A resident shares the surprising value of learning to deal with uncertainty and adapt to unpredictability.
You may have just started your undergraduate studies this year, or maybe this is your last year of undergraduate before entering medicine. Either way, if you’re looking ahead to medical school, I can assure you that it will be an exciting time, when you will meet a group of people with diverse backgrounds and talents, who will be your future colleagues or even friends for life.
At the same time, you will most likely face ups and downs. Along with a lot of rewarding experiences, you will find obstacles that you need to overcome. You will learn new skills, like how to advocate for minorities who need help, how to break bad news in an empathic way, and how to think from multiple perspectives. However, there is one skill that may require you to step out of your comfort zone to learn: the ability to deal with uncertainty and adapt accordingly.
Uncertainty in medicine
People who go into medicine are often the ones who seem to know the right questions to ask during lectures, the right study resources to get and how to choose the right answers on exams. But knowing a single right answer isn’t necessarily what makes a good doctor.
If anything, needing to know the “right answer” — which gives you the feeling of being in control — puts you at a disadvantage when dealing with uncertainty. In medicine, there are situations when there are no straight answers or clear diagnosis. It is also common to see a diagnosis change multiple times as time goes on.
This goes back to an important concept in medicine called differential diagnosis, which is a list of possible diagnoses ranked from the most likely to the least likely. For example, if an elderly person comes to the emergency department with chest pain, the differential diagnosis might include heart attack, pneumothorax, aortic dissection or even shingles. The order of these diagnoses can change dramatically depending on what questions you ask the patient, what physical examination maneuvers you perform, and which tests you order. Sometimes, the final diagnosis may be completely different from the initial differential diagnosis. If you decide to be a doctor, medicine is a career that demands you maneuver through uncertainty and be constantly flexible.
How to deal with unpredictability
With the COVID-19 pandemic, life is filled with even more uncertainty. When the pandemic first hit Canada in March, I was working in the ICU on the front lines, having completed medical school the year before. The situation required me to persistently adapt to the unpredictability.
As a pre-med student, you have had to adapt to unpredictability as well. Many university courses are online now. Your day-to-day routine may have been turned upside down. You may not be able to meet your friends or visit your families.
Change is uncomfortable. However, I encourage you to face the situation with some positivity. Everything starts with a good mentality. It is important to learn to accept uncertainty, because you will be more ready to cope with the unknown once you accept it. Uncertainty is a natural and unavoidable part of medicine. You need to allow yourself to be OK with not knowing the right answer and be willing to make mistakes.
Next is to recognize your emotions. When you become a physician, you will often be faced with emotionally charged and taxing situations. Similarly, fighting against the uncertainty of the pandemic can be emotionally draining. You may be overwhelmed with fear, anxiety and other negative emotions. It is crucial for you to figure out ways that work for you to best deal with these emotions. It might be anything from taking deep breaths to meditating, playing guitar or calling your friends. Last, focus on the present and the things you can take control of and aim for what you can accomplish today given what is happening around you.
I am doing my dermatology residency training now. I constantly encounter the challenges of looking at patients’ rashes and having to generate a list of differential diagnoses. I am learning every day how to deal with uncertainty better and how to best help my patients. The silver lining of the pandemic for you is that it gives you a golden opportunity to learn how to deal with uncertainty in your own way. Grab the opportunity, and you will become a better doctor in the future, because adaptability is one of a doctor’s most valuable traits.
Harry Liu has a Bachelor of Science degree in biochemistry from McGill University and Doctor of Medicine degree from the University of Alberta. He initiated a range of projects in the field of patient advocacy and medical education over the past several years. He is passionate about, and has published research articles about, reducing unnecessary and potentially harmful tests and treatments for patients to improve their health outcomes. He is now a dermatology resident doctor at the University of British Columbia in Vancouver, and he has particular interest in global health and skin of colour in dermatology. You can follow him on Twitter or Instagram (@harryliumd) to learn about his stories.