A physician respects the low-yield. See how that changed her life.


I took ten years off to play in rock bands before I applied to medical school. So when, at 31, I found myself drowning as I drank from the fire hose of medical school information, I knew I had to make a change.

I discovered the concept of high-yield and it seemed like the answer to my prayers. It is a simple idea: Some facts are heavily tested on national board exams and generally more applicable to practice as a physician. If you focus on the high-yield and eliminate the low-yield, you will have more time and less stress. Innumerable books claim to have the key to separating high-yield from low-yield. But I found those books didn’t go far enough.

Soon I was discovering ways to implement the concept of high-yield in my everyday life. All junk email was low-yield; I embarked on an aggressive “unsubscribe” campaign. Unwanted phone calls were low-yield; I signed up for the National Do Not Call Registry.

But I didn’t stop with a reasonable decluttering of my life. Small talk with strangers and store clerks, when I thought about it, was also low-yield; I stopped making any effort in the grocery line. Having an opinion about national news was low-yield; I stopped listening to NPR. My husband’s stories about work drama or the hassles of the day? Well, you guessed it. Soon, he was complaining that I only seemed to be listening to him half the time. I, of course, denied it vehemently; but in truth many of his rants simply did not make the high-yield cutoff for my attention.

As I became more obsessed with eliminating the low-yield, I became more and more frustrated with my medical school exams. I remember my rage at having to memorize the different components of mitochondria. Why should I care about the difference between the inner membrane and the cristae?

I believe that the vast wasteland of low-yield is fertile ground for the misery of medical school. The volume is so overwhelming; something has to give. For many medical students self-care is the first thing to go. Others neglect their friends, then their family. Without exception, all medical students at some point will ask themselves: “Why? Why are we learning this minutiae? Why do we need the low-yield at all?”

The answer surprises me. As physicians, we are trusted, privileged, honored with the most valuable and precious commodity in society: an individual’s health. Sure, the nurse practitioners, respiratory therapists, psychologists and others can give accurate and appropriate medical advice, but when questions get difficult, the MDs are called in. We are called not because of our ability to declutter, but because of our ability to retain, analyze, and consider the minutiae. We are called because we spent years learning the low-yield. Many health care providers can tell you that mitochondria make energy for a cell, but when a patient wants to know why her son has strokes, I’ll be glad I can explain mitochondrial cytopathies like MELAS.

Now that I have come to respect the low-yield, I am at peace in other areas of my life. I always ask the cashier how his day is going, and I listen to the answer with attention and respect. I am engaged with politics and willing to put forward an opinion on local issues. Yesterday, I even mustered up some heartfelt empathy about my husband’s minor drama at the shoe store. Long live the low-yield.

Shola Vaughn is a dermatology resident who blogs at SholaMD.com.

Image credit: Shutterstock.com


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