Toxicity of “be the best” culture

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“When you show up to those evaluation meetings, I want you to show up like a star athlete, wanting to improve in every way possible. We want you to become the best doctor there ever was.”

This was the response of an education specialist when asked how can residents cope with being constantly scrutinized and given “areas in need of improvement” at every assessment that occurs at least once a week.

Growth based mindset is a valuable asset in anyone, especially in young doctors who have so much to learn. HOWEVER, there comes a point where a resident becomes good enough to practice safely and competently according to practice guidelines. Beyond that point, it can be extremely demoralizing for residents to receive criticism on something that is not helpful for improving the quality of patient care in a measurable way. Specifically, receiving feedback for the sake of feedback, in a patient interaction where care was safely and competently delivered, can be exhausting for the learner. It can also impede their sense of mastery, contributing to burnout, anxiety, imposter syndrome, and demoralization. At the time of COVID-19 where residents are being redeployed into areas outside of their specialty in a particularly stressful environment does not make things any easier.

We see this outside of medicine as well. Social media bombards us with messages of “be the best you can be”, “achieve all that you can”, etc etc… While these messages can be motivating to a certain extent, it can also feel like a lot of pressure in this world that is already so competitive and stressful.

You ARE enough.

Did you get up today and go to work, even if you didn’t want to? Did you do what you could to finish the work that was needed within a reasonable time frame within the minimum required standards? Were you reasonably kind to others and didn’t hurt anyone, including yourself?

GREAT! In some days, even doing these things can be extremely difficult, so great job!

As a society, it is time we re-evaluate this “growth based mindset”. Growth is great, but so is happiness, satisfaction, and gratitude for who we are today. Striking the right balance between these essential aspects of life should be the focus, not endless “growth and expansion” at the expense of one’s wellbeing.

Again, you ARE enough.

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