​Resolution – Setting Goals in Medical School

Well, it’s nine days since we dropped the bell, rang the gong, and stayed up way past my bedtime to ring in the New Year. I hope you had a happy one. And with the New Year, I’ve been thinking a lot about resolutions-you know, those things that make the gym really crowded for exactly two weeks. I never used to write resolutions at the beginning of a year, but I’ve taken up the practice in recent years. I find it cathartic to reflect on the past year-where I succeeded, where I failed-and look forward to what I want to accomplish in the New Year…

 

I’ll admit, I’m not the best at writing resolutions by any means-I like you take on more than I can chew, or am too vague in my goals. But here’s the kicker-goals, even vague ones, are a lifesaver for the aspiring physician. It’s not a secret that the life of a physician is hard-both the getting there and once “arrived” (though you never really do arrive, but I digress). So today, instead of giving you “7 Tips to Making your New Year’s Resolution Stick” (Buzzfeed can handle that), I want to express why goals-even the ones we fail at achieving- are so incredibly important to the life of a medical student.

Yes, we’ve all been to the assemblies, the pep rallies, the endless professional development courses. They all talk about setting realistic goals and expectations with small goals along the way. I agree with their professional expertise 100%. However, what these gatherings and motivational speakers fail to express, much to our detriment, is that the deep-seated hunger to achieve interwoven into the DNA of virtually every medical student is integral to our mental, emotional, physical, and intellectual health. Allow me to explain. You see, we medical students, though not the special snowflakes we thought we were, are still pretty stinkin’ awesome. We are particularly characterized by a drive to pursue excellence. It’s a good and powerful quality that can’t be taught-that intrinsic fire in the belly that pushes us to compete against ourselves to become our best selves. And such a trait has served us well-it’s challenged us to excel in school (which is why we’re here in the first place), to participate in activities we are passionate about, and to defer instant gratification (like excessive partying, traveling, making money) for future reward (the privilege of being a physician). It’s a trait that is wired into our DNA, and at least from my perspective, often I find my self-worth and well-being in my achievements, talents, and abilities. Obviously this isn’t the best-case-scenario by a long shot, but if we’re being completely honest,  we often find our identity in setting goals and achieving them.

The problem isn’t the goal setting-that’s a very good thing. The problem is that medical school is fundamentally designed with few tangible goals in mind. The feeling of running on a treadmill and never going anywhere is real in medical school. Every exam block feels very much like a slog, where we are “just trying to get through it”, because we know after that block of exams is another one. Or when you feel you’ve mastered “Content Y”, it’s already a week later and everything has moved on. Rarely is there a time to celebrate the goals you achieve, so it often feels as though nothing has been accomplished. It’s hard to receive a feeling of accomplishment when there is nothing to show for it except for a percentile score posted on the blue-haze of the computer screen. I often find myself feeling like I’ve done all of this work studying and have nothing to show for it. While this couldn’t be further from the truth, my internal emotional experience doesn’t correlate with objective reality. The fact of the matter is, I accomplished a lot-I learned some very difficult content. It just doesn’t feel like I achieved that goal, that I scratched off that resolution. We have difficulty seeing the hurdles in our way as accomplishments in and of themselves, because the finish line is so far away. This in turn, is quite discouraging, and so we choose to set fewer goals, which causes us to work less, and it ends up biting us in the back-end in a downward spiral that can cause even the most stalwart of us to doubt ourselves and shut-down.

So why set goals at all if we are going to fail? Or if not fail, why continue in setting and pursuing goals when we rarely experience the emotional high that pushes us to keep going? It’s not because you “owe” it to anyone to finish medical school well- not even yourself. Heck, it’s not even to prove anything in particular. Instead, it’s because every day in, you have two choices. You can give up and do something else (and let me express that this is not the wrong choice), or you can choose to continue down the path you’re on. Setting goals-even when we don’t experience the emotional high of achieving them right away-is an active step that pushes us, motivates us to make the second choice. Just like motor movements have to be organized and planned in the higher cortical areas before the muscles carry them out, goal setting is an active process in choosing to continue. It becomes a lot harder to quit or give up, when you’ve already made your mind up-regardless of the outcome. That’s why I set goals like “Score an 85 on this next test”, or “study for 4 more hours today”. It isn’t because I have to get those feel good neurotransmitters that tell me I’m a good boy for having arrived at my goal-it’s because it’s a whole lot easier to push myself when I’m already committed in my head and heart.

I’ll leave you with three tips when thinking about goals in medical school:

1. Set up goals outside of medical school-be it athletic, related to a hobby or non-medical interest like learning a language, or what have you.
-This will help support a strong sense of well-being that can carry us through times where we feel like a failure with no end-goal in sight.

2. Remember to reward yourself for the goals you do achieve both outside and inside of medical school-set up imaginary hurdles if necessary. For example-once a week as I prepare for Step 1, I take one evening off and do absolutely whatever I want-guilt free. Maybe I’ll go see a movie or eat dinner with a friend, but whatever it may be I do it at the end of the week to remind myself that I just finished something. Just that tiny motivation can help push me through.

3. Finally, even when it feels like we’re in the garden with the Red Queen, we would do well to remember that this road does end-and that there are rest stations along the way.

We must understand that every step is a victory, an achieved goal, a demonstration of our resolution as we pursue this incredible calling.

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By Matthew Wright – Medical College of Wisconsin Class of 2019, Motivate MD Team

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