Feeling Of Knowing Nothing

[Arztin]

Hi,

I'm mostly asking this to senior med students and residents.

I just finished my M1 year and I feel like I know nothing.

I'm trying my best to retain what I learned, but I feel like I'm failing to retain information as well as I should.

I do realize that most junior med students are feeling this way too, but it's not a feeling I like.

 

So, my questions for you "older" folks are: 

- how do you deal with the constant feeling of being inadequate and feeling like you know nothing

- how did you eventually manage to retain information

 

Thanks.

---arz

 

[Renin]

1. There will always be people who know more than you.

2. There will always be people who know less than you.

3. You will always know more about SOMETHING than someone else.

4. You will never know more about EVERYTHING than someone else.

5. When you are a M1, you think M3's are the bomb.

6. When you're a M3, you think PGY1's are the bomb.

7. When you're a PGY 1, you think damn, those PGY4's.

8. You forget how little you knew as a M1.

[a1b1]

Ya i have the feeling too sometimes. It gets better in 2nd year thought once you know more stuff. A prof even told me that this feeling is going to last a long time, even when you finish residency appearently (she was a family dr). I personally feel like its normal to feel this way, given the current curriculum of doing 1 month of cardio, endo and gyneco... you cant be expected to become a cardiologist, endocrinologist or gynecologist after 1 month.

[samy]

I felt the same 3 years ago after my M1 and most of M2... and most of M3. I think we all feel this way somehow.

 

The biggest shock is when you start your clerkship and hit the clinical world. You realized quickly how little you learn about "real" things. Fortunately, residents/attendings know that you are starting and have very little expectations. Within no time, you will learn a huge amount. The feeling of of knowing nothing will stay, but your knowledge will grow. Someday, you will be the only one to know an answer to a tough pimp question.

 

What Renin wrote is 100% true. You can not know everything about topic X.  Work hard and read every day. It will pay at the end.

 

I am starting residency this week. It will be quite a shock on my first day. I will too feel like I know nothing !

[thatonekid]

For the feeling of knowing nothing, I think the main thing is to remember that you know SOMETHING. It may not be the exact thing you need to know, but it's something to build on. I don't want to say 'you need to accept it', but I think there's something to be said about being ok with not knowing all the stuff. Personally, it drives me to study and be better for my patients and their care.

 

You'll be surprised how much you actually know when you get to clerkship. It's more application of the material, and I think this allows people to retain more. It's no longer simply learning information; it's coming across a presentation and recalling a time where you used a framework to treat a patient.

 

It gets a tiny bit better every day and you don't notice it as it's happening, but like Renin said, you'll look back and realize just how much you actually do know!

[ellorie]

I think you just get used to the anxiety of always having to try a little harder and reach a little further.

 

I have a deck of index cards where I try to write down compliments people give me or times I knew something or did something cool, so I can look at it when I feel really down on myself.

 

Remember that nobody expects you to be an M3 or a staff physician or a resident right now.  All you have to be right now is an M1, and when you're an M2, all you'll have to do is be an M2.

 

Also, you will remember things better when you're a clerk and things are in the context of patients and actually doing the tasks.  When the context comes up, you'll find that things come back to you.

[samy]

I have a deck of index cards where I try to write down compliments people give me or times I knew something or did something cool, so I can look at it when I feel really down on myself.

 

When I have a bad day I usually look at this video a few time. Cheers me up, slightly.

 

[LittleDaisy]

Thank you for the video Samy. I almost died when I was a teen, for now, I am simply happy that I am still alive and can still enjoy little moments in life

When I have a bad day I usually look at this video a few time. Cheers me up, slightly.

 

[shikimate]

It's hard to remember information without clinical context; on the other hand, for example once you see someone with ascites and jaundice in late stage liver failure, I guarantee you'll remember forever what ascites and jaundice is like (and logically why shifting dullness makes sense etc). Just try to see and absorb as much as you can in M3 and M4, those are two best years of learning. 

 

Also as a med student you are expected to know the high yield knowledge like common causes of liver failure, rather than relative risk from the newest studies on liver failure. To that end it's very much like music, where in school the emphasis is on high yield pieces like Chopin's etudes. I will mention First Aid (especially for Step 2CK and CS) and Case Files again because I believe they are superb study and summary resources for all stages of med school, very much like Chopin's etudes. 

[ralk]

This is pretty much what everyone goes through.

 

As some posters have pointed out, this is partially due to simply being early in training - you'll know less than you think you should, but you're really on track. It's also a reflection of the immensity of medical knowledge. None of us will be true experts in all medicine - at best, we'll be experts in one small area and initiates in the rest. Many practicing physicians have forgotten what you've learned in your first year and they do just fine.

 

Part of that feeling also comes from the way preclerkship is generally taught. As shikimate says, without a clinical context, it's hard for that information to be retained. There's simply nothing to anchor those facts in your memory. The "drinking from a firehose" approach that most med schools take to preclerkship contributes as well - schools overload you with more information than any normal person could possibly retain. It might seem like you're not retaining much, but the small percentage you are retaining adds up to quite a bit. One of the issues with this approach is that what you retain may be markedly different from what others retain, so it does make it a bit difficult to determine where you stand.

 

Bottom line is that everyone goes through this to an extent. As long as you're keeping up with your class (ie you marks aren't dramatically behind the average), you're doing fine.

 

For me, it helped to do some reading outside what was required for class. It let me direct my own learning a bit and solidify small portions of medicine in my head that class so that, if nothing else, I knew those small portions well.

[Harvey Specter]

How it feels to know nothing:

[Renin]

How it feels to know nothing:

 

HAHAHAHAHA. +1.