I am both relieved and nervous because they say that the first year is the worst, but now I have the overarching cloud of doom following me around during second year: Step 1.

Now that I’m home, I constantly am wondering how I made it this far — in disbelief that I passed all my courses pretty well. I constantly ask myself if exams were too easy and if I’m just getting lucky. Then I remember the countless obstacles I had to overcome while living alone in medical school, and I realize that the potential of human beings is absolutely remarkable. I lost my entire world and my best friend in my first semester. I didn’t get to say goodbye to my grandmother, and I didn’t get to hear her voice one last time.

Instead, I had to pick myself somehow up and learn the complex physiology that we were lectured about that day. I took quick breaks in between to allow myself to cry and pray for her. And I continued studying. I understood that medical school would take away your social life almost entirely. But no one told me that you wouldn’t even be given the time to mourn. It hit me months later during winter break that she was gone because that’s when I had completed my first semester. So I spent my break every single day mourning and looking through pictures of her. Although it’s not the best way to spend a break, I think that’s what I really needed more than any vacation. My grandmother was a victim of inadequate health care in Lebanon. I wonder what her doctor thought of himself during medical school. Was his ultimate goal passing exams and getting that financially secure job? Or was it learning everything he possibly could in the most effective manner to use that information later on when lives were on the line?

So, I think succeeding during my first year was way more than luck. Once you absolutely love what you’re learning and doing for a future job, you start to excel. I thought about my future patients that would be in my grandmother’s position and how they would’ve wanted me to give my classes my absolute best. They deserve the highest quality of care once they trust me with their lives. This mentality allowed me to power through every challenge I encountered and every bad day I had where I couldn’t just take a day off from studying. It’s a constant struggle of recognizing that my hard work (not my luck) allowed me to conquer the most challenging exams.

This reminds me of a class I had one day during my master’s program over a year ago. It was about something called imposter syndrome.

Imposter syndrome is when an individual tends to label every single achievement or success in their life good luck. This person spends their life thinking that their accomplishments are attributed to external circumstances, rather than themselves. Then it hit me that every single time I’ve ever obtained or accomplished anything in my life, the first sentence I’ve ever uttered was, “Wow, I really got lucky this time.” I realized that in my entire 24 years of existence, I don’t think I have ever actually appreciated my hard work. And it’s one of those things that is easier said than done — if you actually sit down and think about it — how many times have you received a rare job offer, for example, and immediately thought they accepted you just because they needed to fill an empty spot or because they needed to fulfill some racial requirement so that the school checks off their diversity box? When instead you should be considering the qualities that they found admirable and worthy of that position, or because they saw your inner potential — your ability to excel and overcome difficulties, and most importantly, what a great addition you’d be to their institution.

It’s positive and constructive thinking like this that allows others to thrive and achieve their seemingly impossible goals. So acknowledge yourself. Acknowledge the blessings that have allowed you to reach wherever you are, while simultaneously recognizing how incredible you are and how hard you’ve worked. After that, I’m sure life will get a million times better.

Batoul Harissa is a medical student who blogs at With Beautiful Patience.

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