…Like a boss

USMLE Step-1.

The dragon, the beast, the…well really it’s just a test. While an important one, capable of wedging open the doors of higher learning and career pursuits, I’m beginning to worry considerably less about it. In fact, I’m looking forward to it.


Some weeks back I read an article in the Harvard Business Review: “How to negotiate like a boss .( As a card-carrying millennial, I click anything that says “like a boss’ for better or worse. ) The article highlighted a simple principle,  

“Promotion-focused people think about their goals as opportunities to gain — to advance or achieve, to end up better off than they are now. Whenever we think about our goals in terms of potential gains, we automatically (often without realizing it) become more comfortable with risk and less sensitive to concerns about what could go wrong. Prevention-focused people, on the other hand, think about their goals in terms of what they could lose if they don’t succeed — they want to stay safe and keep things running smoothly. Consequently, when we are prevention-focused, we become much more conservative and risk-averse.”
(HBR-…like a boss)

This claim was tested by a relatively low-powered experiment: 54 business students negotiating for a contract. One was told to avoid losing money for their company, the other, to gain as much as they could. Predictably, those whose backs weren’t against the financial wall fared better – but the underlying principle might just be applicable to medical practice, and (more immediately) medical studies. There’s a fine line between the two worth exploring, for the sake of my personal development and future patients.

Promotion- focused people excel at:

  • Creativity & innovation
  • Seizing opportunities to get ahead
  • Embracing risk
  • Working quickly
  • Generating lots of options and alternatives
  • Abstract thinking

(Unfortunately, they are also more error-prone, overly-optimistic, and more likely to take risks that land them in hot water)

Prevention-focused people excel at:

  • Thoroughness and being detail-oriented
  • Analytical thinking and reasoning
  • Planning
  • Accuracy (working flawlessly)
  • Reliability
  • Anticipating problems

(Unfortunately, they are also wary of change or taking chances, rigid, and work more slowly. Diligence takes time.)


For safety’s sake I combine this “promotion” mindset with the tried-and-true Ben Carson M.D. risk analysis:

Four questions: ‘What’s the best thing that can happen if I do this? What’s the worst thing that can happen if I do this? What’s the best thing that can happen if I don’t do it? What’s the worst thing that can happen if I don’t do it?

Ever learning, ever growing.



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