Shame and Medicine Exeter
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My medical education

When I look back at my early 20’s and my time at medical school, shame overshadows much of my experiences. There is so much joy, and I have been so privileged, but shame has an ability to hide this. I am sure I am not alone in feeling ashamed, embarrassed, or disappointed during my medical degree, but it is rarely talked about, , when we look at wellbeing.

I started medical school with  so much hope for everything I would achieve. I had been scientifically-minded through high school and supposed I would take to learning medicine like a duck to water. My head was quickly turned by endless opportunities. I felt like I was thriving and my self-confidence was building.  Until my mother became ill.

Over the next six years my mother’s health would slowly decline and she passed away in 2018. During her illness I would throw myself into anything that would distract me, whether that was joining every committee that would have me, participating in any event I could, or socialising and often drinking too much. I have always been anxious, but this became Anxiety and Depression. Through all of this my exam results would worsen, and I would eventually fail my 3rd year OSCE causing me to re-sit the year.

All of this made me feel shame. Shame that I wasn’t achieving as I thought I would, but also how others expected me to. Shame that I wasn’t managing my mother’s illness as well as the rest of my family were. Shame that I wasn’t strong or smart or a good person, and certainly not someone cut out for medicine. I remember feeling stuck and seeing no way out. I was too close to everything to see how unhealthy I was being, all I knew is I wanted an excuse not to think about home and also to feel ‘normal’.

The effect of this shame was that I distanced myself from everyone. My shame convinced me that no one cared and the result was a wall between myself and those around me, including my family. I visited home far less than I should have done, sure that no one really wanted me there. I also wanted to hide from them that I wasn’t coping. Shame shut me down, made me selfish, and lost me in myself.

When I failed my third year OSCE and found out I was resitting the year I felt I’d reached a low point. I saw a GP and was started on medication, and I reached out to the university advice and counselling service. They recommended group counselling for me, something I thought would be mortifying but became my safe space for five years. Being in group therapy showed me that, whilst not everyone is dealing with my exact situation, the way our emotions presented themselves were remarkably similar. Every Friday I would laugh and cry with these people, sharing with them things I did not dare share with others. In this space shame and judgement were removed, allowing us to speak with a freedom we often did not have.

I know much of the story I’ve shared above is personal to me but the feelings of failure are known to many medical students. Shame is a common tool used in medical teaching. I know I’m not alone in remembering being stood on wards whilst a senior clinical asked me a question that, I could not answer. When this happened, I would often already feel embarrassed, but a snide comment was all it took for me to want to disappear into my shoes. From personal experience I know when I am made to feel embarrassed I don’t learn. All I do is think about that small piece of knowledge, missing the wealth of other learning available to me.

Through all this I became passionate about medical education. As part of this interest, I did two projects both looking at theatre techniques. One focused on how theatre can be used to teach about suffering and the other was developed a practical workshop looking at unconscious gender bias. Shame came up throughout both projects. We are soaked in a culture at medical school that puts perfection front and centre. When complete perfection is your goal you become ashamed of those perceived faults that make you human. By denying our own vulnerability and suffering, how can we ever connect with patients? By denying our biases, because we’re scared of what people will think of us, how will we ever notice them and combat them?

I am now an FY1 Doctor. I still feel shame when I look back at the person I was in medical school. I know that I was not a good friend, or a supportive family member. But my friends had the patience to wait for me to come back to them. People have an enormous capacity for forgiveness when you let yourself reach out. The experiences I had in medical school have taught me how unproductive shame can be. It shuts down conversation and closes someone’s mind. It seems to be seen by some as a tool for learning and change and I feel strongly that this isn’t the case.

Dr Grace Catchpole – @catchpolegrace

21 June 2022

Photo by Kristin Snippe on Unsplash

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