The Seven Habits of Highly Effective Medical Students

Derrick Beech, M.D., F.A.C.S.
Department of Surgery
Meharry Medical College
Nashville, TN

This manuscript represents the keynote address during the Class of 2010 White Coat Ceremony at Meharry Medical College
.

Greetings, Class of 2010!

Two thousand ten – that has a nice ring to it.

I am honored to have an opportunity to address this entering medical school class at Meharry Medical College.  You should be commended on your accomplishments.  Acceptance to medical school is a big deal – this is a tremendous accomplishment.  It is a time of celebration for students, parents and friends.  Thank you for inviting me to celebrate with you and participate in today’s event. I have had an opportunity to reflect on my own emotional state nearly 22 years ago when I entered medical school.  I was filled with overwhelming excitement and nearly paralyzing anxiety.  I suspect that as you sit here today, you too are filled with a myriad of emotions – joy, excitement, anxiety.  It is my goal today to help you strip away all anxiety and nervousness and to help you develop a strategy to achieve your ultimate goal of becoming a doctor.

We all have images of what it is to be a doctor. As you receive your white coat today – understand that the duties of a doctor really relate to an agreement for service.  We pledge to serve those in need of our skills and we also pledge that we will prepare ourselves for this service by obtaining the requisite skills and knowledge to be an excellent physician.

Over the next several months you will be given stacks of course notes, books and materials.  ALL of these require that you memorize and master them in a very short period of time.  You will spend countless hours studying and many sleepless nights preparing for examinations.  You will be pushed beyond what you previously thought was your limit.  So, to prepare you for this, I have extracted a framework for discussion from Stephen Covey’s book.  The medical student version of this will be entitled:  The 7 Habits of Highly Effective Medical Students. Habits are defined as reproducible actions resulting when knowledge, skills and desire merge to create a pattern of behavior.  This intersection of knowledge, skills and desire create a sense of what to do and why it should be done (knowledge), how to do it (skills), and lastly, wanting to actually perform that task and do it (desire).  The seven habits of highly effective medical students are:

1.    Know thyself
2.    Understand the “big picture” – the ultimate goal
3.    Develop a foundation
4.    Plan ahead (for lectures, exams, clinical rounds)
5.    Practice Excellence
6.    Fine-tune strengths
7.    Give your all to every task (Always bring your “A” game)

Habit 1:  Know Thyself
It took me a long time to accept it, but I simply was not going to be the next Michael Jordan.  I had to finally face the fact that a future career in the NBA (or NCAA for that matter) was not going to happen. For starters, I am 5’10” tall; can’t dribble, shoot or rebound a basketball. But like every kid in my inner city Atlanta neighborhood, when I played “ball” I pretended to “be like Mike”.  I would dribble to the hoop with the ball and take it over my head pretending to make a slam dunk or layup –ultimately going up for the power layup.  The tragic reality is that 9 times out of 10 I’d miss the shot.  So, it ultimately occurred to me that as much as I wanted to “be like Mike” it was just not in my future. It became apparent that my God –given talents had nothing to do with basketball (or any sport, for that matter).  Over the next years I have grown to understand my gifts and talents. Eventually, I was able to define and discover my passions. My passions are that I love to teach and I love taking care of patients.

It is very important early in your career development to take a good honest look at the things that make you tick – What are your passions?  What are the things that you enjoy; that you can do everyday, any day?   The trick to understanding your true passion is to ask yourself a few questions.

•    What would you do if money/salary/wealth were not a factor?
•    What would you do if you knew that today was your last day on earth?
•    What injustices do you feel so deeply about that they grate at your very soul?

The answers to these questions will help you define who you are; what you believe and what your true passion is.  Knowing oneself is the critical first step on the journey to becoming an excellent physician.  Therefore, know thyself remains the foundation of all the other habits that follow.  It is the first of the seven habits of highly effective medical students.

Habit 2:  Understand the big picture – the ultimate goal.
A few years ago a woman came to see me in my clinic office.  She was a middle-aged lady who I noticed through the receptionist window as she came through the door struggling to walk.  It was as if she was dragging her leg across the floor.  Her umbrella and overcoat were dripping from the rain – there was a terrible thunderstorm that day. Well, I proceeded to see patients in the examination area of the clinic.  Nearly an hour passed – I had seen 5 or so patients. But I hadn’t seen the woman that I noticed in the waiting room.  I asked my receptionist and nurse what had happened to that patient.  Their response shocked me – it simply broke my heart.

We sent her away because she didn’t have a ‘pre-certification from her doctor’….Now, this poor woman had taken the bus in the pouring rain to come see me at her scheduled appointment time.  My staff turned her away because they had forgotten about the big picture.  The bottom line is that we were there to help patients – primarily those with cancer – but our goal was to serve the patients.  In understanding that the big picture is to use our skills and talents to serve the suffering – not make a bunch of money, drive a fancy car nor strive for prestige or prominence.  But, our goal in the grand scheme of it all is serving our patients and striving for significance.  So what did I do?  Understanding who I am and what drives my decisions – my passion I asked my team to help correct this unacceptable miscommunication.  We packed our medical supplies, patient chart, and notes in the car and drove to this patient’s house in the storm.  This was my first (and only) house call.  We did this/I did this because it was the right thing to do!  Several weeks later after several CT scans, biopsies and MRI’s we successfully resected this patients’ thigh sarcoma and saved her leg.  Again, the ultimate goal of a physician is to provide the highest quality of care to all patients.  So, Habit 2 is extremely important.  You must always remember the ultimate goal and understand the big picture. Avoid having your vision clouded by smaller issues.

Habit 3:  Develop a foundation
It is very important that you dedicate yourself to mastering the basic science concepts – physiology, pharmacology and anatomy.  A strong foundation in the basic science courses will complement the information learned during the clinical sciences.  The majority of care concepts that I use in my clinic practice stem from foundation materials learned during the first two years of medical school.  Remember, the small details that you learn during the 1st and 2nd year of medical school will help you take better care of patients with a deeper understanding of their problems.

Habit 4:  Plan Ahead
This is really self explanatory.  It is an extremely important concept.  Always be prepared – for lectures, for labs, for quizzes and exams, for attending rounds.  Read in advance. Review the lecture material before you attend class.  Planning ahead is an essential habit that must be mastered by successful medical students.

Habit 5:  Practice excellence – it will become a habit.
Once you move through the earlier habits –

1.    Know thyself
2.    Understand the big picture
3.    Develop a foundation
4.    Plan ahead

Then it becomes important to not just perform okay or good, but perform in an excellent fashion.  Don’t accept average – always demand excellence with everything you do.  If you fall short with some of your efforts – that’s alright – just get back up and continue to demand your best effort.  Soon excellence will become automatic.  It will be a part of you – It will become a habit.  According to Aristotle “We are what we repeatedly do”.  Excellence then, is not an act, but a habit.

Habit 6:  Fine-tune strengths
For the medical student this usually comes late in the 3rd year.  Part of this will also include deciding on your future specialty.  It’s important to choose a specialty with a clear understanding of who you are and your passion.  If you are not a morning person or you faint at the site of blood, then a career in surgery is probably not a wise choice.  If the thought of taking care of sick kids bother you, then I suggest not picking pediatrics as a profession.  Plan your career choice based on how you’d like to live your life 20 years from now – then make plans during 4th year medical school to fine-tune your skills in preparation of that specialty.

Habit 7:  Always give your all
Do your best, always!  Understand that your best after being up all night on-call might not be the same as your best when you’re well rested.  And that’s okay – because if you do your very best with every patient encounter or problem then that’s all that anyone can hope for.

I have presented you with the “7 Habits of Highly Effective Medical Students”.  Live them and success will be yours.

I would like to end with a brief benediction:

Robert Powell’s edited version of Martin Shaw’s – Pauline benediction
Go forth into the world in Love,
Heal the sick,
Remember the poor,
Strive unendingly for Peace.
Work wholeheartedly for Justice and
Render unto no one evil for evil.

Learn to receive with graciousness,
To give with joy,
Have patience for those less fortunate or
Less gifted than yourself for you will learn
Kindness begets kindness, as love begets love.

Keep a kind word on your lips
And a dream in your heart.
Cultivate the courage to struggle for the weak and helpless,
Resolve to embrace what is right and good, and
Champion personal sacrifice for the use of equity.
Happiness awaits those who learn the secret of giving.

The success of human civilization will be measured,
Ultimately, by what is assured the least fortunate,
The least privileged, and the least gifted in our mist.  Learn from them.
Let us serve them and all others that suffer.

Thank you for the honor of serving as one of your professors at Meharry Medical College.

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