Advice for Severely Declining Performance

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JohnnyKnoxville

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I am a third year who just finished my first clerkship. And I failed the shelf. Did outstanding on the clinical portion, but missed passing the shelf by the smallest of margins. I’m furious, confused, and frustrated.

For M1 and M2, I was an honors student, excelling in every block. During Step study, I felt a little ill, but still managed to score fairly well. After the exam, I went to the doctor and found out I had multiple chronic health issues, which have more or less consumed my life since. I’ve been trying to push through because I’ve never been one to make excuses, but after also failing my most recent clinical skills exam before clerkships, this seems to be a trend.

I am striving for a fairly competitive field, and I feel like I’m doing irreparable harm, and it feels out of my control. I can’t help but think that I’m putting myself out of anything competitive the more this goes on.

Does anybody have advice for how to proceed? I’m considering taking some time off, but I’m really concerned over loans and whatnot. I also don’t want the red flag of taking five years to finish. But I cannot go on like this.

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I am a third year who just finished my first clerkship. And I failed the shelf. Did outstanding on the clinical portion, but missed passing the shelf by the smallest of margins. I’m furious, confused, and frustrated.

For M1 and M2, I was an honors student, excelling in every block. During Step study, I felt a little ill, but still managed to score fairly well. After the exam, I went to the doctor and found out I had multiple chronic health issues, which have more or less consumed my life since. I’ve been trying to push through because I’ve never been one to make excuses, but after also failing my most recent clinical skills exam before clerkships, this seems to be a trend.

I am striving for a fairly competitive field, and I feel like I’m doing irreparable harm, and it feels out of my control. I can’t help but think that I’m putting myself out of anything competitive the more this goes on.

Does anybody have advice for how to proceed? I’m considering taking some time off, but I’m really concerned over loans and whatnot. I also don’t want the red flag of taking five years to finish. But I cannot go on like this.

I would absolutely get help of some sort. It is not natural for a top student who honored years 1 and 2 and did well enough on step to consider the competitive specialties to be failing a shelf. Student's don't just go from the top quartile to the bottom in a couple months.

As for your dreams of a competitive specialty, most of the elite fields want to see Mostly Honors with a few High Passes. If this shows up as a failed/remediated clerkship on your transcript, it could very well be the kiss of death for any chance at these fields. If you can retake the shelf and pass the clerkship you may still be in the game. Also it's probably much better to voluntarily take a leave of absence then to trodge though 3rd year with poor performance and then potentially be forced to take an LOA anyways after it's too late.

tldr; you need to figure out what has changed or is going wrong and fix it asap
 
I would absolutely get help of some sort. It is not natural for a top student who honored years 1 and 2 and did well enough on step to consider the competitive specialties to be failing a shelf. Student's don't just go from the top quartile to the bottom in a couple months.

As for your dreams of a competitive specialty, most of the elite fields want to see Mostly Honors with a few High Passes. If this shows up as a failed/remediated clerkship on your transcript, it could very well be the kiss of death for any chance at these fields. If you can retake the shelf and pass the clerkship you may still be in the game. Also it's probably much better to voluntarily take a leave of absence then to trodge though 3rd year with poor performance and then potentially be forced to take an LOA anyways after it's too late.

tldr; you need to figure out what has changed or is going wrong and fix it asap
I can pass with no mention on my transcript if I pass a retake. It’s just so demoralizing to fail by a point. I’m not this stupid, and I have a track record that backs it up. I don’t even know if this is a desirable field anymore. We are told to be compassionate, and to give our all for patients, but can’t even get a little bit of slack to take care of ourselves when crisis hits. And then the patients blame us and call us stupid anyways.
 
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I can pass with no mention on my transcript if I pass a retake. It’s just so demoralizing to fail by a point. I’m not this stupid, and I have a track record that backs it up. I don’t even know if this is a desirable field anymore. We are told to be compassionate, and to give our all for patients, but can’t even get a little bit of slack to take care of ourselves when crisis hits. And then the patients blame us and call us stupid anyways.

You 100% can't blame yourself right now, there are obviously other factors at play that are interfering with your schooling and ability. I can't imagine what you must be going through and it's so important that you don't beat yourself up or let other people get you down.

You clearly are an exceptional student, if you need to take some time off to get yourself back on track and fix anything else that may be interfering with your schooling, you should definitely do that. This is an anomaly and you will be able to get through this and get back to your baseline. I would recommend reaching out to someone from your school/administration to get their advice and options about where you should go from here.
 
I am a third year who just finished my first clerkship. And I failed the shelf. Did outstanding on the clinical portion, but missed passing the shelf by the smallest of margins. I’m furious, confused, and frustrated.

For M1 and M2, I was an honors student, excelling in every block. During Step study, I felt a little ill, but still managed to score fairly well. After the exam, I went to the doctor and found out I had multiple chronic health issues, which have more or less consumed my life since. I’ve been trying to push through because I’ve never been one to make excuses, but after also failing my most recent clinical skills exam before clerkships, this seems to be a trend.

I am striving for a fairly competitive field, and I feel like I’m doing irreparable harm, and it feels out of my control. I can’t help but think that I’m putting myself out of anything competitive the more this goes on.

Does anybody have advice for how to proceed? I’m considering taking some time off, but I’m really concerned over loans and whatnot. I also don’t want the red flag of taking five years to finish. But I cannot go on like this.
Better to take the LOA and go heal, than fail out of med school, or have multiple failures on your record.
 
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