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The F Word; Talking about Failure in Medicine

The medical profession is one that is based on continuous tests and selection procedures, which starts right at the beginning of a candidate appearing for their entrance examination for medical school, and goes on constantly till about the time the person is associated with this field. This system of continuous assessment and elimination is not just in India, but all over the world. The process, needless to say, is necessary for maintaining standards and ensuring quality, but it may be tedious for medical practitioners.

Adding to this, people associated with the medical profession have to deal with a wide range of serious issues on a daily basis. Their actions have consequences more so on the well-being of their patients and their families. All of this combined brings out the F word into medicine. We’re talking about ‘failure’ here, rather than profanity. It is interesting, how words can be so open to interpretation. The word failure can be associated with anything from failure in clearing a test, to sometimes generating a different outcome than expected, or not meeting the standard required.

The “F” word-failure, is a shocking and taboo word in the world of medicine among medical students and doctors, Intellectual students and academic perfectionists often tend to “strive for the unachievable”, in their personal and professional field, a trait frequently associated or needed in medicine. For individuals who’re as ideal, cannot afford to view failure as an opportunity to learn from their mistakes but instead fuels their anxiety and can damage their self-worth. From another point of view, “The greatest Teacher, Failure is.” Failure helps to learn and adapt. Despite the inevitability of mistakes, doctors continue to work day and night to heal their patients, learning from their own mistakes to find better ways to help the next person who was through the door. Asking for help is not a sign of weakness. It is important to move on and not allow one tiny moment of an individual’s medical career to define them. Sharing clinical errors and experiences in a formalized setting and platform where many others are doing the same can be much easier, even if the topic of failure in medicine may seem abnormally foreign. But medicine revolves around a culture of perfectionism that almost seems anaphylactic to failure and the term “failure” embodies a sentiment of great defeat and rejection that is capable of throwing your life off course.

In a profession, where employment decisions are based on ranking, being competitive can influence an individual’s morals and values needed to be a doctor. The need to be competitive can affect a person’s authenticity, and in the process of scoring points and seeking to distinguish one’s oneself from others can contradict the values of sitting down and speaking with patients, staff, and peers, beyond the point systems. For medical students, guilt is replaced by a stronger emotion of shame, which is a deep-seated feeling that can destruct their self-confidence, driven by the thoughts of how their peers would judge or perceive them. Failing an examination can be a huge shame for them and the cause of the downward spiral in their academic achievements and social and emotional well-being.

Medicine is a consuming and high-stress profession, their work and outside life being blended as one. It’s who they are. And so being able to cope with failure is an important general life skill for medical professionals, because failing in their profession is equivalent to failing in life. Although it is important to raise awareness about the impact of perfectionism, competition, shame, or embarrassment, as they’re unavoidably a part of medical education, it is also necessary for individuals and institutions to drive quality in teaching and learning and how to cope with failures and setbacks with care, compassion, and the right mindset.

The aim is to minimize the negative impact and maximize the opportunity for growth. For a start, counseling and hearing the mentors talk about failure can help normalize and change the perspective of physicians on inevitable events in their life. Formalized sessions, adding them to the medical education curriculum, or discussions on failure by trainees can help a long way. And act as a step in the right direction.

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