“Are you the medical student?” the resident asked me in between bites of his vegetable lo mein. We were in the hospital conference room, and I was sitting at the table by the projection screen while he was scarfing down a quick meal before the noon lecture. “Actually, I’m the attending,” I replied. He paused with fork in hand and turned beet red. “Sorry,” he murmured.
I couldn’t blame him for his mistake. I was wearing an open-collar shirt without a white coat and carrying my personal items in a backpack; I even had my helmet resting on the table after bicycling to work that morning.
As a young faculty member at an academic medical center, I am routinely reminded of my age. Patients, in a respectful but inquisitive manner, often ask me about the date when I finished my medical training. It doesn’t help that I physically look even younger than I am, particularly in this world of medicine in which we (rightfully) acknowledge the myriad ways in which advanced age and experience can be of tremendous benefit.
If each of us thinks about our greatest mentors and role models, more often than not, we gravitate in our thoughts towards clinicians in their 60s, 70s, and beyond. This makes sense intuitively for a number of reasons. First, experience in clinical medicine, by necessity, comes with time, and older physicians have gained much knowledge, skill, and success in their journeys caring for patients. Second, we naturally equate seniority with professional excellence, and this association is reinforced by seeing many older physicians serve as keynote speakers and award winners at national meetings. Beyond these facts, older doctors have the benefit of longitudinal perspective; they have witnessed fads in medicine come and go, and through these experiences, they have gained the valuable ability to see the forest for the trees and realize that progress occurs slowly over time. For all of these reasons, it makes sense that the visage of the wizened older clinician brings a smile to the face of doctors near and far.
Even if you ask many of your patients, you will find that the premium on age is, while not universal, quite common. When referring my patients to other specialists, they will often ask me to kindly “find someone who isn’t fresh out of medical school.” Many patients, particularly those of more advanced age, have stories of doctors whom they have known for decades and with whom they have forged an enduring personal bond. They have seen one another’s children grow up, they have shared stories of family vacations, and they have regularly supported one another through thick and thin. These doctors may even have cared for multiple generations of the patient’s family.
Thus, this can all be incredibly daunting to the young physician. How can we feel confident in our ability to adequately care for patients even while grappling with the reality of our relative youth and inexperience as compared to many colleagues? How can we gain the trust of those we are treating when we ourselves may be struggling with self-doubt? These fears on our part often extend to our role as teachers. Standing before a group of medical students or residents, how can we not feel that we may be better suited sitting in the audience rather than standing at the lectern?
In essence, we are constantly asking ourselves: what do we have to offer as young clinicians and educators?
Well, a lot actually.
If I think a bit more about my interactions with patients, I can come up with several ways in which my youth can be an asset. When I meet a new patient, even one who is older and was with her or his previous doctor for many years, I am excited by the opportunity to delve in, to get to know this person as an individual, to deeply understand the personal and medical history. I try, like so many other young physicians, to approach each patient’s story with a fresh set of eyes. I, of course, greatly value the thoughts and actions of the patient’s prior doctor, but I do not take presumed diagnoses for granted, and I am not afraid to consider alternative ideas and treatment plans.
When it comes to my role as an educator, I see the benefits of being much closer in age and experience to trainees than to that of many of my faculty peers. I am truly able to have the best of both worlds: I can go to my more senior colleagues with questions or to ask for advice, and I can then convey this information at a level that makes sense for early learners. While many great educators, throughout their careers, retain the ability to see things from the student’s perspective, this practice grows harder with time as skills and habits become more subconscious, deeply ingrained, and almost instinctual. For me and many other young educators, we do not have to think that far back to when we were encountering anew most of the core concepts and teachings in medicine. We can place ourselves in the shoes of our learners and understand, on a guttural level, what it feels like to dip one’s toe into the expansive ocean that is the practice of medicine. I feel as though I can walk side by side with the students, residents, and fellows whom I teach as they slowly build the foundation of cognitive skills upon which they will construct memory palaces over the course of their careers.
Finally, on a broader level, young doctors and doctors-in-training can help the field of medicine advance not only through cutting-edge research but also through fresh ideas on what the practice of medicine should entail. The recognition of gun violence as a medical issue, the importance of understanding the patient’s experience on topics like mental illness and substance abuse—these are but a few examples of how young doctors are shaping the future of medicine and helping our practice evolve in step with society.
So while being mistaken for a medical student from time to time may still be somewhat awkward, I have come to embrace both the good and the bad of being a young doctor. In truth, there is so much that we can—and do—add to the world of medicine, and the field as a whole benefits from the balance of older and younger physicians, who each bring specific tools and skills to the table. I may yet be subject to more mix-ups with medical students and trainees, but I can rest assured that one thing now seems clear: age is just a number.
Jason Liebowitz is a rheumatologist.