Bad Excuses

A bad excuse when generating a differential for a case is "Oh it can't be cancer since we haven't learned about that" or "We're in the infection block; it has to be something bacterial, and we can rule out pulmonary embolism." It disappoints me when I hear my classmates say something that artificial. We're beginning to hear this a lot, but our small group leader said, "Make mistakes now, it's a luxury you won't have for long. Here there is no penalty, and in fact I want you to make mistakes as it's a teachable moment. Next year, you'll be caring for real patients and you'll be expected to get everything right. And three years from now as a lone intern on a dark ward at 3 in the morning, you can't afford to make a mistake when deciding whether to prescribe the antibiotic or not."