The views and opinions expressed in this collection are those of the authors and do not necessarily reflect the positions of the Association of American Medical Colleges.
Nabeel Salka is a third year medical student at the University of Michigan. He is passionate about cultivating friendly, supportive communities to build a joyful learning environment.
My first piece of written feedback during my clinical year was ripe with criticism. I regrettably reacted to it by reading and re-reading it, allowing discouragement and imposter’s syndrome to slowly infiltrate my psyche. My voice began quivering during my presentations on rounds. My thoughts quickly became consumed with what every attending might be thinking of me at any given moment. It became harder to concentrate and learn. I stood in my own way, allowing my dependence on external validation to hamper my professional growth.
I chose the University of Michigan Medical School for its legacy of excellence. But clearly I needed a better game plan when it came to feedback. I drew inspiration from those who have experienced this before me, notably University of Michigan alumnus, Tom Brady.
In 2000, Brady was selected as the 199th (second to last) pick of the NFL draft. His performance at the NFL combine was perceived as pedestrian, resulting in sharp criticism from pundits and coaches alike. “He’s very common,” one scout reported. “God, you can see his ribs on his build. His arm is just adequate.”
Only four years into his professional career, Brady shocked the sporting world by winning his first Super Bowl. Sports fans and journalists struggled to understand Brady’s success; they pointed to his negative scouting report. Brady responded, “So basically they’re saying that I don’t look like an NFL quarterback…And I mean, do I still look like an NFL quarterback? I think I’ve grown into that a little bit more. But at the same time, I haven’t changed that much…I think they underestimated my competitiveness.”
Many of Brady’s peers who were drafted ahead of him had brief NFL careers. They were discouraged by poor performances following high-stakes matchups and hard hits from opposing teams. They responded to their initial failures with dejection and regret. Unlike Brady, they lacked the commitment to their own talent and dedication.
It wasn’t until a faculty member commended me on my performance later that I noticed how deeply I internalized the opinions of others. I began to realize that my success as a student prior to medical school made me ill-equipped to respond to negative feedback. The confidence I carried with me into medical school was built on years of positive reinforcement during which hard work was rewarded with good grades and a feeling of accomplishment. So when I was confronted with heavy critique for the first time, I allowed it to define me.
I was initially ill-prepared to respond to negative feedback, but now I am grateful for the experience. I learned to speak honestly about my struggles with senior students and develop supportive community of friends. I participated in a medical student dance group, which allowed me to see myself not only as a student, but also as a teammate, leader, and performer. I found ways to develop confidence in myself without the need for external validation.
When medical student rotations were abruptly suspended in response to the COVID-19 pandemic, many students felt aimless and guilty for not helping patients. However, I was confident in my ability to adapt. I reached out to students and faculty, brainstorming ways to help manage the crisis. Ultimately, I participated in an amazing initiative to redesign prenatal care and support social distancing. I called hundreds of patients, offering reassurance and resources to help them navigate through an increasing complex landscape. I didn’t allow the circumstances surrounding me to dictate how I felt.
Nearly a year after receiving my first piece of written feedback, I read it again. This time I didn’t feel hurt or ashamed. In fact, I felt like I understood the actual content of the criticism for the first time. Rather than concerning myself with the grade and how much the resident disapproved of my performance, I learned that I could be more organized when presenting. The communities and experiences I created for myself in medical school allowed me to learn and grow as a student rather than resign to the feelings of grief and disappointment. I now understand the truth about who I am as a learner and future physician.