On Friday morning, I will receive an email that tells me where I will go for residency. I have spent most of the last year preparing for this email. Over the summer, I completed my sub-internships where I hoped to impress members of my chosen field (psychiatry) and secure letters of recommendation. On my consult-liaison psychiatry sub-internship, I was genuinely interested in my patients’ lives, but I also felt my internal coach urging me to perform daily. When things went well, it was difficult to disentangle whether the reward came from witnessing a patient get better or receiving positive feedback from an attending physician. By the end of the month, I was exhausted from learning to care for patients but also from the effort I had invested in showing that I was learning.
In September, I began revisiting old resumes, deciding which past experiences to include in my formal residency application. Mentors had told me about the importance of creating a “narrative”—a story that strategically integrates prior life experiences to justify my choice of specialty. After writing the first draft, I was told that I needed to insert myself more prominently. I took this feedback seriously and crafted an essay weaving together fragments from my life, specifically selected to illustrate the ways I cared for others. This sentiment was genuine — I do care deeply about family, friends, patients, and members of my community. But it left me feeling confused: I was spending vastly more time and mental energy promoting myself through my anecdotes of compassion and empathy, than actually taking care of those people.
During interviews, when I was asked about mistakes I had made, I was sure to answer the question in a way that conveyed I would never make that mistake again. Throughout the process, I took note of which stories were greeted with enthusiasm and discarded the answers that were received with confusion or apathy. When an interviewer complimented me on a letter of recommendation or a past experience, I silently wondered whether I would be able to live up to the expectations that I had created for myself. During interviews, I enjoyed sharing excerpts of professional and personal growth, but at times I felt distanced from the kind of physician I actually want to be: one that is sufficiently comfortable with herself to be able to care for others without continually broadcasting her own worth.
The characteristics that make a successful residency applicant may actually be at odds with the habits of a well-rounded physician trainee. The application process incentivizes medical students to curate an idealized version of themselves: one that accentuates strengths and minimizes areas of weakness. The identity encouraged by the application process leaves little space for vulnerability or ambiguity. But it is that ability to identify and share what we don’t know that allows us to learn. In my experience, the best trainees are individuals who seek out feedback, initiate conversations to learn what they don’t already know, and interact with patients out of genuine care, not because they are performing for an evaluation. This creates a culture where others can ask questions and dare to be wrong.
As I move past the residency application process, I am eager to shift focus away from my polished applicant identity to embrace the messy reality of being an earnest, caring, unapologetically fledgling first-year resident. I feel grateful that I have had the opportunity to attend medical school, and I look forward to cultivating my own identity as a resident clinician treating patients with mental illness. As we approach Match Day, I hope to be accepted to a program that encourages residents to ask tough questions, make mistakes, and not feel ashamed when something doesn’t go well.
Simone Phillips is a medical student.
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