If I had to describe how I felt after receiving my first medical school acceptance e-mail, it would be relieved. According to my parents, I knew I wanted to be a doctor when I was 10 years old. Since then, the road to getting to this point has been excruciatingly long, extremely challenging, and let’s not forget, very expensive. Matriculating into medical school came with a one-way ticket out of the notorious pre-med lifestyle and thus, was a milestone worth celebrating. If relief was the first emotion I felt, elation was next on the list. Medical school had always been the end goal and I always thought all I had to do was get in and the hardest part would be over. If I’m being honest, in the 12 years it took me to get to this point, I probably gave very little thought to life after getting accepted. This part came a few weeks after the excitement had wound down and I had accepted my offer of admission. Anxiety was next in line as I realized that what lay ahead of me were 4 more years of countless examinations, endless lectures, sleepless nights and lost weekends.
Getting into medical school was only the beginning of another journey and I knew I was going to have to adjust to all the changes it would bring. Since I was also moving into a new city, it felt like other aspects of my life were also in transition mode, but my greatest concern was how I would survive my new academic curriculum and the exams that came with it. My concerns were validated when on our first day of orientation, one of our academic directors gave a speech to us about ‘learning how to fail’.
Regardless, I resolved that with hard work (which really just meant a lot of studying), I could excel academically. Even so, I wasn’t necessarily surprised that I had only passed my first exam by a whopping 2%. I was relieved that I had at least passed, but this was a drastic fall in performance from what I was used to in undergrad. As dictated by my Type A personality, I figured I just had to study harder for the next assessment. Despite doing much better on the second exam, I was disgruntled because I felt it still wasn’t good enough.
I should probably mention that like many other medical schools in Canada, our curriculum is based on a pass/fail system. This means it actually doesn’t matter what grade you get as long as you don’t fail. The faculty doesn’t care if you get 100% or 74%. Which is a complete 180º from how things worked in high school and undergrad, where what mattered most was how high my GPA was. So even if the faculty couldn’t care less about how high I scored on exams, it was still inherently in my nature to obsess over it.
My first shadowing experience with a staff physician was pivotal in helping me to understand the purpose of my learning and the exams that seemed to be thrown at us every 2-3 weeks. Up until this point, learning seemed to begin and end in the classroom. On the hospital floor, I witnessed how this knowledge extended to the care provided to patients. What we learn during our lectures in class is a crucial foundation for the knowledge & skills we will eventually need in order to provide competent care to patients.
As has been the case in countless educational institutions for decades, exams seem to be the best way to motivate students to learn and assess the quality and quantity of knowledge acquired. The pass/fail system adds a bit of a twist to things. It isn’t necessarily to lower standards or produce mediocre doctors. On the contrary, it alleviates the pressure of having to get ‘perfect’ grades and encourages us to care more about understanding the content being taught. Also, by not releasing the answer key to our exams, our faculty encourages us to be intentional about seeking out ways to fill the gaps in our knowledge independently.
In hindsight, my learning style wasn’t completely off target. I didn’t necessarily allow my learning to end with each exam. I agonized over questions I got wrong and went back to my notes or spoke with friends in an attempt to work through difficult questions. Where I was off target was allowing my learning to be driven purely by frustration. I found my learning more enjoyable and less of a chore when it was driven by a priority to provide excellent care to my future patients.
This doesn’t change the fact that studying can be tedious and annoying. It also doesn’t mean I don’t strive to perform well on assessments or that I don’t get mildly upset when I get a poor mark. I just find it less stressful and more sustainable if I approach studying and exams with this mindset. Also, approaching exams this way did not come instinctively and it is still a work in progress. Hopefully, it will help me stay grounded over the next four years of medical school and beyond.
Frankly, when I’m providing care to a patient as a clerk (in 2 years’ time), it won’t matter that I got a 95% on that immunology exam if I can’t offer my patient the care they need at that moment.