Association publication from 2019 showed two out of every three physicians screen positive for mental health issues or depression , and medical students have a three times higher rate for suicide than their same age counterparts . Hierarchal systems in medicine have created an undercurrent for learners to view their leaders as infallible and unflappable . We often pimp our trainees in a punitive manner , rather than one to acquire knowledge and pull from previous learning experiences . Our shame prevents us from allowing those we are responsible for to know that we also struggle . This , inevitably , leaves our students , residents and fellows stating to themselves , yet again , “ I am not good enough .”
If shame is the culprit , vulnerability may very well be the cure . So let me tell you my story . I failed the pediatric critical care board exam . Twice . By one question each time . Our board exams are offered every other year at over three thousand dollars per sitting . Redeeming myself was not a quick or painless process . Until I passed the exam on the third attempt , you could not convince me that my partners did not view me relative to my lack of a passing score or judge my medical decision making . I felt like an imposter on rounds , teaching at the medical school , winning awards . To be honest , the sense of being a fraud seeped into the very sense of who I thought myself to be inside and outside of medicine . I sat in meetings listening to how recruiting intensivists and fellow candidates who could pass the board exam was of the highest importance . I would think , “ I am
FEATURE a really good doctor . I know how to connect with patients and yet I can ’ t pass this damn test .” I saw people who were less than stellar at communicating and the nuance of interpersonal interactions sail through exams . With a lot of reframing , therapy , hard work and self-love , I passed the exam on the third ( and final ) attempt .
The people in my daily life , both at work and at home , knew of my struggles around the failures . However , it wasn ’ t until I spoke on imposter syndrome in medicine to a group of medical students and told my story that I was fully vulnerable with the journey and what it cost me . I received a flood of emails from students thanking me for my honesty and transparency . They told me they wished more attending physicians were able to share their struggles so that students did not set such unattainable goals for themselves .
I am not cured of the shame culture and fear of vulnerability , but I am , at least now , aware of it and try to confront it in myself . If we as a medical community want to change the culture of education , improve the mental health of ourselves and trainees , and move forward into a more compassionate future , we must take small strides at sharing our struggles , being courageous enough to be wrong and admit , and strive towards vulnerability . So , I challenge you to tell your story . Maybe you could be the spark that changes the five words someone hears in their head to , “ You are more than enough .”
Dr . Henderson practices pediatric and cardiac critical care medicine at Norton Children ’ s Hospital .
WHERE ARE YOU REALLY FROM ? ( continued from page 17 ) society can drift towards hateful discrimination .
When news broke of the shootings in Asian-owned businesses in Atlanta , I immediately thought of my peaceful , hard-working parents who live in Atlanta and enjoy massages from time to time . When video after video gets posted of elderly Asians being attacked , I think of my grandparents who gently love everyone they meet , who sacrificed so much to come to this country to provide better opportunities for their children . It is horrifying and heart-breaking , but the muted public outcry and the silence from my own medical school has left me with hesitant thoughts : is it okay to feel scared when I walk out in public ? Surely the recent violence , if anything , should jolt us into action and drive the Asian-American community to be more outspoken about injustice in its many forms .
I ’ m currently on my AHEC family medicine rotation in rural Kentucky . Just a couple days ago , I spoke with a patient for some time before the conversation meandered to the topic of the pandemic . He gave me a knowing look before confiding in me ,
“ I was in the military so I know all about the COVID . The chinamen took the virus and tried to make it into a weapon .”
Later that evening , I looked at the census data for the Asian population where I was staying : 0.00 %. I tried not to think about how I may literally be the only Asian in this small town .
References :
1 https :// www . reaganlibrary . gov / archives / speech / remarks-meeting-asian-andpacific-american-leaders
2 https :// www . pewresearch . org / social-trends / 2018 / 07 / 12 / income-inequalityin-the-u-s-is-rising-most-rapidly-among-asians /
3 https :// www . csusb . edu / sites / default / files / FACT % 20SHEET- % 20Anti- Asian % 20Hate % 202020 % 203.2.21 . pdf
4 https :// ajph . aphapublications . org / doi / full / 10.2105 / AJPH . 2021.306154
5 https :// censusreporter . org / data / table /? table = B03002 & geo _ ids = 16000US2179068,05000US21135,04000US21,01000US & primary _ geo _ id = 16000US2179068 # valueType | estimate
Nicholas Chen is a third-year medical student at the University of Louisville School of Medicine .
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