4 Medical Skills No One Talks About

Every once in a while I will write for the American College of Cardiology (ACC). Mostly about finance and business since I’m interested in the business side of medicine — something we’re not taught at all.

The ACC was asking the trainees what their advice would be for medical students that are interested in cardiology. Trying to be as different as possible, I came up with a few tongue-in-cheek tips that I felt really helped me along my journey. This is not to say that the usual bits of advice is not helpful, but simply that they are obvious. None of these have to do with actually knowing medical knowledge. Knowing medical facts can be memorized using various resources online. Getting involved in research is something every pre-med knows. Instead, I wanted to focus more on processes that, if firmly grasped, make medicine and potentially life easier. Not coincidentally, they tend to make people a bit more well-rounded.

While memorizing facts is important to be a physician, much of medicine is about knowing what to do when you don’t know what to do.

Play more video games

Video games require strong hand-eye coordination. Growing up, video games were seen as a waste of time and for the most part, they were. Excelling at video games like Super Smash Brothers hones the link between your fingers and your eyes which are interpreting signals from a screen. It only seems mindless. Timing, proprioception (knowing where your body is in space), and dexterity determine success or failure in Super Smash and many other video games.

The same can be said for manipulating wires that are in the heart. Something I never thought I’d be doing.

As medicine continues to grow, more procedures transition to minimally invasive options. Echocardiograms allow one to take videos of the heart. Obtaining those videos requires you to move a probe based on what you see on a screen. While not as stimulating as a video game, being able to interpret information and adjust in real-time with dexterity makes obtaining these tests incredibly easy.

The same can be said for cardiac catheterizations, ablations, robotic surgery, and laparoscopic surgery. All of these techniques require physicians to manipulate tools based on what they interpret on a video screen.

I mentioned this to a mentor of mine. While I was more or less laughed out of the room, I still think it holds true. Hand-screen coordination makes these procedures so much easier.

Use your left hand

As a former drummer, using both hands was mandatory. Exercise after exercise required the use of my left hand. As someone that was right-handed, this was frustrating but for some reason that I never understood, the books I learned from focused on the left had just as much as the right hand to keep everything even.

These seemingly pointless exercises came back for a huge win once I started residency when it came time to perform medical procedures. Similar to developing strong hand-screen coordination, being able to use both hands equally (or roughly equally) helps perform procedures comfortably. Being able to comfortably perform procedures is one of the easiest and most forgotten ways to set yourself up for success.

When doing any medical procedure, the most underrated rule is to set yourself up for success. Make sure you’re comfortable. Don’t do procedures with your back bent. Don’t overstretch yourself, hunch over, or look over your shoulder for a long period of time.

This is important for procedures as you never know how long the procedure will take, after a while your back will start ache or your neck will cramp, making the procedure even more difficult and dangerous.

As I’m in a procedure-heavy specialty, often we have to perform procedures on one side or the other. Ergonomically, sometimes it’s just easier to use my left hand as opposed to my right. These instances are relatively rare, but when they come about, using your off-hand makes procedures so much easier.

Despite this being a general rule, there are times when it’s easier to use my left hand than my right. It helps before big procedures when there are lots of doctors and nurses around the patient and space is limited. I haven’t gone as far as my dad who worked on writing with his left hand, but I am able to use my left hand when using needles, scalpels, and other medical tools.

Learn philosophy

“There are no answers to these questions”. This was the most common complaint I heard about Philosophy 101 in college. Being the nerd I am, I promptly signed up for more.

Science has given us a lot of answers, but for every answer, there are hundreds more questions. Despite all of the questions, we still need to make management decisions. Start a patient on medicines, give them pacemakers, or escalate treatment plans. This happens in medicine every single day.

We still know remarkably little about the human body. There are a lot of questions we don’t have answers to.

So what do we do in these situations? We manage and deal with uncertainty. The same uncertainty we deal with in philosophy when there is often no right answer or no clear right answer.

Studying philosophy in college helped me immensely in writing papers, developing an argument, and being able to support it. Writing philosophy forced me to articulate myself and my views clearly and concisely. I’m still struggling with talking about my emotions though.

Above all, philosophy helped me develop and enact plans when the assignment was “write a 20-page paper for your final term paper”. No clarifications, no further instructions, just “write a paper”. Instructions that sparked anxiety in many of the type A personalities that needed a list of instructions.

Philosophy helps navigate the sea of uncertainty.

Moreover, medicine, and science in general, requires tough questions, large-scale data, and tight experimental designs. Despite the noise on the internet, not everyone can critically assess scientific studies.

Not everyone is good at thinking. Not all opinions are right.

Humans are disastrous at using data to guide decision-making - if you don’t believe me read Daniel Kahneman’s Thinking, Fast and Slow. TLDR: **Watch this short youtube video. Critical assessment of science requires skill that needs to be honed, nuance that needs to be appreciated, and a foundation of prior studies.

Scientific thinking is difficult for doctors, people that do this stuff for a living. While you may not be weighing the pros and cons of surgery or medical treatments on a day-to-day basis, making decisions is something done thousands of times every day. Learning how to sift through large data may help you make difficult decisions.

These critical thinking skills are the foundation of philosophy. Overall they can help anyone improve their critical thinking skills when most people rely on erroneous biases and heuristics that are often unknown, under-appreciated, and therefore dangerous.

Learn how to write and speak well

As a kid, I never wanted to learn how to write well. It seemed pointless to me. I figured I would be a man of science and having to write and write well was not something I would have to do.

I even had a biology lab partner that would handle the writing for our projects and I just had to handle the content creation - thinking through the science of it all. I figured it would be like this for the rest of my life. I passed English and didn’t want to write like Charles Dickens.

Like most fields, medicine requires you to write a lot. We write letters, notes, personal statements, applications, and research papers. Despite all of this writing, there are plenty of physicians that can’t put two words together in a coherent thought.

Being able to type and make a coherent thought is an underrated skill. I’ve read personal statements from applicants for medical school, residency, and fellowship. And unfortunately is a lot of bad writing out there. A lot of the personal statements sound the same.

This is not to say that we need to become the next Hemingway, but simply that writing and communication is an important skills. Often first impressions are made in writing.

Soft skills like writing and speaking will help you interact with employers and patients alike. While we don’t focus on these skills in medicine, like at all, they help immensely with research, presentations, organizing your thought process, and getting your point across in a concise fashion.

Above all else being able to communicate well will help in any profession, medicine or not.

What do you think? Is there any unusual skill that was helpful in your training? Let me know in the comments below.