As a medical student, you will spend most of your time drinking from a firehose of knowledge, and when pimped there is a strong chance that you won’t know the answer. Your attendings were all once medical students, so they will understand the occasional lapse, but even so, they may get annoyed if the answer to every question they ever ask is a blank “I don’t know.” With that in mind here is a quick list of 5 better ways to say “I don’t know.”
1. “I don’t know but…”
This is one of my standbys—something I pull out when I want the slimmest opportunity to save face before I am utterly annihilated in my ignorance. More than just the root phrase, this gives you an opportunity to address the question on your own terms. This allows you to cast yourself in a bit more flattering light by either turning the question back at the attending (tread lightly here) or showing that you actually do care enough to follow up later.
2. “I’ll have to look that up.”
This is more or less a continuation of the last point. By promising to look up a fact that you did not know you can demonstrate to an attending that you are actively trying to learn throughout your rotation and not just passively taking it all in. A word of caution, however, this response is like drinking unicorn blood—it can prolong your life but at a terrible cost. If you promise to look something up, you better be certain that you do so because you may have saved face today, but you may be called upon to answer the same question in greater depth in the future.
3. Think out loud.
This solution is very attending-dependent. Some physicians prefer a quick answer or none at all, but if you are going to be with someone for a longer period of time (i.e. during a long surgery) this can be very useful. For this method, if you don’t know the answer to a question, tell them what you do know and try to logic out the solution based on first principles. For example, if you can’t remember the effect of metoprolol on cardiac output, you could say that it is a Beta blocker and therefore it interacts with B1 receptors on the heart which decreases heart rate and contractility and additionally you know that CO = SV x HR so it must decrease cardiac output.
4. Strong and wrong.
Sometimes you are backed into a corner and you have no way out but to guess. In these situations, it’s best to portray confidence, even if you don’t actually feel it. I believe it is better to be strong and wrong than right and silent.
5. Run away.
Generally, your attendings are much older than you. If all else fails, run away—they will not catch you.