3rd year problems

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This is going to sound ridiculous, but it's not a joke, I assure you I am 100% serious.

I'm having a lot of trouble in 3rd year. I was OK first and second years, but now that I'm 2 months into 3rd year I am finding myself very uncomfortable. I really don't like being in the hospital or around sick people- it scares me. The entire environment gives me the creeps. Looking at disfigured and diseased people freaks me out. Maybe because I know that could very well be me someday. I don't want to feel this way, I know it's terrible, but I can't stop it. I've always known that I was uncomfortable in medical settings, especially around blood and needles, but I felt that I should just "man up" and get over it. But now, 3 years into med school, I'm still not over it and I don't know if I ever will be. I'm terrified going in every day. Has anyone else here encountered this? Does it get better? Is there something I can do to get over it? I dont' know how I'll handle another 2 years and then residency. If I could go into a field like radiology or pathology, that wouldn't be so bad, but my Step score and grades are pretty mediocre and I've been told by the dean that primary care is my best bet.

Some people tell me to quit, but I can't. I don't have anywhere else to go if I do, and there's really nothing else I have thought of doing, though working at a desk job in an office somewhere might be better. Fortunately I don't have loans, because my parents have covered my tuition. They've worked really hard- extra hours, weekends, etc- to get the money for it. I can't just throw out that money by leaving, not to mention all the hard work and effort I've put into getting this far.

I'm just really desperate right now. I can't go to anyone in my school about this because it just sounds absurd and wrong... that's why I'm posting it anonymously on a message board.

Time to sack up. The biggest question, on my mind, would be how to pay back 100k+ in loans.

I don't have any loans.

Hook up with your school's mental health. At bare minimum, it's a neutral party who can talk it out with you (and potentially they can be a lot more service than that - maybe some form of systematic desensitization would help, etc.). Is it a kind of uncommon feeling? Probably, at least to the extent you're experiencing it. But it's not the type of thing I would foresee issues arising from your bringing it up

There are field in medicine that don't have that much patient contact. Pathology is one, and I don't think it is all that competitive.

I guess the issue is how bad is this problem? Do you think you can stand to go through all your required rotations feeling this way? If it's not possible, it's not possible, and there is nothing really to talk about.

Apply broadly to path.

You know OP, another option for you might be consultant for big pharma. I'm not sure how viable this is if you don't have any clinical experience, but you could edge this way if you put in a little bit of time in clinic and the rest looking over data/how drugs would affect patients. It's good money.

I'm sorry to hear you're having this problem though. My friend was a MD but couldn't stand sick people so went the research route and now works for big pharma (not as a consultant), just doing lab work/paperwork all day. This might be something for you to think of too.

Actually, now that I think of it, there were a couple of MDs in the lab I worked in that didn't necessarily want patient contact. They worked their way up to a supervisory position that you would normally start off as a PhD, but through time, they eventually got these positions as well.

Did your MD friend who works for pharma go to residency? What route did he take - if you don't mind me asking?

I'd be very cautious about going into big pharma these days, the industry is currently going down the sh:tter with no rebound in sight. While you may find a job in the short term, I'd worry about long term career prospects if I were you. If you get an MBA, you'll have better job security... But MD consultants/researchers are a dime a dozen and just as good via teleconference from Mumbai, if you catch my drift...

Originally Posted by YH5

Apply broadly to path.

For a guy as easily grossed out as him, path is probably one of the last specialties he should be considering.

Originally Posted by peteB

This is going to sound ridiculous, but it's not a joke, I assure you I am 100% serious.

I'm having a lot of trouble in 3rd year. I was OK first and second years, but now that I'm 2 months into 3rd year I am finding myself very uncomfortable. I really don't like being in the hospital or around sick people- it scares me. The entire environment gives me the creeps. Looking at disfigured and diseased people freaks me out. Maybe because I know that could very well be me someday. I don't want to feel this way, I know it's terrible, but I can't stop it. I've always known that I was uncomfortable in medical settings, especially around blood and needles, but I felt that I should just "man up" and get over it. But now, 3 years into med school, I'm still not over it and I don't know if I ever will be. I'm terrified going in every day. Has anyone else here encountered this? Does it get better? Is there something I can do to get over it? I dont' know how I'll handle another 2 years and then residency. If I could go into a field like radiology or pathology, that wouldn't be so bad, but my Step score and grades are pretty mediocre and I've been told by the dean that primary care is my best bet.

Some people tell me to quit, but I can't. I don't have anywhere else to go if I do, and there's really nothing else I have thought of doing, though working at a desk job in an office somewhere might be better. Fortunately I don't have loans, because my parents have covered my tuition. They've worked really hard- extra hours, weekends, etc- to get the money for it. I can't just throw out that money by leaving, not to mention all the hard work and effort I've put into getting this far.

I'm just really desperate right now. I can't go to anyone in my school about this because it just sounds absurd and wrong... that's why I'm posting it anonymously on a message board.

This isn't really surprising. Medical school admissions and the first 2 years of medical school don't really resemble anyone's medical career. We have a very odd way of selecting and training in this field. One of the few where you don't spend a majority of your time on what the job will be like until you are 6 years into a 11 year process.

Medical educatuon is very odd.

Originally Posted by GuyWhoDoesStuff

For a guy as easily grossed out as him, path is probably one of the last specialties he should be considering.

True

Do you think this grossed out feeling will pass eventually? Has anybody experienced this and gotten over it? How did you do it?

Originally Posted by GuyWhoDoesStuff

For a guy as easily grossed out as him, path is probably one of the last specialties he should be considering.

He mentioned that he would consider pathology as a career. I'd assume that as a third year student, he has enough exposure to the field to know if he could handle it. It seems that he is more bothered by interacting with sick patients than grossed out by body parts.

Plenty of path outside of autopsies regardless

Originally Posted by YH5

He mentioned that he would consider pathology as a career. I'd assume that as a third year student, he has enough exposure to the field to know if he could handle it. It seems that he is more bothered by interacting with sick patients than grossed out by body parts.

Yes, this is correct.

Originally Posted by notbobtrustme

Time to sack up. The biggest question, on my mind, would be how to pay back 100k+ in loans.

Did you even read his entire first post? lol
OP, how about radiology?

If I were you i'd hang in there. Many med students may feel the same way you do- most get used to it- if not there is also psychiatry, radiology, ophthalmology as well as pathology- areas where you are not likely to see too many MEDICALLY ILL patients.

Originally Posted by loveoforganic2

Plenty of path outside of autopsies regardless

Sure, but plenty of autopsies during residency.

if you can make it through the rest of med school and intern year, go for it! there are plenty of specialties were you dont interact with quite so many sick peopl. well maybe not plenty, but there is rads, and path, and rad onc. maybe even ophtho? you only look at eyes. and psychiatry!!!
i think its natural to be grossed out to some degree... can anyone honestly say that sick, smelly patients (say with an infected diabetic foot ulcer) dont gross them out? there were times where I had to turn away from the patient bc i was literally gagging from the smell...

How did you get through anatomy?

Originally Posted by flodhi1

Did you even read his entire first post? lol
OP, how about radiology?

I wouldn't mind radiology, I'd probably actually like it, but my scores are too low to even try, I think. My Step 1 is 198...

Originally Posted by tiedyeddog

How did you get through anatomy?

Anatomy wasn't great, but it also wasn't that bad. In our school we each only have to do a part of it. The rest I learned mainly from books.

My problem is mainly with the living sick and the hospital environment. The way my friend put it is - you don't have a problem eating a chicken after it's fried, but you would have a problem eating a live chicken... lol

Originally Posted by peteB

My Step 1 is 198...

Match rates for US grads with Step 1 scores between 191-200:

Pathology: 26/27
Radiology: 10/15
Psychiatry: 92/99

Originally Posted by VisionaryTics

Match rates for US grads with Step 1 scores between 191-200:

Pathology: 26/27
Radiology: 10/15
Psychiatry: 92/99

Wow! Why does everyone say Radiology is competitive then??

Originally Posted by peteB

Wow! Why does everyone say Radiology is competitive then??

As an American grad, you can do even competitive specialties with a poor step 1 if you don't care where you go. You may get a rads residency, but it would be a terrible program in the middle of nowhere. Still, that might be okay for you if you really hate being around sick patients that much.

Also, it sounds like you are bothered by physical disease. How about mental disease? If you haven't had your psych rotation yet, wait to see what it's like. You might be pleasantly surprised at how interesting it is. Also, your step 1 is only a little below the psych average. You might be able to get an okay psych residency depending on the rest of your app.

Originally Posted by DrSnips

As an American grad, you can do even competitive specialties with a poor step 1 if you don't care where you go. You may get a rads residency, but it would be a terrible program in the middle of nowhere. Still, that might be okay for you if you really hate being around sick patients that much.

Also, it sounds like you are bothered by physical disease. How about mental disease? If you haven't had your psych rotation yet, wait to see what it's like. You might be pleasantly surprised at how interesting it is. Also, your step 1 is only a little below the psych average. You might be able to get an okay psych residency depending on the rest of your app.

Psych is a possibility, I haven't had my psych rotation yet, so I'll wait and see how that goes. It's too bad that the first two years of medical school aren't like real medical practice at all. If it were I'd probably have figured out if I could manage this or not first year itself and maybe if I couldn't I'd find another career...but now I'm in too deep!

Originally Posted by peteB

Psych is a possibility, I haven't had my psych rotation yet, so I'll wait and see how that goes. It's too bad that the first two years of medical school aren't like real medical practice at all. If it were I'd probably have figured out if I could manage this or not first year itself and maybe if I couldn't I'd find another career...but now I'm in too deep!

Realistically you should have figured this out before starting medical school.

Originally Posted by tiedyeddog

Realistically you should have figured this out before starting medical school.

You're right, I screwed up. Can't blame anyone but myself on this one!

Originally Posted by tiedyeddog

Realistically you should have figured this out before starting medical school.

It's extremely difficult to think about something like this unless you have a reason to consider it.

I never considered whether I would be grossed out by the sick and disfigured. I always figured if I did, I would get over it.

OP, if you are mainly at issue with the living sick, then I would definitely consider pathology. It's not that dead bodies disturb you, it's those that are still int he process of dying, which I completely understand.

I am the same way you are, except with sick kids, so I am 99% going to avoid pediatrics.

Originally Posted by evilbooyaa

It's extremely difficult to think about something like this unless you have a reason to consider it.

I never considered whether I would be grossed out by the sick and disfigured. I always figured if I did, I would get over it.

OP, if you are mainly at issue with the living sick, then I would definitely consider pathology. It's not that dead bodies disturb you, it's those that are still int he process of dying, which I completely understand.

I am the same way you are, except with sick kids, so I am 99% going to avoid pediatrics.

Thanks, I'm really happy to hear from someone else who feels the same way I do. I'll definitely try either pathology or radiology.

Originally Posted by evilbooyaa

I am the same way you are, except with sick kids, so I am 99% going to avoid pediatrics.

You avoid it for the sick kids. I avoid it for their parents.

Originally Posted by DrSnips

You avoid it for the sick kids. I avoid it for their parents.

Well, those too. The 1% of pediatrics I would consider would be the NICU. Kind of hypocritical, but at least you won't see a 5 year old that's 100 pounds in the NICU.

Also, outpatient tends to be less "sickly"-- though occasional exceptions do arise. What aspect of it is gross to you? The fact that they are unpleasant to sight/smell/etc, fear of getting what they have, other apects?

Its possible to tough it up from here and residency and do outpatient in like family med, peds, others (Im not the most knowledgeable) where the patients may still be sick but its not like an inpatient ICU kind of sick

Like others said, psych of course doesnt really deal with that much, but also keep in mind in your rotation that inpatient psych is a different beast than outpatient-- so if inpatient seems too "nuts" to you, outpatient might work (once again there are exceptions on a case-by-case basis)

Originally Posted by evilbooyaa

Well, those too. The 1% of pediatrics I would consider would be the NICU. Kind of hypocritical, but at least you won't see a 5 year old that's 100 pounds in the NICU.

I saw a 45 pound 2 year old on peds. My attending asked me to guess the weight. I guessed 50 lbs. The mom got offended. Go figure.

Originally Posted by DrSnips

I saw a 45 pound 2 year old on peds. My attending asked me to guess the weight. I guessed 50 lbs. The mom got offended. Go figure.

lolol

Originally Posted by peteB

Wow! Why does everyone say Radiology is competitive then??

I would be very careful about Radiology though. With time a lot of American radiologists are going to be struggling to find a job. The whole high tech world is changing everything including the way we will be practicing medicine. Why would a hospital pay a radiologist in the US $350,000 / year when they can simply hire a radiologist in India for $25,000 and obtain almost the same results. I know it sounds unethical but we know how companies are trying to profit every day.

Originally Posted by flodhi1

I would be very careful about Radiology though. With time a lot of American radiologists are going to be struggling to find a job. The whole high tech world is changing everything including the way we will be practicing medicine. Why would a hospital pay a radiologist in the US $350,000 / year when they can simply hire a radiologist in India for $25,000 and obtain almost the same results. I know it sounds unethical but we know how companies are trying to profit every day.

Would it be legal to hire someone in India who isn't licensed in the US?

Originally Posted by flodhi1

I would be very careful about Radiology though. With time a lot of American radiologists are going to be struggling to find a job. The whole high tech world is changing everything including the way we will be practicing medicine. Why would a hospital pay a radiologist in the US $350,000 / year when they can simply hire a radiologist in India for $25,000 and obtain almost the same results. I know it sounds unethical but we know how companies are trying to profit every day.

Did you know people have been peddling that kind of bull**** scaremongering for past 10 years?

Why is it going to happen now.

Originally Posted by peteB

Would it be legal to hire someone in India who isn't licensed in the US?

This sounds like a huge liability for the hospital, especially since so many crucial decisions are made based on how a radiologist reads a study. A subtle finding can determine whether a patient receives surgery, is treated with serious medications, etc. Because of this, I doubt that radiologists will be competing with their Indian counterparts any time soon.

Originally Posted by ijn

Did you know people have been peddling that kind of bull**** scaremongering for past 10 years?

Why is it going to happen now.

It is definitely possible, but I don't think it's that practical because of the legalities involved... I'm pretty sure you'd need to have at least some radiologists licensed in the US working for your hospital.. I do know my own hospital has images read in Australia overnight, but the radiologists here still look at the them afterwards.

Originally Posted by yuiness

This sounds like a huge liability for the hospital, especially since so many crucial decisions are made based on how a radiologist reads a study. A subtle finding can determine whether a patient receives surgery, is treated with serious medications, etc. Because of this, I doubt that radiologists will be competing with their Indian counterparts any time soon.

I suppose it is possible that the overseas radiologists could do the bulk of the work, and the American radiologists would just be checking the work. That would probably allow the hospitals to cut down the number of radiologists.

Originally Posted by ijn

Did you know people have been peddling that kind of bull**** scaremongering for past 10 years?

Why is it going to happen now.

I'm not going to say anything but there are hospitals that I have seen with my own eyes getting their images analyzed by international physicians present in foreign countries.

Originally Posted by flodhi1

I'm not going to say anything but there are hospitals that I have seen with my own eyes getting their images analyzed by international physicians.

This is true, my own hospital has radiologists in Australia reading images.

This is one of those cases where you just have to make the best of the situation.

Originally Posted by flodhi1

I would be very careful about Radiology though. With time a lot of American radiologists are going to be struggling to find a job. The whole high tech world is changing everything including the way we will be practicing medicine. Why would a hospital pay a radiologist in the US $350,000 / year when they can simply hire a radiologist in India for $25,000 and obtain almost the same results. I know it sounds unethical but we know how companies are trying to profit every day.

This is ridiculous and uninformed. You can't practice medicine and get paid without a US license regardless if it is a heart transplant or reading an imaging study. Following your logic, surgeons and medicine docs would be at the same risk. Just bring over indian attendings and have them work for pennies on the dollar.

I can name about a dozen reasons why third world country doctors will never be making final reads on US imaging studies.


The radiology job market isn't great for other reasons. But its nothing to prevent you from finding a job if your are flexible about location.

Originally Posted by flodhi1

I'm not going to say anything but there are hospitals that I have seen with my own eyes getting their images analyzed by international physicians present in foreign countries.

International physicians or US trained and licensed physicians living in other countries? There is a big distinction. I believe its actually medicare fraud to sign final reads on anywhere thats not US soil.

Originally Posted by link2swim06

This is ridiculous and uninformed. You can't practice medicine and get paid without a US license regardless if it is a heart transplant or reading an imaging study. Following your logic, surgeons and medicine docs would be at the same risk. Just bring over indian attendings and have them work for pennies on the dollar.

I can name about a dozen reasons why third world country doctors will never be making final reads on US imaging studies.


The radiology job market isn't great for other reasons. But its nothing to prevent you from finding a job if your are flexible about location.

Everyone is entitled to their own opinion and I respect yours. I'm not trying to start a flame war here about something completely irrelevant so I'm just going to drop this whole thing. Back to the topic OP, you have many options of practicing medicine without freaking out so don't give up and best of luck!

Originally Posted by link2swim06

International physicians or US trained and licensed physicians living in other countries? There is a big distinction. I believe its actually medicare fraud to sign final reads on anywhere thats not US soil.

I am unaware of where they received their education or what their legal status maybe. I have had long lectures from multiple attending Radiologists who explained why they think the job market was going to be shifted out of the country with time but that's another topic for another day.

Originally Posted by flodhi1

I am unaware of where they received their education or what their legal status maybe. I have had long lectures from multiple attending Radiologists who explained why they think the job market was going to be shifted out of the country with time but that's another topic for another day.

I am obviously not a radiologist. But for awhile was really interested in radiology and spent a bunch of time on aunt minnie (the radiologist forum) reading threads which made this seem extremely unlikely.

Some of the factors I remembered brought up was: you can't bill medicare/medicaid from outside the US, near impossible to get the needed liability insurance w/o the US training, etc. Even if a foreign person screws up 1/5000 reads, that might cost a 2 million dollar lawsuit and make the US radiologist the actual cheaper option.

Sorry to go off topic OP. Just explaining what I meant.

Originally Posted by link2swim06

Sorry to go off topic OP. Just explaining what I meant.

No problem I am actually interested in this discussion because I am interested in radiology.