Pulse Check with Dean Nelson - September 2025
Sharing thoughts, laughs, and a little wisdom!
The Journey from "I Know Nothing" to "I Know Enough"
As we settle into our new academic year, I've been reflecting on something that strikes at the heart of medical education: the paradox of confidence and competence. Picture this: a third-year medical student walks into the emergency department on their first clinical rotation. They've mastered anatomy, aced pharmacology, and absorbed volumes of pathophysiology. They feel ready to diagnose and treat. Yet within hours, they realize that textbook knowledge, though comprehensive, is just the starting point.
I experienced this myself during emergency medicine training in New York City. Despite graduating medical school with honors, my first night shift humbled me quickly. When asked to interpret an ECG, I confidently declared it showed ventricular fibrillation - only to learn it was electrical interference from a nearby unshielded device. This was the 1980s, and I had just hit what psychologists call the 'peak of Mount Stupid' - the Dunning-Kruger Effect in action, – where the less we know, the more confident we feel about our abilities.
This phenomenon defines medical education. Early students often display remarkable confidence in clinical reasoning, while experienced physicians approach complex cases with healthy skepticism. Experience doesn't make us more uncertain—it makes us aware of uncertainty, which paradoxically makes us better physicians. It's the classic challenge of not knowing what you don't know. The journey from unconscious incompetence to conscious competence is perhaps the most critical transformation in medical training.
At the Schmidt College of Medicine, we've designed our curriculum around this understanding. Our small-group, problem-based learning approach creates environments where students can test understanding, make mistakes, and learn from them safely. When I observe students working through clinical scenarios, I see them grappling with uncertainty - and that's exactly what we want.
This learning curve isn't just about individual growth - it's about creating a culture where seeking help is seen as strength, not weakness. Whether through our simulation center exercises or clinical partnerships, we are normalizing the learning process. Our faculty model lifelong learning, showing students that competence isn't a destination - it's a journey.
Our goal isn't to graduate physicians who think they know everything, but practitioners who are comfortable with uncertainty and skilled at finding answers when they need them - physicians who can reach that ‘plateau of sustainability’ where competence and humility work together. At the Schmidt College of Medicine, we are dedicated to guiding each student through their individual learning journey, knowing that the humility they develop here will serve their patients well throughout their careers.
Fresh off its Emmy win for Outstanding Drama Series, "The Pitt" continues to resonate with audiences - and not just for its compelling storylines. When showrunner R. Scott Gemmill dedicated the award to healthcare workers, saying "Respect them, protect them, trust them," he captured something that medical educators understand deeply: the importance of supporting those navigating their learning curves.
The show's portrayal of mentorship rings particularly true. When Robby tells Jack about incoming med students and interns, Jack's sarcastic "Lucky, lucky me" captures what many mentors feel - but Robby's response reveals Emmy-worthy leadership. Instead of dwelling on the burden, he welcomes newcomers with "Welcome to The Pitt. Let's go save some lives," acknowledging their potential while setting clear expectations.
The Pitt's Emmy Award-Winning Learning Curve Survival Guide:
- Embrace the chaos - "This is the job that keeps on giving" reminds us medicine is unpredictable - exactly why we need strong teams.
- Stay humble - When asked if he's found work-life balance, Robby admits, "No, not even close." Growth never stops.
- Prepare, don't discourage - "Is it always this busy?" "No, it gets busier" sets realistic expectations while offering support
Whether you are in an Emmy-winning emergency department or a real medical school classroom, everyone is navigating their learning curve. Your job isn't having all the answers - it's asking smart questions, helping when you can, and staying curious.
As Robby says - and as the Emmy voters clearly agreed - "Let's go save some lives" and learn something along the way.