Suhaib Anappadiyan (pictured) is a GP resident doctor in Northampton
P N Boteju is a GP Partner, Trainer, and Educational Supervisor in Northampton
At 4:59 pm, I was still consulting.
The patient sitting opposite me had no idea that in one minute an email would arrive that could influence the next chapter of my career.
I smiled.
I listened.
I asked about their concerns.
I discussed a management plan.
I safety-netted.
I documented.
Outwardly, I was a doctor doing what doctors do every day.
Inside, however, my heart was somewhere else.
Waiting.
Many doctors will recognise this moment.
Medicine teaches us how to deal with uncertainty in our patients … It teaches us much less about dealing with uncertainty in ourselves.
Results day.
The day we continue seeing patients while quietly carrying our own fears.
The day we reassure others while struggling to reassure ourselves.
The day we appear calm while counting down the minutes.
Medicine teaches us how to deal with uncertainty in our patients.
It teaches us much less about dealing with uncertainty in ourselves.
The conversation we never have
Medical training is filled with examinations.
We talk endlessly about revision techniques, question banks, courses, mock examinations, and pass rates.
What we rarely discuss is what happens emotionally.
The waiting.
The fear.
The self-doubt.
The feeling that years of hard work may somehow be reduced to a single result.
Every trainee knows the thoughts.
“Did I do enough?”
“Should I have revised more?”
“What if I fail?”
“What will people think?”
The strange thing is that these thoughts affect almost everyone.
Yet we often suffer them alone.
When failure feels personal
Most doctors are not used to failure.
For years we have passed examinations, achieved goals, and moved from one milestone to the next.
Medical school.
Foundation training.
Membership examinations.
Specialty training.
We become accustomed to moving forward.
Then one day the result is not what we hoped for.
The disappointment is immediate.
But what follows is often worse.
Self-doubt.
A failed examination can quickly become a failed identity.
We stop saying:
“I failed an exam.”
And start thinking:
“I am a failure.”
These are not the same thing.
Unfortunately, under stress, they often feel identical.
The doctors nobody talks about
Medicine celebrates success stories.
We hear about distinctions.
Fellowships.
Research grants.
Consultant appointments.
Awards.
What we hear less about are the doctors who quietly struggle.
The trainee revising after putting children to bed.
The doctor caring for an elderly parent.
The colleague dealing with anxiety.
The registrar carrying financial worries.
The international graduate adapting to a new healthcare system.
The trainee who has not slept properly for months.
These doctors exist in every training programme.
Many of them are exceptional clinicians.
Many of them will fail an examination at some point.
Not because they lack intelligence.
Not because they lack ability.
But because they are human.
Burnout does not announce itself
Burnout rarely arrives dramatically.
It arrives quietly.
A little less energy.
A little less patience.
A little less motivation.
Another late night.
Another missed meal.
Another weekend spent revising.
Eventually exhaustion becomes normal.
Many trainees continue functioning remarkably well despite carrying enormous pressure.
Patients rarely notice.
Colleagues may not notice.
Sometimes we do not notice ourselves.
Until one day our performance suffers.
The surprising thing is not that some doctors fail examinations.
The surprising thing is that so many succeed despite the pressures they face.
The myth of working harder
Doctors are exceptionally good at working harder.
When something goes wrong, our instinct is often the same.
Do more.
Study more.
Work more.
Sacrifice more.
Yet not every problem can be solved through additional effort.
Sometimes the issue is not knowledge.
Sometimes it is exhaustion.
Sometimes it is communication.
Sometimes it is confidence.
Sometimes it is stress.
Sometimes it is preparing for the wrong examination.
Understanding this can be uncomfortable.
But it is often where growth begins.
The consultation is more than knowledge
Many postgraduate examinations are not assessing what we know.
They are assessing how we apply what we know.
Patients do not arrive with textbook presentations.
They arrive with fears.
Expectations.
Beliefs.
Emotions.
The best consultations are rarely perfect.
They are human.
The patient feels heard.
The clinician feels connected.
A plan is made together.
Under examination pressure, many of us forget this.
We become scripted.
We focus on saying the correct words rather than understanding the person in front of us.
The irony is that in trying so hard to pass, we sometimes stop being ourselves.
More than a doctor
One lesson many trainees learn too late is that medicine cannot be our entire identity.
Medicine is important.
It is meaningful.
It is a privilege.
But it cannot be everything.
Because when our entire identity depends on our performance, every setback becomes a crisis.
Every mistake becomes evidence against us.
Every failed examination becomes a judgement on our worth.
Life has to be bigger than medicine.
Family.
Faith.
Friendships.
Health.
Reading.
Walking.
Exercise.
Laughter.
Purpose.
These things are not distractions from our careers.
They are what sustain our careers.
What resilience really means
For a long time, I thought resilience meant never struggling.
I thought resilient doctors were somehow different.
Stronger.
More confident.
Less affected by setbacks.
Experience has taught me otherwise.
Resilience is not the absence of difficulty.
It is continuing despite difficulty.
It is asking for help.
It is accepting disappointment.
It is resting when tired.
It is learning from failure without becoming defined by failure.
Most importantly, resilience is recognising that your value as a person was never dependent on a result email.
Most importantly, resilience is recognising that your value as a person was never dependent on a result email.
To the doctor waiting for results
Perhaps you are reading this while preparing for an examination.
Perhaps you are awaiting results.
Perhaps you have recently received disappointing news.
If so, remember this.
You are not the first doctor to feel this way.
You are not the first doctor to doubt yourself.
You are not the first doctor to question your future.
And you certainly will not be the last.
Good doctors fail examinations.
Good doctors experience burnout.
Good doctors lose confidence.
Good doctors sometimes struggle.
None of these things make them bad doctors.
The patients we care for will rarely remember our examination scores.
They will remember whether we listened.
Whether we cared.
Whether we showed kindness when they needed it most.
An examination result may influence the next stage of a career.
It does not define a life.
And it does not define the doctor you are capable of becoming.
Featured photo by Miryam León on Unsplash.
