Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

A trauma surgeon reflects on the Yale System, 20 years later

Ara Feinstein, MD, MPH
Education
June 14, 2019
Share
Tweet
Share

The best lens for reflection is to be immersed in the places and people that spawned those memories. Why else would reunions matter? Twenty years after we graduated the Yale School of Medicine, I found myself on campus embracing my classmates again. But it didn’t take long before I felt something creeping up behind the celebratory mood. Amid storytelling and laughter, I couldn’t help reflecting on some of the more difficult parts of my journey there.

I’m still not entirely sure how it was that I was accepted to Yale. I experienced academic success as an undergraduate at the University of Arizona while jumping through the requisite hoops of research and volunteering. I also benefited from being the son of a surgeon, which allowed for an early focus on becoming a physician. That said, I recall an embarrassingly naive sense of confidence that would lead me to apply there for early decision.

In designating Yale as my early decision school, I was forbidden from applying to other institutions until a decision about my application was rendered. The majority of schools had rolling admissions policies, which meant that most spots are gone for applicants late in the cycle. If I was rejected at Yale, I might not be accepted anywhere.

Why take such a risk? In researching medical schools, it became clear to me that there was something very different about Yale. The “Yale System” professed that the practice of medicine is collaborative, not competitive. Students historically learned in an environment where there were no grades, no tests, and no class rank. Instead, students were expected to learn with and from each other, not at each other’s expense. By demonstrating how much I wanted to go to their medical school, I hoped they would take a chance on me. It paid off, and I was accepted to the Class of 1999.

I recall an early meeting in the auditorium where the admissions director gave an accounting of our small, hundred-person class. Roughly two-thirds were standouts from the Ivies, Stanford, Berkeley, MIT and the like. Several already had PhD’s. They had survived wars and cancer. They had started foundations and flown fighter jets. They were star athletes and accomplished artists. They had published papers and won prizes. In one way or another, many of them had already made a mark on the world.

My hubris at being a state school superstar mostly stemmed from my serial procrastination that was mitigated by pulling all-nighters and acing exams. As excitement gave way to the monumental task of learning to be a physician, I noticed that my peers’ questions were articulate and insightful. Their answers to instructors’ queries were mature, demonstrating deep understanding of the subject matter. In comparison, I felt childish and lost. I tried to study, but unlike college, there was no assigned reading material. Without being told what to memorize and regurgitate, and in the absence of a looming exam that actually mattered, I floundered.

We had “optional” exams so we could gauge our progress, but they were anonymous and didn’t count for anything since there were no grades. Paradoxically, my classmates studied harder than I had ever seen anyone study before. By the time our first “exams” came, New Haven had grown grayer and colder. My scores, which no one knew but me, were abysmal. It was a secret, devastating academic failure. In its wake, I remember sitting at my desk, anatomy books open, staring out the window of my dorm room. I wondered if I had made a terrible mistake.

That’s when I decided to ask for help. I reached out to my classmates. I asked what books they were using. I asked how they studied. Someone taught me to make a reading schedule. I adopted a classmate’s policy of passing on social events unless I had completed my day’s tasks. If I didn’t understand a concept, I would ask a colleague that did. What better person to ask a question about neuroscience than the guy who already had a Ph.D. in neuroscience from Stanford? I shadowed my studious friends, plopping down my books where and when they did.

Slowly but surely, I began to understand how and why to learn. It was not about tests, but about knowledge. In retrospect, what my classmates so generously gave me were the tools and discipline to understand medicine. By the time first year ended, I felt like I belonged. Not just in my grasp of the information, but in my attitude towards being a student physician. It became rooted in the idea that time, energy and effort we invest in our knowledge pays endless dividends for our patients. This concept was transformative and to this day underpins not just my high expectations of myself, but also my students and residents.

The late Yale surgeon and author, Sherwin Nuland, summed it up best during a lecture where he admonished us, “People are going to ask you for advice, to make life and death decisions for them and their families. You better know damn well what you’re talking about!”

Spending time with my classmates at the reunion filled me with gratitude and humility. I still appreciate their investment in me. I’m not sure if they would have been so generous with their support if we were competing for a spot at the top of the class. What good would it have done, there amongst the best and brightest, if they didn’t help me?

Being a physician is a journey of lifelong learning, and no one can chart that path for you. The Yale System allowed me to find motivation and discipline with the support of my colleagues. As physicians, we collectively embrace the endeavor to attain knowledge and competence to deserve the trust that our patients place in us. Without the Yale System, I may never have reached that conclusion. When I tell people I went to Yale, sometimes they comment on what an impressive place it is. I always say yes, that’s true to some degree … but it was the people that mattered the most.

Ara Feinstein is a trauma surgeon and physician executive, Banner Health.

ADVERTISEMENT

Image credit: Shutterstock.com

Prev

Death threats won't stop this doctor from advocating for vaccines

June 14, 2019 Kevin 2
…
Next

We are OB/GYNs: What you need to know

June 14, 2019 Kevin 0
…

Tagged as: Medical school, Surgery

Post navigation

< Previous Post
Death threats won't stop this doctor from advocating for vaccines
Next Post >
We are OB/GYNs: What you need to know

ADVERTISEMENT

More by Ara Feinstein, MD, MPH

  • 5 tips on choosing the right medical specialty for you

    Ara Feinstein, MD, MPH
  • Work getting you down? What you watch on TV might be making it worse.

    Ara Feinstein, MD, MPH
  • It’s not hard to do surgery, it’s hard to get to do surgery

    Ara Feinstein, MD, MPH

Related Posts

  • A graduating medical student reflects on the last few years

    Akhilesh Pathipati, MD
  • Why creative endeavors are important for the future surgeon

    Thomas L. Amburn
  • Trauma: Encountering the past in the present

    Anonymous
  • Why is trauma activation so expensive?

    Skeptical Scalpel, MD
  • A code, a trauma, and our fragile humanity

    Amy Blake
  • For medical students: 20 pearls to honor every clinical rotation

    Ton La, Jr., MD, JD

More in Education

  • Why medical student debt is killing primary care in America

    Alexander Camp
  • Why the pre-med path is pushing future doctors to the brink

    Jordan Williamson, MEd
  • Graduating from medical school without family: a story of strength and survival

    Anonymous
  • 2 hours to decide my future: Why the NRMP’s SOAP process is broken

    Nicolette V. S. Sewall, MD, MPH
  • What led me from nurse practitioner to medical school

    Sarah White, APRN
  • Bridging the rural surgical care gap with rotating health care teams

    Ankit Jain
  • Most Popular

  • Past Week

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • How community paramedicine impacts Indigenous elders

      Noah Weinberg | Conditions
    • Would The Pitts’ Dr. Robby Robinavitch welcome a new colleague? Yes. Especially if their initials were AI.

      Gabe Jones, MBA | Tech
    • How to speak the language of leadership to improve doctor wellness [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • How medical culture hides burnout in plain sight

      Marco Benítez | Conditions
  • Recent Posts

    • Would The Pitts’ Dr. Robby Robinavitch welcome a new colleague? Yes. Especially if their initials were AI.

      Gabe Jones, MBA | Tech
    • Why medicine must stop worshipping burnout and start valuing humanity

      Sarah White, APRN | Conditions
    • Why screening for diseases you might have can backfire

      Andy Lazris, MD and Alan Roth, DO | Physician
    • How organizational culture drives top talent away [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why perinatal mental health is the top cause of maternal death in the U.S.

      Sheila Noon | Conditions
    • Why medical student debt is killing primary care in America

      Alexander Camp | Education

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

Leave a Comment

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • How community paramedicine impacts Indigenous elders

      Noah Weinberg | Conditions
    • Would The Pitts’ Dr. Robby Robinavitch welcome a new colleague? Yes. Especially if their initials were AI.

      Gabe Jones, MBA | Tech
    • How to speak the language of leadership to improve doctor wellness [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • How medical culture hides burnout in plain sight

      Marco Benítez | Conditions
  • Recent Posts

    • Would The Pitts’ Dr. Robby Robinavitch welcome a new colleague? Yes. Especially if their initials were AI.

      Gabe Jones, MBA | Tech
    • Why medicine must stop worshipping burnout and start valuing humanity

      Sarah White, APRN | Conditions
    • Why screening for diseases you might have can backfire

      Andy Lazris, MD and Alan Roth, DO | Physician
    • How organizational culture drives top talent away [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why perinatal mental health is the top cause of maternal death in the U.S.

      Sheila Noon | Conditions
    • Why medical student debt is killing primary care in America

      Alexander Camp | Education

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Leave a Comment

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...