Good Enough

MedStudentGod over at Creating the God Complex is having a little crisis of confidence:

In some ways I think I’m inferior to other medical students around the country simply because I attend a “humbler” medical school. I’m not trying to sound arrogant here, but a sizeable portion of my class wouldn’t have been accepted anywhere else and were only allowed in after completing some after undergrad program...I don’t know. Right now I consider myself lucky to be in medical school at all, but wonder how it would have been in another school – a top 50 medical school.

Here's my answer to him (edited, because I've had more time to think about it):

NEWS FLASH: There really is such a thing as "good enough". All US medical schools that teach you enough to pass parts I and II of the Boards are "good enough". Beyond that (residency) your education is truly up to you: you will get out of it what you put into it.

Despite your dim view of some of your classmates, the fact remains that they did get into medical school, which means that someone, at some point in time, thought they could become good physicians. In many ways medical education is as screwed up as the rest of the health care system in this country, beginning with the fact that too many people who will make lousy doctors are admitted in the first place. On the other hand, the real issue is that it's impossible to tell. Plenty of jerks in school get their heads handed to them one way or another later on, which turns them into pretty nice people and decent docs after all.

I know this sounds difficult (if not impossible) to believe, but there really will come a time when you will no longer be tested, graded, ranked, compared and evaluated continually. (No; specialty board re-cert doesn't count. It's too sporadic and too easy.) Not only that, but despite the fact that you are finally in a group of equals, the system still insists on ranking you. If 1000 valedictorians get into Harvard, 10% of them will wind up at the "bottom of the class" -- by definition -- 4 years later. Whether or not you are a "good doc" or a "bad doc", or even a "mediocre doc" is entirely up to you, and has NOTHING (I need to repeat that: NOTHING) to do with the name of the school on your dipoloma.

There are docs from Harvard and Yale who suck, and alums from your school (note: I don't even know what school you're at, and it doesn't matter) who are amazing. Coming from what you and others may consider a "mediocre" school just means you may have to work harder. It's not fair, and I applaud your surgery professor for wanting to change things, and I agree, med students deserve better, but don't go getting yourself into an inferiority complex.

The whole "prestige" thing of paying attention to (or even noticing) what residency or med school you attended is really only an issue in the academic setting. Guess what: there's a very big, wide world out there composed of sick and hurting people who need your help, and who don't give a shit about that stuff.

You sound like you need a bolus of confidence. Infuse it over twenty minutes, preferably through a central line (straight into your heart) and re-check your anxiety level in the morning.

Be the best doctor you can be by concentrating on your patients, especially when you get to residency. I know you can do it.