How do attendings remember it all? (philosophical sorry)

[Hollow Knight]

Howdy docs, I appreciate you guys and gals. I've lurked SDN for a while (I miss Blue Dog.......)

I'm one of those rural people who has always been pretty set on FM. My only reservation is that I question my ability to responsibly master the field.

This might be a stupid question coming from an M3, but I guess what I'm saying is, does it happen by osmosis? Working long hours in training? Do you just keep reading constantly?

I did fine (middle of the pack) in my classes, I passed step 1, and my attendings seem to like me (haven't done my FM or IM rotation yet though). I guess what I'm saying is I just question my ability to recall everything in Harrison's, and I'm wondering if I'll ever feel more confident about it all? I don't want to be an FM doc who just refers everything, but it seems like there's just a lot more to know than other specialties. Maybe It's just my inexperience showing though. I just don't currently see how I'll end up like my genius FM attendings....

Did any of you feel this way as an M3?

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[Sardonix]

My confidence and knowledge was dog poo in M3 due to imposter syndrome, a board score issue, and just being myself.

During residency that persisted, but it improved gradually. Now that I am an attending and seeing my own patients, my confidence and knowledge is dog pee rather than poo, so that's nice.

Key things I've learned is emulate the good things you like from your attendings and don't replicate the bad. Learn as you can, but understand it's a process. Things come with time and repetition. As a student, your job is to learn and study as able. As a resident, it's more of the same but you get repetition--and LOTS of it. You transition from being just a learner to a learner and a practitioner. This is where you build your knowledge and skill base that you will ideally grow as an attending--and foster any bad behaviors or poor coping mechanisms that will affect you going forward, so tend to yourself wisely.

Attendings appear like all knowing bad***es because they are but also because they were once in your shoes. Being smart with a high board score helps, but some of the best docs I know struggled academically and excel clinically. But none of them got to where they are overnight.

Give yourself time and grace. And give us a presentation about your experience during rounds tomorrow.

 

[cabinbuilder]

Seeing lots of patients.
Know what you know and know what you don't. So look things up when you aren't sure.
You get comfortable with your field and what you do every day.
Learn everything you can in residency and don't be a lazy ass because once you are out there, it's on you.

 

[Eysteve228]

I would echo the above and just add that you are going to be in the thick of it in residency to the point that it just sort of... Happens. Students I precept have asked similar questions and I'm only about 4 years post residency so I very much remember the feelings you're experiencing. Study up when you encounter things you don't know (now, as a resident, and as an attending), get as much hands on experience as you can during training and don't be afraid to put yourself out there and make mistakes. Recognize that you'll never know it all and act in the best interest of your patients.

If you keep putting in the work and caring, you really will be amazed years from now when you realize you've become one of those bad ass attendings.

 

[BocephusTim]

Don't wrack your brain with stress and worry over this question. You'll learn what you need to learn as you progress through your career. To be blunt, I don't think I ever met any FM attending who could recall Harrison's cover to cover. So just calm down and sharpen your people skills and keep up on your reading. And always remember there are many thousands of NP's out there doing 95% of what FM's do on a daily basis and they have 1/10th the amount of education and training that you will have when you finish residency.

 

[cabinbuilder]

Plus, the sad reality these days is not how bad ass you are, but is how good your ratings are in the eyes of admins. I could care less about ratings (I can't even recall what the term is right now, that's how much I don't care). I don't even look at my comments because I'm not there to feel bad at work about what I do. I'm there to give good care the best I know how with high volume in urgent care. Take care of your patients well and they will come back willingly and they will tell their friends too.