The Shame in Medical School

“Perhaps the relevant truth is that we all find ourselves in temporal currents and that unless you’re paying attention, you’ll discover, often too late, that an undertow of weeks or of years has pulled you deep into trouble.” – Joseph O’Neil

“Congratulations on your acceptance.” Four words and your life has changed forever; a palpable confirmation on a piece of paper that your years of steadfast learning and meticulous planning were not in vain. You are one step closer to putting on that white coat and getting those two precious letters before and after your name. Little do you know, that by entering this honored realm of higher education, you are also entering a profession and culture that will continuously have you asking, “Am I good enough? Do I even belong here?” There’s an undertow rarely seen in medical school that many fall victim to, and it’s that of shame. 

Brené Brown says, “There are three things shame needs to grow exponentially in our lives: secrecy, silence, and judgement.” A med student is nothing if not a very good actor. We hold our cards close to the chest. If I failed that exam or blabbered and blundered through my clinical skills practical, you will never know it. Why? Because I’m going to smile like I just found $20 in my pocket and tell you it was a piece of cake. I am going to cry from the stress away from prying eyes in the bathroom or at home. I am a duck in water: calm on the surface, yet feverishly kicking underneath. I have an infallible image to maintain. I’m going to be a physician. Secrecy. 

On the rare occasion when I do choose to be human and I acknowledge and verbalize my frustrations, I am quickly thwarted. The mentions of sleepless nights, loneliness, and feelings of inadequacy are quickly rebuked by the eternal reminder, “Well if it were easy, everyone would do it” statement, which truthfully, is simply a more eloquent way of saying, “Shut your mouth, stop complaining, and get back to work.” Silence. 

You see, in choosing the path of medicine, I seemingly forfeit my right to complain. I relinquish the emotional undertaking and internal conflicts associated with loving something with every fiber of my being, knowing that it is where and how I’m supposed to make my mark on this world, yet rejecting how on particular days I can be left feeling less than and like an imposter. I am silenced externally and internally out of worry that expressing feelings of unhappiness or frustration might make me seem less appreciative of the opportunity I have been given. I’m continuously being reminded that it’s “a privilege to study medicine” and that people would “kill to be in your shoes.” Anything resembling that of being human has a specific time and place; not in the hallways or when speaking to some of my professors, but behind the heaviest doors and most airtight rooms. Judgement.   

A culture of shame cannot exist without the individuals that exacerbate or placate its messaging. Each of us is guilty and complacent in our refusal to make change. From advisors or administrators that hand out cookie cutter phrases, simplifying the complexity and demand of the medical school education process to the peers who are reluctant to be vulnerable…we do not have to wear our test scores or challenging experiences like scarlet letters across our white coats, but we are the sum of ALL of our parts, not simply the aspects that make us appear to be our best. 

We encourage the toddler who falls as he/she is learning to walk. We applaud the resilience of the runner who stumbles off the blocks yet continues to run and finish the race. Empathy for one’s struggles, kindness towards ourselves and one another, the search for commonality as opposed to difference – in this environment, shame cannot exist. Where there is comradery amongst those who have chosen this path, there are open hearts and minds. When we use the power of our words to uplift and develop self-worth, through the basics of our humanity, we turn “am I good enough,” into “I am enough.”