don't think I can do this.

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tpn89

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Hi. I'm not new here, I've been lurking, but this is the first time I've posted.

I'm currently a 4th year medical student at a school in the northeastern US. It's been almost 3 weeks since ERAS opened up and I still haven't sent out my residency applications. The thing is, I'm pretty depressed and feeling somewhat hopeless. I've been struggling with medical school since day 1. I repeated 2nd year and repeated the Step 1, barely passing the second time around. I barely passed every shelf 3rd year. I still haven't taken Step 2 CK because I keep taking NBMEs and not passing, despite doing Uworld almost twice.

My bigger concern is that I just can't perform well clinically no matter how hard I try. I'm 4 months into 4th year and I'm really struggling with things that pretty much all of my classmates are handling without a problem. This includes just getting a basic history from a patient, or presenting a patient. I just can't handle so much information at once. It all gets mixed up in my brain. I can't organize even the simplest of cases. When I'm talking to patients my thought process will just freeze. The same thing happens when I'm presenting cases. My brain just gets lost and stops and I can't think. I can't keep my focus when people are talking. I keep missing entire words and sentences and I don't even realize it. If I'm reading something I have to go over it numerous times before it will register what it means. I can't make obvious connections that seem obvious to all of the classmates that rotate with me. If I have several patients I keep mixing everyone up. I try to write things down and organize myself as much as I can, but I just can't get organized. It just takes me too long. I'm already incredibly slow.

I don't know what's wrong with me. I'm probably just not smart enough for this and somehow managed to slip through. I thought I'd be improving, but I'm just not. I've been told multiple times that my clinical skills are poor. We had an observed H&P exam, which I failed 2 times and passed on the 3rd because the attending felt bad for me. I also failed our Step 2 CS practice exam because I was incredibly disorganized. I'm honestly scared about residency (assuming I even match). It's coming quickly and I feel like I am so far behind where I need to be that I'll fail miserably. That's why I still haven't applied.

I've been seeing a psychiatrist who suggested that I might have performance anxiety. He prescribed me propranolol, but it really hasn't helped. I thought I might have an attention disorder given my symptoms but he assured me that if I did, I wouldn't have made it to medical school.

I'm not really sure what to do to improve my performance at this point, do any of you know? This is really depressing me. I'm honestly embarrassed to go in every day now because my performance is just so much worse than everyone else's.

Sometimes I just want to quit but I don't know what else I could do, or how I'd pay off my loans. I feel doomed to failure and I've gotten pretty depressed.

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How bad are your loans?
 
I'm sorry you're feeling like this and it sounds like you have a number of issues going on. My first suggestion would be to go back to your psychiatrist and share what you're saying here with him/her. If you feel like that relationship is not working, you may want to try a different one. You may also want to sit down with student affairs or whatever student services your school has and talk openly about what you're feeling and see what advice they have. There may be a number of things going on but it's beyond what we can really figure out on a message board like this.

You're clearly at a place where you need a lot of help. We all get to such places where we truly have to lean on others, and you may be at such a place right now. Five years from now when things are much better and this time is a distant memory, these are the people you'll remember and be thankful to have known. Please continue to seek help and if someone can't help you, keep looking for someone who can.
 
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I have no good advice as I have not gone through that yet, but hang in there OP. All I can say is you have nothing to be ashamed of. After 4 years you've made it to near the end of a journey that most people would not even think of undertaking. You've made it this far, you can't give up now!!
 
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It's good that people are being supportive, but I can't help thinking that residency is not something you want to enter without a solid degree of confidence.

If you don't feel ready, maybe you should take some time off, e.g. for a research position. Reevaluate.
 
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I dont think you should apply to residency if you cant take a history.
 
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I'm sorry you're feeling like this and it sounds like you have a number of issues going on. My first suggestion would be to go back to your psychiatrist and share what you're saying here with him/her. If you feel like that relationship is not working, you may want to try a different one. You may also want to sit down with student affairs or whatever student services your school has and talk openly about what you're feeling and see what advice they have. There may be a number of things going on but it's beyond what we can really figure out on a message board like this.

You're clearly at a place where you need a lot of help. We all get to such places where we truly have to lean on others, and you may be at such a place right now. Five years from now when things are much better and this time is a distant memory, these are the people you'll remember and be thankful to have known. Please continue to seek help and if someone can't help you, keep looking for someone who can.

Thanks, I've been hesitant to open up and talk to people about this because I'm very embarrassed about it, and I don't want to expose any more weakeness to any more people than I have, but you're right that I need help.

The question on my mind is though, if it turns out I just can't improve, what do I do?
 
What would I do otherwise?

I don't know, honestly. Have you seen someone that can help you with clinical skills? Your post didnt mention anything about getting tutoring and practice.
 
I don't know, honestly. Have you seen someone that can help you with clinical skills? Your post didnt mention anything about getting tutoring and practice.

Yeah I am getting tutoring from the school due to failing the in-house CSK exam.
 
Thanks, I've been hesitant to open up and talk to people about this because I'm very embarrassed about it, and I don't want to expose any more weakeness to any more people than I have, but you're right that I need help.

The question on my mind is though, if it turns out I just can't improve, what do I do?

What specialty are you planning to apply for?

I don't know about you, but when I'm faced with difficult situations, I like to think of the worst case scenario and work up from there. It makes me feel a bit better when the worst case isn't all that horrible. I think the worst case scenario would be having to seek a different career that you might enjoy. Yes, it would suck being faced with a mountain of loans, but perhaps you can find a career in a field you enjoy and are able to perform well for the rest of your life. Even if you have to go back to school and take a few classes, this is not the end of the world.

Another scenario - would it be possible at this point in the year to take a LOA, perhaps do some research and continue to improve your clinical skills? Then you can re-attack 4th year next year and perhaps get some good evals before applying.

I'd also suggest finding a different psychiatrist for a 2nd opinion. What he said about attention deficit people not getting to medical school is patently not true, and a different psychiatrist might have a different approach to therapy and treatment that might help you more.

I'm really sorry you're going through this, but I don't think residency will be a possibility in your current state. If I were in your shoes, I would seek a year off in order to improve clinical skills, get adequate psychiatric help, do something productive like research, and do some soul-searching.
 
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What specialty are you planning to apply for?

I don't know about you, but when I'm faced with difficult situations, I like to think of the worst case scenario and work up from there. It makes me feel a bit better when the worst case isn't all that horrible. I think the worst case scenario would be having to seek a different career that you might enjoy. Yes, it would suck being faced with a mountain of loans, but perhaps you can find a career in a field you enjoy and are able to perform well for the rest of your life. Even if you have to go back to school and take a few classes, this is not the end of the world.

Another scenario - would it be possible at this point in the year to take a LOA, perhaps do some research and continue to improve your clinical skills? Then you can re-attack 4th year next year and perhaps get some good evals before applying.

I'd also suggest finding a different psychiatrist for a 2nd opinion. What he said about attention deficit people not getting to medical school is patently not true, and a different psychiatrist might have a different approach to therapy and treatment that might help you more.

I'm really sorry you're going through this, but I don't think residency will be a possibility in your current state. If I were in your shoes, I would seek a year off in order to improve clinical skills, get adequate psychiatric help, do something productive like research, and do some soul-searching.

Thanks for the advice. I'm applying for Internal Medicine. I've got everything ready to go - personal statement uploaded, ERAS done, letters in - I just need to actually send the applications out.

An LOA is a thought I hadn't had. What could I do to improve my clinical skills during that time? I wonder if there's any way to do extra rotations or something. I'm not sure that research would do anything for my clinical skills, which is my main concern. I might actually do worse when I come back because I've been out of practice.

I'm really scared because if I can't make it to residency, I have no idea what I'm going to do to survive. I don't have any other skills or degrees that I could use to get a job. I would be totally lost if that turned out to be the case.

The funny thing about all of this is there is really very little indication on my application that my clinical skills are bad. Even though many people have told me I need a lot of work, no one has ever written anything negative in my evaluations...
 
Depending on your loan burden, I would think that coming out with the MD should be a priority. There are a number of different career paths that will be open to you with an MD, even if you choose not to do a traditional residency.
 
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Depending on your loan burden, I would think that coming out with the MD should be a priority. There are a number of different career paths that will be open to you with an MD, even if you choose not to do a traditional residency.
What are these career paths?
 
If u hate taking histories, why not do path?
 
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If u hate taking histories, why not do path?
I don't hate taking histories at all. I love working with patients. I would not enjoy path at all because I came to medical school for the patient contact. The problem is that I really struggle at it. I realized that just wanting to be good at something and being passionate about it doesn't actually correlate to being good at it, unfortunately.
 
Thanks for the advice. I'm applying for Internal Medicine. I've got everything ready to go - personal statement uploaded, ERAS done, letters in - I just need to actually send the applications out.

An LOA is a thought I hadn't had. What could I do to improve my clinical skills during that time? I wonder if there's any way to do extra rotations or something. I'm not sure that research would do anything for my clinical skills, which is my main concern. I might actually do worse when I come back because I've been out of practice.

I'm really scared because if I can't make it to residency, I have no idea what I'm going to do to survive. I don't have any other skills or degrees that I could use to get a job. I would be totally lost if that turned out to be the case.

The funny thing about all of this is there is really very little indication on my application that my clinical skills are bad. Even though many people have told me I need a lot of work, no one has ever written anything negative in my evaluations...
Take LOA, get a second opinion with another psychiatrist [as my attending says, put 10 psychiatrists in a room and you will get 10 different diagnosis lol] and get that sorted out. Based on your post, performance isnt the problem, you just have a hard time focusing. We can't tell you how to sharpen your clinical skills except get practice, getting tutors, etc.
 
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I don't hate taking histories at all. I love working with patients. I would not enjoy path at all because I came to medical school for the patient contact. The problem is that I really struggle at it. I realized that just wanting to be good at something and being passionate about it doesn't actually correlate to being good at it, unfortunately.
Yes, it's a common fallacy on SDN that you should go into the specialty you like. 1) There are a lot of confounders with that bc you don't just get to choose what you like and match into it and 2) Many times people like the theory of doing something and aren't able to actually do it.

EDit: Your psychiatrist is an idiot for just giving you propranolol based on your history. Also to say one doesn't have ADD bc they got into medical school is pure BS. He's just afraid to prescribe it.
 
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An LOA is a thought I hadn't had. What could I do to improve my clinical skills during that time? I wonder if there's any way to do extra rotations or something. I'm not sure that research would do anything for my clinical skills, which is my main concern. I might actually do worse when I come back because I've been out of practice.

From what I am seeing here, the biggest barrier to your clinical skills is your mindset and possible psychiatric issues.

Taking a LOA for a research year would give you a chance to get your head on straight. You could also do some informal shadowing/electives to keep your toes in the water clinically (in possibly a more relaxed setting where you won't feel as anxious).
 
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From what I am seeing here, the biggest barrier to your clinical skills is your mindset and possible psychiatric issues.

Taking a LOA for a research year would give you a chance to get your head on straight. You could also do some informal shadowing/electives to keep your toes in the water clinically (in possibly a more relaxed setting where you won't feel as anxious).
Except he gets all the history stuff jumbled up. That can be quite daunting to overcome esp. in a setting like an ER in which your time is very limited. @tpn89, just curious, did you attend your Physical Diagnosis course? Or did you skip it sometimes?
 
Except he gets all the history stuff jumbled up. That can be quite daunting to overcome esp. in a setting like an ER in which your time is very limited. @tpn89, just curious, did you attend your Physical Diagnosis course? Or did you skip it sometimes?

I've gone to every physical diagnosis/clinical skills class and I've actually gone to extra help sessions many times and am still going as a 4th year. I really want to be good at this, I just don't know why I'm struggling so much. Maybe it's a psychiatric issue, or maybe my brain just can't handle this. I'd rather it be a psychiatric issue because at least I can get treatment for that. If I'm just not smart enough, there's absolutely nothing I can do about it and I'm stuck with a massive bill I have no way to pay off in addition to having my dream job shattered. :(
 
I've gone to every physical diagnosis/clinical skills class and I've actually gone to extra help sessions many times and am still going as a 4th year. I really want to be good at this, I just don't know why I'm struggling so much. Maybe it's a psychiatric issue, or maybe my brain just can't handle this. I'd rather it be a psychiatric issue because at least I can get treatment for that. If I'm just not smart enough, there's absolutely nothing I can do about it and I'm stuck with a massive bill I have no way to pay off in addition to having my dream job shattered. :(

as others have said you need to get your head straight. you said yourself that you are depressed; many psychiatric conditions can leave you with difficulties in cognition which could lead to you feeling jumbled and not being able to organize information. i take the year to work on yourself, be good to yourself, exercise, see a shrink and see how you feel.
 
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I agree with those who said it's ridiculous that you were told you would not have made it to medical school with ADD....certainly know those who have and then needed and benefited from treatment. In fact, that sounds like a real possibility from what you describe. It is unlikely that you got into medical school without being smart enough, but I can understand why your struggles have given you those doubts. In any case, you owe it to yourself and your dreams to obtain the best, objective, professional assessment of your problem. That might mean educational testing/neuropsych testing (my previous career) alongside psych eval....anxiety and depression can be certainly be sequelae of learning issues. Rushing into residency doesn't seem wise. If you are dismissed for poor performance, your options will be greatly diminished from then on. Is there an advisor or mentor at your school you trust that you can meet with and be honest about your concerns before you go more public with them? Getting an extra year for research or anything else while you try to get the best available treatment, but then still apply as a current student next year, seems like the best option. Your school has obviously worked with you so far, so that's encouraging.
 
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even a cashier can take a history, this is definitely a psyche condition, get help and uproot and move yourself if you think it's what it takes.
 
I've gone to every physical diagnosis/clinical skills class and I've actually gone to extra help sessions many times and am still going as a 4th year. I really want to be good at this, I just don't know why I'm struggling so much. Maybe it's a psychiatric issue, or maybe my brain just can't handle this. I'd rather it be a psychiatric issue because at least I can get treatment for that. If I'm just not smart enough, there's absolutely nothing I can do about it and I'm stuck with a massive bill I have no way to pay off in addition to having my dream job shattered. :(
If that's the case then it's most likely a psychiatric problem - likely more an anxiety problem. That being said there are many therapies in that realm that help people.
 
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even a cashier can take a history, this is definitely a psyche condition, get help and uproot and move yourself if you think it's what it takes.
There is a difference btw taking a history and presenting it to your attending.
 
There is a difference btw taking a history and presenting it to your attending.
no one can satisfy an attending, no one!!! Maybe only the cashier at hospitals cafeteria, once or twice a day at most, maybe.
 
If that's the case then it's most likely a psychiatric problem - likely more an anxiety problem. That being said there are many therapies in that realm that help people.
Yeah, you guys have convinced me to get a second opinion. I feel like my psychiatrist has been downplaying my issues when what I need is more aggressive treatment.
 
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I agree with those who said it's ridiculous that you were told you would not have made it to medical school with ADD....certainly know those who have and then needed and benefited from treatment. In fact, that sounds like a real possibility from what you describe. It is unlikely that you got into medical school without being smart enough, but I can understand why your struggles have given you those doubts. In any case, you owe it to yourself and your dreams to obtain the best, objective, professional assessment of your problem. That might mean educational testing/neuropsych testing (my previous career) alongside psych eval....anxiety and depression can be certainly be sequelae of learning issues. Rushing into residency doesn't seem wise. If you are dismissed for poor performance, your options will be greatly diminished from then on. Is there an advisor or mentor at your school you trust that you can meet with and be honest about your concerns before you go more public with them? Getting an extra year for research or anything else while you try to get the best available treatment, but then still apply as a current student next year, seems like the best option. Your school has obviously worked with you so far, so that's encouraging.

I think you're right but my psychiatrist told me he thought it was incredibly unlikely because if I really did have a learning disability it would have 1) been caught far earlier, and 2) it's very unlikely I would have not only graduated from college but made it to medical school without failing anything or running into trouble academically. He had me see a psychologist in his clinic to be tested because I inisisted, but that lady also agreed with him and didn't test me.
 
Except OP struggles to even take the history.
All the more reason to see whether it's an anxiety issue that is stopping him from being able to take a history.
 
I think you're right but my psychiatrist told me he thought it was incredibly unlikely because if I really did have a learning disability it would have 1) been caught far earlier, and 2) it's very unlikely I would have not only graduated from college but made it to medical school without failing anything or running into trouble academically. He had me see a psychologist in his clinic to be tested because I inisisted, but that lady also agreed with him and didn't test me.
The material in med school gets exponentially harder. High school and college are a joke in comparison.
 
Except OP struggles to even take the history.
My issue is that I just get stuck and don't know where to go next in a focused HPI. I don't really have an issue with just asking all the generic questions, but the issue is when I'm trying to figure out the questions I need to ask to elucidate the info I need for the diagnosis. I just get stuck and don't know where to go. I also can't remember everything the patient says unless I write it all out and organize it. Otherwise it just gets impossibly jumbled up in my head. When the patients jump from one thing to another it completely throws me off and that's why I failed my observed H&P's.

I'm scheduled to take the Step 2 CS in a week and I'm freaking out...
 
My issue is that I just get stuck and don't know where to go next in a focused HPI. I don't really have an issue with just asking all the generic questions, but the issue is when I'm trying to figure out the questions I need to ask to elucidate the info I need for the diagnosis. I just get stuck and don't know where to go. I also can't remember everything the patient says unless I write it all out and organize it. Otherwise it just gets impossibly jumbled up in my head. When the patients jump from one thing to another it completely throws me off and that's why I failed my observed H&P's.

I'm scheduled to take the Step 2 CS in a week and I'm freaking out...
Well Step 2 CS isn't like a typical patient encounter. It's standardized - hence easier. I thought First Aid for Step 2 CS was enough.
 
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All the more reason to see whether it's an anxiety issue that is stopping him from being able to take a history.

I know. I was just clarifying for your response to Kahreek.


My issue is that I just get stuck and don't know where to go next in a focused HPI. I don't really have an issue with just asking all the generic questions, but the issue is when I'm trying to figure out the questions I need to ask to elucidate the info I need for the diagnosis. I just get stuck and don't know where to go. I also can't remember everything the patient says unless I write it all out and organize it. Otherwise it just gets impossibly jumbled up in my head. When the patients jump from one thing to another it completely throws me off and that's why I failed my observed H&P's.

I'm scheduled to take the Step 2 CS in a week and I'm freaking out...

Are you able to push back the test, since you are receiving tutoring?

What you're describing sounds similar to inexperience, like the first few times you do an H&P on a real patient with the expectation of synthesizing and presenting the information. I sucked at asking clarifying questions and had to write everything little thing down at first. You have plenty of experience, though, which makes it seem more like a psychological thing holding you back.
 
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I know. I was just clarifying for your response to Kahreek.




Are you able to push back the test, since you are receiving tutoring?

What you're describing sounds similar to inexperience, like the first few times you do an H&P on a real patient with the expectation of synthesizing and presenting the information. I sucked at asking clarifying questions and had to write everything little thing down at first. You have plenty of experience, though, which makes it seem more like a psychological thing holding you back.
Yeah I think you're probably right. I can't push the test back anymore because of the deadline, I'm just going to go to a couple more tutoring sessions and hope I do well enough to pass.

I'm going to get a second opinion from another psychiatrist. I'm getting a huge amount of pressure to submit my applications from everything, including my advisors, friends, family, etc. I told most of them I already did it just to get them off my back. I think I'm just going to go ahead and send some out and see what happens. If I can't do it, I can pull out before the match right?
 
Well Step 2 CS isn't like a typical patient encounter. It's standardized - hence easier. I thought First Aid for Step 2 CS was enough.
I find standardized patient encounters harder because they mark you off points for not asking questions in order, not having the proper choreography, draping, etc. I have a really really hard time remembering to do all these tiny things.
 
I find standardized patient encounters harder because they mark you off points for not asking questions in order, not having the proper choreography, draping, etc. I have a really really hard time remembering to do all these tiny things.
I don't think the order of questions is as important on Step 2 CS. It's a rubric which you get points on. It's what you'd want the ideal physician to do -- wash hands, drape patient, etc.
 
I don't think the order of questions is as important on Step 2 CS. It's a rubric which you get points on. It's what you'd want the ideal physician to do -- wash hands, drape patient, etc.

I took Step 2 CS a few months ago and was surprised at how much emotional intelligence was required on the exam. I can definitely see how some people fail the exam, and I agree about the rubric thing. I could see the boxes being checked off as I did this or that based on their responses.
 
I took Step 2 CS a few months ago and was surprised at how much emotional intelligence was required on the exam. I can definitely see how some people fail the exam, and I agree about the rubric thing. I could see the boxes being checked off as I did this or that based on their responses.
Yes, it's very much fake and robotic in terms of amassing the points you need. Very scripted. Pretty much useless and just another hoop to jump thru for med students.
 
It definitely sounds to me like there is a psychological issue playing a huge role here. In my non-expert opinion, your psychiatrist is just wrong. I agree you should get another opinion, and why on Earth they wouldn't at least test you is beyond me. It certainly sounds like you have some pretty serious anxiety, and trouble organizing your thoughts. Now whether you actually have a learning disability or ADHD, I think only a proper test could really say. But it's definitely not unheard of for those kinds of things to come out in higher education. Like DermViser said, high school and college are a joke compared to what's expected in med school and a lot of smart people can get through them, but when things are ramped up like they are now, they start to struggle. I've seen it firsthand with classmates. If you've made it this far I doubt it's an issue of you not being smart enough. You would probably benefit a lot from some CBT and/or the right medication.

As far as residency goes, I think you should at least submit your applications and see what happens. I think you might regret it later if you got this far and didn't even look into residency at all. And like you said, if you still feel like it isn't for you, you can always withdraw from the Match. You wouldn't be the first one to opt out of residency (what exact alternative options there would be for you I'm not sure, but there are certainly some out there). I would also suggest getting some input from advisers or someone else at school about how you might fare in residency and see if they have any suggestions on how to improve your clinical performance, whether that means taking a LOA or something else. Good luck and hang in there.
 
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Hi. I'm not new here, I've been lurking, but this is the first time I've posted.

I'm currently a 4th year medical student at a school in the northeastern US. It's been almost 3 weeks since ERAS opened up and I still haven't sent out my residency applications. The thing is, I'm pretty depressed and feeling somewhat hopeless. I've been struggling with medical school since day 1. I repeated 2nd year and repeated the Step 1, barely passing the second time around. I barely passed every shelf 3rd year. I still haven't taken Step 2 CK because I keep taking NBMEs and not passing, despite doing Uworld almost twice.

My bigger concern is that I just can't perform well clinically no matter how hard I try. I'm 4 months into 4th year and I'm really struggling with things that pretty much all of my classmates are handling without a problem. This includes just getting a basic history from a patient, or presenting a patient. I just can't handle so much information at once. It all gets mixed up in my brain. I can't organize even the simplest of cases. When I'm talking to patients my thought process will just freeze. The same thing happens when I'm presenting cases. My brain just gets lost and stops and I can't think. I can't keep my focus when people are talking. I keep missing entire words and sentences and I don't even realize it. If I'm reading something I have to go over it numerous times before it will register what it means. I can't make obvious connections that seem obvious to all of the classmates that rotate with me. If I have several patients I keep mixing everyone up. I try to write things down and organize myself as much as I can, but I just can't get organized. It just takes me too long. I'm already incredibly slow.

I don't know what's wrong with me. I'm probably just not smart enough for this and somehow managed to slip through. I thought I'd be improving, but I'm just not. I've been told multiple times that my clinical skills are poor. We had an observed H&P exam, which I failed 2 times and passed on the 3rd because the attending felt bad for me. I also failed our Step 2 CS practice exam because I was incredibly disorganized. I'm honestly scared about residency (assuming I even match). It's coming quickly and I feel like I am so far behind where I need to be that I'll fail miserably. That's why I still haven't applied.

I've been seeing a psychiatrist who suggested that I might have performance anxiety. He prescribed me propranolol, but it really hasn't helped. I thought I might have an attention disorder given my symptoms but he assured me that if I did, I wouldn't have made it to medical school.

I'm not really sure what to do to improve my performance at this point, do any of you know? This is really depressing me. I'm honestly embarrassed to go in every day now because my performance is just so much worse than everyone else's.

Sometimes I just want to quit but I don't know what else I could do, or how I'd pay off my loans. I feel doomed to failure and I've gotten pretty depressed.

How much money do you owe?
 
I don't understand what you're asking.

Well, I'm wondering if your approach/decision making would be different with that debt load. I ask because a lot of people owe that now, I have no doubt that a decent number will end up in your position.

Re: your original question--you are a 4th year and as such I would try like hell to finish. Have you thought about applying to psych? I would guess that would be your best option and a field that would be a good fit for you and what you have described as your typical level of aptitude.
 
I definitely agree with seeking a second opinion.

Out of curiosity, did you struggle like this to some degree in college as well?

I don't think someone can rule out ADHD or some of other learning/psychiatric disorder just because youre in med school. There may be a pattern of this going back years that you've been to compensate for and it's just not coming to light due to the amount of material and stress.
 
Well, I'm wondering if your approach/decision making would be different with that debt load. I ask because a lot of people owe that now, I have no doubt that a decent number will end up in your position.

Re: your original question--you are a 4th year and as such I would try like hell to finish. Have you thought about applying to psych? I would guess that would be your best option and a field that would be a good fit for you and what you have described as your typical level of aptitude.
I really don't know what I would do if my debt was 500k. I mean, it's not like I don't want to succeed in medicine. I'm trying as hard as I can. I'm just struggling. I don' t want to quit, I want to go to residency. The thing is I don't know if I can survive. There's no way I could have predicted things would have turned out this way. I did fine in college. I got into med school.

Hopefully not a lot of people end up in my situation with a 500k debt. If they do, and they end up not being able to complete a residency, I really don't know what they'll do. It's just really bad luck I suppose.

Psych is a thought, but unfortunately at this point I can't apply to psych since it's already extremely late and I have nothing prepared for a psych application. I'm just gonna have to send out IM applications and see what happens, and in the meantime try to get some help :(
 
I definitely agree with seeking a second opinion.

Out of curiosity, did you struggle like this to some degree in college as well?

I don't think someone can rule out ADHD or some of other learning/psychiatric disorder just because youre in med school. There may be a pattern of this going back years that you've been to compensate for and it's just not coming to light due to the amount of material and stress.
I didn't struggle in college at all interms of grades. I had a 3.8/4.0 GPA. I've always found it difficult to concentrate and organize a lot of material, but I always managed to get it done and assumed that was normal.
 
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