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!