Soft skill: Some Med Students Don’t Get It!

The previous post sounds a bit bitter, isn’t it? LOL. Trust me, I can’t maintain feeling bitter for long. It is simply not in my nature.

So I thought this time, I am going to do a helpful post instead. 😀

I am going to talk about the GAME in Medical Studies. The game that most Malaysian medical students who study in overseas don’t seem to understand.

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You see, only stupid people give tips. And I am one of them.

Puzzled now?

Let me explain and demonstrate:

My elder sister is the brain in the family (that’s a bit of a background info for you to know what I am trying to convey). When I was 16 years old and was just in the verge of discovering the torture of learning Chemistry and Add Maths and Physics, I used to ask her for tips.

“Kak Long, macam mana nak belajar Kimia ni? Aku dah baca…bukannya aku malas study pun. Aku usaha macam orang lain juga! Tapi kenapa bila nak jawab soalan, I can’t even detect which parts of the theories is this question testing me on? Like I never ever come across this before!”

Do you know what my Kak Long said. “Just study properly. Just study the book.”

Was my Kak Long helpful, do you think?

Well, I certainly didn’t think so. But now, I understand that it was not her fault she could not understand what I was after.

But when my younger sisters who later discovered the same torture of Chemistry and Physic and Add Maths came to me for tips, I was unstoppable in the current of words that came out of my dainty (really!) lips. I was full of them!

You know why?

Because I was stupid. I went through all the difficulties and the self-reflection necessary in order to understand why I didn’t understand…and therefore I had gone through the steps needed to overcome that difficulties. So I was able to understand what was it that my younger sisters found difficult, and as a result I was able to give them tips on how to approach the problem.

To naturally intelligent people, they have NO IDEA what we are after when we are asking them for tips. To them, all you have to do is study and you’ll get it!

That’s why there exist this really condescending saying which sounds something like this: Those who know, do. Those who don’t know, teach!

All teachers in the world will be deeply offended by such utterance of an  egotistical nincompoop, I am sure. But the truth is, a lot of teachers are really really really helpful to less intelligent students, like me. To naturally intelligent people, teachers were only there to teach the most rudimentary basics of anything, and they will be able to do the rest of the syllabus quite merrily on their own. They are able to GET IT on their own and they don’t even know how they know.

Now, I am here to let you know that I am not one of those  who are naturally endowed with amazing brain prowess. I am here to let you know that as a less intelligent person, we have to use our other talents to acquire intelligence. And my other talents consist of something like this: the power of observation, the ability to imitate, and the natural instinctive knowledge of what I should do to get what the others naturally got.

Fake it, fake it, fake it…till you make it. And never stop praying along the way.

Now, are you ready for my tips?

Before I start spewing all the tricks up my sleeve, I will leave you with these self-reflective questions:

1)Are you a medical student who find theories difficult (that is, Year 1, Year 2 and Year 3 of medical studies) and regularly fail your exams during these initial years.

2) Are you a medical student who always pass all your medical science years but struggle during your clinical years (Year 4 and Year 5)?

3)Are you a medical student who struggle in BOTH question number 1 and number 2?

4) Do you always pass regardless of the theoretical years or the clinical years? (then, these tips are not for you and you can stop reading now.)

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In my opinion, the struggle that people experience during the theoretical years is because they don’t know what to study…not because they don’t study. So if you struggle in your medical studies during these initial years, it’s time you start thinking about strategy and method of study.

Knowledge-wise, we want to be all-knowing without being too exam-oriented. But in order to move on in your studies, you have to be SOMEWHAT exam-oriented…because the truth is things that come up in the exams must be the things that are important to shape you as a a safe doctor, anyway. It’s useless for you to read endlessly about the blood clotting pathway if you have no idea how to treat a patient who is bleeding!

So, you have to decide how in-depth are you going to go for everything that you study, so that you will have more time to study what is indeed important for you to know in greater depth. So, don’t study without any guidance and direction; the self-directed learning propagated by the uni is a load of crap full with haphazard willy-nilly philosophy that’s not gonna help you in answering your exam!

So, listen up. If you have trouble in your theoretical years (after having studied and put in just as much effort as everyone else), something is wrong with what you have studied, the depth of what you have studied (you may study unimportant things in too great details but study important things only superficially), and the way you understand and apply what you have studied (and the only way to tell whether or not you understand something is by doing lots of questions).

In order to know what to study: look at the lecture notes and the learning targets. And ask other people what books do they use to study these things. Chances are, if all of you study the same thing using roughly the same books/materials, you all will be (un)able to answer the same questions; your marks with the rest of your bacthmates will be similar and therefore you will not find yourself outside the bell curve.

In order to know in how much details you need to study: Ask the seniors! Ask me! Ask your kakak usrah! Some people who are naturally intelligent, they don’t understand what you want from them. So be specific about what you want. Don’t just ask vague questions like “Do you have any tips on how to survive 3rd year?” Ask them SPECIFIC questions like, “Do you know how much in details should I cover Rheumatology?  If I only use the Kumar&Clark book, would it be enough? Do you have your notes that I can borrow?”

To test your understanding, you MUST do past-year questions! You must! You may think you understand everything that you have read, but applying that knowledge is the hardest bit. I usually do my past years papers when the exam is near. In the mean time (while studying for specific topics), use books like “medicine recall”  or pharmacology recall”. (it is a question-answer book; the questions and answers are arranged side-by-side. So you don’t have to turn the page around at the back for the answers.You don’t know how many exams this book has helped me through. Get it! And use it, jangan perap dalam almari buat pekasam.)

Now, for the clinical years, the tips that I will write about below will be applicable assuming your medical knowledge is quite good or at least average. But let’s face it, we all forget stuff! It’s not possible to know every single question being fired at your general direction. So, you have to know that knowledge-wise, you have to keep up.

But there are other more INNER issues, more difficult elements that is hard to change because it is not who you are naturally. These things are important but you may not know it because no one has told you. Now, I am being open and honest about this. Now I am telling you free-of-charge what other aspects of being a medical student that you need to brush up and polish other than knowledge. And these things (trust me!) are more important than knowledge alone. How do you think most of us survive clinical years?

Like I said, some people don’t realize the importance of these tips because to them, they have always done it anyway. It’s who they are. They have always appeared confident, presentable, like-able, they don’t tell you all these because they don’t realize that this is helpful. They are the lucky naturals.

If we are not the lucky naturals, we just have to fake it, folks. While you are not a hot-shot consultant just yet, you don’t have the luxury to behave however you like. Once you have reached the top of your game, then you can do whatever you want. For now, you have to follow the unspoken rules of the game, otherwise you will be disqualified even before you sit for the viva exam.

Here’s the tips!

Tip number 1: Medical studies is a game! It’s a game show with some fashion sense!!

This is THE MOST important tips in the clinical years of medical studies. If you don’t remember anything else, remember this tip!

The Medical Game Show (with a fashion sense) requires you to be Presentable and Professional and Put-Together.

I will call this the rule of 3 Ps: presentable, professional, put-together

Now what do I mean?

No, I am not saying you have to go to the hospitals with tons of make up on. I don’t even put on a lip gloss.

What I mean is: all your clothes are ironed and they fit you at the shoulder (but loose in other areas, of course). It’s a CRIME to go to the ward rounds with wrinkled top that looks like it will fit someone triple your size.  I know, you want to look modest. But darling, that’s NOT a modest look you are achieving. You only manage to look like you don’t have enough money to own the clothes on your back and therefore have to wear someone else’s. You should not want non-muslims to look at you this way.

I have seen a very loose, knee-length modest top that looks perfect on a Muslimah and she just looks very good. Presentable and Put-Together; like she actually takes time to THINK about what she is wearing.

And don’t even get me started on your hijab. Again, please iron it! It’s sooo important that people look at this symbol of our Islamic modesty favourably.  It does not matter how lengthy you want your hijab to be; it’s totally your prerogative. The same Muslimah that I mentioned above does wear lengthy hijab too, but it looks NEAT on her.

And please THINK about how you are putting it on. Some girls are just ridiculous with the ‘arch’ of their hijab…some of them pull the arch too far forward until it cast a shadow over their face. What are you trying to do, girl? If you are trying to be modest and hide your face, you should have straight away worn the niqab; then at least people would think that you are indeed trying to be modest. But when you are wearing a normal hijab too far forward until your face is all but SWALLOWED by the arch of your hijab, you are giving a very untidy look. Some would even interpret it as a very un-confident look because it does look like you are ashamed of your face. It does NOT look like you are modest because if you are, then you should wear a niqab instead.

I am sorry but I have to be blunt! You have to make a BOLD statement with your hijab. Don’t do it half way. If you really, really, really want to cover your face, do it properly like the saudi sisters do; wear the niqab. If you don’t want to cover your face and are just wanting to cover your hair as usual, then make sure your hijab does not cast a big grey shadow over your face.  Let them see your natural intellectual thinking expression (lol), let them see the noor in your face as you smile at your patient, let them see the way your expression shows to them that you understand whatever it is they are teaching you during ward rounds (even if you are just pretending to be enlightened, lol).

Tip Number 2: Medical studies is a game! It’s a game of oratory skills.

No, you don’t need the oratory skills of Plato. You don’t even need to talk like your school debater who insist emphatically and emphasize enthusiastically on what is after all an obvious fact.

You just need to OPEN YOUR MOUTH and say things clearly.

Don’t just talk crap! But while talking those craps, make you sure you look like you are confident that they are not craps!

Say it like you mean it! Got it, folks?

Remember one thing! In the clinical years, the examiners are not marking some faceless answering sheets. In the clinical years, the examiners look at you (hence the rule of 3 Ps), the examiners look at your face (hence the rule of 3 Ps and the importance of good hijab hygiene), the examiners can hear the stutter in your answer, the examiners can detect the slightest non-verbal cues of your lack-of-conviction. The examiners become annoyed when they have to say “Pardon me? Can you say that again?” multiple times just because you  have the audacity to MUMBLE and DON’T PROJECT YOUR VOICE loud and proud.

What you have to know is….whenever you have answered some questions, the one thing you NEVER want people to say is “Pardon me?”….it’s always a bad sign! A bad sign with multiple exclamation marks!!!!!!!  It means only two things: 1)your voice is too soft so you better speak up, and 2)your answer is soo ridiculous and out of this world.

Whenever you can, please do whatever you can in your limited human power to reduce the “pardon me” response from your examiners. Because even when your answer is right, there is nothing on earth like  the ‘pardon me’ expression to kill your confidence; except being told straightaway that you are stupid!

I know, it’s hard to sound confident when you don’t know what you are saying. It does require SOME knowledge to appear confident, but not A LOT of knowledge. When I don’t know what I am saying, I too tend to stumble my way through a satisfactory answer.

But the amazing thing is, some people even mumble under their breath for something that they KNOW is right. And with these people, I really feel exasperated with them. WHY??? WHY do you mumble when you KNOW you are right? You are making people think that you don’t know what you are saying. When you act this way, no one will believe whatever you say if you don’t look like you believe it yourself.

So, in order to ALWAYS be able to have the confidence to say things clearly and loudly, you have to always be honest. When you are honest, you will be confident with all your answers and hence it will help you to say things out loud.

1)If you are not sure, admit it and  say loudly and proudly, “I don’t know the answer to that. I will have to look it up. I do know that Haemochromatosis can lead to heart failure. I am just not entirely sure the details of the exact pathophysiology. I have to look it up, I am sorry.”

Don’t MUMBLE, “ehem..well, uh…I think, erm I am not sure.”

2)If you know NOTHING at all, you are not even half-sure, again clearly admit it. “I don’t know. I don’t think I have ever come across that particular fact, before. ” Say it in a nice smooth clear sentence. No stutter, no shame, no embarrassment.

It does NOT matter if others think that “gosh, she does not know??”. Everybody in Medicine knows that not everyone can know everything all the time. What matters is for people not to look at you as insecure and incompetent.That is of the utmost importance.

Tip Number 3: Medical Studies is a game. It’s a game show of discipline and courtesy.

Discipline: The aim of discipline is to give them an overall good impression of you as a student.

-Arrive on time.

-Perform beyond your expectation. There are many rotations that only requires you to attend 30 hours of clinical exposure per week. By right, you should be able to complete those hours in 4 days. But most of the time, I would go the full 5 days anyway because I know the doctors who I attach with will have no idea about the actual hours that the students have to do. All they care about is whether or not you are around and you don’t go missing in action all of a sudden with no explanation.  It’s okay if you want to do only 4 days per week, but you have to make sure that the doctors in your team know why you are not around on the 5th day. Just say, “I am required to do 30 hours per week. So I am thinking to have  Fridays to myself for study time, if it’s all right with you. ” Don’t just decide to not turn up and expect the doctors to know about your course requirement; they are not uni students and they have no idea what you have to do and what you  don’t have to do. In their mind, if you are not around, then you are not around.

Try not to let them have the slightest suspicion about your character, no matter how unwarranted that suspicion is.  Go beyond the expectation.

-Show initiative and effort to ask questions and discuss. Even if you have to ask something that you already know, in desperate cases.

Courtesy: This takes  SOME communication skills. But not much!

– Smile! Please smile! Be approachable. You will be surprised how many people you can tame even before talking to them, simply by smiling. Smile openly, honestly, like you mean it!

Now, I don’t go around smiling to all and sundry. In fact, my mother always says that I am a bit snobbish and not as approachable as my elder sister. “Kak Ngah ni sombong. Cuba tengok macam kak long. Pandai bergaul dengan orang.” But I am not snobbish… I am shy (really); I just don’t like to LOOK shy, therefore I LOOK like I am snobbish, but I am not.

But hey, this is a a game, remember. I can’t go to hospital looking like I don’t want people to approach me.  So, I smile at my colleagues and my superiors as a show of courtesy. A smile of “Look, we are a team, I am happy to work together with you for a few weeks. Let’s make this as fun as possible because we are going to be stuck together, regardless.”

– Greet each other!

How hard is it to make the first move and say brightly “Good Morning!”.  Go to the Nurse Unit Manager who you meet at the morning meeting everyday and say, “Hello, how are you?”. Do some boring small talk before the meeting.

The nurses LOVE my hijab (hence the important rule of 3 Ps). It does not matter if they only say it to be nice. You can return the courtesy many other ways.

-Talk about your patients and exchange opinions.

There’s nothing more effective in endearing you to the nurses other than your concern about their opinion regarding certain patients. I know that you and the doctors know what’s best for your patient, but it’s the nurses who look after their daily needs and their observation chart. Have the courtesy to consult them occasionally and make  their job easier.

Let me put it this way: Doctors are like our fathers at home. And nurses are like our mothers. While we know that fathers are important for the survival and direction of the family, mothers are the ones who run the family. What our mothers want, our mothers get because our fathers’ lives will be difficult without our mothers. So it’s very important to keep mothers happy but at the same time, mothers have to pretend that fathers make all the decisions, lol.

Tip Number 4 : Medical studies is a game. It’s a game show to obtain the ultimate prize: confidence.

All tip number 1-3 are important to get to tip number 4.

Confidence!

Imagine a doctor who is not confident that he hears a murmur. Imagine a doctor who is not confident that the treatment for Myocardial Infacrtion after initial stabilization is aspirin. Imagine a doctor who cannot be confident of his diagnosis (even when all the symptoms and signs are there) and therefore cannot proceed to treatment because he just could NOT be confident!

What kind of doctor would he/she become?

Certain things need practice and a lot of faking…until you suddenly realize that it has become part of you.

A study was done where people are asked to pretend that they are happy and act happy…after a few days they do notice that they begin to feel happy.

Confidence is like that too. If you realize that you are not confident, then this is the time for you to swallow your fears and take the plunge of committing yourself to faking it. One day you will wake up and realize that you no longer have to fake it. It’s become part of you, until even not knowing something, does not rattle your confidence at all because you can simply twist your answer, CONFIDENTLY letting them know that you will look it up; that not knowing something does not mean you don’t know where to look for an answer.

In order for you to improve your confidence, you have to feel good about yourself. If you think you are not confident because you don’t know what other students seem to know, then study, study and study! It will make you feel good because you have taken the steps to improve your confidence.

If you are not confident because you feel that people are always not taking you seriously when you say something at tutorials, then maybe you just have to say it louder next time and give examples and evidence (with references) of why you are right, until they can no longer ignore that you are indeed saying the right thing. If you prove yourself right at least 4 times in a row, people know that you are not someone they can ignore in the future. You mean business, baby!

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So this is what some medical students are yet to understand. People don’t judge you for your knowledge; that comes later. As long as you are not overly stupid and can’t answer even ONE question right, they are not going to penalize you for not knowing.

You have got to master the core HARD skill: knowledge, strategy of studying, improve understanding.

And at the same time work on your soft skill: Remember the rule of 3 Ps, Oratory skills, discipline and courtesy and the ULTIMATE Graduation prize of confidence.

This soft skill is EQUALLY important as the hard skill. You can’t pass your viva without the soft skill. And you can’t pass your paper without the hard skill. And not passing one of them would mean that you won’t pass at all.

No one has ever told me about the soft skill. I work it out on my own and it’s up to you whether you want to believe it or not.  Some people may notice that they lack this soft skill, but astonishingly, they don’t do anything to correct it. They think that by focusing on the Hard Skill alone, they will pass the viva. Trust me, you need the soft skill to reflect what you have of your Hard Skill. If your soft skills are terrible, the examiners will assume that your Hard Skills are terrible too.

Don’t let this happen to you. It’s not fair! Help yourself.