Every July, I walk the hallways of my hospital and can immediately identify intern doctors and medical students. It’s almost like being in high school when the freshmen stick out like sore thumbs. As I walk by these students and young doctors, I ask myself, what is it about them that makes it so easy to tell they’re new?

Back in my premed days one of my mentors, Dr. Ellis Ingram, took me on a tour of the medical school. During this expedition, I was curious to know if I was allowed to be in the “doctors only” areas. He told me, “Dale, you can pretty much go anywhere you want as long as you act like you belong there. Nobody will question you.” Those words have stuck with me since that day. I understood them to be true, but remained conflicted. The question then became, how do I act like I belong in an environment when nobody in it looks like me? As I’ve progressed in my career, I’ve developed clarity around this question.

1) Look people in the eye! In America, lack of eye contact is one of the biggest telltale signs that someone is out of their comfort zone. As I walk past the “newbies” rarely do we lock eyes. It’s even less likely that we’ll have a conversation. The medical field is full of pride. Academic medicine specifically is very hierarchical, and everyone wants to be the be “big dog”. People are constantly sizing each other up and trying to get a sense of who outranks who in terms of seniority. Interns understand they’re at the bottom of the totem pole and typically this translates into less confidence which is physically displayed in ways such as poor eye contact. The unfortunate truth here is that often this poor eye contact leads to others further doubting your ability and it becomes a vicious cycle. An easy way to better fit in is by looking people in the eye and speaking with them.

2) Do your homework! This means be prepared for every situation. The second telltale sign someone doesn’t “belong” in an environment is that they always appear confused. As I walk the hallways, it’s easy to spot interns because they’re often swiveling their heads left and right at intersections trying to figure out where to go. Clinically, they struggle to find orders and sometimes put in the wrong orders. This is VERY understandable and something I struggled with too as an intern. Again, it is unfortunate because it makes others believe you don’t know what you’re doing and their confidence in you as a clinician can drop. The best way to address this is by being prepared. This means that prior to entering an environment, do your homework on it. Go to the hospital the day prior and walk your routes a few times. Shadow someone as they carry out their clinical work so you have a better understanding of how to put in the orders. As I type this, I recall one of my Attending Physicians in residency telling me that they’d always come in a day early to ensure they were very well prepared for their first day on clinical service. Do your homework and hit the ground running!

3) Believe you belong there! This is the most powerful of all. You have to kick “imposter syndrome” in the butt and truly believe you’re supposed to be there. When you truly understand that you’re capable of being in any given environment, your walk will show it. Your talk will show it. Your smile will show it! Every now and then I meet an intern and mistake them for a senior level resident simply because of how much confidence they exuded. The only way to exude confidence at that level is to truly believe you belong!

Acting like you belong in the environment you’re in is the first step to success. This doesn’t mean that you fake it until you make it. Rather it means, ask the right questions and get up to speed with the environment as fast as you can. Once you’ve done this, it’ll be much easier for you to believe you belong there. After that, nobody will be able to stop you from achieving greatness.

Do any of these recommendations resonate well with you? What other suggestions do you have to help people better fit into their environments?

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