Dear MS1,
In order to be a successful medical student and then doctor, you must first learn how to fail. This seems counterintuitive; every step that has led you to your matriculation to medical school has been contingent on a near-perfect academic record, stellar scores, and perhaps a peer-reviewed publication or two. If you are anything like I was before my white coat, failure is a foreign, terrifying, taboo thought. But failure in medicine is inevitable — and just as you previously embraced a new vocabulary of amino acids in college, you must embrace failure like the wise teacher it is as an MS1.
A little about me… After barely passing the written portion of our first anatomy exam, I absolutely bombed the practical. I confused the stomach and the spleen, labeled every nerve as a vein, and straight up forgot how to tell my left from my right. I scored less than 50%. Three weeks later, I failed the entire Epidemiology course, which I had to make up after winter break.
I’d be lying if I said I did not wallow in the feeling of defeat. For several days, the energy that I didn’t spend studying was dedicated to stressing about three things: 1) the remaining six weeks of the semester, 2) passing the anatomy course via the next two exams, and 3) immense imposter syndrome. I was certain that I would fail again, and that thought was immobilizing.
Then I met with my advisors, who helped me to realize that I was hardly the first MS1 to ever fail exams or classes — and I am writing to you now because I will most certainly not be the last. Many students before us, so many of whom have gone on to become brilliant doctors, underperformed at some point in their medical education. Almost every doctor will admit that at some point in their career they misdiagnosed a patient, neglected to order the right test, or made some other error that — had it gone unnoticed — would have caused harm. While we all should strive to do our best, we must remember that doctors are humans, and humans are fallible. Medicine is a lifelong practice that cannot be perfected for more than an instant.
While it was annoying to retake the epidemiology final after winter break, I now understand the subject better than I would have had I gotten a few extra questions right on the first try. As part of the remediation process, I met with the course director, and he re-explained the material that I found confusing. The second time around, Epidemiology had my undivided attention, and I began to enjoy the subject. The definitions of and equations for sensitivity and specificity are forever burned into my brain because I failed.
It goes without saying that the consequences of failing academically are far less than those of failing a patient. Still, academic adversity can teach us the coping mechanisms needed to tend to our patients’ emotions, as well as our own. When we make mistakes that affect patients, we must focus on the patient and their family. Their pain, discomfort, or broken trust must take priority over our bruised egos. It is not any patient’s job to reassure us or put us back together when we are disappointed in ourselves. In moments of failure, we must lean on our support systems and call upon the muscles of grit and self-compassion that we have strengthened from past failures. We must give ourselves time, space, and energy to lick our wounds — but not at any of our patients’ expense.
Failure is also an integral part of clinical research. Every study will hit logistical and scientific roadblocks. A vast majority of clinicals trials flat-out fail. Take a look at any medical journal and you will see just how important a result failure is. To borrow from Thomas Edison: Failure teaches the scientific community “2,000 ways how not to make a lightbulb.” As scientists, we must learn to use failure to redirect our research questions and to reinvigorate our desire to find answers.
So, what do you do when you fail? Remember that you belong here. You deserve to be in medical school. You are smart enough and hardworking enough, and you bring your own unique flare to the world of medicine. No numerical score can account for the impact that you will have on your future patients or the contributions you will make to your field. You will have advisors and mentors who support you; they will set you up with the resources that you need to learn the material and pass classes. Medicine is a team sport, and you’ll have students in years above you who have been in your shoes and are eager to help. Please know that we are rooting for you to succeed, even if that means failing along the way.
—An MS2
