My mentor's point was to stay intellectually humble. The practical application to clinical medicine is obvious. We've all learned about the different types of biases that lead to medical errors and diagnostic misses. As trainees, we have seen physicians who exhibit too much hubris make mistakes.
Residency is endlessly humbling, but interacting with interns has shown me how much I have grown as a physician. I can answer all of the questions mentioned above, and even a few more.
As my years of residency have gone by, and I have made the transition to senior resident, it has gotten harder to say "I don't know." Just like my mentor predicted. Not knowing things on the wards or missing something in clinic stings my pride more now than it did when I was an intern.
A surgeon said this, while preparing to take a patient with abdominal pain to surgery for suspected appendicitis. In this particular instance, appendicitis is exactly what the patient had. It was one of those times to be decisive, and rapidly decisive. But whether through conscious effort or subconscious tendency, we often take "fake it until you make it" too far. We become insecure and isolated clinicians hiding behind façades of confidence. This tendency leads to worse outcomes.
Effective teamwork: clinicians who admit they don't know everything are more open to the input of others and more likely to see the patient's big picture.
Better education: A safe environment, where learners are empowered to disclose their gaps in knowledge, allows educators to address those gaps more effectively.
For newly minted resident physicians, my advice is to embrace "I don't know." You will do yourselves and your patients a great service. I will continue to say those three words as well, no matter how sharply it hurts my pride. If any of this inspires passion, positively or negatively, please leave a comment. I am looking forward to communicating with you this year through the Insights blog.
Read more about residency on the Learning+ blog.
I agree with everything you say when the discussion occurs among medical professionals. With patients, I prefer the sentence "I don't know yet". Some patients can be troubled when a doc says "I don't know". For me it is a wise and sure way.
It is the best advice that can be given to a student.