my parents and my brother are MDs. Because I spend all my time in this environment, it can start to feel like getting a PhD or MD is a normal thing, or sort of a baseline achievement. As a result, when I took a leave of absence from grad school, I had a lot of shame about it because I felt like I was failing at something that the whole rest of the world seemed to be breezing through. But really, I am doing a *really* hard thing that very few people even attempt to do (and also, struggling =/= failing, but that’s a point many people here have already made). So if you find yourself comparing yourself to your former classmates, just try to bear in mind that you are comparing yourself to a very small, exceptionally high achieving subset of the people in the world.

      • Kaz said:

        I hear your last paragraph so hard. I have *so much* shame about my PhD because I took almost two years longer than typical (standard UK time is three and a half to submission, I was at five and a bit), because I have a disability that did not play nicely with the PhD structure at all. So I totally get OP’s feelings about all their peers being beyond them – the feeling as all of my cohort submitted and defended and left while I was still not nearly done, and then the year *under* me started submitting and defending and leaving, good gravy – and the shame of not being where you’re “supposed” to be at that point in your life…

        But, anytime I talk about this outside academia or my family (which pretty much qualifies as an offshoot of academia – both my parents have PhDs and my dad is a professor) it’s “wow! You have a PhD! That’s incredible!” which… does put things into perspective? As you say, it’s NOT normal, it’s a really hard thing that not many people attempt to begin with, and the exact details of how you got where you did and how much you struggled along the way are irrelevant in comparison.

        Case in point: although I am sooo hard on myself for taking so long to finish, my first reaction to the OP was “wow, you finished med school, and you’re a doctor! That’s incredible!”

        (Also, Hannah, I just want to say – go you for doing a PhD, and I think a leave of absence is ENTIRELY understandable and not something anyone needs to be ashamed of. I think it’s easy to lose track, when you’re doing one, that your main aim in life does not have to be “finish PhD in shortest time and then do postdoc and continue until I am a tenured professor” and deviations from that are not failure. I had this realisation a few years into the PhD that it didn’t matter whether or not I *could* do a postdoc because I was 99.9% sure I would be *miserable* doing a postdoc and therefore I should not go into academia. This realisation was a bit mind-blowing at the time.)

  18. Courtney said:

    LW, I’m not a doctor, but I can tell you that *as a patient* I would much rather be treated by someone who has bounced back from a failure than one who sailed through everything and thinks that they can’t be wrong. Doctors who think they can’t be wrong are less likely to *listen* to patients and less likely to question their own biases (like that fat patients are lazy/dishonest/noncompliant or that weight loss is the answer to every complaint brought by a fat person or that women can’t be trusted to accurately articulate their pain levels, or that patients with chronic pain are drug-seeking addicts, etc.) I suspect that your experience makes you a better doctor, if only because it reminds you that you are human and keep you from seeing your opinions as unquestionably correct always and forever.

    • RSVP said:

      Yes! This! A bit of humility in a doctor is a good thing.

  19. kddomingue said:

    I’ve been a teacher and I’ve been a student. I was the student who could not memorize anything for love nor money. I had to learn and understand a thing from the inside out. I was the student who failed in certain higher math classes because I couldn’t move forward until the why of a formula was explained to me….. and “just use it, it works” was not enough of an explanation. When teaching, I found it fairly easy to tell which student was good at memorization and which student was good at learning and incorporating the new knowledge in with what they had acquired previously. Students who memorize well, usually score well on standard exams. Students who learn well, often do not.
    As a patient, I am sceptical of a doctor who has never failed an exam while in school. Give me a doctor who has failed an exam and I will feel more confident that I have a doctor who has learned about my ailment as opposed to one who has memorized a checklist about my ailment. Never failing can lead to arrogance…… not an appealing quality in the person I’m entrusting with my health and wellbeing.
    Someone who has never failed may come to feel that they know it all…..someone who has failed is fully aware that they don’t. I will trust the doctor who knows that he doesn’t know it all.

    • RSVP said:

      I think the reason I did so poorly at math in school was because most teachers only wanted to teach the good-at-memorization kid. They didn’t have the patience to explain the “why it works” of an equation. So people like me, who are sort of mechanically minded, tended to fall behind and see it as a foreign language. I’d like to hope that classes are smaller now (I was at the tail end of the baby boom, usually 30 or more classmates per class) so that teachers do have time to do that.

  20. kaberett said:

    I’m going to reiterate what a lot of other folk are saying: I’m a complex and expert patient, and I am much more comfortable with doctors who are willing to say “I’m not sure; I’ll have to look that up” or “okay, I was wrong” than I am with doctors who, having decided that something is the case, feel the need to stick to their guns about it or Look Bad.

    I’m also coming up to the end of a year out of my PhD programme, having also taken a year out of undergrad, and everyone I started undergrad with is handing their theses in. So: I hear you on feeling left behind, but also, I reiterate that I’d probably find you much easier to trust than many of your colleagues.

  21. Clarry said:

    Here’s what helps me. I take all my negative thoughts and put them in the mouth of an Imaginary Horrible Person, someone who judges me and puts me down. Then, in my mind, I hold a conversation with IHP. Since this is all imaginary, I can be condescending or mean or stretching the truth, whatever works.

    IHP: So you flunked out that semester.
    Me: Yes, it was a shame at the time, but now I realize how lucky I was.
    IHP: Oh please, lucky you failed?
    Me: Definitely. I needed the time to really learn the material, and now I’m a much better doctor because of it.
    IHP: Well I wouldn’t want to be a patient in your care!
    Me: That would put you in the minority. I’ve gotten excellent evaluations, and my patients are clamoring for me.

    I can get wilder than this, really anything horrible that’s nagging in the back of my mind and some that isn’t. It’s like I give it over to someone else, and then listen while I tell that other person how wrong she (or sometimes he) is.

    • Trotula said:

      I do sort of the opposite of this, but for similar effect: when my jerkbrain is beating me up about something, I imagine myself saying those insults to another person who was in my situation. Like *really* imagine saying those actual words to someone else.

      99.9999% of the time I’m like, “Oh my god, that’s horrible, I would *never* say that to that person,” and then I ask myself, “Why not?” I explain all the reasons why I empathize with that hypothetical person and see the ways their situation is hard and frustrating. Then, finally (this is a thing I learned working at crisis lines) I ask myself, “What advice or support would I give to that person?”

      And voila, whatever I would tell that hypothetical person is usually what I need to say to *myself* right then.

      • Jackalope said:

        Yes, I find that useful sometimes. I find it has even better effect when I imagine saying it to one of my good friends, because I wouldn’t make jerkbrain comments to a good friend. Just NOPE. And then I think, “Well if you can’t say it to [Awesome Person X], why is it okay to say it to yourself?” That helps give me perspective.

    • strophoria said:

      I do sort of an opposite thing, where I picture someone I admire and think of as compassionate, and imagine what they would say if they heard me. It usually works quite well!

  22. neveraprince said:

    Hey LW. Your story really resonated with me, and after reading some of the other comments I can see that I’m not the only one. Maybe reading these comments and seeing all the people who’ve been through something similar will help you keep a handle on your own internal dialog. Something that has helped me is to remind myself that I am judging myself far more harshly than I would judge a friend in a similar situation. When reading through all these stories I assume you are not thinking about what horrible failures we all are right? Try to give yourself the same compassion and understanding you would to a friend or all these internet strangers sharing their stories.
    When I started medical school I was young – I had rushed through my bachelor’s degree, and a lot of my sense of self worth was wrapping up in the grades I got and the speed with which I’d accomplished a bachelor’s and been accepted to medical school. My main reason for going was essentially to prove that I could, which is a stupid fucking reason for starting an intense and expensive degree program.
    Two years later I withdrew with a pile of failed exams behind me. By that point I was so depressed I rarely managed to haul my ass out of bed, let alone crack a text book. I can’t really say whether my failures were the result of my depression or my depression was the result of my failures, and I’m not sure it matters. What I am very sure of was that medical school was not the right place for me and clinical medicine was not the right career path for me. Even when I was convinced that the whole would judge me as irretrievable failure, that my family and friends hate me (100% not true! Thanks lizard brain.), I knew leaving medical school was the right decision for me.
    I moved to a new city, worked a series of shitty hourly jobs for many years. But while I was working those shitty jobs to get by, I did a couple of important things. One, I learned to knit. That may sound silly, but just the act of knitting helped with my anxiety and depression, and, mastering a new skill gave me a much needed confidence boost. And two, I built meaningful relationships with people who would become life-long friends, and in one case my life partner. So many of these awesome, interesting people that had become my new community were doing whatever jobs they could to make ends meet, and we were not our jobs. I learned, over those years, to value myself in ways that had nothing to do how well I could answer test question or the speed with which I could tack an MD onto my name.
    And eventually I went back to school (NOT medical school). I passed tests, finished a thesis, published a research paper, and got a degree. And yes I struggled with depression and anxiety when I went back to school. I felt inadequate compared to my classmates who were all 7-8 years younger. I was sure I would be judged when I explained how I’d spent all those years since I’d finished undergrad. There were absolutely days when I was sure that was going to spectacularly flame out of the program and that I’d been stupid to even try. But this time around I was seeing a counselor regularly, I had a hobby and social life that had nothing to do with grad school, and perhaps most importantly, I LOVED the work I was doing. And that made a huge difference.
    And when I landed an interview for a job I wanted very badly, one of the interviewers (there was a whole panel, talk about nerve wracking omg) asked me to tell them about a time I made a mistake, and what I did about. And do you know what? They gave me an even better job than the one I’d applied for. So that my happy (for now) ending. Sorry that got super-duper long. I hope someone finds this at least a little bit as helpful as it was for me to tell it .

    • I just learned how to knit last year and can vouch that it is GREAT for curbing Jerk Brain flare-ups. Let no one tell you it is an economical way to make presents for loved ones (many of whom have NO CLUE how much time and effort and money it took to make that scarf/hat/toy/wrap/pair of gloves/whatever), but you definitely do feel a sense of accomplishment and pleased with yourself when you turn out something nifty. Also, when I feel an urge to indulge in emotional eating to ward off The Sads/Mads/Bads, which I occasionally do (when I’m not ‘forgetting’ to eat all day, instead), my hands are busy.

      I also agree that my friends and I all are guilty of being far harder on ourselves than we would ever be to each other, and some of us are harder on ourselves than we are to strangers or people who are actually actively being abusive or shitty to us. What’s up with THAT? I am really trying my best these days to be nicer to myself, and to cut myself a little slack. I hope you will be nicer to yourself as well.

  23. I notice a lot of people focusing on the exam as a source of non-confidence.
    I don’t see a lot of responses to ‘everyone else is ahead of me’

    It seems to me that the LW is going into a situation analogous to a successful person going home for a weekend and suddenly turning into an adult version of ‘baby of the family’ because that is their accustomed role IN THAT CONTEXT, and also because everyone around them is further ahead in age/career.

    So there is a double issue of remembering failure about the test, and of seeing everyone else who was once your cohort in management over you and able to give you orders. It’s hard not to revert to little-kid/junior-member under those circumstances.

    I have no advice, but I want to point out that it is NOT all in your head, there will be a lot of automatic assumptions on other people’s parts as well.

    • Clarry said:

      I have some advice for when you see all the people who are ahead of you. Have you noticed that you DON’T see all the people who dropped out and are doing something else altogether? That’s because they’re not in your program, not working in the hospital, not there at all. They may actually be thrilled and happy to be doing something else because they realized they’re not suited for medicine, but that doesn’t figure in at the moment. The point is that you’re way ahead of them.

      This bit of advice was given to me by a man who taught kiteboarding. I was terrible at every bit of it. I’ve never been good at direction, ropes, speed, new equipment, and I still don’t know why I consented to go with my boyfriend to learn this sport that admittedly looked like fun but that I didn’t stand a chance of becoming even moderately proficient at in many expensive lessons. I went along, gave what must have seemed like weak effort but which was really a lot for me, and gave up in frustration after a pretty short time. I was telling myself to keep at it and just couldn’t. FAIL. As I was wading through the water to shore with tears in my eyes and trying to explain to the instructor, he came out with: What about all the people who have never even tried for 15 minutes to learn this? What about them? You’re miles ahead.

      Point taken.

      So yeah, LW, you failed some exams in medical school. You’re welcome to consider me. I’ve never even tried to take one exam in medical school, much less passed any.

    • Temporary Null said:

      I think seeing other people who are ahead of you is a pretty universal experience. I feel behind my peers in my career and several of my hobbies. Sometimes that stresses me out, but I remember that a lot of my peers don’t do all the different things I do, and they probably are unhappy about parts of their lives too.

      If someone thinks less of you because you struggled, then they are a dick. Seriously, If they look at you and think “Wow, things didn’t come as easily to them as it did to me, and they had to STRUGGLE and TRY HARDER and WORK LONGER to get where they are. Boy, they’re a loser,” they SUCK.

  24. Hi LW! There are a lot of things in my life that other people might see as failures on my part, including academically, but there are very few that I actually regret. I have learned a lot from every decision I’ve ever made except the easy ones.

    A few school related examples: my first time in undergrad, I dropped out of a programme I hated in the middle of the term. I have a whole term of Fs in my transcript. I got into a different programme that I liked a lot with no problem whatsoever when I was ready to go back. Later as a graduate student and teacher, when my students came to me in tears because they weren’t doing very well, in my class or a different one, I could look them in the eye and tell them that it was absolutely not the end of the world. It might be a little hard for a while. It might require them to make hard decisions. It might require a little extra work. But it was never going to be the end of the world.

    A year and a half ago, I left my doctoral programme ABD. It was a hard decision. It was tough and I second-guessed myself and I cried a lot and asked my pals for validation and made plans to leave a country I loved and cried some more and worried about money and felt stupid. But I felt at the time that it was the right decision for me, even with all the crying. I still feel that way now that I have a great job with great people in a great city, about to be promoted into a position that I am only qualified for because of academic decisions I made, some a decade ago, that an onlooker would probably have called bad at any point in the last 13 years. I am the happiest I’ve ever been, except for an incipient sinus infection.

    Things that I reflected on when I felt bad: People do not care as much about my failures OR my successes as I think they do. Most of the time I doubt they notice. Grades do not reflect very much about someone as a person except the ability to test well and, to some extent, the ability to show up for a test. Where I am in my life can’t be compared to anyone else, because no one else has my life, and doing so is the kind of thing that’s fine to do if you feel like beating yourself up, but less useful for any other purpose, including motivation. I also reached out to Team Me whenever I needed it, without feeling bad or guilty that at hard times in my life, I needed love and validation. 🙂

    You have made good decisions for yourself. You have made them for good reasons. You are actively trying to be the best doctor you can be. To me, that’s what success looks like.

  25. Beth said:

    Doc,

    I am a doc, too. I’m guessing from your letter that you’re in a country that runs its postgraduate training in the same kind of way as mine does and that you’re at about the same stage of training as I am.

    I have failed at a few things, by now. I extremely fucked up my exams when I was eighteen, to the point that I ended up doing a whole other degree and a year’s worth of really terrible customer service job just to get *into* medical school. I failed the first part of my postgraduate exams, a *lot*. And then I messed up the interview for physician training by, among other things, forgetting the word for adenosine — “It’s that thing. That drug that begins with an A. That resuscitation drug that begins with an A. Oh, you know, the one that isn’t adrenaline, or atropine, or amiodarone. That one.” I had another half hour of interview to go, and my confidence was off down the stairs and halfway to Canada. The confirmation that I had not got onto the training programme, while unsurprising, came when I was in a lecture theatre in the middle of a course with fifty of my colleagues, all of whom got confirmations at the same time that they *had*.

    Sure, part of my devastation was that I had to go off and look for a non training job for a year and that I’d sort of humiliated myself, but a big part of it too was that, like you, I’d end up a year behind my colleagues and my friends and I was worried that that would be weird.

    So, having lived my story, I’ve got a few pieces of advice to offer.

    1) In terms of how smart you are, how good a doctor you are, or how good the patient care is that you provide, this does not matter.

    2) A lot of doctors in our kind of system take a year or two out of their training programme, to do an additional degree or to have babies or to figure out what the heck kind of doctor they want to be or to finish their MRCP or because there aren’t the posts available in the training programme they want to get into. My point is that it isn’t unusual for people who were in the same year at medical school to end up staggered across the ranks.

    3) There is no hurry. You’re going to be a consultant for a really really long time.

    4) I am surprised when I meet a junior doctor who has never failed at anything. It is a thing.

    5) By failing at something when you did, I guarantee that you have learned something (although maybe not everything) about how you learn and how to study. This is a valuable thing to learn, as you are going to be self-directedly learning for the rest of forever.

    6) I have been in the position of being both the junior to people who were my peers and the senior to people who were my peers. It’s never been as weird as I thought it was going to be. Well, maybe the time my junior got my attention by tapping me on the bum and the nursing staff didn’t realise we were friends. But that was a hilarious kind of weird.

    7) Your patients do not know, and if they did most of them wouldn’t care.

    With apologies for the double-reply because apparently I also fail typing,

    Doc Cheering You On

    • Hannahbelle said:

      This is just lovely. I wish someone had said all this when I was going through my version.

      One more thing to the LW–my pet psychological trick to evade jerkbrain is actually a remedial parenting strategy: give up punishments and praise. It takes a lot of practice to do this (life feels totally disorienting and meaningless at first), but when you get steady it suddenly becomes easier not to care about failure or success because those are just grown-up psychological versions of punishment and praise. The new perspective doesn’t last very long at a stretch–at least not for me–but you can always re-initiate it. I don’t know if this would help you, too, but I figure it’s a good skill to learn early.

    • Mary said:

      Not a doctor, but I work in medical education in the UK, and this is bang-on. If you are in the UK and want the stats, around 40% of juniors doctors are taking time out between the foundation programme and CT/ST1, and plenty of people are taking time between core training and higher specialty training too, or doing out-of-programme experiences or having kids and so on.

      Point is, if it feels like “everyone” from your original cohort is now a registrar – that’s probably not the case? There is probably quite a bit of confirmation bias, where you automatically notice the people who are “ahead” of you and not the ones who are also taking the long way around and enjoying the view?

      Lastly, (again, if you’re in the UK), there are lots of services aimed specifically at doctors through organisations like the MDU, BMA, Royal Colleges and so on – if you are a member of any of these organisations, have a look at what’s available, because you may be able to access specific counselling or at least a listening service which is doctor-run, which may or may not be useful, but definitely worth having a look. If you’re in Australia or New Zealand, there may be equivalents?

      Good luck! Your goals are yours, and your experience is yours: you’ve nothing to apologise for!

  26. Hello, LW.

    At the moment, I am one career step below someone who started their job at the exact same time as me. (Well, 5 minutes before because I was late the first day). When they got promoted, I was Unhappy. Part of this was because I felt like I was rubbish at everything, and part of it was that *I* was supposed to be top of the class. What can I say, gifted kids get a weird sense of entitlement about this stuff.

    I’m now totally okay with this situation. Time helps. It’s been a year now and I honestly don’t think about it at all.

    I wish I could say that I have now truly learned that it is not a race and to value myself for the things I am rather than beating myself up for not being what other people are, but there is now someone else at work overtaking me at the thing I wanted to do and I’ve been grumpy about it for the past few months. But, you know, comparatively less grumpy.

    I wanted to address the “my old friends are overtaking me on the career ladder” part of your letter, and also maybe show you that you’re not alone. I too feel the pang of sadness when people go “I have got this good thing that you do not have through my hard work!” (Facebook is legitimately the worst for this). I think a lot of us put pressure on ourselves to feel only empathetic joy and end up in a spiral of horrible feelings. Nope. I am officially Done with that attitude. You are only doing something wrong if you are an arse about it to other people (and venting to other people doesn’t count as being an arse).

    • I think you have brought up something very important, which is that people who are good at academics, maybe really good at it, live in a false world growing up.

      Life is not school school school and A’s on exams.

      It can seem so. But there is an entire world out there full of stuff that cannot be studied for and we are not sitting in a room being tested on. When we are in our Academic Bubble, it can seem that failure is the end of the world. Part of that is the defined stepping stones that everyone gets, brightly labeled, that puts a person in a school of their choice and then sets them loose on the world.

      But there is so much more to life than that. Many ways to succeed and fail. It is easy to look back and see where, if we did absolutely everything right, we would be “further along” than our peers. But no one can do everything right. It is much easier to imagine that than it is to actually do it.

      So you need to shift your thinking to a more adult and world-oriented view of success and failure. The older you get, the less that school-world has meaning.

      Understanding that now… That is what will put you ahead!

  27. I haven’t had time to read all the comments, so I apologize if this is a repeat. Is it possible that you’d be questioning yourself no matter what? I don’t know if your tests are strictly pass/fail or if they are scored, but if you got a just-passing score, would you be playing these same tapes in your mind now, except about how you just squeaked by? I know lots of PhDs and many of them have a fear of being found out as a “fraud” of sorts because they passed everything without any failures or major hiccups along the way. Having failed, you actually know that it isn’t a fluke that you made it through, you didn’t just get lucky**, you had some trouble, and you overcame it. You now know that at one point you were declared not ready and now you have been declared ready, and you can rest in the knowledge that you have been on both sides of that line and firmly know where you stand now.
    As far as feeling bad that your friends are ahead of you… I think this is most painful when people are still in a rough cohort. In a few more years some people will be slowing down and you’ll be plugging along. You’ll likely pass some people, some people will take paternity/maternity leave and get a little behind for awhile, some will move away or transfer in, etc. It will just shake out as it goes and your being a little behind won’t give you so much trouble. I can imagine myself running all these same scripts if I were in your shoes, but from my perspective over here, it seems like you’re actually a brave and robust person who didn’t let a significant setback send them spiraling off into long-term woe and self-doubt, considering an entirely different career rather than face the challenges before you. That’s actually pretty kickass and I applaud you for your success!

    **Not that my friends did either, but they don’t have any data to set the experience floor for where the line between failing and succeeding actually is.

  28. Devin said:

    One thing I noticed is that City A Hospital wants you back and wants to promote you. So obviously, after you failed your exams and then succeeded, you went to work for them and they liked what they saw. If you’re looking for outside validation, that’s something.

  29. solecism said:

    Surprised no one has mentioned Carol Dweck’s research on motivation and growth vs fixed mindsets. See her TED talk: http://www.ted.com/talks/carol_dweck_the_power_of_believing_that_you_can_improve?language=en
    But maybe the website would be more directly useful? http://www.mindsetonline.com/

    LW, you embraced the challenge after you failed the first exam. You succeeded and became a better person as result. And many people have already convincingly argued that you became a better doctor too.

    The people in your medical school cohort are starting to scatter. Note that this scatter is in a multidimensional space. You are focused on only one dimension in the relatively short term to beat yourself up, but there are many dimensions involved, and as time goes on, the divergences will only increase because each individual makes endless choices that affect their personal trajectory. So comparing yourself against the cohort or specific individuals becomes only an exercise in self-punishment rather than drawing meaningful conclusions. I hope you are able to find a therapist to help change your internal dialogue so that you can grow beyond this self-limiting self-doubt.

  30. Saira Ali said:

    Oh LW. I have so much sympathy for you. Like SylviaMcivers, I see lots of good comments about how to cope with failing exams and that making you a stronger person and a better doctor, and I agree with all of that, but there’s very little in here about how to cope with seeing your former peers overtake you.

    I’m not a medical doctor, but I had a similar experience in grad school. I messed up big time in undergrad, graduated late, and then worked in industry for several years while taking night classes, because no PhD program would take me with my grades. I eventually rehabilitated my transcript and got into a PhD program only to discover I had gone to university with my advisor. She entered at the same time I did, and while our paths never crossed (it was a big university) it was humiliating to know that we used to be peers and could have even been lab partners or study mates but for random chance. And there I was in my first year of graduate school while my advisor was up for tenure review that year.

    I’m not going to lie to you: it was hard and awful. What got me through it was 1) reminding myself that I brought skills, experience, and a degree of professionalism to the table that the younger first-years absolutely did not have and 2) getting to know my advisor and developing a relationship with her. Once I was in the habit of talking to her frequently, not just about my work but about interesting papers in the field, department politics, etc, it became clear that she wasn’t looking down on me or thinking poorly of me for having taken a much different path. And once I realized my advisor (and the other faculty and my classmates) weren’t looking down on me, it was easier to ignore the nasty voices in my head/jerkbrain/brainweasels.

  31. megpie71 said:

    There’s a lot of people talking about the specific example of failure. I’m going to talk about the more general example of the anxiety jerk!brain pulling up past failings and parading them for you on the stage of the Grande Olde Embarrassing Recollection (aka the Bad Memory Tapes, which a lot of people with anxiety disorders, or anxiety related conditions, or anxiety co-morbid conditions like depression, get on a regular basis). It really sounds as though you’re having a bad case of this at present.

    About the best remedy for these I’ve found (it isn’t a cure, it doesn’t make your brain stop pulling The Tapes out, it just makes things improve in the short term) is to interrupt the Tapes, and ask your brain “what am I supposed to be doing about this Right Now?”

    Seriously – it’s the one thing I’ve found that can bring the tapes to a glitching halt.

    Anxiety, at the heart of it, is about getting caught up in the past (worrying over what has happened before) or the future (worrying about what might happen). When you bring things back to the present, and to the practical reality of what you can do about them, it grounds you a lot more than you’d think. So I’d argue the question you need to be asking your brain each time it brings up these worries for you is: “okay, what can I do about this right now, in this particular moment?” (Spoiler: often, the answer is “nothing, really”) If there is something you can do, do that. If not, tell your brain as much. Out loud, if you have to.

    Further tricks for defusing anxiety spirals: ask yourself what you’re actually worrying about – what is the issue at the heart of the spiral of worry. Then ask yourself whether the thing you’re worrying about is certain, probable, or only possible (for example: the sun rising is pretty much certain; the sun rising in the east is highly probable; the sun rising in the west is possible, but unlikely) – get a handle on how realistic the worry is. Next, ask “what can I actually do about this?” – ground yourself in practicality (there’s a limited amount you can do about the sun not rising, or the sun rising in the west… once you have an idea of what those things are, you’re allowed to stop worrying about the issue).

    Incidentally: you appear to have an unreasonable expectation of yourself, that you’re required to forever remain in lock-step career progression with the group of people you first entered medical school with – despite diverging life paths. You may want to ask yourself about that particular expectation, where you acquired it, and whether it has any practical utility these days.

    • ” I’m going to talk about the more general example of the anxiety jerk!brain pulling up past failings and parading them for you on the stage of the Grande Olde Embarrassing Recollection (aka the Bad Memory Tapes, which a lot of people with anxiety disorders, or anxiety related conditions, or anxiety co-morbid conditions like depression, get on a regular basis). It really sounds as though you’re having a bad case of this at present.

      About the best remedy for these I’ve found (it isn’t a cure, it doesn’t make your brain stop pulling The Tapes out, it just makes things improve in the short term) is to interrupt the Tapes, and ask your brain “what am I supposed to be doing about this Right Now?””

      I get this, and didn’t have a good name for it. Bad Memory Tapes is a better description than The Ughs, for sure. I am going to try this next time my Jerk Brain begins spamming me in the middle of the night with a long list of Things I Said Or Did Wrong That i Regret or a Lowlights Reel Of My Life’s Greatest Failures and NOPEs. Because the middle of the night when I am tossing and turning due to insomnia, my period (seriously, WTF, leave me alone), summertime blues (when it is only about 100 degrees Fahrenheit at midnight inside your house even with A/C, no big) or what the fuck ever my Jerk Brain is using as an excuse to torment me, it is likely to be much more effective than going ahead and wallowing in all that old anxiety/depression crap stew and feeling terrible.

      Seriously. I am writing it down right now.

      • A_Lopez said:

        I also have a bad memory tape alarm clock, so that intense emotional pain wakes me up the way physical pain would. It invariably relates to something that is long over and done with and there is absolutely nothing to be done about, and all I want to *do* is get back to sleep. This morning this happened at 5 a.m., and I had not gone back to sleep by the time the alarm (actual) went off at 6. It was horrible. But I wonder if I should actually do something like reading or writing instead of ruminating. And not writing about anything contained in the memory tape, either! But I wanted to share a technique that I’ve developed recently for the memory tapes. I freeze the frame and then my 40+ self of today walks into the scene and speaks comfortingly to then me. This has been most effective with childhood memories where I see and hear grownass me saying “I’ve come from your future to tell you that things will get better, I promise. You will survive this experience and one day you will be able to get away from all this.” Past me and my adult self are the only things moving against a frozen background. I have to be a bit careful that I don’t imagine my adult self giving 9 year old bullies a dressing down because then I can get into coulda woulda shoulda thinking … though I’ve also thought validation: “These people are really mean.” I listen to and validate the feelings I had then. And I tell myself “I love you”. This invariably makes me cry, which is a good way of expressing the grief. It seems to be a good way of reparenting.

  32. Here’s the thing about Perfectionism.

    It only takes one setback to ruin it.

    That’s why it’s really not a good life plan. Instead, do what I (still try) to do. Strive for Excellence.

    And I think you’ve done that.

  33. Lisa Thaviu said:

    One reason I loved our family doctor is that he was not afraid to tell me that he needed to find out the answer when he didn’t know it. I am sure you have discovered that in practice, you won’t always have the answers at your fingertips, but that unlike an exam, you are allowed to look up the answers, which is a much better way to practice medicine isn’t it. One thing you should remember. Dr. Frederick Banting, whose discoveries have probably saved more lives than anyone’s, was not considered a good enough physician to inject the first patient with insulin for the trials because he was not qualified for the particular hospital where the trials were occurring. I am no doctor, but I have given myself a load of insulin injections – probably more injections than the doctors they chose for the trials! I am certain that when he started, Dr. Banting was “behind” others in his medical class, but he made a big difference in peoples’ lives. So can you. Good luck.

  34. I’ve been, not quite here, but certainly adjacent to here.

    I failed some stuff in medical school. I didn’t Match for a residency and had to Scramble into a leftover slot. Then I didn’t Match for fellowship and had to Scramble again. (The Match and The Scramble are specific US medical education terms for how trainees get put into programs (or DON’T get put into programs while almost everyone else does. I don’t know of anyone else who had to Scramble twice. It’s not an exceptionality I’m terribly proud of)

    I failed for a lot of reasons including non-accommodated disabilities, which means I have a lot of anger about the lack of accommodation mixed up in my history of failure. And it’s hard to get away from because people don’t ask if you failed medical school exams, but they do ask why you chose to do your training in Place X and the honest answer is, “I didn’t.”

    And now I’m finally where I wanted to be in my career, with more and more time elapsed between the Stuff I’d Rather Forget but Have to Explain and Stuff I’m Good at Now that is Important to People. Which is good. But I can’t deny I don’t still have some If Onlies. Sometimes a lot. I don’t have friends who went on past me, but I do run into people professionally I’d been hoping to train with, who didn’t want me then. Which leads to a similar situation of ongoing feelings.

    Yes, I think knowing how to fail can make someone a better doctor. Yes, I have life experience that a lot of my “more successful” peers don’t have, which helps me immeasurably in my career (including personal experience with disability.) Yes, I’ve always felt better about the trainees who researched what they didn’t know, compared to those who knew more at baseline but didn’t continually seek further knowledge. But there is also so much pressure on physicians to be all-knowing and all-capable, both from within and without, and I think it’s important for us to acknowledge that, too. And how hard that can be, in addition to all the other things that make our work hard. Because there aren’t a lot of safe places to talk about having failed and being a doctor

  35. storyranger said:

    Hoooooooboy does this hit home for me.

    LW, I failed my first year of engineering. Totally and completely. Luckily, I’m in a super supportive school that lets you retake things over the summer so you can graduate on time. Even with this I still ended up starting one course behind in second year.

    I had two choices: bend myself into a pretzel to graduate on time, or just plan to take 5 years and use the gaps this would give me in my schedule to take extra courses in a different field I love.

    I’m five years in, most of my peers have graduated, and I don’t care. I’m so, so happy to be taking my time with it. But to GET to this point, I had to spend the first three years going in circles with my jerkbrain. I told myself a lot that because I had failed I was a fuckup and I hid behind that title a lot. Fuckups don’t have high expectations on them, after all. I had to move past denial, anger, and grieve for the goals I had set for myself before I could embrace the new person I’d become, and have now grown to love. I don’t call myself a fuckup anymore. Every mistake I made taught me a specific lesson, and I did learn.

    Most of my TAs are people I was once in classes with. It’s awkward, sometimes. But mostly, it’s fine, because we recognize that whatever our previous relationship, we’re in this dynamic now and we have to make it work. If someone is unprofessional and treats you weird because they used to be your classmate, well, 1. they’re the problem, not your past failure and 2. document it and know who to go to for help.

    Every mistake will hurt. But getting up and dusting yourself off gets a lot easier with time, I promise.

    If you still feel like an imposter in three months, get thee to a therapist who is NOT affiliated with your place of work (if the idea of that is something that bothers you) and talk this out because reasonableness checks really help.

  36. Geranium said:

    There’s a thing I usually call the “20 Years Rule” for when I’ve done something embarrassing: picture the people I did it in front of, talking about it in 20 years. This works because it is ridiculous: can you seriously imagine that in 2036, when you are all (however old you will be), the big scandalous topic of conversation would be that you failed that test and graduated from med school a year later than the rest of them?

    Also, I totally endorse the “learning how to fail is a valuable life skill” message.

    Good luck in your new job!! You will be awesome and rock their socks off! 🙂

  37. A_Lopez said:

    Dear LW, I totally feel your pain. I have failed at so many things (professional exams, job applications), while others sailed through and have sailed way ahead of me now. It smarts. I don’t know your gender or the type of parents you have, but I know that my feelings that my worth depends on what I do and achieve arise from being the daughter of a narcissistic mother. I am currently working to heal from this and it has helped me to understand why I compare myself to others so much and why I feel insecure if I can’t prove my value or at least my usefulness.
    As happened with you, when my failures happened the game wasn’t over, and I went on to leave them way behind me and enjoy countless successes. Sometimes I “overtook” those I had lagged behind at first. My parents also had/have a tendency to bring up childhood “failures” forever. In fact if I ever say something in my childhood was good, my mother is swift to tell me something negative and humiliating about it. I think this family obsession with the past informs my inner critic’s tendency never to let me forget anything, even from decades ago and long since resolved or improved upon in some way.
    I have been doing some grieving and have become better at forgiving myself, because I’m always the person I really resent. The grief work has been key. I think if the emotional aspects are addressed it becomes easier to believe what the rational brain has known all along: that failure is useful and that past failures don’t matter now. May you find comfort and peace.

  38. Libby said:

    Failure is so hard! I’m super hard on myself and strive for perfection in most things I do. (Way to be realistic, Me.) In 2011, I was fired from a job I hated. Even though I hated it and hadn’t found another job yet, I was still super upset about it for way longer than I should have been. I still wonder why to this day since they gave me a vague send off almost 6 years: “It’s just not working out”. However, I am grateful for the experience because it taught me how to figure out how to deal with it, and I actually did improve my career because of that particular job. It’s no fun telling prospective employers that you got fired from your last job, but I think a lot of them don’t care as long as you’re honest and now it’s a couple jobs behind me so things eventually work out.

    All that to say I’ve been there, and keep doing the things that make you happy in your job and make you feel that confidence that you felt at City B. Eventually I hope your brain can start telling you that in the big scheme of things, you are bigger and better for it! I’ve also learned to keep telling myself “who cares what people think?” Anyway, good luck in the new job, and know that we’re all behind you! 🙂

  39. zaracat said:

    Hi LW. I think the previous commenters have said most of what I’m going to say, but I’ll chuck in my 10c worth anyway.

    I’m a doctor myself who had to make some major career compromises due to single parenthood/ongoing mental health problems. For the last 10 years I have worked part time in a low stress medical job, but one which is still hands-on and very satisfying and pays well enough to live on. And I am damned good at it and patients are happy.

    It took me years to feel that I wasn’t a failure for not a doing a high powered full time specialist job, and this was not helped by a few people being judgemental about ‘working beneath my abilities’ in a job that ‘anyone could do’ (in some places my type of work is done by nurses or technicians). Sometimes I still feel this way – ‘I am a failure and this is all I can manage’ – but other times I see it as a marvellous lifestyle choice that gives me time to spend with family and pursue interests outside medicine. How I feel about my situation depends on how I’m coping generally with life, because the underlying circumstances don’t change. When I am stressed I frequently have nightmares about being back in a high pressure hospital situation and not knowing enough, or being in the wrong place, or late.

    If this is a one-off blow to your confidence, then I have no doubt you’ll bounce back with time. It may feel awkward at first to be a little behind your colleagues, but as time goes by this gap will narrow. And things will happen in other people’s lives that slow them down as well. But if feeling so hard-hit by your exam failure is part of pattern of never feeling that you’re good enough, perhaps related to childhood experiences, then professional counselling is the way to go.

    • Mary said:

      Ohhh, I like your last paragraph. Yes, I think it’s a really good idea to ask yourself whether this is a temporary wobble that you can ride out, or whether it plays into a bigger, deeper fear that holds you back. If it’s not possible to answer that from inside the wobble, then you can set yourself a period of time to live with it, and then reconsider. Maybe promise yourself that if you’re still worrying about this six months into the new job, it’s time to go and look for help?

  40. Sarah said:

    Hi LW, I have failed a lot too and/or felt like I wasn’t as good as my peers in college with me. I forgot to cite my sources in several essays and I feel that my fellow foreign language students are all mostly better speakers than me. When I get the ‘bad memory tapes’, I make a list of all the things I am proudest of, even if it looked like a fail at the time. This could be something like “asked for help when i needed it, summarized a film in a foreign language, got my merit award, just held conversation in foreign language.” I also tell myself what the other commenters said, that nobody is perfect and everybody has something they struggle with.

    It’s always more impressive when people know the limits of their own knowledge and can admit it.

  41. Godric said:

    At a commencement speech for an Ivy-League school (possibly Harvard), JK Rowling said something like “Remember, your failure looks like a lot of other people’s success”.

  42. Rose Fox said:

    The first time George Washington was given a military command, he got all his men killed and started the French and Indian War.

    Despite that rather awkward start, he did okay for himself in the end, and so will you.

  43. Kate Monster said:

    I have great empathy for you, LW. One thing that I haven’t seen addressed is the advantage of knowing so many people who are one stage ahead of you.

    I say this as a younger sibling: it can be immensely helpful to see someone else go through a system first. Instead of forming new relationships with strangers to learn more about what to expect, you can learn from people you already know. And you probably already know which ones are prickly or status-conscious or fronting in ways that would make them less likely to share their stories in authentic, helpful ways.

    You, too, have a lot to share with them. While Hospital A is the main professional environment they’ve known, you have experience and contacts from Hospital B. You know more about the “outside world” and the fact that you can succeed outside of this one unique environment where everyone is familiar.

    For that matter, you have a second cohort now, too. The others at your level could probably also benefit from your knowledge of Hospital A and any insight you can offer about how to get along with the registrars you know.

    Good luck! Hopefully remembering these advantages of your situation will help when your mental tapes only have the negatives and worries on them.

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