{"id":2165,"date":"2016-09-20T11:54:37","date_gmt":"2016-09-20T15:54:37","guid":{"rendered":"http:\/\/blogs.nejm.org\/general-medicine\/?p=2165"},"modified":"2016-09-20T11:54:37","modified_gmt":"2016-09-20T15:54:37","slug":"academic-near-miss","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2016\/09\/academic-near-miss\/","title":{"rendered":"Academic Near Miss"},"content":{"rendered":"
\"Jamie<\/a>

Jamie Riches, DO, is a 2016-17 Chief Resident in Medicine at Memorial Sloan Kettering Cancer Center<\/p><\/div>\n

I began one of my PGY2 medical oncology rotations alongside my co-resident: an MD\/PhD, fast-track (pre-matched into fellowship) future oncologist. Among my three interns that rotation, two were \u201cHarvard kids.\u201d Needless to say, I was intimidated. My colleague and counterpart not only had the entire catalogue of genomic alterations at the tip of his tongue, he knew and understood their implications on disease. I saw my intern having a long conversation with a nurse at our patient\u2019s door, and when I approached to see if there was anything I could do, I observed him giving a flawless lecture on the approach to an abnormal urinalysis and what really necessitates antibiotic treatment. I wasn\u2019t really sure what I could add to this equation. <\/span><\/p>\n

\"ECMO<\/a>

N Engl J Med 2011; 365:1905<\/p><\/div>\n

Over the course of the rotation, I found my place, and we all settled in to our roles. We learned from and taught each other different things. We had sick patients, and we took good care of them. When we felt like we\u2019d exhausted all of our medical options to potentially reverse whatever underlying condition that we were attempting to treat, we would joke, \u201cit\u2019s time for ECMO.\u201d\u00a0\u00a0When the joke began, I knew <\/span>what<\/span> ECMO was<\/em>, but I didn\u2019t really know <\/span>how<\/span> ECMO worked<\/em>. I silently laughed along, certain that my co-resident and intern possessed\u00a0superior understanding of this process and would lose all faith in my future contributions to the team should they become aware of my knowledge deficit. But, as we sat at the workstation one day, my co-resident opened Wikipedia and asked, \u201cHow does ECMO work exactly?\u201d From there, the intern opened a series of diagrams and images, and we stood together, learning. I look at that experience as an academic \u201cnear miss.\u201d <\/span><\/p>\n

(If you’re curious about ECMO, read this.<\/a>)<\/span><\/p>\n

This experience is admittedly mundane, but it highlights one of the turning points in my career. I realized that, for years, I was embarrassed to read<\/em>. The one piece of advice we\u2019re given as trainees is \u201cread more.\u201d It is tattooed onto our physician-in-training souls. And I did read, but I had been reading \u201cin private,\u201d ashamed to admit that any knowledge deficit existed. I was convinced, each time I read, that I was looking something up that \u201cI should already know.\u201d And yet, there we sat for 5 minutes, looking up\u00a0something in broad daylight! <\/span><\/p>\n

\"stack<\/a>I now know more about ways to learn. Working for 12 or 18 hours and attempting to absorb an article or chapter on the subway ride home is self-sabotage. \u201cSpaced learning\u201d is on the rise. Gone are the days of walking to the library to check out a stack of books. Medicine programs (such as my own), major journals, and academic societies \u201cfeed\u201d you information via Twitter. We have infinite access to information in real time and limited time to access it. Despite our own aspirations for perfection, not having infinite knowledge is human. A piece of advice to interns and residents: Ask questions. Look up your own answers. Read more. Let what you don\u2019t know motivate you. Being ashamed to acquire knowledge is a tragedy. <\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

I began one of my PGY2 medical oncology rotations alongside my co-resident: an MD\/PhD, fast-track (pre-matched into fellowship) future oncologist. Among my three interns that rotation, two were \u201cHarvard kids.\u201d Needless to say, I was intimidated. My colleague and counterpart not only had the entire catalogue of genomic alterations at the tip of his tongue, […]<\/p>\n","protected":false},"author":1277,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2],"tags":[17,72,37,69],"class_list":["post-2165","post","type-post","status-publish","format-standard","hentry","category-about-residency","tag-chief-resident","tag-medical-education","tag-resident-experience","tag-teaching"],"yoast_head":"\nAcademic Near Miss - Insights on Residency Training<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2016\/09\/academic-near-miss\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Academic Near Miss\" \/>\n<meta property=\"og:description\" content=\"I began one of my PGY2 medical oncology rotations alongside my co-resident: an MD\/PhD, fast-track (pre-matched into fellowship) future oncologist. 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