A key skill to have during oral exams back in med school was never to admit not knowing. Avoid the areas you’re uncertain of, dodge the examiner’s field of expertise as much as you can, and never ever say “I don’t know”.
These sage words were passed on from generation to generation, propagated by everyone, including me. Only, this wasn’t what I or any of my friends actually thought. It was a poke at the climate of intellectual dishonesty at our school, not a guide to success in medicine.
Starting residency, though, flips the sarcasm switch somewhere and the funny guidelines become instructions to be followed verbatim. The knowledge in question is different—patient data instead of textbook medicine—but the idea is the same. Observe the modern American intern’s vocabulary:
- Not that I know of (means I don’t know).
- I wasn’t aware of that (means I didn’t know).
- I don’t think it is (means I don’t know if it is).
- I believe so (means I have no idea, but yeah, maybe).
- It probably was (means I don’t have a clue but I did a D6 roll in my head and it was a 5).
I used all of the above, and more, during internship, but still get frustrated hearing it from others. Which makes me a liar and a hypocrite, yes, but at least I’m being honest about it. If you are an intern, or anyone reporting patient data to a person above you in the pecking order, try using “I don’t know, but I can find out in a second” instead. Then start practicing your EMR skills to truly make it a second.