The best teacher I’ve ever had once told me ‘Accept ignorance, accept that you just don’t know, once you get that into your head you’ll start to learn.’ (Since many have asked me, the person who gave me this advice was Dr. Jim Ducharme…a true master and student of emergency medicine)

Emergency medicine is the broadest of disciplines, we treat all comers for all problems. The field represents a body of knowledge that borders on the un-master-able. Every experienced emergency doctor will tell you how the pride goes before the fall, when everything is clicking just perfectly when you have finally become a master physician prepare to be humbled by your next patient. And yet there is another side to emergency medicine, a side that demands from us a confidence and an arrogance to be the person who steps up when a patients life is on the line and says ‘I am the best person to take care of this incredibly sick patient’.

Unfortunately we have all been through a teaching process as medical students and residents where we were taught that identifying our own ignorance of a problem identified our weakness. As a result most doctors have a tendency to flee from ignorance. When confronted with a situation where our knowledge is inadequate we tell ourselves ‘I mostly knew what to do’ or ‘I figured out what to do’. We don’t want to admit to ourselves the truth, our knowledge was inadequate, because we have been taught that this makes us a bad doctor.

If you doubt that doctors dislike confronting ignorance offer to audit your departments CME for a year. You will see that the best ECG reader in your department is going to more ECG courses and your tox guy is going to more tox courses. This is often more an process of continuous medical affirmation than continuous medical education.

People are worried about admitting that they don’t have all of the answers; ‘If I admit I don’t know something the people I work with will think I’m an idiot.’

Au contraire mon frere. When you admit you don’t know something and are able to rapidly and effectively learn and apply information the people around you, both professionals and patients, will be impressed. We live in a world surrounded by information, the days where information was scarce and had to all be kept in our heads are gone. No one expects us to know everything (half of the patients we see think that we are junior doctors not yet seasoned enough to have our own practice and relegated to the emergency department), and ‘I don’t know but I can find out’ is perfectly acceptable.

The secret to life long learning is simple. Everyday, and every patient ask yourself ‘Could I have done that better?’ Then identify the gaps, with brutal honesty, and fill them in. Then, when someone asks you if you’ve mastered emergency medicine yet you can proudly say ‘No, but I am a better doctor today than I was yesterday’. And that humble doctor, who slowly and relentlessly improves, on every single shift, by admitting their own ignorance, is eventually the doctor everyone on the medical staff wants treating them when they have their own emergency.