Match Day, which rolled around this year on March 15, is arguably one of the most important days in a doctor’s life.
On that day, medical students across the United States open cream-colored envelopes to learn what hospital residency programs they will be working in for the next few years. About half get their top choice. The rest don’t. It’s a small bump in a long road that’s sure to have bigger ones.
Remembering full well how difficult medical school was, I commend all of the students who are headed toward graduation and their first jobs as doctors. But as they celebrate their success, I think they should take a moment to acknowledge the flip side of success: failure.
Some medical students felt failure on Match Day by not matching at their top choices — or not matching at all: About 1 of 20 U.S. medical students don’t get an invitation to join a residency program. Other physicians-to-be don’t experience failure until later.
I’ve met many brilliant medical students whose vocabulary doesn’t seem to include the word “failure.” They embraced endless nights in the library, sacrificed countless sunny afternoons to studying, and worked very, very hard to do well in high school, college, and medical school, surviving a gauntlet of lengthy standardized tests along the way.
Many young physicians jump through all the hoops with flying marks. That’s why we need to train them for when they miss the mark, as they surely will. Failure can hit them the hard.
So I want to ask all future doctors to look forward to the failures that lie ahead.
Despite your best efforts, some of your patients will die — mine have. You will sometimes anger your patients or their family members or not be able to resolve their fears — that’s a gut punch. At some point you will disappoint your patients and, equally jarring, yourself.
You will break promises to come back to a patient and explain to her the implications of a diagnosis. You will fail to put in an intravenous or central line, or cause a patient excessive pain while doing so. Cancer, heart disease, and infection will get worse despite the treatments you recommend.
Mistakes are failures too. You will prescribe the wrong medication, or the wrong dose of one. You will overlook crucial blood tests. You will overdiagnose some patients and miss diagnoses in others that, in retrospect, were the size of barn doors. You will have cases that you run through your mind again and again thinking, “If only I had …”
You will try your hardest not to do any of those but they will happen anyway because failure is not just a part of medicine, it is inevitable.
The only way to survive such failures is to learn from each and every one.
Medical students often model their future careers on the idea that doctors are black boxes into which symptoms are fed and diagnoses and treatments emerge. That’s why I believe the doctors of today need to share with the doctors of tomorrow that they are allowed to be — actually need to be — human and sometimes fail. I have struggled to be the doctor on a pedestal in my head, and so will you.
I urge you to pay heed to the words of Henry Marsh, an English neurosurgeon, from his every-doctor-must-read memoir “Do No Harm: Stories of Life, Death, and Neurosurgery,” about his decades-long career: “It’s not the successes I remember … but the failures.”
In the aftermath of Match Day, you deserve to revel in your achievements. But keep your eyes on the long road ahead and prepare for future failures. By embracing them you will become the doctor you yearn to be.
Martin Kaminski, M.D., is a resident in internal medicine at Cambridge Health Alliance and a clinical fellow in medicine at Harvard Medical School.