Lessons on confidence, uncertainty, teamwork, and becoming a physician
If you are reading this, you are probably somewhere along one of the most demanding—
and rewarding—journeys of your life.
Perhaps you have just begun medical school. Perhaps you are preparing for your first
clinical rotations. Maybe you have already discovered that medicine is far more complicated than
you imagined when you first received your acceptance letter.
Wherever you are on that journey, I would like to share a few things I wish someone had
told me when I was sitting where you are today.
When I entered medical school, I thought success depended on learning enough
medicine. I quickly discovered that medicine itself was only part of the education.
There was anatomy, physiology, pathology, pharmacology, and an endless amount of
information that somehow had to find a place in my memory. But there was another curriculum
that was not written in any textbook.
I had to learn how to speak with frightened patients and anxious families. I had to learn
how to work alongside classmates who would eventually become trusted colleagues. I had to
learn how to earn the confidence of residents and attending physicians. Perhaps most difficult of
all, I had to become comfortable not knowing everything.
Medical school was exciting. It was also overwhelming.
There were days when I wondered whether I was capable of learning everything expected
of me. There were moments when I felt inadequate, uncertain, and occasionally embarrassed.
Looking back after more than four decades in medicine, I can tell you something I wish I had
understood then:
Almost everyone around you feels that way.
Even the students who appear most confident often carry the same doubts privately.
Medical education has changed considerably since I was a student. Today’s curricula are
more integrated and collaborative, and they increasingly encourage students to take an active role
in their own learning. Those changes reflect an evolving understanding of how people learn best.
Yet one thing has not changed.
Medicine is not simply about acquiring knowledge. It is about learning how to think: how
to make decisions despite uncertainty, how to remain calm when others are looking to you for
answers, and how to continue moving forward even on the days when you question yourself.
During your clinical rotations, you will likely witness your first medical emergency.
One of my earliest memories of participating in a cardiac arrest is not of a particular
patient. Instead, I remember the remarkable transformation that occurred when the overhead
announcement called a “Code Blue.”
Within moments, physicians, nurses, respiratory therapists, pharmacists, and other
members of the health care team converged at the bedside. To a medical student, it initially
seemed like organized chaos. Everyone was moving with purpose, performing different tasks
simultaneously while somehow remaining focused on a single objective: saving a life.
At the center stood the physician leading the resuscitation. From where I was standing,
that physician appeared completely calm. Every decision seemed deliberate. Every instruction
sounded confident.
I remember thinking, “One day, I hope I can do that.”
Only years later did I understand what I had actually been witnessing.
The physician was not carrying the burden alone. Nurses reminded the team when
medications were due. Respiratory therapists focused on the airway. Others recognized rhythm
changes, suggested reversible causes, or gently reminded the team about the next step in the
resuscitation.
The best resuscitations were never the work of one extraordinary physician. They were
the work of an extraordinary team.
That lesson stayed with me.
As I progressed through medical school and residency, I encountered many different
teaching styles.
Some attending physicians believed the best way to teach was by asking difficult
questions in front of the team. When you knew the answer, it was gratifying. When you did not, you sometimes walked away embarrassed and wondering whether you truly belonged in medicine. At the time, I accepted that as part of the culture. Whether it was intended to build resilience or simply reflected the personalities of the era, I cannot always say.
Other teachers approached learning differently.
They still asked difficult questions, but when they sensed you were struggling, they did
not immediately give you the answer. Instead, they asked another question—one you could
answer. Then another. Gradually, they guided you back toward the original problem. By the end
of the conversation, you often discovered the answer yourself.
The difference was remarkable.
I still learned. I was still challenged. But instead of leaving the interaction feeling
diminished, I left feeling educated.
Years later, when I became an assistant professor at a teaching hospital, I often found
myself thinking about those experiences.
Suddenly, I was no longer the student answering the questions. I was the physician
expected to ask them.
I quickly discovered that becoming a good teacher required a different set of skills than
becoming a competent physician. Knowing medicine was not enough. I had to learn how to explain it, how to encourage independent thinking, how to challenge students without
discouraging them, and how to recognize when a learner needed confidence more than criticism.
I certainly did not get it right at first.
But over time, I realized something important: students learn best when they are
challenged to think, not when they are made to feel small.
Perhaps the most important lesson I learned as an educator was to remember what it felt
like to stand where my students were standing.
I remembered the uncertainty. I remembered worrying about giving the wrong answer. I
remembered wanting desperately to prove that I belonged.
Those memories shaped the teacher I hoped to become.
Residency eventually gave way to independent practice.
As an anesthesiologist, I occasionally found myself leading cardiac arrests. Although
those situations were relatively uncommon in my practice, the responsibility was enormous.
If your career eventually places you in similar situations, you may discover something
that surprised me: experience does not eliminate anxiety.
When a patient’s life depends on decisions made over the next few minutes, you do not
have the luxury of panic. You gather yourself. You trust your training. You focus on the patient
and the team. Outwardly, you hope you appear calm. Inwardly, you recognize the weight of
every decision.
Those moments were humbling. They also taught me something I had not fully
appreciated as a student.
No physician—regardless of intelligence or experience—can simultaneously keep track
of every medication, every rhythm change, every time interval, every conversation, every
reversible cause, and every evolving clinical decision entirely from memory.
That is not a weakness. It is simply the reality of being human.
Over time, I found myself asking a simple question: Is there a better way?
Not a way to replace clinical judgment. Not a way to replace teamwork. But a way to
support both.
That question eventually led me into medical innovation and the development of a digital
cognitive aid for cardiac arrest. The technology itself is not the important part of this story. The
important part is the question.
Never stop asking how medicine can be improved—for your patients, for your
colleagues, and for those who will come after you.
If there is one message I hope you take away from my journey, it is this:
You do not have to know everything today. You simply have to remain committed to
learning tomorrow.
Confidence is not something you possess on the first day of medical school. It is
earned—one patient, one challenge, one mistake, one lesson, and one day at a time.
You have chosen a remarkable profession. I believe it is one of the greatest callings
anyone can pursue.
Few careers offer the privilege that medicine does.
Complete strangers will invite you into some of the most vulnerable moments of their
lives. They will trust your judgment, compassion, honesty, and integrity—often within minutes
of meeting you.
They do this not because they know you personally. They do so because they trust the
profession you have chosen to join and the generations of physicians who have come before you.
That trust is both an extraordinary privilege and an enormous responsibility. Never take it
for granted.
Remain curious. Remain humble. Ask questions without embarrassment. Listen carefully
to your patients, colleagues, and teachers.
And when your time comes to teach the next generation, remember what it felt like to be
where they are today.
Encourage them. Challenge them. Teach them to think. Help them develop confidence
without ever losing humility.
One day, you may discover that your greatest contribution to medicine is not simply the
patients whose lives you touch. It may also be the physicians you inspire.
I wish you every success on the remarkable journey that lies ahead.
AI use disclosure: Portions of this submission were assisted by ChatGPT for editing, grammar
review, and formatting. The experiences, ideas, analysis, and final editorial decisions are the
author’s own.
