Things Fall Apart

The book by Chinua Achebe describes a man who watches in dismay as his way of life becomes obsolete. The analogy is a pretty good one for 3rd year at the JMP. The first two years, you mosey along, doing PBL like it's a hobby, thinking to yourself how fun medical school has turned out to be. You don't actually bother to remember much from the first year, and you remember a little more from the second. Third year, you begin to realize ways in which some of the common myths passed around the JMP are actually hurting some of its type A procrastinators (hmm, I wonder if I fall into this category).

First, I'm exhausted so please take this post, if you happen to be reading it at the moment, with a grain of salt.

To reiterate: please take this post with a grain of salt. None of these generalizations are subscribed to by everyone, professors and students, in the JMP -- in fact, I think only a few individuals actually believe them. But they have somehow become acceptable to say. I debunk them below.

Top Ten Myths Passed Around the JMP

1. "Don't worry now -- after all, the boards/thesis/exams/wards are a long way away. The best preparation is lots of fun and sleep." This is not true. I cannot even tell you how many times people (including professors) brushed me off instead of helping me find the tools to really learn and make myself a better student. Now, in my 3rd year, I find myself having to correct mid-course. Sleep is important, obviously. But so is taking your work seriously! You're not paying $30,000/year to scrape by.

2. "Oh, whatever -- I barely studied. Who cares, anyway? Screw it." This attitude is addictive. I know I've gotten sucked into it. But really, people? This is not middle school, it's medical school. I realize they both begin with M. But you're still too cool for school?

3. "You'll never know everything, so don't worry about it. Just enjoy it the first time around, it'll be back." Yes, but if you never take the time to understand it when it's fresh and exciting, it'll always be a mystery and eventually you'll develop a mental block, whether it's EKGs, ABG's, or other acronyms that scare you. Better advice would be, "There is a lot to learn, but don't feel anxious. Just take it one step at a time and focus on the task at hand."

4. "Medicine keeps changing. Don't bother to memorize anything." This is something I've heard again and again and again, and truly it does students a disservice. Memorization helps you remember things so that you can understand them the second time around. And glycolysis hasn't changed in my lifetime (or yours, either)! Anatomy? Still the same (evolution isn't that fast). Normal vital signs? Very crucial. So ditch the hippie attitude. It is important and we do need to know it by heart. When it changes, we'll have a basis to understand the change.

5. "In PBL, students call the shots and can learn whatever they want, however they want to learn it." Again, not true. There are standards, they are simply not published. So please, please ditch this myth and the passive-aggressiveness it generates. If you want us to learn something specific, don't use the unit exam to tell us this -- just tell us! Believe me, we won't be offended or crippled by a little spoon-feeding now and then. Getting angry at us when we don't want to 'challenge ourselves' is a failure to recognize a cry for academic, or personal, help. All together, now: 1, 2, 3...HELP!

6. "This is great preparation for the real world." No, this is the real world. I've said this before, and I'll say it again. You don't tell a 5-year-old that learning to write is super easy, so why are they stressing? You don't tell them that a playground fight is no big deal. No, you help them with their writing, even if it takes you three hours, and you clean the wounds from the fight while trying to figure out what's going on with your kids. Here's a secret: medical students are just 5-year-olds who are older. So please accept the fact that for us, life is actually difficult, the demands on our time are perhaps more than we have the skills to deal with, and that yes -- when we're 50 it might be easier for us, but we're still LEARNING. That's why it's called school. So please be patient instead of dismissive when we're stressed or overwhelmed. Of course, that is never an excuse for us to act mean or rude. But realize we're learning more than how to use an iphone app. Some of us are still learning how to keep ourselves clean and clothed.

7. "We have an integrated curriculum." No, we have three arms of the curriculum -- clinical skills, master's thesis, and PBL. They are all vying for our attention (which is very flattering, by the way). They're all useful and exciting. However, they are not integrated. Each arm rarely can describe what's going on with the other two. All of them tend to demand a lot of time and effort. Please don't pretend that you've integrated the curriculum -- you've presented the curriculum to your students, who are integrating it in their studies. But we may as well be taking three entirely different classes in three different departments on three different campuses, because that's how much logistical coordination and effort is required to pull it off. And THAT'S OK. But let's be honest.

8. "We know what you're going through." I appreciate this as what it's meant to be -- a genuine expression of empathy. However, rarely does someone use this when they actually know what I'm going through. Unless you have individually met with a student and figured out how they learn, their academic history, what their home life is like, their level of fatigue, their morals and values, and their other commitments -- then no, you have very little idea of what they're going through. This just sounds dismissive. See #6, above.

9. "Everyone needs a therapist." No. Everyone needs more sleep. Everyone needs food and water and shelter from precipitation in freezing weather. But everyone does not need a therapist. If YOU need a therapist, that's absolutely fine. I like therapists. Hell, I even let them use my bathroom! (That was a joke. Joke. Joke.) But my point is, please, please, please stop telling me I need a therapist. If I've offended you, I'm sorry. Otherwise -- huh? Stress is okay. Sadness is normal. If I feel like I'm sliding, I'll go to a therapist. But it's just rude to assume you know what someone else needs unless you're deliberately trying to stage an intervention. I realize the point of this is to emphasize that MANY medical students go through depression or have other mental health needs, and I think that needs recognition. I just don't need to find a therapist myself to recognize that others might want one! I SUPPORT YOUR DECISION TO GO TO THERAPY. I SUPPORT YOUR DECISION TO GO TO THERAPY. I SUPPORT YOUR DECISION TO GO TO THERAPY. Ahhhh.

10. "If a student doesn't do well on this exam/thesis/final/oral/preceptorship, it must be that there's something wrong in the student's personal life." This is actually not a bad assumption for a professor to make, but it would be a lot easier if they also understood something else: I care about your subject very much. I do not deliberately want to blow it off. But I'm juggling, and sometimes, I cannot prioritize your subject/ball. Sometimes your subject/ball will drop on the ground. I will pick it up, dust it off, and continue to juggle. But until I'm a master juggler, balls are gonna drop. If it belonged to you, I'm truly sorry and will try to do better. But it's really not personal -- it's not about you, and it's not about my personal life. It's purely about my juggling ability.

Wow, that was cathartic. Okay, back to my real life. Which right now involves an emergency nap (we had an exam this morning).

P.S. I just want to say that you rock. That's right, YOU -- mom, dad, brother, friend, partner, unsung professor who really gets it, loved-one-in-some capacity -- you are people I care about, look up to, and try to do well for. Thank you for being there.