75% through third year and I have absolutely no idea what I want to do with my life!

[microshar88]

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Hi all,

I guess I really just need to vent. I'm feeling quite frustrated in my future and what is really achievable for me. I was a barely average student in DO school for the first 2 years and got an abysmal 468 COMLEX Level 1. I was doing atrocious on NBME practice exams and eventually decided that USMLE Level 1 was not in the cards for me (I did not want to risk failing the thing).

I thought I wanted to do EM, however, my suturing skills and ability to stomach trauma really is questionable. I hate doing procedure oriented things. I then thought I would enjoy Anesthesiology because of my love for pharmacology and the principles behind pharmacology. However I don't know if I have a shot at anything in California and would probably be doing AOA (which is okay with me), only thing is, I don't feel good about doing basic intubations. We have not had an Anesthesiology rotation during 3rd year, but we will in 4th year. During my surgery rotation, there was very minimal I could do besides assisting suturing and holding traction and the anesthesiologists would only like to pimp on drugs.

I love pharmacology so much that I was even thinking about becoming a teacher or a researcher at a Medical School.

I really feel like I'm not very procedure oriented because I have not had the comfort of being able to put IV lines and practice intubations etc. I just don't have manual dexterity/fine motor skills (which I realize comes with practice). However, I would like to do these things on dummies or mannequins so that at least my technique is right before doing it on a human being.

I also feel like I've really enjoyed my Psychiatry and Pediatrics rotations the most (psych was outpatient clinic in a rich area) and pediatrics was in-patient. However, that could have also been because the hours were good and I didn't have any real responsibilities in terms of notes, projects, etc. so I really got to talk to the patients and listen to them.

However, the biggest thing, I feel is that I'm not mature and wise enough, even at 24 years of age, to be making such a big decision as to what specialty I would like to spend the rest of my life doing. I feel like a complete loser compared to my classmates who are already piling up audition rotations on VSAS, buying clothes for residency interviews (which they haven't even been offered yet). I genuinely have no clue as to how to approach this audition planning thing given my current mindset about the future. I really wish I could take a year off to maybe take USMLE Step 1 or even do a transitional rotating year, but I'm not sure these things will be of any benefit either. To top it all off, what is probably contributing to this the most, is that my family life is in complete turmoil and no matter how hard I try and isolate myself from it, I still find myself thinking about my problems.

I know that this sounds like a complete jumble of mess, but I feel really under confident about a lot of things and I'm not able to clearly decide on what I want to spend the rest of my life doing.

I was wondering if anyone out there has ever felt the same at my stage in the game? I honestly can't find a specialty I truly hate and can't find one I love either.

 

[Trogghunter]

Why don't you consider Internal Medicine?

After a 3yr residency which is rigorous but somewhat dependent on where you go and 'easier' as you're more senior, you can practice out of the gates in the hospital/outpatient or go to fellowship. IM has the broadest range of post-residency training opportunities. There are like 12 from ICU,GI,cards which are procedure heavy to rheumatology, allergy, nephro where procedural skills are not needed. In nephro you need a calculator and extensive pharm understanding, IR does all off the procedures now. Residents put in all of their lines for dialysis.

If you love pharma then look no further than IM as you'll be managing meds/dosing for all of your patients and even get consulted from other services like ob/gyn, surgery, etc (when MgS04 and norco don't do the trick) regularly.

Your step 1 isn't a deal breaker for IM, and setting up auditions and getting some good letters from them would help a lot as would doing >500 step 2 and passing PE early. You're likely going to have to do the AOA match though. There are lots of threads on this topic.

You also didn't mention family or neuro. Ultimately, don't let people around you contribute to your anxiety and make you feel lost. They're often the ones who project confidence to mask insecurity. Make your own path in this, and don't get too caught up on this forum because a lot of people here have awesome scores/credentials and will make you feel anxious even if you have your stuff on lock. Just keep rotating and do your best because something might click. This decision doesnt take a week to make, and that's just life. You also can apply to your chosen field and prelim/ty years if you're really unsure, so you don't have to put all of your eggs in 1 basket.

 

[HooliganSnail]

If you don't think you can stomach trauma, then ER is definitely not for you. The massive levels of interest among medical students for ER makes me smile, because I don't think many of them would actually be happy 20 years down the line, just my personal opinion, but that is a different subject and I digress....

I agree that choosing a specialty at this age for the rest of your life is a bit daunting, but that is just the way it is. I would counsel you to make a choice soon, whatever it may be, as you are getting to the time of year where you need to schedule audition rotations, especially since you will be going AOA (if there is still two matches next year). Several individuals I know who did not match did so because they could not choose a specialty and spread themselves too thin 4th year.

I agree with the above poster, IM offers a wide array of options at a later date, and thanks to the new merger fellowship opportunities will be open to you if you go AOA.

 

[sleepdoc17]

You could always do a rotating internship. Depending on what you did next, the year could apply to many other career directions.
Don't worry about it too much.
Just keep moving forward. Sometimes passion will find you instead of you finding it.

 

[Goro]

It's OK. At this point in time, most of my 3rd year students mostly know what they DON'T want to do!

Hi all,

I guess I really just need to vent. I'm feeling quite frustrated in my future and what is really achievable for me. I was a barely average student in DO school for the first 2 years and got an abysmal 468 COMLEX Level 1. I was doing atrocious on NBME practice exams and eventually decided that USMLE Level 1 was not in the cards for me (I did not want to risk failing the thing).

I thought I wanted to do EM, however, my suturing skills and ability to stomach trauma really is questionable. I hate doing procedure oriented things. I then thought I would enjoy Anesthesiology because of my love for pharmacology and the principles behind pharmacology. However I don't know if I have a shot at anything in California and would probably be doing AOA (which is okay with me), only thing is, I don't feel good about doing basic intubations. We have not had an Anesthesiology rotation during 3rd year, but we will in 4th year. During my surgery rotation, there was very minimal I could do besides assisting suturing and holding traction and the anesthesiologists would only like to pimp on drugs.

I love pharmacology so much that I was even thinking about becoming a teacher or a researcher at a Medical School.

I really feel like I'm not very procedure oriented because I have not had the comfort of being able to put IV lines and practice intubations etc. I just don't have manual dexterity/fine motor skills (which I realize comes with practice). However, I would like to do these things on dummies or mannequins so that at least my technique is right before doing it on a human being.

I also feel like I've really enjoyed my Psychiatry and Pediatrics rotations the most (psych was outpatient clinic in a rich area) and pediatrics was in-patient. However, that could have also been because the hours were good and I didn't have any real responsibilities in terms of notes, projects, etc. so I really got to talk to the patients and listen to them.

However, the biggest thing, I feel is that I'm not mature and wise enough, even at 24 years of age, to be making such a big decision as to what specialty I would like to spend the rest of my life doing. I feel like a complete loser compared to my classmates who are already piling up audition rotations on VSAS, buying clothes for residency interviews (which they haven't even been offered yet). I genuinely have no clue as to how to approach this audition planning thing given my current mindset about the future. I really wish I could take a year off to maybe take USMLE Step 1 or even do a transitional rotating year, but I'm not sure these things will be of any benefit either. To top it all off, what is probably contributing to this the most, is that my family life is in complete turmoil and no matter how hard I try and isolate myself from it, I still find myself thinking about my problems.

I know that this sounds like a complete jumble of mess, but I feel really under confident about a lot of things and I'm not able to clearly decide on what I want to spend the rest of my life doing.

I was wondering if anyone out there has ever felt the same at my stage in the game? I honestly can't find a specialty I truly hate and can't find one I love either.

 

[microshar88]

Thanks guys. I guess I'm leaning towards IM more and more. I do like the idea of Neurology. However, after doing 12+ weeks of family medicine, I will say that as much respect I have for the field and the wonderful mentors I have found, I don't think its right for me. I also feel that outpatient IM is also not my cup of tea either.


is there anything I have a shot at in ACGME on the west coast? Psych?

Planning on kicking things into high gear as far as step 2 is concerned once this mess of audition planning is over!

 

[microshar88]

not that I'm dissing the AOA residencies or anything, but I have met quite a few 4th years and faculty at my school who say that all the programs are good for training, sometimes (as with any programs), the community hospital setting and the close knit environment (smaller # of residents per attendings) can get quite difficult. The hospital situation is pretty iffy with some of them too. This is neither here nor their, but I thought i would bring this out there. Not that I'm trying to be choosy considering my scores.

Glad that I passed on the first attempt and can't make any excuses worthwhile for the scores I have; however, I do plan on improving.

 

[itallbelongstoyou]

I love this time of year when all the third years are figuring it out. I think it's really mature of you to highly consider a transitional year because it sounds like you really are not quite sold on any one field and it may take really getting saturated and working in the various fields to really get a feel for what it's like to actually be part of the service, responsible for the patient outcomes and in the trenches as they say.

I just wrote about a few things to consider when picking a field of medicine on my blog: http://itallbelongstoyou.com/2014/03/13/growing-up-picking-your-field-of-medicine/

I would say for the DO residency part is to definitely do your homework and spend sometime at the programs if you can. Some residencies are stellar and others aren't. Just like MD residencies, homework is the key. If you're just applying widely and not looking at what the program really has to offer or what sets them apart or if you're a good match then what's the point? If you care about your happiness over the next 3-5 years then put the time in to figure out what you want in a program and apply to those programs knowing that you'll be happy there (TY or whatever you apply to).

 

[microshar88]

I love this time of year when all the third years are figuring it out. I think it's really mature of you to highly consider a transitional year because it sounds like you really are not quite sold on any one field and it may take really getting saturated and working in the various fields to really get a feel for what it's like to actually be part of the service, responsible for the patient outcomes and in the trenches as they say.

I just wrote about a few things to consider when picking a field of medicine on my blog: http://itallbelongstoyou.com/2014/03/13/growing-up-picking-your-field-of-medicine/

I would say for the DO residency part is to definitely do your homework and spend sometime at the programs if you can. Some residencies are stellar and others aren't. Just like MD residencies, homework is the key. If you're just applying widely and not looking at what the program really has to offer or what sets them apart or if you're a good match then what's the point? If you care about your happiness over the next 3-5 years then put the time in to figure out what you want in a program and apply to those programs knowing that you'll be happy there (TY or whatever you apply to).

Thanks for sharing your blog. I agree with you that I might be setting my self up for a TRI.

Regarding the DO residency part, I've been checking on opportunities but are there any other resources to find out the nitty gritty details and inside story so to speak on some of these programs?

As sad as it is to have a COMLEX lower than 500, I am still happy that I passed on my fist attempt. I am regretful that I did not achieve the 508 I received on the COMSAE that my school gave me. However, I still think I did good by not taking the USMLE and getting a 190 or lower.

 

[itallbelongstoyou]

You have to ask the program coordinators and look on the program websites. As I mention on my blog too, you cannot rely on any one source of information unless you go to talk to the program itself (coordinator/current residents) because a lot of the internet info is outdated and inaccurate. So it's a lot of work, but as I mentioned, it's worth it.

As for the COMLEX, don't worry about it. I didn't get above a 500 either and was lower than my COMSAE and now I'm very happy in a very busy competitive ob/gyn program. Show that you can improve on step 2, be a decent normal human being in interviews, work hard on audition rotations, get good letters of rec, get your app in early and you'll be fine. There's other ways to do things than getting the very best scores. It's about finding the residency program that is right for you. If you're looking at programs that are only hung up on COMLEX Scores and don't look at the person behind the score then I'm not sure that program is going to be a great fit for anyone.

Good luck!

 

[Buckeye(OH)]

Thanks guys. I guess I'm leaning towards IM more and more. I do like the idea of Neurology. However, after doing 12+ weeks of family medicine, I will say that as much respect I have for the field and the wonderful mentors I have found, I don't think its right for me. I also feel that outpatient IM is also not my cup of tea either.


is there anything I have a shot at in ACGME on the west coast? Psych?

Planning on kicking things into high gear as far as step 2 is concerned once this mess of audition planning is over!

I personally know of one student in my class that failed and was held back that matched ACGME neurology. Is that on outlier? Could be.

Is it possible? It would seem to be definitely so.

 

[microshar88]

Thanks, I'll definitely get in touch with the coordinators. They seem rather friendly.

It's a bit difficult to get in touch/find the current residents for some programs on SDN, and I haven't found any facebook groups for some of these programs at the small community hospitals. But I'll first check with the coordinators.

Luckily, I did never failed a course. I think it has to do with the fact that I was alway scared to death of failing that I memorized my behind off sometimes. I think this bit me in the rear though as I did not sacrifice lecture/exam studying time of even the lower yield subjects in pathology for instance (eye, ear, skin etc.) while my classmates completely did the bear minimum to pass at the end of 2nd year in favor of doing more uworld questions and using DIT.

What's done is done though, itallbelongstoyou, I agree with you I have to move forward and just work on what I can.

 

[microshar88]

I have been looking into the DO programs. I think as of late, I am finding myself interested in Internal Medicine as well as Psychiatry and Neurology. I would not, however, want to do a combined specialty as I don't think it would be beneficial since i'd end up doing one or the other.

I was wondering, if it is possible to do auditions in all three programs and possibly apply to all three? Or would I have a difficult time with my school when it comes time to applying.

Thanks

 

[RRR96]

I think that you'd be spreading yourself too thin applying to three specialties. I was considering two, but after starting the process of researching programs and rotations, the work became too tedious especially for Internal Medicine programs. There are just TOO MANY to be thorough. Since then I've abandoned the idea and committed to pursuing my top choice (by gut feeling) and it has been less of a cluster fuq.

Not saying that it's impossible, but you're going to want to get into the best program that you can for any given field which means you need as many auditions as possible in that field. For our school, we only really have 4-5 rotations of 11 to use for elective/auditions. That's definitely not enough rotations to spread between 2-3 specialties.