Why I stopped working hard in medical school

When I was a first-year medical student, I aimed high.

I sacrificed my hobbies to study. I spent less time with friends and family, I skipped social events and spent more time in the library. By the end of my first year, I felt burnt out. I got the results I wanted, but I wasn’t happy.

I had sacrificed what made me happy – only to feel empty at the end.

I always told myself “I need to study hard so I can treat my patients better”. As I went further along with medical school, something doesn’t add up about my belief.

I had an epiphany; Good exam results would not make me a better doctor, but the pursuit of grades may make me a worse one.

Doing well for your exams can only do so much to achieve the ultimate end goal of being a good doctor.

Observation, Reason, Human Understanding, Courage; these make the physician.

― Martin H. Fischer (1879 -1962)

Working hard for your goals isn’t wrong. What’s wrong is making work as the end goal, instead of a means to an end.

Too often, we work hard in medical school for the sake of it. We fall into the hype of “I’m a medical student, I must grind”. We neglect what’s important to us. We lose perspective of why we entered medicine in the first place.

It’s important to aim high, but you must be honest about your motives and know where your priorities lie.

I reflected about why I was working so hard in medical school. I asked myself ‘why’ 5 times, a technique used to explore the cause of a problem.

Why am I studying so hard?

• Because I want to get the highest mark in the class

Why do I want to get the highest mark in class?

• To show everyone that I’m the best

Why do I want to show everyone that I’m the best?

• Because I care about what others think of me

Why do I care about what others think of me?

• Because I gain my sense of worth based on what others think of me.

Instead of wasting my life grinding, I went straight to the cause. I needed to change where I put my sense of worth. I’m sure most of you who reads this faces the same problem too.

I tried to gain perspective on what matters to me by asking myself – if I died tomorrow, would I have any regrets?

Would I have any regrets putting in extra hours of studying instead of spending time with my family?

Would I have any regrets studying on weekends instead of working on my hobbies?

Would I have any regrets getting a few extra marks on my exam in exchange for losing friends?

I wasn’t willing to give up my family, friends and hobbies for a few extra marks on the exam.

Why does better knowledge and grades not reflect in better patient care?

Knowing more beyond competency does not mean better patient care. The medical field is subject to the law of diminishing returns. There’s a point where extra knowledge does not lead to an exponential return on patient care.

If you don’t know how to solve a problem, there are specific guidelines and algorithms for you to follow. If you’re a junior doctor, you can always consult a senior doctor. If you’re a senior doctor, you can consult a specialist. Extensive knowledge also does not equal better action. Knowing you shouldn’t use ‘NSAIDs in asthma’ is the same as knowing said mechanism.

Even when you know all medicine, there’s a limit to what we can do as a doctor. We can only treat the patients we meet. No matter how knowledgeable you are, you can only help out the ones in front of us.

This limit does not apply to other fields. For example, an author or researcher has the leverage to scale up their contribution. A doctor who writes a book about healthy living treats more than a doctor limited to the hospital. A researcher who contributes to the COVID vaccine has a greater impact than a doctor who’s knowledgeable.

If the reason why you want to enter medicine is to ‘help others’, you can do so by pursuing skills that scale.

Instead of optimising for better grades, teach yourself skills to supplement patient care. Combine your interests with medicine, and you’ll be able to do more to ‘help others’.

For example, a doctor whose passion is film making can expand their impact by posting videos on YouTube about healthcare.

If we want to become a good doctor, knowledge itself isn’t enough. One needs the ability to communicate well with patients, relatives and colleagues. Good communication also leads to better patient outcome.

A group of about 100 patients undergoing abdominal surgery were studied. The night before the operation, the anaesthetist visited each patient to explain the surgery and anaesthesia. For half the patients (randomly selected), the anaesthetists added in a twenty-minute discussion about post-op pain. Patients were told that pain was a normal part of the process and that it was caused by muscle spasms. They were told where the pain would likely be located, when to expect it and how long it would last…

… The group with the extra discussion needed half the amount of pain relief medication that the control group needed. The real shocker was that these patients were discharged from hospital 3 days earlier than those in the control group. A typical day in hospital costs more than $4,000 dollars, so this was a decidedly low-tech intervention that saved more than $12,000 dollars and spared patients many days of pain and misery

What Patients Say, What Doctors Hear by Danielle Ofri

Rather than grinding at the library, work on your people skills. The ability to communicate and understand others goes a long way into your career. Teach others while you’re still in medical school. Learn to write to clarify your thoughts when communicating. Read books to expand your mental models and thinking process.

Do less of the medical stuff, do more of everything else.