This week I thought it was essential to discuss a dangerous personality trait that can lead to disaster when beginning a radiology residency. Coming from different programs, some residents start out with bad habits formed from their preliminary year. I like to call this dangerous personality type “Never in Doubt But Sometimes Wrong.” More often than not, these residents trained for their prelim year in surgery (But not always!), and had developed this personality trait during the internship. He would have formed skills like talking with strength and charisma. And, usually, this is a good thing. However, this is not the case when this resident does not have the knowledge and experience to back up their overconfidence.
This sort of personality tends to persuade her audience, attendings, and residents, regardless of the evidence. Accessory staff follows these physicians to the ends of the earth based upon the sure command of her words. However, in reality, these residents (and other physicians) know the same or less than their colleagues. Moreover, indeed, they have not developed the experience to make the most critical decisions as a first-year radiology resident.
Why do I bring this up today? Well, I thought it was necessary to be aware of its consequences if you have developed these tendencies. Alternatively, for other residents, I want you to recognize this sort of personality trait so that you do not go down with the proverbial “ship” as well. Also, what better time than at the beginning of residency?
Why is this so crucial? Well, I go through the three main reasons these beginning radiology residents need to alter their ways: Danger to the resident, increased liability, and potential for harm to the staff.
Danger To The Residents
Being sure of oneself is essential to becoming an excellent radiologist. However, not when the radiologist has not read up on the subject or understands the case. Especially for the first years, this is a danger to their career. Every once in a while, we hear about these new residents telling the clinician the wrong diagnosis and management.
Moreover, since these residents have such a charismatic personality, they can often sway their opinion about the case. Unfortunately, however, the clinician listens and begins working up the patient in the wrong way. In the end, the program directors hear about the mismanagement, and the resident can suffer from probation or even worse.
However, the danger is not only for the resident with the personality trait. Also, the followers can suffer just as much. You probably have seen attendings in other specialties that espouse facts with such fervor, only to realize when you look them up that they are entirely incorrect. These attendings tend to be well respected by the hospital administration (but not so much by their colleagues) and wield much power due to their charisma. So, be careful to check everything twice before following one of these strong personalities.
Increased Liability
Not only is “Never in Doubt But Sometimes Wrong” a dangerous personality trait that can lead to bad medicine, but also it can significantly increase your medical liability. Whatever you communicate to the ER, they can report in the medical record. And, guess what? You can be liable for the damages incurred to the patient if wrong.
For example, this sort of dangerous personality may confidently state that the patient does not have appendicitis on CT scan as a first-year resident even though having never seen a case. Subsequently, he convinces the ER doctor that the study is negative. Finally, unfortunately, the patient incurs harm. The medical license of this resident is potentially on the line.
Potential Harm To Staff
In our profession, we have to remember that the world is not always just about the physician. Instead, the rest of the team can play just as essential a role. Confidently knowing wrong information places our nurses, technologists, and aids in dangerous situations. Instructing a nurse to use the wrong needle can lead to injuries. Convincing a technologist that a patient with an ear implant can safely go in the MRI without knowing can cause a technologist to lose his job. These are potential situations that stem from a resident with misplaced confidence.
The “Never In Doubt But Sometimes Wrong” Dangerous Personality
In radiology, there is no space for overconfidence. Our role, just like other physicians according to the Hippocratic oath, is to “do no harm.” And, you can see the significant danger that a resident can cause to themselves as well as others when they become overbearing without the accompanying knowledge and experience. So, I beg you. If you are not sure of something, maintain your humility. Let your colleagues, staff, and fellow faculty know. It is OK not to understand. However, it is not OK to let others think that you do when you don’t.
