"Be More Confident"

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The most important task for every premed and medical student is learning how to appear confident. If we want the privilege of cutting people open and prescribing potentially lethal drugs, we need steady hands.

But confidence is something I've always struggled with, particularly in my academic life. The common theme in my feedback from faculty, bosses, and attendings has been: be more confident. This is a great problem to have. Presumably they all see a reason for me to be confident (who would tell an incompetent person to have confidence?). But it is a problem. 

Here's what happens: a faculty member tells me to be more confident, and my first thought is always, Yeah, but...

Yeah, but I'm not sure that what I'm saying is right.

Yeah, but there's more than one answer.

Yeah, but I don't feel confident.

But what really prompts me to think, "Yeah, but"? 

Stephen Hawking famously said, “The greatest enemy of knowledge is not ignorance, it is the illusion of knowledge.” And it's quite pleasant and intelligent-sounding to argue that my resistance stems from my internalization of the imperative to question one's own knowledge. But that's BS.

In truth, my feelings stem from a much less pleasant reality, which became impossible to ignore when I was studying for Step 1: I don't trust myself. And no situation better exemplifies this lack of trust than the multiple-choice exam. Here's how it plays out: I read the question stem, and I'm already thinking of an answer, let's say endocarditis. Then I see that answer choice B is endocarditis--Yay! I knew something! So I click on B. But then… 

...I read the other answer choices. And somehow during the next 30 seconds I become convinced that the test-writers included choice B just to trick me. They really want me to pick A, cardiac tamponade, even though that's clearly the wrong answer. And I know it's the wrong answer. But I pick an answer that I know is wrong, because I don't believe my brain actually works.

And this happened ALL. THE. TIME. [Insert nightmarish UWorld montage here.]

But I've learned how to cope with this absurd tic: by ignoring the impulse completely. Which brings me back to my first statement: the most important task for every premed and medical student is learning how to appear confident. 

I don't have to feel confident when I take an exam, I just have to act confident, by picking one answer and refusing to second-guess myself, even though everything inside me is screaming THIS IS BAD THIS IS WRONG I AM FAILING NONONONONONO. I now have enough experience to know for a fact that this feeling is a lie: I'm not failing, and I'm not an idiot. I just need to pick B and move on with my day.