4th year jitters

[kat82]

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dont laugh- i know everyone says 4th year is a breeze but i am nervous! i finished 3rd year and im starting 4th year in 2 weeks. this is a follow up to my previous post. ive suffered with some anxiety problems this past year that only seem to have gotten worse and worse as time has gone on. the thing is, its not like bad things kept happening, its really only surgery where i was traumatized by overly harsh residents and daily public humiliation rituals

i think after i had this bad experience on surgery, i got used to dreading my rotations, and i became so overly critical of myself, where i think in the beginning i cut myself alot more slack and allowed myself to make mistakes. i think as time went on, i set higher and higher expectations for myself and it was a setup for constant worry and self-criticism.

i feel so worn out, so beaten down after 3rd year, that im getting scared that 4th year will be more of the same. whats worse, im beginning to fear that the rest of my medical career will be like this!!

PLEASE tell me it gets better, that 3rd year is supposed to be mentally/emotionally hard, and that when im an attending, life will be better

oh and on a sidenote- how are you supposed to know what to do during your sub-is? do your residents guide you a little bit? im not quite sure how to make the transition from lowly 3rd year to lowly subi

thanks for all the advice guys
much love
kat

 

[Anka]

Hi Kat,

Fourth year is a whole lot better than third year. Trust me on this one.

(1) You've now been exposed to each of the different disciplines, and have a basic fund of knowledge. Nothing is going to seem quite as new as it did the first time around.
(2) Even if you are attacked by some jerk resident, it's going to follow the same old same old pattern. And you're going to care less this time around, because it really doesn't matter... these aren't your core rotations that are so very high stakes (see 3).
(3) The stakes are a LOT lower than they were third year. If you run into a jerk resident who wants to make life miserable, who cares? Just avoid the guy. And as a fourth year, you totally can. You're there to get a couple of letters and to learn something, and you have control over who you ask for letters and what sort of contact you have with that person. It's not like third year where you were always under a microscope, and had no control of or idea of who was evaluating you, on what, when.
(4) People are going to give you the benefit of the doubt. If you're on the rotation, you're assumed to be interested.
(5) People expect, and to some extent encourage, fourth year students to slack off a bit (with the exception of the subI in the field you want to go into).
(6) For the most part, you can do what you want. If you want to take a couple of easier electives, you can. If you want to take some electives near home where you have a better support system, you can.

Being a sub I, you're going to have as much input from your residents as you need. If you need help, ask for it, but they know you're just coming up from third year. Heck, look at the way they watch over the interns to start the year!

The big focus of fourth year is figuring out what you want to do, meeting the people in the field, getting your letters and application together. It's really an exciting time. If you find yourself totally dreading every minute of a rotation, just cross it off the list and move on. One of my best friends had a really bad experience third year, dreading every day, then figured out what she wanted to do a few months ago. She is a totally different person -- she exudes confidence these days.

As far as being an attending, your guess is as good as mine, but from the first year junior attendings I've seen, it looks like another HUGE jump with a huge learning curve... except they don't have anyone to talk to. Let's just hope by the time we get there we'll be well trained, and have made some good friends during residency to help us through.

Best,
Anka