Sitting at the oakland aiport waiting for the connection to Portland after spending some qt with the family in San Diego. Always good to see my parents and my brother-- it was nice to actually see sun. Between early hours of work, long days, daylight savings, I really haven't seen or noticed any sun in Portland lately... kind of depressing. Even in New York, one will see sun, even if its a bit colder. On top of not seeing the sun, it has been cold these days in PDX, with light snow right before I left. So San Diego was a welcome respite if only temporarily. Not thinking about ekgs, and cxr's also a welcome break; though now I'm afraid I'll forget everything I've learned.
Between posts I was in the midst of a busy 2 months of ward + ICU which was a great experience for me. Good people to work with and interesting patients. Definitely learning to make decisions on my own and getting a bit more efficient. One piece of feedback that I keep getting is how my quote unquote "laidback" nature can prevent me from demonstrating medical knowledge. Not really sure how it connects, but I've heard it a couple times from attendings I respect, so there's something to them; or at least something to take from them. Which brings me to the dilemma-- how do I address it. I probably have gone through life with the same nature and personality-- in fact i value it as a strength. Im not a yeller; I see myself as a leader, but leading through example and my work, not necessarily by showing off that I know the mechanism of action of aspirin, or by talking loudly: which appear to be the possible ways to improve upon these concerns. I say this because in asking about how I can improve, one comment was that I should read more, as I might have lacked knowledge; another suggestion was to be more decisive in decisions-- even if its the wrong decision/answer. To me, it seems like it means that for me to be a good resident (not nec a good doctor, though it stands to reason that a good resident makes a good doctor), it is important to be able to demonstrate knowledge to others. But how does one do this if one is again quote unquote "laid back." (which by the way I am not a fan of this characterization of me)
In thinking about this, I look to other mentors and physicians and their personalities. It seems to me that those physicians who do well, are respected fall broadly into two categories. Those who are "laid back," "soft-spoken," etc etc and do well are those who are geniuses-- they're the the ones who got a phd, published the mechanism of action for aspirin; they're the doctors that everyone holds is high regard because they're "nice," "calm and collected," and brilliant. Then there are those good doctors that people respect who are loud, intimidating, but decisive-- they are necessarily genius' but they do their homework, read up and then show it off by talking big and acting tough; and those doctors get respect too, because they often have larger than life personality, are somewhat obnoxious, but exude confidence and make the right decisions more often than not. Then there are the cross overs between personality and knowledge, so those who are obnoxious, loud and cocky AND who are brilliant... so what about the doctor who is calm and collected, but not necesarily a mensa member?
Its way too simplistic a model for categorizing physicians, but it is a starting point as someone who will hopefully be an attending in the next couple years. And for the pgy-1 who is not that sure of their decision making, and who knows himself well enough to know he isn't a genius (and not delusional enough to think that he is-- though am I shortchanging myself by thinking this?), and fits the "calm and collected," mode (or the "laid back" bs), striving to show others that I know something is the goal of the next half year... or forever...
suggestions welcome. (i'll be reading and memorizing harrisons)
Channy.
1 comment:
Hey Brian! It's great to read your blog and hear how your first year is going. As an M1, I've been wondering how I'll ever know enough, well enough, to make confident, fast decisions and so found this post really interesting. I can see that to be recognized as a "top" resident you would have to come across as confident in your decisions and actions, and that being laid back may come across as not knowing enough to make decisions when that's not the case. I imagine it's very intimidating, at least initially, to be expected to know what to do in situations you've never come across before, or that are very complex. So then, as you say, the question becomes- is it better to give a confident, quick answer even if it may turn out to be wrong, or is it better to take your time to think through your answer and then be sure the one you give is correct? Does this also correspond to what kind of specialty one would be best at? If you're better at making snap judgments and giving sharp orders, should you consider a career in ER versus a career in medicine if you're more thoughtful/pensive/careful to come to a decision?
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