Floaties, the Deep End, and Becoming a Doctor: You Will Never Feel Ready—Do It Anyway

This week, I handed off the call phone to a new fellow. I walked her through the MTP protocol, gave her a holy book of transfusion reactions, practiced finding HLA compatible platelets, and went over every weird little NIH-specific quirk I could think of. I gave her floaties.

And now she has to jump in the pool.

That’s how it works. I did everything possible to soften the landing, but eventually someone hands you the pager, and you are the one on call. You answer the consults. You make the decisions. You’re still learning—and you always will be—but suddenly the weight shifts. It’s your name on the line.

This is the rhythm of medical training. You will constantly be asked to do things you don’t feel ready to do. Sometimes it feels like the system is pushing you forward too fast. Sometimes it feels like you are holding yourself back. But every single step—from student to resident to fellow to attending—requires a quiet leap of faith. Not that you’re already good enough, but that you’re committed enough to get better.

That’s what I tell the new fellows: you’re not supposed to know everything yet. But you do have to show up. You do have to try. Because medicine isn’t about perfection—it’s about participation. It’s about engaging with uncertainty, asking for help when you need it, and making the best decision you can with the information you have.

Floaties help. So does preparation. But the truth is, we all learn to swim the same way: by jumping in, flailing a little, and slowly figuring it out. The good news is that you’re not alone in the water. There’s a whole team behind you—faculty, colleagues, nurses, pharmacists, techs, and more—all ready to catch you if you start to sink. That’s the hidden strength of medical training. It feels like you’re doing it alone, but you never really are.

And here’s the part I didn’t understand when I was the one wearing floaties: that feeling of not knowing never really goes away. But with time, you start to trust yourself more. Not because you suddenly know everything, but because you’ve seen yourself navigate uncertainty before—and come out the other side. You build confidence not in having the answers, but in your ability to find them.

So jump in. You'll be okay.