For resident physicians, feedback is a lifeline. That is especially true for interns and other junior resident physicians. Still, the challenge is taking it graciously, asking questions to confirm and clarify the underlying issue, and then demonstrating you have learned the lesson at hand.
AMA member Alisse Singer, MD, is a senior internal medicine resident at the University of California, San Diego, School of Medicine (UC San Diego). She learned early on that her success as a physician would depend on knowing how to elicit and accept feedback—not only in residency but throughout her career.
“Our whole job relies on it,” she said. “Studying will only take you so far in medicine. Sure, you can learn how to place orders and things like that, but when you’re working with patients on a day-to-day basis, that can’t be learned from a textbook. We need people to mentor us all along the way.”
In an interview with the AMA, Dr. Singer laid out several things she wished she had known about taking feedback in her first year in residency. One of the themes: When it feels uncomfortable, go with it.
It’s OK to be wrong
“People in medicine are often type A—they want to never be wrong. But everyone in medicine is wrong sometimes. In fact, it’s expected,” Dr. Singer said. “The first lesson is: It's fine to be wrong. When someone tells you that you could be doing things a different way—as long as it's coming from a good place, you should try to receive it with an open mind.”
In addition, that open-mindedness should not depend on who the feedback is coming from, she noted. At times, it might even come from someone below you in the health care hierarchy.
“Every physician has to listen to what others have to say about the things they could improve on, no matter how small those things might seem,” she said. “I try to always remind myself: What can I be doing differently to make the team better, to advance patient care, to be a better physician?”
Maybe you need to do less
“I had someone, one of my attendings, tell me a few weeks ago that I should be more like Homer Simpson in that meme where he fades into the background,” Dr. Singer said. “Because right now I'm a senior resident, and although the urge is to be in control of everything, sometimes I have to take a step back so other people can grow.”
Stepping back also means letting your team know that that’s what you’re doing so they don't feel you’ve abandoned them.
“The second thing is making sure that if the feedback you’ve been given will affect other people, make sure everyone is aware of it,” she said.
Learn more with the AMA about “feedback literacy” and why it is a must in residency training.
There’s not always one right answer
One trick with soliciting and receiving feedback is seeing it not in isolation but in the aggregate. One person’s feedback is not a complete assessment—it’s a snapshot of a situation experienced by just a few people.
In other words, knowing how much weight to give any bit of feedback is a skill, and any skill takes time to develop.
“Feedback isn't always binary,” she said. “Having a lot of people giving you feedback means you encounter a lot of different ways of practicing medicine. You don’t necessarily get to choose the feedback you receive, but you are allowed to figure out which feedback works best for you.”
Discover four keys for new residents on offering effective feedback to medical students.
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Turn the negatives into positives
“I don't think anyone should ever hold back on positive feedback. You work so hard in residency, and people tend to be in a constantly stressed state of mind because they're going through so much,” Dr. Singer said. “But some people’s way of giving feedback is more of a critique, and that never feels good. It also might not serve the points they’re trying to make.”
Knowing that senior residents and attending physicians are just as stressed as you are can help you interpret the feedback they give you.
“I don't think positive feedback is given enough. Even simple statements, like ‘Good job,’ can reinforce what you're doing,” she said. “That's something that shouldn't ever be held back.”
Follow-up is essential
After getting feedback and putting it into action, Dr. Singer has made a point of following up.
“I like to ask: How do you think this is going? Am I doing this better?” she said. “It’s about having a learning goal for yourself and being very open about sharing what other people have thought you could do better.”
The point is to avoid getting the same feedback over and over, she noted.
Think long term
“The main takeaway from all of this is that you're never going to know it all,” Dr. Singer said. “Medicine is one of the professions where there's always room for improvement. No matter how good you are or how long you’ve been practicing, there's always more you could know.”
New studies come out, and practices are constantly developing new techniques—and those are good things.
“You’ve chosen a profession that is a lifelong journey,” she said. “Embrace it.”
Learn about the AMA Resident and Fellow Section, which gives voice to—and advocates on—issues that affect resident and fellow physicians.
