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Borderline Third Year Medical Student

Discussion in 'Allopathic' started by anonymoustudent, 02.09.12.

  1. anonymoustudent

    anonymoustudent

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    I hope to find honest opinions on my situation, something that I rarely talk about with my classmates or residents.

    I hate medical school. I'm in my third year and every year I read on this forum or hear from my colleagues that it gets better the following year. The reason I do not like medical school is because I am a borderline student, despite an absolutely tremendous effort, and it's frustrating to be less than 5 people above the the bottom of the class with a 76 two digit Step I score, unable to answer some of the most basic pimp questions on the floor. I spent the 1st 3-4 months of clinicals going over basic science again and though the fundamental concept is there, I cannot explain to someone step by step the physiological mechanism of ideas like the RAA system, something I was asked to do today. That's just one example of some of the moments I've had in clinicals, though they haven't all been terrible, there have been many embarrassing moments. It sucks to suck this bad at something.

    My 1st two years consisted of me studying to the point where personal hygiene and decent nutrition was a problem and for the most part barely passing my tests and classes and being unable to do nothing beyond recite facts of concepts I did remember. (I only later grasped the actual concepts during my review at the start of clinicals). Of my second year classes, I passed 8 of them right on the dot, with 3 of the eight readjusted grades after successfully passing the remediation exams.

    My problem now is that I still suck. My good skills go nothing beyond a good H&P and decent knowledge of some autonomic and antimicrobial pharmacology. The rest is mediocre or worse and my resolve to improve is lessening and I'm getting tired of being this terrible at something.

    I've thought about quitting a lot. The problem is my $270,000 debt after completing third year and my age (30). My practical side is telling me to at least finish medical school and match into an internship year before deciding what to do next. I'd like to at least pay off $200,000 of what will be a $350,000 debt before I leave medicine altogether and search for a passion that I can excel in.

    I do not care about income anymore, a lot of which is driven by personal reasons. I applied to medical school with the idea of job security and decent income. But I'm perpetually single, somewhat socially awkward, and doing something that is really unsatisfying due to my lack of skill and lack of improvement. I suppose there are many reasons I've been somewhat depressed for the majority of my twenties but I should at least owe myself the opportunity to not be miserable at my job.

    I'm open to any suggestions. Thank you.
  2. amaprez

    amaprez

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    Came in expecting borderline personality disorder

    Edit: Sounds like a difficult quandary to be in. You're basically trying to play catchup for 2 years of under-performance while juggling clinicals. I hope somebody more qualified chimes in.
    Last edited: 02.09.12
  3. jlimback

    jlimback

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    Are you someone who needs time and repetition for things to sink in?

    As with lots of things in life, maybe it gets easier/better the more often you see it. I think you're smart to stick it out until PGY's. It'll give you more hand-on exposure, and give you an idea of whether seeing more of the same thing for extended periods of time will help you remember.

    Also, where else are you going to go? Survive the pimping and kiss a lot of @ss, IMO. The world outside of medicine will require no less of you for a far lesser salary.
  4. vin5cent0

    vin5cent0

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    I'm not a medical student, so take what I say with a grain of salt if you wish, but here are my views on the matter.

    1) Someone has to be last. You could have 500 people in your class, all with exceptionally high IQs, test grades, etc. Someone is still going to be the "stupidest" in the class, ranking dead last. Does that make them stupid? Absolutely not.

    2) Medical school is obviously hard, and you're passing. Even if you're "barely passing", you're still scoring above the threshold that your school has deemed well enough for you to be a competently practicing physician.

    3) You've already toughed out the two hard years of classes. I'm assuming since you're in 3rd year, that is already paid for as well. It would make absolutely zero sense to drop out of school when you only have 1 more year of tuition to do. Even if you don't like the job, I'm sure having an MD opens more doors.

    4) You still have specialties out there you've yet to do clinicals in. Your scores could very well be indicative of a lack of interest in what you've seen so far. The beauty of medicine, at least to me, is that there are some vastly differing specialties out there. Just figure out what makes you intrigued, curious, and interested in learning more, and the rest should come.

    5) Re-evaluate your study methods and mediums. Maybe you just need an adjustment in the way you're studying, or what materials you're using to study. A friend of mine was struggling his first semester in medical school, but he took action and spoke to someone at the school. They talked things out, he changed some habits, and now he's doing way better with significantly less effort on his part.
  5. officedepot

    officedepot

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    .
    Last edited: 04.12.12
  6. VenusinFurs

    VenusinFurs I am tired, I am weary

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    OP, the time and repetition thing is key here, and also, at least you didn't repeat a whole year which a ton of people end up doing at my school. Do you like listening to people whine? Because if so you could do psychiatry. It's not terribly competitive and they don't seem to be in the habit of making you feel dumb about not knowing lots of fascinating facts.
  7. drizzt3117

    drizzt3117 chick magnet

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    I think the OP may benefit from counseling.
  8. Bernoull

    Bernoull

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    This.

    Also stick it out, you've come TOO FAR and have a ton of debt. I'm an M2 so I'm don't know what educational resources are available in 3rd yr, but seek out a mentor or two, perhaps they can help you with the clinical application of the basic science. Talk to some classmates, you'll be surprised to learn that you aren't the only one struggling. Well, you have to gauge the classmates you talk to, since some over-achievers may stress out over 89%! Some camaraderie can help!

    Again, stick it out, identify the resources you need to be successful and keep going!

    :luck::xf::xf::luck:
  9. herewego

    herewego

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    Not sure why you guys think he needs counseling. From reading the OP I don't see any real red flags. Even if the OP is a 3rd year, doesn't mean medicine is right for everyone.

    That being said, OP I think you're worth more than you think, especially if you've made it this far. I'd say tough it up, and go for an easy residency. I know, it sucks when you don't enjoy what you're doing but being this far in I think you owe it to yourself to finish. You're not getting any younger, so whats a few more years? Not like the difference between finishing and not finishing is a couple decades. I think you can still be of benefit to your patients in the future. Just my 2 cents.
  10. mmmcdowe

    mmmcdowe Duke of minimal vowels Moderator Gold Donor

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    OP, to confirm, are you a US MD?
  11. amaprez

    amaprez

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    Why does this matter in regards to his dilemma?
  12. myhandsarecold

    myhandsarecold

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    You can precept PA/NP who wants to own their own clinics ( they pay you to sign their stuff )
  13. drizzt3117

    drizzt3117 chick magnet

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    Depressed for the majority of their 20s and working to the pt where they're compromising their personal hygiene? Sounds concerning to me.

  14. MIAYO

    MIAYO

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    I also agree counseling would be a great idea.
  15. gravitywave

    gravitywave fourth year

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    med school != practice. you are almost there, OP. you will have loads more control over your time as an attending provided you don't pick a workaholic field. plus fourth year is right around the corner and from what i hear, it's pretty sweet.

    the guy who graduated last in his class is still a doctor
  16. sirenomelia

    sirenomelia

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    dumb reason to go to medical school
  17. mmmcdowe

    mmmcdowe Duke of minimal vowels Moderator Gold Donor

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    A remediated and borderline us md student has much more of a shot at residency than if he is carib. Perhaps some of the advice would change if his chances of a career in the us were much lower.unlike the guy in a us school that graduated last, someone off shore in a similar situation is not as fortunately placed.
  18. step1s

    step1s

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    op -- you are not alone in feeling the way you do -- even people at the top of your class feel exposed as frauds during third year
  19. Thats not necessarily a bad thing at this point, if you've ever seen Doctors Diaries ALL the people that got married during medical school ended up divorced.....

    I echo the others suggestion that you talk to someone..... if you are actually depressed a lot of these problems are probably caused by the depression and not you

    I wouldn't waste anymore time consulting SDN or WebMD or whatever other anonymous virtual world, I would get up and do something that will actually help in the real world..... like counseling. Good Luck.:xf:
  20. fahimaz7

    fahimaz7

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    It's not a dumb reason. Everyone has their own reason for doing whatever they do, so back off this guy and let his honest statements mean something. Money and job security are both major factors for a lot of people when it comes to career choices. Now if he hates science, pathology, and diseases then he might be in the wrong field. There are even fields for doctors that hate patients/people.
  21. donkeykong1

    donkeykong1

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    This.
  22. vasca

    vasca En la era postpasambre

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    OP, how many months are you into your 3rd year? If you are only in your 1st rotation, you are most likely confused, bewildered, and utterly not used to the 180 degree change of learning and grading.

    In 3rd year most of your learning is not from sitting in a library memorizing boring books, it's learning how to apply the foundation knowledge of biochemistry and pathology into a real life patient and practicing taking HPs'. Your first HP's will be lame, you will be jittery and nervous when asking awkward questions and some patients will be rightfully annoyed at seeing some jittery looking kid with a labcoat and might ask you to scram. It's not always pretty, you are at the utter bottom of the totem pole and even 4th year med students can pimp you around a bit.

    Guess what, even the most pompous hospital director with tons of research and head of some big name medical academy was a lowly 3rd year med student at one point. Medicine is a bit like the military, everyone starts from the rock bottom and over time they are promoted going upwards which has it's perks and bad things. Perks that you have someone below you to do time consuming scut work and you know more and bad things that with each rank going up you have more legal responsibility.

    If a med student or intern did something wrong under your watch, you will be held responsible for the bad action because you were supposed to supervise them. However in exchange you can give punishments of varying severity depending where you work to the people below you. In Mexico punishment shifts where you work pro bono endless hours is supposed to be illegal, but commonly done everywhere and still socially acceptable among the medical community. If you don't like it, get out of medicine and get a job flipping burgers.

    You must learn how to get used to getting pimped and humiliated with pride and grace. Don't expect to go somewhere crying that big bad attending made you look dumb in front of everyone. Learning to become a doctor also involves a lot of tough love, the life of a patient will be one day under your hand. While 99% of doctors working long enough in the real world won't be expected to remember the steps of an arbitrary biochemistry reaction, the bad attitude you seem to give me will get you into a lot of trouble and could cost the life of a patient and your license you are fighting so hard to get.

    Some attendings are just real jerks and you eventually learn to ignore the bad side of that, the really nasty attendings are usually bitter divorcees with bad personal lives and get a thrill at making gullible med students cry because it's one of the only fun things they have in life. However, most attendings that pimp students are doing it out of good nature and perhaps some attending is seeing there is something really promising inside of you but you only need more direction and that's where tough love comes in.

    I have a nice friendship with a successful radiologist who is insanely highly respected at his hospital because he knows A LOT. Curiously while he did do pretty well in med school and his social service he didn't really know what he wanted to do as a specialty and only randomly chose Rads because he had a good match score in the residency exam and randomly chose a very competitive rads program at a top hospital. Curiously in his first year he was struggling with exams and the rigors of work just like you are doing right now and wanted to quit only 3 months in his PGY-1 year. One day an attending came to talk to him in private saying he sees something great in him and if he studied harder and with more seriousness he would succeed. The talk really opened his eyes that an attending that used to pimp him into insanity was suddenly so nice and honest with him and that gave him the drive and desire to become a better doctor, studied at home his books and tried to suck up as much book knowledge about each case he saw on the job and finished his residency top in the class and has a successful career.

    If you are struggling from poor study habits you should find a mentor that could give you advice on which things can be improved, find good friendships in your classroom so that both of you spend free time practicing exploring eachother and making fake HP's. Medicine should be first learned learning to find what is normal to then get used to search for what is not normal in real patients. If you do get pimped or are in a pimping session and the question the doctor is asking is something you don't know, go read about it at home with a curious mind and sooner or later the little trinkets of knowledge will come in.

    I also suggest you to team up with an intern in your rotation and in exchange for not whining if he asks you to do a bit of scutwork, when the work is over and there is some free time the two of you can go ask questions about interpreting EKG's and x-rays. The more experienced intern will probably be happy to help a motivated med student if you help get the work done fast enough that there's a nice 20 minute opening to learn.

    I too felt a bit lost in my first 2 months of 3rd year but once you get a hang of it, 3rd year becomes really fun!
  23. peppy

    peppy Senior Member

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    Remember that there is more to medicine than inpatient IM. Answering pimp questions and knowledge of the fine details of the RAA system are of course given great weight in inpatient IM, but really not that important in many other specialties, so even if it's true you wouldn't be a great IM doctor that doesn't mean you'll be a bad doctor period. Medicine is a broad field and you may very well discover there is a specialty that is within your reach that plays into your strengths.
    For example, as a psych resident, I would think well of a med student on Psych that can get a good history from a patient and is knowledgeable about pharmacology (two of your strengths apparently), while a med student who remembers lots of small details from biochem and physiology but has trouble relating to patients would have some work to do from a psych perspective.
    Maybe you should also try to investigate PM&R and see if that is more to your liking, since that's more focused than general IM. The advantage with both psych and PM&R is that (while the top programs are of course very competitive in any specialty) they are relatively non-competitive and therefore obtainable even if you did have trouble with step 1.
  24. Untraditional

    Untraditional A bit late to the party.

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    You have to get remedial if you're still missing the basics. Review everything you see each day or start using a smartphone to look up topics in those wasted free moments you have on rotation.
  25. VenusinFurs

    VenusinFurs I am tired, I am weary

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    Yes. Smartphone your way into being a doctor.
  26. sirenomelia

    sirenomelia

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    If you are on the wards every day and not deriving satisfaction from directly helping people in your first year of patient care already and the motivation to be there in the first place was economic-

    1) there are much easier faster ways to financial security
    2) most of us arent rich anyway
    3) job security isnt even a given anymore
  27. Untraditional

    Untraditional A bit late to the party.

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    It's good advice. When you look up "amiodarone" for the 9th time in a day it starts to stick.
  28. link2swim06

    link2swim06 PGY-1

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    And what career would this be?

    Also name what job has better job security than medicine and includes point 1.
  29. Spee

    Spee

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    Switch to Dentistry.
  30. sirenomelia

    sirenomelia

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    http://money.cnn.com/magazines/moneymag/bestjobs/2010/qualitylife/security.html

    None of these occupations demand a fraction of the mental, physical or financial investment nor do they bear the day to day mediolegal risks. "Financial security" is relative. If you go to college for 4 years and then go to work in IT making 80k then you're still going to be better off than losing 8+ years of earning potential, accruing debt, etc even if you finally end up with a higher (for now) paycheck when you're 40.
  31. link2swim06

    link2swim06 PGY-1

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    8+ years?

    You make near a starting IT salary as a resident. I only see 4 years of lost income potential. Plus alot of IT people get master's degrees...so maybe closer to 2-3 years of lost income + 200K debt.

    Also I will be an attending at 29 not 40, none of the people on the IT track will make half of my salary at that point. From that point forward I will outpace any other career track in job security and salary.
  32. sirenomelia

    sirenomelia

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    keep dreaming....you'll make 40-45k as a resident for a minimum of 3 years...more years than that to lead to a job at the 200k range. And if our friend Obama has his way the solution to the healthcare crisis will be in part to continue to slash physician reimbursements or hold fee scales frozen while inflation, costs, overhead, etc keep climbing. Medschool is not a 0 income situation either it is a negatve as you pay to be there and will accumlate debt which will grow with interest. IT managers make double a resident salary even if they plateau in the range of 100k. They will also be working 40hrs/ week by comparison, will not be wasting time and money paying for boards and licenses and fulfilling CME while you will do 80hrs as a trainee and 60ish in practice atleast starting out so you will likely too busy/tired and will spend more money to have things done for you (ie your lawn, replace a toilet, etc) whereas the IT guy will be home at 5:10 everyday and never work a weekend or holiday.
  33. link2swim06

    link2swim06 PGY-1

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    haha you are joking me 40 hours a week in IT. Try 50+ for many jobs in this market. And how does one land this IT manager job right out of college with only a bachelors degree? You will be working at an entry level position for many years.

    IT people are often on call too, what if the server goes down at 4am on Saturday morning, they get to go into work and fix it. My dad was in IT and had a great job for awhile, then his job got sent to india. Sure he found a new job, but its a huge pay reduction. In medicine you aren't going to get laid off and then have to work for near a residents salary and build your way back up. This is commonplace in corporate america, you get a good job till the company outsources, merges, or does layoffs. Then you may have to relocate your family just to find a new job. And this is more like the rule, not the exception.

    Also your resident pay figures arent taking into account any moonlighting numbers. I can double my salary the last 1.5 years of residency. Also not all residencies average 80 hours per week. Several are closer to 60 hours a week.

    With EM I will be working closer to 35-40 hours a week, not 60, making ~ 250K around the same time that IT person gets a promotion to that 100K IT management position.

    The grass is always greener i guess...

    EDIT: To add some IT numbers to the mix, you are looking at less than 10% of people in IT making more than 100K. And alot of those people have MBAs too, that isnt cheap training either. http://www.bls.gov/oco/ocos305.htm
  34. scarshapedstar

    scarshapedstar MD c/o 2016

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    Replace medicine with computer engineering and you basically have the story of my undergrad, the common thread being depression. Also the single part, but that's kinda... related.

    Nothing sticks when you are profoundly unhappy, and then when you sacrifice sleep and a social life to make up for it, you end up in a downward spiral. Maybe pills will help, maybe you need to address the underlying causes, maybe both, but something's gotta change.
  35. Rendar5

    Rendar5

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    EM is not your standard doctoring and makes way more $$$ / hr than most fields for only 3 years of residency. Most residencies also aren't 60hr/wk. and not all 3 year programs allow much moonlighting (unfortunate as I could use the extra money right now). Don't use us for standard comparisons of doctors to other fields. Standard docs are 70-80hr/wk residencies and aren't making $150/hr -$180/hr with 3 years of post-grad training..
  36. link2swim06

    link2swim06 PGY-1

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    Fair enough, but then in all fairness we should be comparing the median of IT too, not the exception, which is closer to 65K than 100K.
  37. greyman21

    greyman21

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    To be fair no one really works only 40 hours and makes a truly comfortable income, those days are long behind us I'm afraid. My dad works 60+ hrs/week as an accountant, my father in law works 70 ish/week as a lawyer, there are select professions where you work 40 and make a living wage (especially if you live in the north east, or california) hell think about most patients their either work their ass off, have a working spouse.....or they are homeless lol.
  38. link2swim06

    link2swim06 PGY-1

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    :thumbup:

    My entire point is no matter how you slice it physician come out basically at the top of the working class. Alot of people in medicine think everything outside of medicine is a relaxing 9-5 with just a bachelors degree.

    Most people outside medicine don't make alot and those who do generally live in very expensive cities like NYC or LA. Plus the trend in most industries is the higher your pay, the greater chance you are targeted for layoffs.

    Apart from a select few government jobs, there are no free lunches out there. Physicians arent private jet/ yacht rich, but I cant come up with many things besides chemical engineer which is close to medicine in the long run.

    Obvious doing something you enjoy is paramount over pay...but nevertheless I dont get the people who say you will earn more money elsewhere. Where is this elsewhere?
  39. gravitywave

    gravitywave fourth year

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    agree with this side of the argument. there is no shortage of people in medicine who lack perspective about what life is like for the 99% (even though most of medicine is the 99% as well :laugh:) there is no more secure meal ticket than medicine. period. no amount of health care reform will change that. income security? no. but secure income? yes.

    funny you should mention chem eng as i believe the prospects there are as dismal as any in engineering. the work is very easily outsourced; the actual manufacturing processes themselves are going that way already.
  40. fahimaz7

    fahimaz7

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    I love to see how angry some doctors are, while talking to doctors that are also very happy with their income and content with their job security and satisfaction. I'll agree that some guys are having reimbursement issues and that the majority of primary care docs are under payed, but at the end of the day we are all making well over 100k/year and for the most part enjoying the majority of what we do.

    That's a lot more than most of the workforce these days. Outside of medicine it's hard to find anyone who actually likes what they do.

    Go into Derm, Rads, Plastics, ENT, Urology, etc if you want to make the bills.

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