Thread by @TheRealDoctorT

To medical students:

Time takes many things away from you as it passes.

Life is often a difficult lesson in letting go.

But Time also gives you one gift; a precious, powerful gift.

A gift that can alter your very reality.

The gift of perspective.

So here’s mine. 1/

I graduated from medical school in 2004, almost twenty years ago.

Reading people’s anxious tweets about med school took me back.

That constant feeling that it’s all out of your hands, no matter how hard you try.

The gnawing uncertainty.

The imposter syndrome.

The stress. 2/

Let me just say something up front, none of what I’m about to say is supposed to let medical education off the hook.

Because, let’s face it, there’s plenty that needs to be fixed in medical education. There was twenty years ago. There is now.

It’s profoundly dysfunctional. 3/

And also none of what I’m about to say necessarily applies to everyone.

I can only speak to my own personal experiences, and my own personal thoughts.

So if you get the urge to say “hey, you’re wrong, I didn’t experience that,” I totally agree with you. You’re right. 4/

The path to medicine requires many things. Discipline, work, patience, delayed gratification.

There’s this tendency to look at medicine as the mountain top.

It’s this distant peak you’re striving towards, wreathed in clouds.

And just like mountain climbing, it’s perilous. 5/

Your oxygen can run low, the weather can change, handholds that seem sure can suddenly turn treacherous, and even with teamwork you can lose people along the way.

You can lose yourself along the way.

What do I realize looking back on it now?

It was never a mountain at all. 6/

Medicine is a shoreless ocean.

It begins long before you ever step foot in a medical school, and it keeps going long after you think you’ll pass some final hurdle.

It’s not about ascending to some great heights.

It’s about learning your own depths and how to swim, together. 7/

I know these are just analogies, so here’s some more thoughts.

In twenty years I’ve never cared where someone went to med school, or did their residency, or whether they’re an IMG, or whether they’re a DO or MD.

I care about what kind of doctor they are, who they’ve become. 8/

The fact that their education tells me nothing about their skills as a doctor, should tell you something.

It isn’t that they conquered some distant mountain peak.

They’re in the same ocean as I am, as we all are.

All that matters is what kind of doctor it makes them. 9/

There will be things that tend to happen. You will do worse than you thought on a test. You will do poorly, and have bad days.

Some days you’ll swear the entire floor saw how bad you did something, and everyone laughed.

Nobody will remember, twenty years from now. 10/

And while you’ve been worrying about a million different things, and facing a million different hurdles, something else has been happening.

Something amazing.

You’re becoming a doctor.

It started long before med school, when you started becoming your own person. 11/

It’ll continue long after med school is over, because you never stop swimming, and the ocean is endless.

Because the ocean isn’t just medicine, is it? It’s knowledge. It’s humanity. It’s life.

There will always be another exam. Another test, another trial.

That’s life. 12/

Use the ocean. Strengthen your lungs, learn to breathe deeply. Learn to go with the currents, and learn to fight them.

Learn to help each other, because we all tire, inevitably.

And know that you are essential, and you belong here, and you aren’t alone. Never alone. 13/

Yes, there are sharks in the ocean, yes there are monsters in the deep.

Yes, it’s possible to drown in this ocean.

The system isn’t perfect. It wasn’t perfect twenty years ago. It needs to change. It needs to measure better things. It needs to teach better things. 14/

I’m no medical education expert. I can’t pinpoint what needs to change. I just know that it needs to.

You might argue that you can’t change an ocean.

Maybe.

But you can swim faster, and stronger.

You can build better boats. 15/

No matter where you go, what doors open or close, you’ll be okay.

Remember why you’re here.

Remember who you are.

You belong. You always did.

There are people you don’t even know exist, who will someday be counting on you.

Now dive in, we’re all here together.