Being assertive

The holiday season has been long, long over, and a blog post has been long overdue, but the second half of second year really hit me like a hurricane! It’s been a whirlwind of tests, meetings, heightened extracurriculars, lots of personal obligations, and trying to find a time to start Step 1 studying in between. This was originally supposed to be a holiday post and then I figured I could make it a Valentine’s day post, but alas, here we are, almost at the end of February.

I want to talk about something that I feel is undervalued for people in medicine — leadership and assertiveness. These are traits that are highly valued and encouraged in all other professions, and yet, they’re not traits that are necessarily actively cultivated in medical students. We spend the first part of medical school in classrooms, learning almost more than we can handle and taking test after test, but sometimes I feel like the real life, personal skills aren’t as well taught amidst all the time we have to spend with our books. A personal skill that I think is important for medical students to learn, however, is being an effective communicator, which in my opinion includes being assertive and speaking up when needed.

I think it’s important for doctors to know how to be assertive and a leader when they need to be. Medicine is an increasingly complex, bureaucratic world. Doctors don’t just interact with their patients. They often have to advocate for their patients with others and engage in difficult conversations with people who may not see eye-to-eye with the doctors, whether that’s with administrators for financial and legal issues or insurance companies so that the patients can get what they need without difficulty. I think that as an advocate for patients, doctors should learn how to be assertive so that these interactions can be productive. This is hard for many medical students, because I think a lot of medical students struggle with communicating effectively and being assertive. I’m not saying everyone is like this, but a theory I have is that to be in medical school, you have to spend a significant amount of time studying and really have to love it, so medicine tends to attract a good number of introverted, studious, life-long learners who are on the quieter side, preferring books to loud social interactions. Most of us didn’t grow up actively involved in debate and mock trial like some of my friends who pursued careers in law and politics, careers that obviously involve a lot of public speaking and leadership, so there’s also a lack of experience and comfort with speaking publicly or strongly on an issue. Or maybe it’s just been conditioned in us to remain quiet after all the years we spend quietly studying in the library! But, whatever the reason for our relative lack of assertiveness, I truly believe that it’s important for us to try to work towards developing these skills so that we can become better physicians.

I previously wrote about how I used to be an introvert but that I really worked to overcome my fear of public speaking. The past year in medical school, I worked to develop and hone my leadership skills. I will write more about this experience later, but I had the privilege of leading the student-run free clinic at my medical school over this past year, and it was an incredible experience that yielded tremendous personal and professional growth. I learned how to present and defend proposals, how to advocate for policies, and manage a group of colleagues and cultivate teamwork. I know these experiences will help me down the line in my career. Doing these things were not easy, especially because I’m an introvert and have a hard time speaking up for myself, but this experience really provided me with more courage to do so when I need to in the future. I also think it’s important to be assertive because medicine is very hierarchical. As a medical student, there will be interns, residents, fellows, and attendings all above you, and while I’m not saying you should argue or fight with any of these more experienced doctors, I think it is appropriate to stand up for yourself and make your presence known. I’m glad that medical schools are focusing more on mistreatment of students and recognize that it’s been a problem in the past, because I think that often the hierarchical nature of medicine perpetuates a belief that medical students should simply stay quiet when subjected to any type of mistreatment or abuse. This is simply not true, and we need to realize that staying quiet is not always the best course of action.

Just because medical students are always studying and spend most of our time quietly buried in books doesn’t mean that we can’t also learn how to be assertive. Being a physician is different from many other jobs for a lot of reasons, but it doesn’t mean that it isn’t an asset to be assertive as a doctor, just like how in most professions, being assertive (in an appropriate way!) is seen as a positive trait. We should all challenge ourselves to learn how to be more effective communicators, speak up for ourselves, and be brave enough to be assertive and bold when the time calls for it so that we can become good advocates for ourselves and for our patients in the future.

Maje coat, J. Crew sweater, ASOS skirt, Report boots

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