Yesterday a student from the medical class I teach came to me looking for advice. I think mine was the only open door on the hallway. She certainly had not sought me out before.
I knew her because she had failed first year Med School (M1), and squeaked by the in the class I teach 2nd year. As is true of many med school lab courses, its big (150 students, of which about 5 are PhDs, andthere are 7 or 8 people in lab, and a couple of us who lecture, etc), the grading is all computerized, pretty much, so there is almost no subjective assessment, and the bit of grading we do by hand, practical exams, is by IDnumber. So, its not like I have much say in pass or fail. And I don't sit on the committee that hears student appeals for grades. So there is nothing much I can do for a student with grade issues.
It seems this woman has failed her first year again. She had failed two basic science classes (Ithink it had been three the first time through). And she wanted advice. Except she really didn't. She wanted to complain. I kept my best sympathetic smile, plastered on my face, almost till the end.
Firstly, she said that she couldn't believe she failed because "she had really mastered the material. In my study group, you know, I always knew the answer". Secondly "this school is in the middle of nowhere and I had no support during the year, and there was nothing to do on the weekends". And, thirdly, "I was part of this program [one we have to help at risk students, in conjunction with a local college, because this university has no undergraduate programs at all] and it required me to drive to go to work there and I wasted time each week driving when I could have been studying".
Smile still plastered on my face. I didn't mention that two and three on her list seemed contradictory. I did say that failing the exams more than once suggested that perhaps she hadn't mastered the material. She insisted that she had, and that she "just couldn't take exams".
I don't want to debate, here, now, whether board exams for medicine are good or bad, whether we select the best people to be physicians, etc. Whether it is worth changing how we assess medical students, whether it is worth my time to work on changing that is another argument. Certainly this woman isn't going to be in a position to do anything about it.
I did ask her how she thought she could pass the boards (Step I, the exam med students take end year 2/ beginning year 3), if she couldn't pass class exams, no matter how much she had "mastered the material". She returned to point 2, "if I only had support I would have done better".
Then she said: I really believe that if someone wants something badly enough, and works at it hard enough, they can do it. I wanted to say: Then, not once, but twice, you either didn't want it enough, or you didn't work hard enough, since you didn't do it. I did say: You know, I was an athlete in high school and in college. But it was very clear to me, at the end of my 20s, early 30s, (and really much earlier) that no matter how hard I worked, I would never make it to the Olympics. (of course it was obvious much earlier than that).
She answered: Oh, that's different. I really want to be a physician. I know I can be a very good doctor. I am going to apply to go somewhere else.
Is it that different? I don't think so. I think part of what separates good amateurs from professional athletes is a kind of physical genius, which begs the whole question of the separation of physical and mental, since it is the brain that controls our motor systems (and I am perpetually irritated by the words "muscle memory". Muscles have no memory. They are stupid mechanical engines following signals from the nervous system). But its hard to acknowledge that your brain may not work in the right kind of way to pass medical school.
After about 20 minutes of this, I said (still trying to be gentle), is there anything I can do for you?
There was not.