Med Ed: Gunning Without a Goal

I finished my first year yesterday--WOOHOO!--so I'm now halfway through the basic science years. (For those of you who aren't medical, the first 2 years of med school are basic science years, which basically means you're in a classroom. 3rd and 4th year are clinical years where you rotate through different specialties, pick one, and apply to residency.) I also just watched another great TED Talk on education by Ken Robinson (see bottom). Ken and the end of first year both got me thinking, as I often do, about medical education (more seriously than my last blog).

Ken Robinson says, "Education is not a mechanical system, it's a human system." Hear, hear! I believe that all of my personal struggles with academics have been a result of this misconception. I've never been able to "just do it." Without having a personal belief that it's important for me to complete a task, I can't do so; and for me, the motivation can't be selfish. In other words, grades alone (perceived future success, status, etc.) can't and won't motivate me beyond a VERY limited point. (See my thoughts on grades in medical school.) I'm a person, not a machine, and no amount of Adderall (legally prescribed!) or coffee can get me to behave like a machine.

In many ways, medical school is an academic regression; I feel like I'm back at the same brick wall I faced during high school and the beginning of undergrad. I'm being told to work as hard as possible, to make the best grades possible, so I can... do what? I personally can't perform at my peak unless I have a specific motivation. It was easy for me to earn [almost] straight A's, to take practice MCATs every Sunday morning and to shadow at 5:00 AM when I knew I wanted to get into medical school. Now that I'm in, I need a new goal.

It's like I not only got sent back to Go, but then the game changed from Monopoly to something I've never heard of, and I have to play for 2 years before I can decide on my game strategy. (Kind of a convoluted simile, but just go with it.) The problem is that I've felt trapped in the classroom; I have a very limited ability to explore what specialty I want to go into. I can shadow at nights and on weekends and I can read as much as I want to, but there is nothing like actually doing something to help you quickly decide if you ever want to do it again. I shadowed an Ob/Gyn for almost a year, but I won't know if I want to be an Ob/Gyn until I actually deliver a baby and do a Pap smear myself.

I'm not proposing that every medical student has this problem, but I know many that do (please comment if you have any thoughts on this!). It's just much easier to be "highly motivated" (my favorite gunner expression) when you have a specific goal in mind.  Right now my goal is essentially "get to 3rd year," and I think that my grades reflect that. (Not that I'm doing poorly, but I'm certainly not honoring every class.) This is funny because I really, really thought my pre-med intensity would translate straight into medical school, but it didn't. I'm proud to say that I'm not a gunner.

So, my intention is not to complain but just to think about something that is true for me. I find it to be a very uncomfortable truth, because one of my greatest fears is waking up during third year and realizing I want to be a neurosurgeon or dermatologist and I don't have the grades to get a residency. Most of the time I can trust myself and trust that I would be more "highly motivated" if my calling was one of the most competitive specialties. I also trust that I'll be able to prove myself when I'm called to do so. If I'm really meant to be a neurosurgeon, someone will see that in me and give me the opportunity no matter what grade I earned in Neuroscience. But every so often I have a moment of doubt, which is usually when I write a blog. :)

Please enjoy Ken Robinson: