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Stanford University School of Medicine

An introvert in medicine, part 2: Updates from the field

More than two years ago, I wrote about some of the obstacles – as well as the opportunities – that introverted medical students face during training. Now that I have many rotations under my belt, it’s time for an update about my experiences on rotations, along with some helpful advice to newcomers.

The Challenges

First, the challenges: Medical school rotations are very fast-paced, and our team members (co-workers and superiors) tend to change very frequently. This means that, for better or for worse, first impressions matter significantly, and there is sometimes very little opportunity to really get to know one another before you're being evaluated or working together in a critical situation. I do think that introverted students have a particularly tough time in this regard, as we often tend to want time to settle in, gather information, and get to know people so we can best adapt to the environment. Unfortunately, we’re not always afforded that luxury, and our initial quietness can often be mistaken for a lack of enthusiasm or interest, which is a big no-no on rotations. One of my more embarrassing moments on surgery was when I hesitated too long before answering a question, and the attending surgeon snapped sarcastically, “You need to actually talk in the operating room!”

Another challenge that introverts face in some clinical rotations is that the evaluation system gives students strong incentives to impress our superiors by advertising every little task that we accomplish. (In this way, our team knows that we are putting in the extra effort to help out.) As somebody who believes that doing my job well should speak for itself, I’ve had a hard time adapting to this. It feels bizarre to announce out loud every time I spend 30 minutes running around the hospital to make sure that a patient could get his new prescription meds before going home.

The Rewards

When I first wrote on this topic, I expressed a hope that being a good and empathetic listener would carry as much weight with patients as having an outgoing and gregarious charm. Thankfully, I’ve found this to be overwhelmingly true. Spending time one-on-one with patients remains one of my absolute favorite things about my job, and I’ve had more meaningful relationships with total strangers than I ever would have thought possible, made possible by taking time to listen to, get to know, and really understand my patients.

In some ways, medicine sets us up well to succeed in this regard: Patients come to a doctor in a vulnerable state, in need of assistance, and often in times of discomfort or distress. Most patients want to trust their physicians and have a strong need to be cared for. This primes us to have meaningful interactions far beyond what we would normally get from a stranger on the street, or even an acquaintance in a typical social situation.

The Advice

  • Play to your strengths. Know what your strengths are, and use them to develop your own personal style. Not every doctor fits the same mold.
  • Let go of perfectionism. Everyone hates being wrong (especially in public), but on rotations it will happen all the time. Embrace it, learn from it, and then move on.
  • Seek out one-on-one time with your patients. This is where the relationships are really formed -- not on rounds when there are six other people in the room.
  • Don’t sell yourself short. It’s okay to share your hard work and your accomplishments with your team, even if it feels uncomfortable at first. You deserve to get credit for all of the time and work that you are putting in.
  • Remember that you’re not alone. I’ve had a number of peers, attendings, and even administrators reach out to me and share that they have personally identified with this topic. It’s not an accident or a mistake that you’re here, so enjoy the ride!

Stanford Medicine Unplugged is a forum for students to chronicle their experiences in medical school. The student-penned entries appear on Scope once a week during the academic year; the entire blog series can be found in the Stanford Medicine Unplugged category. 

Nathaniel Fleming is a fourth-year medical student and a native Oregonian. His interests include health policy and clinical research. 

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