On Learning Medicine

I introduce myself as the preceptor working with medical students, then step back to the rear of the room. One student begins to take the patient’s history, listening intently while scribbling notes. The other follows with the physical exam, auscultating the chest, palpating the abdomen and verbalizing their impressions.

When we step back into the hallway, the students turn toward me to present the patient. They glance at their notes and piece together the story, pausing occasionally as they search for the right words.

During residency, I volunteered as a preceptor for the Transition to the Wards course at The Johns Hopkins Hospital, a curriculum designed to help second-year medical students prepare for their inpatient clerkships. This experience has given me room to breathe amid a demanding work schedule. Just as importantly, it has offered a chance to remember the first steps of a path I am still walking.

Five years ago, I stood where they stand now.

I followed the OLD CARTS mnemonic to assess the patient’s symptoms, onset… location… duration... and methodically moved from one question to the next. I worked my way through the physical exam just as I had rehearsed in the classroom. But when it came time to present to the preceptor, my thoughts tangled, revealing gaps I had not learned how to bridge.

Much has changed since my first patient encounter. I graduated medical school, survived intern year and made it more than halfway through residency. I now serve as a primary care provider, lead ward teams and work overnight in the intensive care unit. From the outside, these feel like clear milestones. From the inside, the core experience of learning medicine remains unchanged.

I still feel the unease of meeting a patient for the first time. I grapple with physical exam and lab findings that challenge my working formulation. I hesitate through presentations, revisiting the plan and wondering what I could have done differently. Even as my understanding grows, certainty never quite settles.

Becoming a doctor hurts, each day, at every step.

Precepting for the Transition to the Wards course has been a quiet reminder to trust the process. I know that these medical students will become competent physicians and leaders in their respective fields. Through that same lens, I can extend that confidence to myself, and to the version of me from five years ago, each of us learning to belong in these spaces.

This course has shaped the kind of educator I hope to become. During my most vulnerable moments in training, what grounded me were my teachers who acknowledged my strengths and showed faith in the person I was becoming. I try to offer medical students that same steadiness, observing and naming the growth they may not yet see in themselves.

As they transition onto the wards, I hope they carry that trust with them. And as I continue forward myself, I hope I do, too.

Related content

• Transition to the Wards: A Pivotal Point in Medical School Training
• On Being an Intern
• Mindful Moments in Medical School

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