Dr. Ross Prager, an Intensivist at the London Health Sciences Centre, shares ten crucial life lessons that are often missing from medical education. He highlights the importance of emotional connections with patients, focusing on how genuine care trumps clinical knowledge. Prager emphasizes that true character shines in tough moments and shows that passion is not a weakness in medicine. He also critiques reliance on standard evidence while advocating for accuracy in diagnoses and nurturing personal joy in healthcare. Authenticity and kindness remain central themes.
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volunteer_activism ADVICE
Make Patients Feel Cared For
Sit down with patients to make them feel cared for and to enhance their perception of the interaction.
Acknowledge and validate patients' emotions and be authentic, even admitting when you don't know something.
question_answer ANECDOTE
Worst Moments Are Most Remembered
Dr. Prager recalls a moment in residency when stress made him behave poorly toward a colleague.
That single negative interaction overshadowed many positive ones and impacted their relationship permanently.
volunteer_activism ADVICE
Show Competence by Caring
Show competence through kind, patient-centered care rather than by displaying knowledge impressively.
Being present and caring demonstrates true clinical skill more than performative displays of knowledge.
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Date: May 14, 2025
Dr. Ross Prager
Guest Skeptic: Dr. Ross Prager is an Intensivist at the London Health Sciences Centre and an adjunct professor at Western University. His expertise in critical care medicine is complemented by his research interests in critical care ultrasound and evidence-based knowledge translation.
This is an SGEM Xtra episode. The inspiration was a thread Ross posted on X: Here are 10 lessons they don't teach in medical school (but should) that I've learned the hard way over the years. He shared ten hard-earned lessons from his clinical life that never made it into the standard curriculum. These lessons are rooted in humility, human connection, and the everyday realities of medical practice.
1. Patients Don’t Care How Much You Know, but How You Make Them Feel
Sit down with your patients — standing can seem rushed.
Recognize emotions: “I imagine this must be stressful.”
Be human. It’s OK to say “I don’t know” or admit fallibility. Patients value authenticity over perfection.
2. You’re Remembered by Your Worst Moments
When stress hits, your true self emerges — that is what people remember.
Grace under pressure matters more than glory during routine.
3. Stop Trying to Impress People with Knowledge
Competence is shown, not shouted.
The best clinicians are present and kind, not performative.
4. Being Keen Is Not a Crime
Passion is a virtue, not a vice.
Don’t hide your enthusiasm. It’s a sign you care.
5. Med School and Residency Are Long Job Interviews
Every rotation, every shift, every colleague — it all counts.
Build your reputation day-by-day with kindness, work ethic, and humility.
6. Absence of Evidence ≠ Evidence of Absence
Not everything is backed by RCTs — that doesn’t mean it’s invalid.
Clinical observation and physiologic rationale matter (e.g., vasopressors).
As always, be skeptical of the lack of evidence, too.
7. Character Is How You Treat People Who Don’t Supervise You
It’s easy to be kind to your boss.
Your true self shows in how you treat nurses, janitors, and trainees.
8. Focus on Diagnosis First, Treatment Second
Most medical harm arises from misdiagnosis, not mismanagement.
Think ten times harder about “what’s going on” before “what should we do?”
9. Don’t Postpone Living Until After Residency
If you're waiting for life to get better after training, you're doing it wrong.
Find joy now. Build habits of balance early — your future self will thank you.
10. Remember the Spark
Recall your first patient: the awe, the uncertainty, the honour.
When burnout creeps in, revisit that moment. Reconnect with your “why.”
Final Thought from Dr. Prager: “Medicine is not just about answers, it’s about presence. Our best tool is our humanity.”
The SGEM will be back next episode with a structured critical appraisal of a recent publication. Trying to cut the knowledge translation window from over ten years to less than one with the power of social media.
Remember to be skeptical of anything you learn, even if you heard it on the Skeptics' Guide to Emergency Medicine.
The Skeptics Guide to Emergency Medicine 