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S2E19: Coping With Failure in Med School

Apr 10, 2019

Failing medical school is probably the biggest fear for every medical student. You don't anticipate you'll fail, and you can't really prepare for it either ... but what happens if you do fail? How do you handle the situation logistically? How do you handle the situation mentally? In this episode, we talk about the difficult topic of failing medical school and how to move forward.

Episode Transcript

The following is a summarized version of the episode's transcript.

Failing Medical School

J: The biggest thing that happens if you fail something in medical school is that you immediately feel like you don't belong or you're not good enough and there's a lot of shame. And when it first happened to me, I, of course, did not share it with anyone. So what happened to me was I failed the final for the end of a unit, and because of that failure and because my overall grade in the course wasn't passing, that automatically sent me to a committee to be evaluated in terms of whether or not I would continue in medical school.

So that was a really terrifying time for me, that interim between failing the test and that committee. And because of the nature of medical school, it was right into the next unit. So I was sort of trying to deal with this very difficult new unit while trying to figure out what exactly was going to be the consequence of this failure.

I think that, as medical students, a lot of our sense of identity is tied up in the accomplishments that we've had to have in order to make it this far and our sense of our own competency and our ability to understand medicine and provide care for patients.

The decision was made that I would not be continuing with my medical school class and that I would need to repeat the course. And because of the way that the courses are done I couldn't repeat the course until the following year. It was about October, and I was basically told that I was done.

Doubting Yourself After Failure

Harjit: In this process, I'm pretty sure there was a moment where you questioned things, like, 'Is this the right path for me?'

J: It was really a gloomy time for me. So, when I started in medical school, I was also in a dual degree program, and because I had been put on the suspension, an academic suspension, that automatically triggered a review of me in that dual degree program. And that review kind of dragged on for many months.

And so, during that time, I felt really stuck. I felt like I couldn't move forward and try to pursue something else [...] it was really emotionally difficult for me. It brought up all of these questions about whether or not I would be able to actually pursue my dreams.

Harjit: So what did you do for that year when you were waiting to join the class? I'm pretty sure that must have been really difficult.

J: I'd like to say that I did a lot of things during that time, but I really didn't. I tried to maintain my sanity and engage in yoga, which I love. And I do have to say that the wellness program that we have here really supported me. I don't think that I would have gotten through everything without the support from the wellness program. I was able to see a therapist weekly and sort of talk about everything that had happened and really process it. So I studied. I did yoga. I waited for this decision about my future to be made, and ultimately, the decision was that I would not be continuing on in that dual degree program. And that was the point that really made me question continuing in medical school.

And what ultimately drove me to continue in medicine was the fact that my difficulties that happened during the point in time where we're not doing the practice of medicine. And I knew that I enjoyed interacting with patients, and so I felt like I needed to see for myself whether this hang-up was something that would prevent me from being a competent physician or if this was just a temporary setback and that I could actually do this.

Supporting Each Other Through Failure

Leen: You're very vocal about your experiences and that's very brave, and I think it takes a lot to want to do that [...] What was your process to say, 'I'm going to put this out there for those who also need something like this'?

J: So I remember at the end of the first unit of first year, my class actually went through a lot of attrition. We lost a lot of students. And I remember coming back and seeing that there were people missing and wondering about them, but kind of feeling bad talking about it with other people because it really felt like gossiping, and it felt . . . it came from a place of concern, but it still didn't quite sit right. I'm fairly exuberant and participatory, so I knew that people would notice that I was gone, and I didn't want them to have that feeling of wondering what was going on. Once it happened, I made a Facebook post for my original class telling them everything that had happened, and I received so much love and support. And then over the course of that year when I was waiting, I actually had a couple of students reach out to me and ask me for advice when they were going through something similar.

When I joined my new class, you guys, I didn't initially want to say it because I didn't want that to be my first impression. And I knew that I wanted to share it, but I didn't know exactly how. Right after we took the final for the unit that I hadn't passed in the prior year, I was looking at the histogram and I noticed that there were one or two scores that weren't at that passing threshold and I said, 'I need to tell my story. I need to be able to help anyone who might be going through this.' Because the biggest thing that I felt when I first found out that I was under review and may not be continuing was that I was so alone and that it hadn't happened to anyone else. And, you know, if it did happen to someone else, then they were just gone. It was sort of a medical school death sentence.

Harjit: I think it's so beautiful that you were the one who took control in telling your story the way that you wanted to because it's authentic and it's honest, right? There's no room for 'This is what I think happened' or 'This is what I think could have happened.' And I think that authenticity is what really shined through to all of us.

J: One of the great things about medical school, actually this is one of the great things and [also] one of the worst things about medical school, is that I have met the people that I have always wanted to meet in my life. I've made some of the most profound and important friendships of my life. I didn't want to feel like I was hiding something from everybody, because it felt very much like a subtext that maybe everyone would be thinking something or wondering something, or maybe everyone would know, but it wouldn't have been directly from me. So it would have been something that was a taboo topic, and I wanted to take that taboo out of it. I didn't want it to dictate my interactions with other people.

Normalizing the Conversation Surrounding Failure

Leen: How can we normalize this topic? [...] How can we make it be something that we can all communicate about and bring to light and be able to address and connect and make it safe for everyone to feel, 'Med school's hard and this can happen, but there is a support here and this is something we can all relate to and bring to light'? What would be some ideas or what do you think about normalizing the topic?

J: Well, I have to say that I love how much attention imposter syndrome has gotten, especially recently, because this whole experience felt like, 'Oh, I'm an actual impostor.' It was like the syndrome became reality, that I had been found out that I was inadequate and I couldn't do this. And so I think that, in medical school, it's so easy to fall into the trap of seeming really with it and competent and sort of putting up that shield and being strong. That desire to appear competent can really push the reality out of the light. I wish that I knew how to make that better, and I guess by sharing that's my hope, is to empower people to share the times that they've struggled and may have been found wanting in some way.

Recovering from Failure and Moving Forward

Leen: So we come into med school with all these dreams and, you know, aspirations of what we want to be, and then something strange happens to us here where we get funneled into thinking of the system. We think of the numbers. We think of the histograms. We think of class rankings. And it almost, to some extent, can jade us. But I think what's very powerful about your story is that what you fell back on was your dreams. You got tangled in the numbers and you got tangled in the histograms and even the committee asked you questions towards that. But what you fell back on was, 'My dreams are stronger than this. My dreams are stronger than my place on a histogram.' And I think that is very different than a person who only thinks of the numbers and then goes to meet patients, because patients don't understand these things. Patients don't know numbers. Patients don't know class rankings. Patients want to know that they have someone who they can connect with, someone who's down to earth, and someone whose dreams pushes them to be a better person to care about their care.

Harjit: It takes a lot of courage, but also wisdom on your part for having that understanding when you're already in a place that is so alone, so low. It's the truth. It's so low because that's kind of like the stereotype around it.

Leen: It's a stereotypical rock bottom, right? But you didn't make it that way. You pushed yourself out of it and you were able to, you know, grab hands as you went up and pulled other people with you up there.

J: The idea of rock bottom to me implies that you have to go up the way that you fell down. And I really kind of tried to figure out a new way through it as opposed to just getting back to where I was, which wasn't what I wanted to do. I wanted to come out of this someplace that was different. [..] I've modified RuPaul Charles' quote, some of you may be familiar with it, 'If you can't love yourself, how in the hell are you going to love somebody else?' And I have sort of changed that for myself: 'If you're not taking care of yourself, how in the hell are you going to take care of somebody else?'

I think that I said it to myself a lot more during that first year and bit. And through all of this, I've really started to believe it. Because espousing it is one thing, but really internalizing it is another. I would say that through this I have learned a lot more compassion for myself. I think that, as med students, we're all kind of hard on ourselves. We are demanding of ourselves and we expect the best. Since all of this has happened, I am more willing to let things go. Instead of lying in bed at night mulling over some dorky thing that I said, I can let that go a little more.

I've also learned a lot more compassion for other people, which I think has really translated into patient care. I think that I have been very fortunate in the life that I've lived. I have a lot of privilege and I hadn't ever really messed up like that before. And so seeing how that mistake had such a domino effect on everything else in my life, it has made me understand patients more when they come and their life is in shambles and they can sort of look back to a pivotal moment where something that was only partially or not even in their control affected them deeply. So I think that it has given me a lot more perspective, and it gave me a better ability to empathize.