Dealing with the pressures of learning as a physician-in-training


The other day, I happened across a YouTube video called the “Try Not to Look Away Challenge.” There were some obvious video clips, such as a person vomiting, a spider, and a spooky video game. What struck me was a clip from a movie in which a middle-aged woman forgets where the restroom in her house is located. After letting her husband know that she was headed to the restroom, she walks downstairs. She treads more and more slowly, until the final step, when she hesitates. Then she briskly walks to a door and opens it, to find nothing more than a closet. She tries a couple more doors adjacent to it, almost manically, until her husband rushes downstairs to find her in tears.

All these years, those memories, just couldn’t find their way to the forefront of her mind. I almost cried seeing this video clip. In a way, I think that I have this fear too. I feel it every time I hear how much medical students are expected to know by 3rd year, 4th year, residency, board exams, etc. It turns out that I am not the only one who feels this way. During my first-year medical school curriculum, we read an article about a resident who blanked out, forgetting what “Tylenol” meant. All you can do is go home (albeit not voluntarily in this case because he was sent home), and hope that your memory comes back.

It never ends. Not in this profession. Physicians and physicians-in-training spend countless hours learning and honing their skills, working long hours not to get ahead, but to keep from falling behind. It’s an endless game of catch-up, and not just in medicine. What do a lot of these professions come down to? Expertise. Knowledge. Skills. Things that are so dependent on memory that they wouldn’t be possible if it weren’t for our capacity to learn, forget, and learn again.

Anatomy really challenged me. It pushed me to what I think were my brain’s limits, although I hear it’s not nearly what we should be capable of. Cramming in four lectures per day, expecting that we should remember details from the twelve lectures prior, as newer lectures are piled on top of that? No wonder you look at the stress level of medical students, and it’s high. I don’t think I’ve ever heard my roommate sigh so many times in a day (I think I counted ten today), let alone restrict our conversations to “Hi” and “Good night.” Now that I think about it, sometimes the “Good night” is absent now. I’m no different.

Why do we do this to ourselves? Our first answer might be: “Because we can’t fall behind.” My second answer is: “Because I can’t afford to forget.”

I feel myself forgetting sometimes (for example, my long-term recall of topics covered even from a couple weeks prior). Even though we had just learned biochemistry, I felt that there was a limited capacity in my brain for new material. I found myself resorting to a “pump and dump” routine. Things that I had no trouble picking up before starting medical school, I struggled learning. As a hip hop dancer, I could not retain dance choreography and certain eight-counts as well as I could before school started. I was also forgetting simple things, such as what date it was and what appointments I had made with friends. My mind was so narrowly focused on learning the class curriculum in a particular way that I neglected other ways I learn.

Medical school is hard, but even more so for the students learning the material for the first time. A part of me wishes I had taken an anatomy course prior to medical school, but another part of me is proud that I was able to conquer the class on my first try. Reflecting now, after my first year of medical school, I knew that learning the sheer amount of material we did in a short amount of time was not healthy for me. It’s like taking a prescription medication for a medical condition, knowing that there’s always a risk for side effects.

It astounds me the amount of empirical knowledge I gained this year. But it also made my mind more prone to forgetting. Isn’t that ironic? I fear this forgetfulness, because I know someday, in the not-so-distant future, a life will depend on it. Maybe many years from now, there will be a day when I try to learn a series of dance moves, and I just won’t get it. And I shouldn’t be devastated by that, because it’s the nature of life. We know it’s coming, like the highs and lows of life, but only the universe knows when.

It bewilders me sometimes what a high-strung society we live in, where “productivity” can be valued more than experiences. At times, it is tempting to forget that the beauty of life lies in life itself. That we have the capacity to feel, to love, to remember, and to forget.

Linda Nguyen is a medical student who blogs at Medium.

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