Admin doesn’t want you to know… (1)

Welcome to a new miniseries: “Admin doesn’t want you to know”. It isn’t that there are deliberate secrets in the medical community, just some things you only learn along the way. Some of these insights concern the profession, some are about school, and others are more personal. So without further ado, here’s your first lesson from the hidden curriculum:

Admin doesn’t want you to know…

Half of what we’re taught in med school is wrong, we just don’t know which half. I decided to start with this trite truism because it was actually something an administrator at UWSMPH told me in my first week. (So I guess Admin does want us to know this, but not to actually believe it because then we’d waste too much time guessing which half.) He followed up with the classic story of how stomach ulcers were shown to be caused by bacteria, and not stress like everyone thought. So the more I learn about the human body, the more awed I am by the privilege to be among one of the few generations in history to understand even a little about how the whole thing works. But the more I learn, the more skeptical I become as well. The more I realize that we really only kinda understand what’s going on, and despite our best efforts, most of medicine is still just treating the symptoms. So an exciting prospect for all med students should be the opportunity to challenge what we are taught. It is our duty as physician-scientists practicing evidence-based medicine to acknowledge and confront our own limitations.

Unfortunately…

The medical community is notoriously slow to admit when we were wrong. Many revolutionary scientists and physicians have lost their careers for promoting unpopular opinion, even if their theories were later embraced (hand washing between deliveries, for example). This truth is hard to acknowledge because consciously we all embrace the scientific ideal that better evidence means admitting we might have been wrong in the past. And yet in practice it is incredibly difficult to regard our own knowledge with humility. That is part of the reason you see so many “expert opinions” that are totally contradictory to one-another. For the sake of our own happiness and the health of our patients, it is vital to reject a false sense of certainty.

Be humble. Accept that even after a lifetime of study, we’ll barely scratch the surface. And don’t give up on learning just because half of what you learn is wrong.

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