Some vets are constantly questioning themselves--not because they lack confidence, but rather because they wonder how they could have done better. Are you confident in your diagnostic and therapeutic capabilities? Here is an interesting way to look at competence: There are four stages in every endeavor, whether you are doing a laparotomy, learning photography, perfecting your golf swing or landing a plane on the Hudson River. They are: Unconscious incompetence Conscious incompetence Conscious competence Unconscious competence. Unconscious incompetence is when you have no clue what you’re doing. But worse, you don’t even realize that you are incompetent. Ouch. This is the baby trying to crawl. Or the toddler learning to eat with a spoon. Sadly, this is also the case of many people learning the ropes, including in medical professions. Of course the good news is that babies, toddlers and medical professionals have someone to guide them. In time, they will climb the ladder … of incompetence. Conscious incompetence is when you have no clue what you’re doing, but at least you’re aware of it. I think we can honestly say that this is how many of us felt when we first started working “in the real world.” Conscious competence is hopefully where most of us are in our careers. With experience, trial and errors, we have learned a few tricks and finally became consciously competent. This is when you look at an X-ray or an ultrasound, see a rock in the small intestine and declare, “I know I can remove this rock safely.” Unconscious competence is the holy grail. You start doing thing so well that you don’t need to think about it. Do you drive stick? How hard do you have to concentrate when you switch gears? In surgery, this would be when you’re doing a spay or cruciate surgery or a fracture repair and at the same time discussing post-op care and go-home medications with your nurse. You have reached a level of excellence that allows you to perform (and excel) without too much concentration in a completely relaxed state of mind. It is reassuring that with time we can all reach unconscious competence. It takes a lot of effort and sacrifices, but it can be done. One author guesstimates that it takes 1,000 hours to become competent at any worthwhile skill. This translates into 125 eight-hour days. Do you think this is a lot? Tiger Woods wouldn’t. Mozart wouldn’t. Fred Astaire wouldn’t. Another way to look at it is that if you need knee or brain surgery, you want the surgeon who has spent much more than 1,000 hours perfecting his art. So where do you stand in your personal or professional life? 11/2/2009 - Obesity is just as bad as smoking 10/19/2009 - Is Losing a Patient Worth $1.77? 10/16/2009 - Welcome to “Cutting Edge”