I had been driving for fourteen years before I moved to the United Kingdom two years ago. Back home in Malaysia, driving had become almost instinctive. It was something I rarely thought about. But moving countries meant starting over. To continue working as a community psychiatry registrar, I needed a U.K. driving license.
Twice I took the practical driving test. Twice I failed. I could spend hours dissecting the examiner’s decisions, but that is not the point of this story. Whether or not I agreed with the outcome, the result was the same: I walked away feeling that a skill I had practiced for years had suddenly become invalid because I had crossed a border.
For the past year, I had walked to patients, navigated public transport, and relied on the kindness of colleagues for lifts. I had worked through rain, hail, and the occasional summer heat because I could not legally drive. The examiner knew none of this. Nor should he have. His role was simply to assess my performance on that particular morning.
Still, failure has a way of following us long after the event itself has ended.
That afternoon, I logged on to teach a group of junior doctors. I briefly considered canceling. Instead, I joined the session, determined not to let my disappointment affect a commitment I had already made. During the discussion, a senior colleague confidently made a statement that contradicted both my recent revision and the teaching material in front of me. Another experienced colleague agreed.
Real physician voices, twice a week
Free, and one click to unsubscribe.
Ordinarily, I would have spoken up. I would have politely questioned the point or suggested we look back at the slides together. Instead, I remained silent. Only hours earlier, I had experienced a very public reminder that I was capable of failing. Although the two events had nothing to do with each other, I found myself wondering whether I had somehow misunderstood what I had revised. Perhaps I had remembered it incorrectly. Perhaps the more experienced clinicians knew something I did not.
After the teaching session, I looked up the evidence. It confirmed my original understanding. What had changed was not my knowledge. It was my confidence. Failing a driving test had not made me a less competent doctor. Yet, for a brief moment, it had made me trust my own judgment a little less.
That realization stayed with me throughout the long flight home to Malaysia that night. The following day, I found myself back behind the wheel of my own car. Sixteen years of cumulative instinct returned effortlessly. My ability had never disappeared. Only my confidence had.
We often talk about the dangers of overconfidence in medicine. Overconfidence can lead us to overlook alternative diagnoses, dismiss colleagues, or stop questioning our assumptions. We speak far less about the opposite problem.
Sometimes confidence can be quietly eroded by experiences entirely unrelated to clinical practice. A failed examination. A rejected application. A difficult conversation. A setback in our personal lives. None of these necessarily diminish our competence, yet they can make us hesitate when we would otherwise have spoken, questioned, or contributed.
Looking back, I do not regret failing the driving test nearly as much as I regret remaining silent during that teaching session. Not because I needed to be right, but because I had allowed an unrelated disappointment to dictate how much I trusted myself.
Competence and confidence are not the same thing. One can remain intact while the other quietly slips away. Perhaps that is something we should remember, not only for ourselves, but also for the colleagues who may be carrying invisible disappointments into work each day. We readily recognize the risks of misplaced confidence. We should also be mindful of misplaced self-doubt.
Crossing a geographical border did not erase sixteen years of driving experience. Neither did failing a driving test erase my clinical judgment. For a brief moment, however, I allowed it to convince me otherwise.
Loshi Rajen is a psychiatrist in the United Kingdom.
