Performance Punishment, Perfect Punishment?

20 Nov 2024

By Jenna Kwon

I heard about it for the first time during a recent meeting with my mentor from the AWS Mentoring Program. As I was telling her I wanted to dedicate more time to research, she advised me to ask my current research mentor if there were additional projects I could join, saying, “since good work gets rewarded with more work.” 

My immediate reaction during the meeting was, “I hope he thinks I did a good job so I can get more work.” After all, I both wanted and needed research opportunities. After the meeting, as I looked through my notes on a Post-it, I noticed that the phrase about good work being rewarded with more work was circled several times with a small, sloppy “??” scribbled next to it.

How lucky would it be to get involved in a research project you are passionate about—and to keep getting more chances to contribute? I think this stood out because, on one hand, I was a little envious of people who don’t have to chase opportunities with endless “Sent x days ago. Follow up?” Gmail reminders. On the other hand, the idea of being given more work for doing well seemed both obvious and oddly counterintuitive. I started to wonder if this concept was actually a thing and if so, what we—who generally love giving names—decided to call it. 

Typing… I pressed Enter.

“When good work is rewarded with more work, it’s often called performance punishment.”

Punishment? How did words like “good” and “rewarded” come to mean “punishment”?

This made me reflect on how we, as medical students, often find ourselves in situations where extra work is seen as a reward for our efforts or, simply, more learning opportunities. As medical students, the most common question we hear is, “Have you decided on a specialty?” This is often followed by, “Yes, but I’m keeping an open mind.” Perhaps this process—deciding, staying open-minded, accepting the hard path—becomes part of our journey in medicine, even though it often leads to more work.

Perhaps it’s the nature of medicine: to excel requires continuous learning, adapting to evolving technology, and keeping up with new protocols. By doing a good job, we inevitably take on more responsibilities. Not to mention, for women, this often means taking on additional volunteer work rather than advancing their careers. While its prevalence does not make this phenomenon fair, it does explain why we’ve come to somehow accept it, which may contribute to high physician burnout rates. 

Of course, my thoughts may evolve in the future. But for now, as a medical trainee aspiring to be a surgeon with boxes to check off, performance punishment feels more like a reinforcement of others’ reliability in my responsibility. So, if it is a “punishment” by definition, I’d gladly take it as my “perfect punishment.”

 

Jenna Kwon is a medical student at the Warren Alpert Medical School of Brown University. She grew up in Seoul, South Korea, and she plans to pursue an integrated vascular surgery residency. Outside of medicine, she enjoys taking hot yoga classes, writing reflective essays, and learning about animals.

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