So close but yet so tired

[katiemaude]

I am one semester away from finishing my prereqs. Taking the MCAT in June. Applying in the summer. But I'm so ... tired. I missing working full time. I'm worried about not having enough money to get through the semester. Part of me wants to throw in the towel, get a full-time job at a hospital and apply to PA schools instead -- not because I want to be a PA, because I'd be done with my prereqs already!

I don't have any research under my belt; I still have to shadow more. I'm wondering if I'm cut out for this med school journey because this is the second time in the past 18 months that I've thought about shortening it and becoming a PA instead. But, at the end of the day I don't think I want to be a PA. (But then, how can I know if I've never been a doctor OR a PA?)

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[Genesea]

You could shadow or interview some PAs to see for yourself what the differences are. I watched physician assistants do exactly the same work as physicans in a hospital emergency department. (They just had to have the physicians sign off on their orders.)
I think it would depend a lot on what specialty you think you'll end up in. In the ED or primary care, for instance PAs have a lot of autonomy.. but in other areas it's less.

I know a PA that is now going for MD because (though originally she worked in the ER and loved her role) she found her true passion is orthopedics and she doesn't like the role of the PA in that setting. She wanted more responsibility, to be the one making decisions for her patients.

Another thing she confided in me was that gender played a small role in her decision to switch.. her patients sometimes questioned her authority or mistook her for a nurse. She felt that a male PA would not have encountered the same doubt or confusion.

edit: btw here's some more threads on the PA vs MD/DO topic
http://forums.studentdoctor.net/showthread.php?t=271413

http://forums.studentdoctor.net/showthread.php?t=579236

http://forums.studentdoctor.net/showthread.php?t=775552

http://forums.studentdoctor.net/showthread.php?t=178533

http://forums.studentdoctor.net/showthread.php?t=160974

but if you're just looking for motivation, i'd say keep chugging along. you know yourself best. think honestly about the time commitment, about your goals, your values and decide what fits you best. if it's physician, then don't give up and keep moving forward. lost dreams and regret are what lie ahead if you settle for less.

 

[Quik]

You could shadow or interview some PAs to see what the differences are. I watched physician assistants do exactly the same work as physicans in a hospital emergency department. (They just had to have the physicians sign off on their orders.)
I think it would depend a lot on what specialty you think you'll end up in. In the ED or primary care, for instance PAs have a lot of autonomy.. but in other areas it's less.

this pretty much says it. My sister, who is a PA, continues to insist that I look into becoming a PA for pretty much the exact reason you, and the quoted post above, state. The burn-out you are feeling now will only get much worse in med school, and as mentioned, the PA does much of what physicians do anyway.

 

[Eik Ooc]

The burn-out you are feeling now will only get much worse in med school, and as mentioned, the PA does much of what physicians do anyway.

I don't think feeling exhausted during the premed process is indicative of how we'll fair in medical school.

Many of us are working fulltime, volunteering and taking full courseloads of science courses with labs. Of course we're extraordinarily tired. Additionally, we do all of this knowing that only half of the national pool of medical school applicants are selected each year.

Knowing that such sustained hard work has a 50% likelihood of resulting in nothing more than a rejection letter is, I think, a distinct contributor to feeling burned out.

 

[mauberley]

I don't think feeling exhausted during the premed process is indicative of how we'll fair in medical school.

Indeed, and depending on what sorts of activities you're juggling, I see the whole process as helping prepare yourself for med school. This is, of course, my no-experience-whatsoever-to-back-it-up opinion, but I feel that when you're balancing a multitude of different, unrelated activities like a full-time job or raising a family in addition to your premed coursework and extracurriculars, it's much more consuming/draining because you're being pulled in what feels like so many different directions. Once you've made it over the hump and are in school, you're more focused and it's less tasking.

If you can survive this, you've got a good shot.

 

[katiemaude]

Thanks for the encouragement. I've volunteered in an ED for the past year 1-2x a week, 4-6 hrs at a time and I've observed a lot of traumas as well as quick checks and patients in the regular ED. I haven't followed any physicians for a full day but I have observed them in the ED during my shifts and sometimes stay longer. I really do need to get some more shadowing in.

I know some PAs personally (two in primary care, one in orthopedics) and I spoke to one in derm when I was initially trying to make this PA school/med school decision. I think being a PA could be a very satisfying life and if my circumstances prevented me from going to med school, I can imagine this would satisfy me. Is that a sign that I shouldn't apply to med school? I've heard others say that if you can imagine doing anything else, you shouldn't go MD/DO. I've already spent a decade in another career and part of the reason I chose it was it indulged my other passion -- writing. But it wasn't enough. It wasn't what I really wanted to do, and I didn't get the feeling that I was making a difference in anyone's life, let alone their day. I still do writing as a creative exercise but it's not how I want to make my living anymore.

So originally I was thinking I wanted to get into primary care, and basically everyone I talk to (PAs, MDs) says it's not worth the medical school debt to do that. But how do I know if it's what I really want? I mean, isn't that what the third year of medical school is for... to figure out what specialties could interest you?

I guess I'm wondering if my fatigue/hesitation is a sign I shouldn't apply to medical school, and if I do decide primary care is for me, if I'm being irresponsible by taking on that debt load for it. What most appeals to me about becoming a physician is the wide body of knowledge. I want to really understand what is going on with my patients.

As for my activities now, besides the volunteering, I work part-time and I'm a landlord so I have responsibilities dealing with tenants I won't have in medical school. This semester was relatively easy (just ochem and physics) and that's part of what scares me. I wasn't tired during the semester, just thinking about next semester with those classes and activities plus studying for the MCAT and some shadowing. I mean, c'mon. I'm such a baby.

 

[QofQuimica]

The burn-out you are feeling now will only get much worse in med school

The exhausted you will be in medical school is definitely of a different animal than the exhausted you are as a premed. Different environment, different challenges. Unless you're planning a career as a professional premed, I wouldn't read too much into the stressfulness of being a premed as a strong predictor of how you'll handle being a med student. For one, you're going through your premed journey more or less alone. In med school, there are many sources of support, from your classmates to the student affairs office to your advisor. My school even has a specific advisor to help those of us who are applying to residency. It's tremendously easier to navigate the system when you have upperclassmen and administrative types who are guiding you through. Also, in med school, you're almost certain to graduate once you start. Like Eik Ooc pointed out, the fact that there is a very real chance that a premed might not get into med school is always gnawing at you in the back of your mind; the only thing worse than delayed gratification is no gratification.

OP, a few things. First, unless you're applying MD/PhD or MD/MS, forget about research. Just cross it off your list altogether. Not necessary to be a competitive candidate for medical school, not worth giving yourself an ulcer over.

Second, how much shadowing have you done already? If you've done enough shadowing where you've gotten to know a physician well enough where s/he can write you a strong LOR, then it's enough. If not, do some more shadowing with that goal in mind. Also keep in mind the fact that if you're applying to DO schools, you will need a letter from a DO at some of them. It's not a bad idea to get a DO letter if you're not sure, because MD schools will also accept them.

Third, if you're feeling like you're hitting a brick wall no matter which way you try to run, maybe you need to stop trying to run. There's no crime in extending your post bac one more year if that's what it takes. I waited an extra year to apply, and it was one of the best decisions I made in terms of preserving my sanity and giving me the time I needed to put together the best possible application of which I was capable.

Finally, give yourself permission to be human. You *are* human. It's ok to get overwhelmed sometimes. It's ok to have doubts about your plans. It's ok to adjust your plans. It's ok to think about being a PA instead of a physician, and it's ok to change your mind and go to PA school instead of medical school if you decide that's what you want to do. It's even ok to decide not to change careers at all if you realize that you miss your old job more than you thought you would. The right decision for you may not be the same as the right decision for other people, and no one who matters will judge you if you decide medicine isn't for you. On the other hand, if you decide that medicine is for you, then you should seriously consider tweaking your plan as I've already said.

Hope this helps, and best of luck.

 

[katiemaude]

Thanks everyone. Thanks, especially, to Q. I don't know how you do it, but you always seem to know the right thing to say!

I got my grades back (As in ochem and physics! yay!) and I'm feeling a bit more rested than I was a week ago. Winter break has been crucial for my mental health. Now I'm debating how to go about studying for the MCAT (see other post in this forum).

You da best.

 

[wagmanager]

Thanks everyone. Thanks, especially, to Q. I don't know how you do it, but you always seem to know the right thing to say

My thoughts exactly. And the post helped clear up something i was struggling with. Research, not really interested in it unless, (forgive my vanity) it's something to preserve my youthful skin. So now I'll channel my limited energy into other things.Thanks

 

[Quik]

The exhausted you will be in medical school is definitely of a different animal than the exhausted you are as a premed. Different environment, different challenges.

You raise a good point. I supposed I overlooked the obvious; what we're trying to balance as a pre-med is entirely different than what we'll eventually balance as med students. I guess I was speaking generally as to the workload, and although it may be more rigorous in med school, it is definitely more concentrated than scattered, as it is in the pre-med work/study/volunteer/shadow life...

A lot of other good advice in your post, Q. Thanks

edit from memory; I was also speaking from the anecdotes shared by my sister (the PA) who was very clear on the stress and burnout experienced by the DO students at her school. Apparently, many asked "why didn't I take the PA route, rather than suffering through an additional two years." Anyway, whatever you decide, either way you'll still be practicing medicine, helping people.

 

[QofQuimica]

How do I know what to say....well, this is now the seventh app cycle I have witnessed/endured since joining SDN, my fifth year as a senior mod, and my fourth year as a student adcom. At the risk of sounding a little jaded, there is very little under the SDN sun that has not already been asked, debated, argued, examined, experienced, considered, inspected, polled, questioned, and otherwise beaten to death by posters before you, some of whom are already attendings. If you stick around long enough, you, too, can be the forum know-it-all.

Wag, you definitely don't need to do research if you're not applying to a program that aims to train physician scientists. It can't hurt you to do some if you feel like you want to try it. But if you're debating between getting some extra clinical experience versus doing time in a lab, and you're not excited about doing time in a lab anyway, then get the clinical experience. You can't ever have too much of that.

Quik, if your sister did the first two years with the med students, it's not surprising that she saw a whole bunch of burnt out med students at the same time that she was graduating. Second semester of second year is one of the most (if not the most) stressful parts of med school for the majority of people, since that's right before the students take Step 1 at most schools. But not all of medical school is like that.

Yes, the med school workload *is* intense, and some people naturally cope with it better than others. But if you consider that the attrition rate for medical students is lower than it is for every other type of post-undergraduate training out there, it's clear that nearly everyone does learn to cope with it. If you choose to go to medical school, chances are very good that you, too, will learn to cope with it. Chances are also good that PA school is not exactly stress-free either.

 

[Lefty Doodle]

Katie,
I'm also in my last semester of post-bac (also just taking Orgo II and physics II and prepping for the MCAT!). I hit a similar wall last semester, early on. I didn't get orgo and I was kind of like "well who says I have to be a doctor anyway this is my decision!!" so I started looking into vet schools (still my second choice!!). And I slacked a bit in school (things still ended up ok) but in the end I somehow got re-excited and now here I am, in my last semester of post-bac, about to take the MCAT, and the future is happening!!

Basically, I think it's good to be like "just because I am doing this doesn't mean I have to be a doctor, this is still my decision." Because then when you do go through with it you know you looked into other options and decided that, in your heart, this was what you wanted to do.

Reasons for choosing MD/DO over the other options. My mom is a nurse practitioner and my dad is a doctor. My mom was about to take the plunge when she was a bit younger than I am now, but got discouraged by her physics grades and the people around her made her feel like it wasn't something she could do, so she instead focused her energies on excelling at nursing. Today she works as many or more hours as my dad, is more stressed out, has sicker patients, and gets cooler business trips. And they probably do understand things in a very similar way, but my mom regrets that she didn't have all of those years to be immersed in learning it the way my dad did. She doesn't feel as confident. That is probably the big reason she wishes she were a doctor. And it's a big reason I'm doing that instead of nursing. I want to take care of people, I want a stable job, I'm not hung up on the prestige or respect thing--but I know I am at a place in my life right now where I can spend that time to go to med school and accumulate as much knowledge and practice as possible before I start practicing. Just my two cents. Good luck!

 

[katiemaude]

Thanks, Elizabeth, you summed up how I feel regarding having the time and wanting to be immersed in learning. Sometimes we need someone else to articulate it.

I've been taking this process step by step, seeing how I do and reevaluating after each new experience. At first I did it because my plan seemed so outlandish to everyone around me; now I do it to make sure I'm doing what's right for me. I recently took a practice MCAT and considering that I've never cracked and MCAT review book or thought about testing strategy, I did well enough on the verbal (12) and physical science (9) sections but bombed biological (4!). Partly because I missed 10 minutes to run to the car to feed the meter - I was taking it a Kaplan center - but still, there were so many passages in that section that made me go HUH? And I've taken A&P! *smh*

 

[Lefty Doodle]

Hey,
That's a great diagnostic score (except for Bio--it's because of the meter though!). I have even heard that Kaplan tests are hard because they want to reel you in! Wow!