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Struggling To Be Best

JeffJeff Wonoprabowo -- People say that you need to know your own limitations. I think that you need to do more than that. You need to learn to accept those limitations. For most things, it is easy for me. I can accept that I'll never run like Usain Bolt, swim like Michael Phelps, ride like Lance Armstrong, or hoop it up like Kobe Bryant. But for other things, it can be hard. Who really wants to accept that they aren't as good as they thought they were? Or that they just can't achieve the same things others can? I sure don't. It's a humbling experience.

Before medical school I heard people say that the entire medical school class would be people who, for the most part, were at the top of their respective undergraduate classes. And they were probably also near the top of their high school classes. But within every medical school class, there will always be someone ranked first and someone ranked last. And nobody ever entered medical school planning to end up at the bottom.

The problem is that, in general, the kind of people who make it into medical school are pretty competitive. They want to be the best. And it is pretty difficult to not have the class ranking one is used to having.

Maybe the solution is to just be content. I guess I may have to accept the fact that I am not the best. But maybe I can hold on to the idea that my best can still be very, very good. And when I try to think like this I feel better -- I feel that as long as I give my all, I will be content with my performance.

And then I think about people who have risen to the top of their fields. Did they ever just "let off the gas pedal" and accept that they weren't the best? Did they ever feel that "just good enough" was really good enough?

How does one navigate between the desire to be better and the wish to be content with a job done well enough? I don't know. I wish I did. I guess I'll struggle with it some more.

December 18, 2008 in Jeff Wonoprabowo | Permalink

Comments

Hey Jeff,

It is a part of growth to realize you are not the best and I wish you luck on that journey. The way that I like to think of it for myself is that I know I am the best doctor I can be. While in clinicals your patients don't see your exam scores or your other classmates (except maybe that other student who may or may not be from your school). Therefore you get to be your best- I think that in the end that is what matters most. And if you are beating yourself up some days - just remember Tiger Woods hasn't won every tournament in a row either! :)

Posted by: Irene | Dec 18, 2008 5:05:04 PM

I learned a long time ago not to compete against my classmates in grad school. You'll beat yourself up over it. And you can be the best if you really work hard for it. The cool thing about rotations is that you go into each new one with a fresh slate. Usually the team doesn't know you so you get that chance again to prepare, prepare, prepare, and show them how great you can be. :)

Posted by: Brian | Dec 18, 2008 11:10:01 PM

Here here to that. I came to a similar realization while going through my first few semesters in med school as well. However, I just altered my focus from "I want to be the best" to "I know I can do better for myself." The difference is I'm not competing with my classmates, rather myself and pushing myself to do better because frankly, in the end we aren't doing this for ourselves but those that we serve. So I figure, patients won't care if we were the best in our class or not, they'll care whether or not we know what we are doing.

Posted by: Sauhang | Dec 23, 2008 2:13:13 PM

We should all compete with one another in order to strive to be at the top of our fields and therefore provide patients with the best possible care. Competition hopefully never entailed anything but a desire to know more and at least as much as your classmates, who presumably started off on more or less a level playing field (barring PhDs in neuroscience that enter medicine). The way I like to look at it is that we are competing as a school, a class, against other classes across the US. There should be no medical school class, matched by year, that knows more about basic science and patient care than mine. That breeds a sense of collaboration among your classmates and inspires the desire to instruct one another. One might even get super ambitious and extend that sentiment across the US, to compete as a country of physicians with our counterparts in Europe or Asia. There is always room for a little competition.

Posted by: Mark | Dec 23, 2008 2:52:23 PM

I don't know how we can compete as a nation against the UK and Asian when we accept the best from those nations into medical school. Ultimately as another said we are competing against ourselves. Our primary goal is to help others not to be in a race. Grades and scores don't always let us know who is best in the long run. Like another said look at Tiger Woods. He doesn't always when. Grades just help us keep score and let us know that we are improving as an individual against a preset bar.

Cheers and Happy Holidays!

Posted by: AJ | Dec 23, 2008 4:35:07 PM

Hi Jeff. Thanks for a great article. You should be more than happy knowing you are the best you can be. Nobody can do what you can do, they can only do what they can do. I know there is always someone out there who is bigger than I am and someone smaller than I am; someone more educated and someone less educated; higher IQ's, lower IQ's, etc. etc. It's a satisfying feeling to know that you're doing the best that you can for your patient. Anyway, have a Merry Christmas and keep up the good work.

Posted by: Doug | Dec 23, 2008 10:04:55 PM

It's an interesting reflection on your part. We all need to realize that even doctors fall under a bell curve. This bell curve is not concrete. Certain pay for performance systems may try measure this and reward and punish those that are at the tails of the curve. However, grading doctors is not as easy in practice as it is in theory. The sobering reality is that most likely we'll fall within 1 standard deviation of this illusive mean. One can argue that the best student in medical school will not be the best practicing physician. There is no current way to prove who is the best physician. When patients try to figure out who the best physician is, it's mostly based on anecdotes with the usual sample size of 1. As a result, it's up to us as individuals to try our best, but realize it may not be enough.

Posted by: Brian Y. | Dec 23, 2008 10:09:23 PM

Relax Jeff!!!! Though I seem to be the only one posting who feels this way!! You are here, you made the cut, everything from this point out is about creating your own career, and being the best doctor for your patients. This is the first time you don´t need to be worried about others, at least not about their grades anyway. I don´t know if your school is graded pass/fail, but it sounds like it is not. Keep in mind that a very high score on a physiology exam does not translate in any way to being a good doctor (if it did, all the physiology PhDs would already be doctors). You must be able to integrate what you are learning, pharmacology does not occur in a vacuum. But more importantly, you must be able to understand that you are dealing with a patient who is a whole human being. Even the "best" or most "scientific" treatment you are expected to know in school may be horribly wrong for them! But if you just rely on book-smarts and never know how to relate to your patients, you will miss that entirely. Strive to be the best, but make sure it is for the right reasons and with the right goals in mind!!! As an ex-chronic overachiever, that was a little difficult for me to say! But those guys can have their 98% on their basic science exams, I´ll work on improving my knowledge of what it means to care about patients too, not just books.

Posted by: shauna | Dec 24, 2008 12:20:33 AM

There is a big difference between having the best grades and being the best in a clinical environment. Some students spend a plethora of time studying and just don't test well. You will learn that many have the book smarts but lack the ability to apply it. The only way to properly evaluate a med student or a physician is to examine then end result when they are practicing. That is what you should strive for.

Posted by: | Dec 24, 2008 6:13:16 AM

i think the important thing is to always remind ourselves that we are learning to be good enough for the patients not to be top of the class :)

Posted by: q | Dec 24, 2008 10:02:47 AM

Go do something fun Jeff.

Posted by: Matt | Dec 24, 2008 10:08:53 AM

my name is samia . Iam in the fourth year of faculty of medicine" Ain Shams University" . It is easy to to tell us such speech, but in fact it is so difficult to be done . I'll tell you my problem in studying. I can't concentrate at all & I open the book all the day ,but I can't study . If you have any decisions , please, tell me.

Posted by: samia | Dec 24, 2008 10:25:06 AM

Hi Jeff, I also learn that being the best in the class doesnt really make you the best out there. So just do your stuff the best you could and you'll make it there =)

greetings from germany and happy holidays

Posted by: Oscar | Dec 24, 2008 10:41:39 AM

Nice thougts Jeff... I´ve finished my medical school just yesterday and I always had to stuggle in matters like this you´ve wrote about! Well... the idea of having comfort from doing just our best has proved to be a source of solance to me, as well!
This is the way... actually I think being the number one in the formal evaluation process of the faculty is good but ins´t all... if we discover we can´t get it, this is no reason to be ashamed at all, once we keep the habit of doing our best in everything we do. Doing like this, our time will come - the sooner or the later! =)

Posted by: Dailson Bz | Dec 24, 2008 10:52:13 AM

Something i would like to disclose- trying to be the best just makes you lonely and less of a teamplayer- which is not what being a doctor is about. I think competitiveness is wrong and one should be striving to be a better person by setting personal goals which do not influence or put other's down intentionally.

MERRY CHRISTMAS!!

Posted by: bev | Dec 24, 2008 10:54:00 AM

Jeff don't be so hard on yourself. Just like a line from an otherwise lame movie (Alexander) - Your failures still tower over other men's successes. And you're right when you say we can't be like people like Phelps but I think we can still learn something from them. Phelps could have taken it easy after the 2004 olympics where he won 8 medals (albeit 2 bronze) but he knew he could do better and make it all 8 gold - which he did in Beijing by training harder and not resting on his laurels nor dwelling on his 2 bronze disappointments.

Posted by: Rashid | Dec 24, 2008 10:54:50 AM

Hi Samia, I also needed quite a while until realizing how to concentrate on learning. Here are some clues that helped me, and probably might be helpful to you:

1) Study Room: Look for a Place that is quiet, without distracting elements such as TV or a refrigerator (Don't ask me how often I checked my fridged when I should have been learning ;-). Go to the library and take a remote place.

2) Clear your mind. Try to eliminate everything that bothers your heart and soul. Before learning, try to motivate yourself by thinking of something positive. Find a friend whom you can talk to.

3) Do breaks at fixed intervals.
4) Get enough fresh air in between
5) Do some sports, this will clear your mind
6) You might think of meeting with other students at regular intervals to repeat your acquired knowledge. Pick someone you get along with well.

These things helped me to concentrate. maybe someone als has other tips

Merry Christmas To All of You

Posted by: jerry | Dec 24, 2008 11:01:48 AM

well done said jeff.... u have tried to solve the major problem of not only medical students but of all those who are competing in one field or the other.......... so keep it up bro ...

Posted by: rehmatullah khan | Dec 24, 2008 11:19:53 AM

I'm proud of whatever you accomplish. You are always a good inspiraton. DAD

Posted by: Alicia Jones | Dec 24, 2008 11:20:24 AM

I struggle with these issues too... and can understand completely... be careful though; don't be too hard on yourself... i ended up on antidepressants 3 years ago...
try to enjoy Christmas; take some time off to get your strength and feel refreshed.

I'm in final year and my class is very competitive... we even keep tutorials a secret from each other and most people don't tell others when there's a good patient in a particular ward.to think that we'll be working 'together' in a few months' time... it is disgraceful. The Hippocratic oath also emphasises teaching and sharing knowledge... but some people seem to think it is too old to be applicable - well I am a strong Hippocratist and it is difficult to be one in this day and age.

Very Good article Jeff. I assure you though, you will make both a good doctor and also a good future educator to other medical students in future... because you have the capacity to understand... and with the power of knowing one's limits, one is safer from making the negligent mistakes overconfident people fall into.

Thanks for the quote Rashid... it has helped me... :)
Good thinking Bev.
Thanks for the ideas Jerry.

Happy Christmas to all.

Posted by: final_exam_pressure | Dec 24, 2008 11:25:56 AM

Hi jef
nice talking, actualy compitition is some gift from God to humanity to survive and move forword, but ofcourse every thing have limitation in life and its good to understand these limitations, and i think succes comes from the tru beleive that u r succesful, and being the best is every bodies right, but every one in what nature gave him or her, not necesarely in the same thing,and so we compleet each other, and life will be nice
thanx every body and merry christmas to all

Posted by: niga | Dec 24, 2008 12:17:05 PM

hey,,it is a nice topic to share..and i think it pops in every medical student's mind...what i learnt from my first through fifth year is the same as what jeff has said, plus i learned to get benefit from each competition by pushing myself to learn a new skill or add something to my knowledge,,i found that this will be enough and is a permanent benefit rather than the transient feeling of being the best that goes quickly!!
Good luck!

Posted by: Kais | Dec 24, 2008 12:23:02 PM

Yeah, that's right. Almost all of med.students are very ambitius. But in medicine, i think, future events are much more important, that's why there are too much professionals, who're very recognized in their specialities were not best in groups of medical students. But knowing it they always create themselves with critical care. IMHO.

All the best, colleagues an Happy New Year!

From Ukraine with love.

Posted by: Andress | Dec 24, 2008 1:00:06 PM

My medical school is a little too competitive in my opinion with every not asking if you passed or did well but wanting to know what percentage you got. There will always be the memory of 1 of my classmates standing in front of the results board in tears on realising she had failed and one of my more egotistical colleagues walking up to the board and saying "yeah, i knew that was too easy" and walking off. I learnt to only accept my own standards and as long as I pass and become a good doctor what difference does it make if I'm top of the class?

Posted by: Karen | Dec 24, 2008 1:18:35 PM

I am a 5th year medical student. i find all of my group of mates are very competitive. People are want to be top of class at any cost. so readig your blog made think everwhere students are same.

I think most of student forget that in working life we are going to part of group. working togther to make common good for patient. i think medical school have take more proactive role. I rather take someone who will work part of team than someone just top in group.

Posted by: aj | Dec 24, 2008 1:34:36 PM

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