Instead of comparing, let’s nurture the next generation of physicians

Years and years ago, everyone always walked up a mountain of snow and ice barefoot while dragging a carriage behind them to get to school, and their stethoscopes were made of bamboo. They were hard, hard times, and it was a time-honored tradition to hear the talk from our attendings about how hard training used to be and always elicited an internal groan. The follow up refrain frequently heard in medical institutions’ hallways was about the spoiled younger generation who had it so “easy.”

It used to be I was one of the young ones. Now, I find myself working in undergraduate medical education, listening to the complaints of the unfairness and rigidity and thinking … when I was your age. Now, I’m overworked, underpaid, under-appreciated, with so many hopes and dreams and goals that I can’t meet because there aren’t enough hours in the day. The result is that it’s difficult to empathize with these shiny new students who feel entitled to achievement and honors and AOA and dean’s lists and exceptions to the rules because that’s what they’ve always had when what they’re getting is a crushing sense of average. Excelling in a group of “cream of the crop” just isn’t as attainable as it was in high school and college.

The first patient I had as a medical student was an 18-year-old male who’d been shot in the forehead by his mother. He rolled into the emergency room with half a skull, half a brain, and no pulse. I was tasked with assisting in cutting off his clothing and clutched the trauma shears as we heard the overhead disembodied voice announcing his arrival. The books and Step questions and Anki flashcards and Pestana paragraphs and emotional healing seminars couldn’t have ever prepared me for the moment he rolled in. The frenzied, yet controlled, activity began. I stood by the bed staring, unbelieving, frozen, failing then weeks later, I continued to wake up night after night shaking after watching the scene replay on a loop through my dreams. What was I doing in medical school? How could I have taken out loans and lost so many days and weeks and months in this endeavor when there was no way I could succeed as a doctor? No one at the medical school noticed that I was no longer sleeping and having trouble eating. This likely wasn’t something I would have ever felt comfortable sharing, even if someone had asked. The shifts and didactics and quizzes continued, and eventually, the memory faded, replaced by new trauma, eventually building up to a healthy callus. Others lost their way and took their lives that year.

Now, I see students go through the system block after block and year after year. My first thought has been, here we go for more complaining. Why do we have to listen to how difficult and unfair things are? How quickly I’ve forgotten that I once stood in their shoes. If I take a moment to ask, how are you really doing, what would they say? What have they seen that haunts their thoughts? Have they come to the realization yet that life will never be the same, that now that they know just how finite, delicate, tenuous, insubstantial our hold on this life really is, life will never truly be the same?

Step 2 CS is out; we’re headed towards pass/fail grades and hear and learn much more about wellness than ever before. Sure, medical school is changing every day, but this does not mean the process of becoming a doctor is any less deserving of our empathy and compassion as attendings and educators. The challenges faced by this generation are different from those we lived through but, rest assured, they exist. We don’t need to compare – rather, let’s nurture this next generation of physicians, and together, we may achieve what has never been seen before.

\The author is an anonymous physician.

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