Adam Cifu, MD, general internist at UChicago Medicine in Chicago, made an emergency room mistake early in his medical career that he will never forget.

A 70-year-old woman had the classic symptoms of a urinary tract infection — burning, frequency, and incontinence — and a urine sample confirmed it. Cifu wrote a prescription for antibiotics and sent her home.

Two days later, the woman returned to the emergency room unable to walk. Cifu read the triage nurse’s note from 2 days earlier. The patient had recently been diagnosed with metastatic cancer, and her primary care physician was concerned about spinal cord compression from pulmonary tumors. He missed the note.

Cifu apologized to the patient, who soon began inpatient hospice for her advanced cancer. He will always wonder: What would have happened if he had treated her early signs of spinal cord compression? Would her family have made different decisions about her care?

A mistake like this one shakes a doctor’s trust in their own skills, experience, and judgment. 

“When we make mistakes, our accuracy doesn’t change — in fact, maybe our accuracy gets a little bit better because we’ve made a mistake,” Cifu said. “But our confidence in our accuracy gets worse, so in the time after that, it changes the way we care for people.” 

The Morning After…and Beyond

Julia Harrison, MD, PhD(c), associate professor and head of the Monash Medicine Course at Monash University in Melbourne, Australia, has spent years helping medical students regain trust in themselves after making mistakes.

There’s a reason she wound up on that path. About 20 years ago, Harrison returned home from the hospital after a long shift. Her phone rang. It was the attending on duty. She had treated an infant with a prolonged seizure and somehow given the child 10 times the appropriate dose of medication. After she’d left, the barely conscious infant had to be transferred to a larger hospital. 

“When he told me, I just felt like I was falling into a hole with no bottom,” Harrison said. “I felt sick.”

Harrison’s mind swirled the next day. She’d used a calculator and double-checked the dose, so how did she still get it wrong? “I tried to understand why it had happened, and I couldn’t,” she said. “It was like doing a silly mistake in a math test. It was a sum that was easy.”

She hadn’t slept the night before the error, so that fatigue could have been a contributing factor, but she will never know for sure. A few days later, Harrison visited the infant, who was awake and doing well.

The attending said something important: It might help you to know I’ve done worse. “Even though they were very simple words, they had a lot of meaning,” she said.

Harrison isn’t alone. The number of serious mistakes across medicine each year can only be estimated. Among the “Big Three” — vascular events, infections, and cancer — misdiagnoses alone were estimated annually at 11% for errors and 4.4% for serious harm, according to a 2023 Johns Hopkins School of Medicine study. Meanwhile, 11% of nearly 6600 physicians surveyed reported making a “major medical error” in the previous 3 months, according to one pre-COVID study in Mayo Clinic Proceedings.

The attending’s kind words didn’t completely erase Harrison’s pain. “We spend a lot of time teaching how to not make mistakes, but because of the nature of the work, mistakes will still happen, and they can be very distressing,” said Harrison. “Of course, it’s the patients and their families who carry a heavy burden for serious mistakes.”

Trusting Yourself Means First Trusting Others Will Help You

Harrison is the lead author on a 2025 review of research on programs to help medical students cope with error. She found storytelling to be one of the most helpful. Simply talking with a trusted peer or senior doctor and telling the story can help physicians cope with their normal, human fallibility. She also shares positive messages for doctors to remember — even if that means printing them out and putting them on a bulletin board. Human fallibility is normal. Good doctors make mistakes and recover. It’s okay to talk about making mistakes, and talking can help. There is support out there. 

“Conversations matter,” said Jo Shapiro, MD, associate professor of Otolaryngology-Head and Neck Surgery at Harvard Medical School and founder of the Brigham and Women’s Hospital Center for Professionalism and Peer Support in Boston. “The conversations we have after these events really, really matter to the healing of the people involved in them.” 

Research by Shapiro and others shows that many physicians would rather talk to a peer than a mental health professional. Talking about an error was once considered taboo and might still be in some places, but norms are changing. “I’ve really tried to help organizations understand the importance of this and then have these champions in the organization say, ‘We can do this,’” she said. “Let’s get people trained to go for this huge culture change that we need.”

Reassurance from another doctor helped Harrison believe in herself again after her overdosing error. When she went back to work, she gradually began to trust her judgment again. One experience that helped: Working with other doctors and nurses in a simulation center for high-risk medical scenarios helped her see the multitude of factors behind medical errors.

“You trust yourself up to a certain point, but you can never relax, and you might come back to work or come back to that same procedure with more vigilance, more attention, and care, and that’s needed,” Harrison said. 

Cifu agrees — at some point you must let the circumstances of the error out into the open, whether verbally to another physician or like he does in a journal. “When I’ve made mistakes, they tend to keep me up at night, and I wake up in the morning thinking about it for days,” Cifu said. “I write these things down because I think it’s really important to learn from them.”

His experience treating the woman with spinal cord compression taught him the importance of reading nurses’ notes. If the lessons aren’t obvious to you, a trusted colleague might be able to help you spot them. “Was it something you were misreading about how sick the patient was?” asked Cifu. “Was it one of the classic kinds of clinical reasoning errors that we make all the time? Did I reach early closure? Was there anchoring bias? If you figure that out, then going forward you’ll do better.”

Shapiro agrees and says questioning your competence is natural and necessary. “Almost everybody says they’re hypervigilant [after an error],” she said. “They’re double, triple, quadruple checking everything and spending more time in the hospital because they’re asking: What if I miss this again?” In her experience, it takes people at least a few weeks to start feeling competent again.

Don’t Forget How Helpful Patients Can Be

Almost two decades ago, Stacy Wentworth, MD, radiation oncologist at Duke Health in Durham, North Carolina, made her first medical mistake on a patient’s radiation plan. While the error didn’t influence the patient’s odds of recovery, it did require extra treatment, which takes time and can cause side effects. 

“I felt like I was the worst doctor ever, and that I had missed something, and that my medical career was going to be over,” Wentworth said.

At the same time, she knew her devastation wasn’t the top priority. “The more important part was getting the patient with cancer the right treatment, but I did prepare myself that she might want to see another doctor, not trust me, and I absolutely would have understood,” Wentworth said. 

When Wentworth told her patient what happened, the patient thanked Wentworth for finding and correcting the mistake. That helped rebuild shaken confidence. “I really do credit her magnanimous response as a pivotal point in my young career,” Wentworth said. 

Alex McDonald, MD, a family and sports medicine specialist with Southern California Permanente Medical Group based at Fontana Medical Center in Fontana, California, also came to realize the critical role patients play after an error. McDonald performed a thoracentesis that resulted in severe bleeding that required surgery. “This situation really severely impacted my mental health and confidence,” he said.

The first step was a debrief with the surgical and pulmonary teams. But the bigger step was explaining what happened and apologizing to the patient’s wife. “That was actually probably one of the hardest things to do in this whole process, but at the same time was very therapeutic,” McDonald said. “The patient’s wife was very understanding.”

Then he was subject to a quality review process. “It was determined that there was nothing that I did wrong per se; it was just one of the known complications, but that doesn’t change the fact that a patient was severely harmed by a procedure that I performed,” McDonald said.

Grappling with that reality was a struggle. His sleep was off for the next week. “The self-doubt that creeps in can be really insidious and very damaging because it sort of casts a shadow over everything,” he said.

Fortunately, his health system had a support program, and McDonald spoke with a psychologist to help him process his self-doubt. He also asked colleagues to watch him the next few times he performed thoracenteses. They said his technique was sound, feedback that helped to rebuild his confidence. 

But the biggest lesson of all: The experience reaffirmed the importance of discussing risks and benefits with patients. McDonald suspects the patient’s family might have been so understanding in part because they had been informed about the potential adverse outcomes of the procedure beforehand. Now, he’s even more explicit in his informed consent process.

“Sometimes patients are a little more cavalier about it, but then you really make sure you check for understanding and spend a little bit more time having that conversation,” McDonald said.

Wentworth knows talking to her patient — and finding out the woman didn’t think she was the world’s worst doctor — helped Wentworth trust herself going forward. Now, she shares the story with trainees who are struggling after a mistake. She also reminds early-career physicians that future patients need you, and you are still a healing person even if you made a mistake.

“The only way that this impacts future care is if you don’t learn from it and don’t change something about the way you practice,” she said.

Get Back to Being a Doctor ASAP…but Better

Normalization — not of the mistake, but of your response to it — is an important step for recovery, said Mickey Trockel, MD, director of Evidence Based Innovation for the Stanford University School of Medicine WellMD Center in Stanford, California. “This response of feeling overwhelmed by an error, and that what happened is catastrophic and far-reaching, is a normal reaction for so many physicians,” he said.

Shapiro concurs. “Sometimes these things do happen, and yes, they feel terrible, and we should feel terrible because we care, right?” she said. “But it’s not who you are.”

Who you are — that physician identity — is what will help drive you forward. Teaching others how to handle mistakes is therapeutic, Harrison said, and research shows this can aid long-term coping with past errors. More importantly, helping others with their mistakes has become part of her medical identity, the very thing that was shaken all those years ago. 

Guarding and feeding that identity is critical — as is accepting you’re human. “Everybody in medicine that I know wants to practice as perfect of medicine as they can, and so acknowledging limitations is important,” said Trockel.

The experts cited in this article reported having no relevant disclosures.

This article is part of an ongoing, year-long Medscape series examining the decline of public trust in medicine. More content is available here.