Why medical students are so insecure

I'm not too familiar with the administrative logistics of medical school in other parts of the world, but here in the UK, when you start a new placement or rotation, your large year group gets divided into smaller groups called 'firms'. These can have between 5 and 10 people and you are often attached to a particular consultant (or group of consultants) and have a similar timetable for teaching. This makes sense considering my year group is made up of about 300 people spread across various hospital sites. How else would we learn anything useful?

The benefit of this kind of small group teaching is that you get to know your group a bit more so you aren't afraid to ask stupid questions (even though we all know those don't exist.... um yes they do, we'll get back to that later) and have more one on one input.

Now enter another phenomenon, less talked about but very well established: Comparison. What can influence the dynamic of a small group is this need we all have to prove to ourselves and everyone else that we deserve to be here just as much as the next person. This often takes the form of relentless comparison of oneself to one's peers and a small group is the best place to do so.

The root of this comes from the fact that once you get into medical school, 

"noone one cares about what you got at A levels"

-according to a lecturer on my first day. And this is true. This level playing field does provide, however, the perfect foundation for a new elite to arise. We are all 'smart' but what causes the cream to rise to the top is clinical placements. Pre-clinically, noone really knows each other's true capabilities but there's nowhere to hide when you get asked a question in front of a patient and your peers.

So back to insecurities and comparison. Part of the reason we all experience the massive highs and lows of medical school is because we constantly compare ourselves to the next person. How do I know this? Because I have heard one too many stories (and told a couple myself) about that person that got that question wrong but they should have known the answer because it was soooo easy. Or the person that asked that stupid question: "like seriously how could you not know what first line treatment for C. diff infection is?" We gloat in this kind of self-made glory because well of course we knew the answer.... that time.

But because we constantly mentally degrade our peers vying for a place on the imaginary heirarchy we have created, when the tables turn, we face this steep descent into despair that we will never be more than average. 

Dreams are crushed everyday. Sometimes just with one wrongly answered question.

Moral of the story? Comparison is the thief of joy. Best to stay away.