Taking Risks

I've never considered myself a risk-taker; in fact I would very adamantly assert that I'm terrified of taking risks, of pursuing actions and routes that aren't thoroughly calculated to produce a predictable and ideally positive result. Perhaps I feel this way out of fear of critique and judgment for how the result may act as a direct reflection of my intellect, a feeling that I imagine I share with many of my fellow classmates. Entering medical school, we have always been academic achievers that strive for perfection. Very few of us have a history of failure - we avoid failure by understanding what it takes to succeed and acting in a predictable manner along that line of knowledge.

So imagine my surprise when I was officially dubbed the "risk-taker" during my first clinic experience with Dr. Ho Ping Kong, a widely-acclaimed physician here at Toronto Western Hospital known for his cryptic questioning style and complex patient cases, which ultimately add up to a very different clinical learning experience. The "risk-taker" title came after he presented a case of exophthalmos through a  patient photograph and asked us what the diagnosis was. Having been taught to approach patient cases with a thorough history first, I was rather unfamiliar with generating a diagnoses based on appearance only. He continued to press us for a diagnosis, however, and with Graves Disease on the top of my mental list I quickly blurted it out. To my surprise, it was the correct diagnosis. The rest of the clinic day proceeded with similar questions: more diagnoses based on images; questions about patients' social histories that we clearly don't know yet, among many others. Surprisingly I found myself more comfortable with taking risks. Giving the wrong answer wasn't a deterring anxiety anymore, as it had been in other settings.

What was it about this particular clinic experience that made me step out of my comfort zone? A number of factors come to mind, however I want to focus specifically on Dr. HPK's mentorship style -a style that differs remarkably from the traditional "approach to ______" usually employed by preceptors. He challenged us to think both within and outside the box, and welcomed our responses regardless of how wrong we were. He injects humour, history, experience and personality into his teaching points, helping us connect patients with stories. As different as it was, his teaching style really worked to keep us engaged. The fact that most of his patients have complex histories and/or diagnoses is also an added bonus, allowing us to explore aspects of health away from the bread-and-butter cases we normally encounter. Together, these facets created an environment that encouraged risk-taking. To be honest, I didn't expect myself to enjoy this style of teaching as much as I did. I'm usually quite disengaged when stepping out of my comfort zone, but in an environment where you're not expected to always have the correct response and you're encouraged to think big and broadly, risk-taking doesn't seem much like a risk anymore.

-JJ