How do you judge if you are doing well or poorly? How do you know if you need to change something? How do you decide what the right course of action is? Is it the feedback from your boss? The surveys from customers? The smiles of patients? The profits that come in? The respect of those who are important to you? Most people, including myself, cannot provide a logical and concise answer to this. In reality for most of us the answer is probably yes… all of the above. We take surveys, feedback, smiles, profit, and respect, run those past the internal compass of who we are are and what we believe to be important, and then judge ourselves based on that.
The third year of medical school is the first clinical year. The first year in the clinic and thus the year at the bottom of the hierarchy. In medicine, as with many other fields, things can be right for two reasons: One, there could be empiric evidence supporting the fact, or Two, there is no empiric evidence but only the preference or dearly held belief of someone higher up the ladder. The point of education is to gain the first and disregard the second without damaging the tender egos above. Reading Ayn Rand (The Fountainhead and Atlas Shrugged) while in this environment is simultaneously amusing, ironic, and bewildering. Yet it also is centering. Although Rand’s ideas are not all correct, the radical juxtaposition of her ideals and modern medical education is enlightening. It highlights what aspect of the education that really matters, in this case excellence in evidence based medical practice and a deep personal enjoyment of the work, and what does not matter at all, in this case petty arguments, myopic practitioners, and patients who refuse to take responsibility for their own health.
So whether the field be medicine, law, business, or any other field, slowly yet intentionally developing a base of empiric evidence and discovering a personal pleasure in the task is the most important method of judging success. Everything else, feedback, surveys, and profits are superfluous and peripheral if they do not align with first two.