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Anxiety About Med School

Discussion in 'Pre-Medical - MD' started by AspiringERMD, Sep 7, 2014.

  1. AspiringERMD

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    Hello SDN.

    I don't know what I'm even expecting to get out of posting this. I guess I just need to vent and possibly commiserate.

    Lately, I've been incredibly anxious about med school next year (provided I even get in somewhere, which is never a given). I just don't know if I can handle it, and this terrifies me. I was a math major and am not used to memorizing superhuman amounts of information. My anxiety over it makes me worry that I'll still have the same anxieties in med school and will just shut down and fail out. I do have a psychiatrist who has known me for a decade, who is adamant that I am emotionally and cognitively capable of it. I have been very stable for a long time (GPA= 4.0 undergrad, 3.97 post-bacc), but this constant anxiety is making me wonder if I'm actually not emotionally capable of dealing with the stress after all.

    How much anxiety are other people experiencing over the nature of med school? Or is everyone too focused on the app cycle to be paying attention to that aspect of it? Is this abnormal enough that I should think about bailing, or at least deferring any acceptance I might get?

    Thanks for listening, even if you can't relate. So glad I found these forums.

    EDIT: I actually feel several notches calmer just having written this out. Maybe I just need more friends who understand. People outside the medical world tend to underestimate the level of commitment and difficulty, I think.
     
    #1 AspiringERMD, Sep 7, 2014
    Last edited: Sep 7, 2014
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  3. crossingthefingers

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    What I've heard from people in med school is that you don't necessarily think it's possible but you manage to do everything and get through it. I definitely know that for me, worrying would only make it feel worse. I've had the most success when I've just sucked it up and made stuff happen.

    I do feel a little worried about you. Are there ways that you can cope with your anxiety that usually help you feel good?
     
  4. AspiringERMD

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    Well, I do have prescribed Xanax which usually allows me to re-focus and get to work if I'm otherwise just too anxious to do anything. But it's usually rare that I'm anxious enough to need one. Lately I feel anxious much more commonly. (My psychiatrist is aware of all this, by the way.)

    I am also able to be distracted from the anxiety. Watching Netflix and going out with friends often provides temporarily relief if we don't talk about medicine. But obviously, that can't take up too much of my time in med school.

    I don't know. I guess I just want to know how much more I'm worrying than everyone else, and whether this is cause for rethinking this med school idea entirely.
     
  5. DermViser

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    I think you have to be objective on WHY exactly you are anxious. Is it medical school itself? Is it you're fearful about the results of how you will fall academically in med school both in the first 2 years and in the clinical years? Is it the number of years involved to complete your education (4 + residency + possible fellowship)? These are very valid concerns. You can take as much Xanax (with its side effects) as you want, but you can't mask over the issue.

    And just as an aside (as I'm not giving medical advice), I'm surprised you were given Xanax as most psychiatrists start out with SSRIs for anxiety.
     
  6. AspiringERMD

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    Believe me, we tried damn near every SSRI on the market back when I was in high school and the issue wasn't under control yet. They might as well have been placebo pills. No response whatsoever (actually, occasionally I'd be worse on it). We have had practically miraculous success with Wellbutrin (just raised the dose last week), but the Xanax is a PRN backup. I try to use it only when distracting myself is failing and the anxiety feels like it's escalating, since Xanax is more effective the less you use it.

    I have some anxiety about the length (mostly because I'll matriculate at 28), but I think it's the volume of information that I worry I can't master, and the fact that most pre-existing relationships end during MS1. I fully agree that Xanax is just a band-aid and will not fix these issues, but these are just reality. That's why I'm worried about being able to handle it; there's just no escaping either of those facts.
     
  7. ftp902

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    Although I think it's normal to be anxious during application cycle, I do believe that you have to reevaluate yourself regarding what you want our of your life. At the end, we live to pursue happiness, wherever that comes from, and if you already know/worry that you will be anxious through medical school more than you will be happy from pursuing your dream, I would say think about it again. I am not saying it to discourage you, but I am saying it for you to step back and see what really makes you happy.
     
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  8. hoihaie

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    I'm scared of med school too - the amount of info, the time required to succeed, the stress during clinical years...etc I'm also scared of the fact that someday someone will die under my care and it might very possibly be my fault...

    But I also really like the science and the opportunity to help people in medicine and believe the positives outweigh the negatives by far. THis gives me a some comfort - to focus on the bigger picutre and the end goals. Regardless of what career we chose to go into, there will always be hardships we have to overcome. Maybe it's not the copious amounts of information needed, but it'll be something.

    Focusing one step at a time helps me in dealing with the anxiety and fear. For now, it's preparing for the coming interviews, writing a good letter of intent, and what to make for dinner so i don't starve my skinny a**.

    Keep strong, I'm right there with ya!
     
  9. AspiringERMD

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    I appreciate your honesty. That's part of what is so distressing; I can't see myself as anything but a doctor. Frankly, this has always been true, and going into a totally different field was a mistake. I have finally felt, for two years now, happier than I have ever been because everything finally feels like I'm on the right path. And now this anxiety has happened just in the past month. To understate things, this really blows. If I can just get through med school, I'm reasonably certain that I will finally have a career I love. It just remains to be seen whether I can get through the schooling.
     
  10. AspiringERMD

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    Thank you very much. :) Your post made me feel a little better. It's nice to feel less alone!
     
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  11. kraskadva

    kraskadva ...
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    I'm not much for motivational [email protected], but there's one poem I keep on my wall to reread when SHTF and I'm stressing out.
    http://en.wikipedia.org/wiki/Desiderata
    For you right now, this part in particular might be applicable:
    Take kindly the counsel of the years, gracefully surrendering the things of youth. Nurture strength of spirit to shield you in sudden misfortune. But do not distress yourself with dark imaginings. Many fears are born of fatigue and loneliness.

    Find some friends (here or IRL), maybe have a drink (you're certainly old enough), and breathe...
    Life will go on. Whether you succeed brilliantly or end up dropping out and doing something else. Anxiety about the future is normal. Letting it cripple you is a problem. But no matter what, you can only take it one step at a time.
     
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  12. DermViser

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    I think what your expectations are for medical school, residency, as an attending are very important and whether that is in-sync with reality. I think part of the problem and what's so anxiety provoking for you, is that you don't actually know and it's hard to get a realistic view with such narrow experience as premed - unless you've done certain EC activities that expose you directly to it. The first 2 years you have some level of understanding as it's what you've been doing in undergrad - studying and taking exams. While I agree that's tough, that's not only what medicine is or encompasses. It's a lot more than just studying, retaining, and taking exams. For some, that's a good thing, for others that's a bad thing. Yes, the amount of information is a lot, but it's not "superhuman". Contrary to SDN dogma, and this is just my opinion, the first 2 years are not the "hard" part. It's relatively controlled with respect to time, getting enough sleep, studying, exercising etc.

    In residency, you'll be studying also, but you'll also be working at least 80 hrs. per week (save for few specialties), and there will be some sleep deprivation added to that. MS-3 gives you a taste of that. It's education but also service of actually seeing patients and being responsible for patient care. The stresses in residency affect people both w/ and w/o an official diagnosis of anxiety.

    Honestly, (for me) what kind of jumped out at me at your situation is that your anxiety has been recalcitrant to treatment and you had it since high school. It's not just mild anxiety but moderate-to-severe. Medical school is not an obstruction on the land to happiness. I know a lot of premeds feel if they can just get thru med school, everything will be just fine and dandy, but that's almost never the case. Physician is not the only route, PA and NP are also routes as well in which you do a lot of the same duties, although with lower overall call responsibility, better lifestyle, etc. It's all a risk-benefit ratio and only you can decide if the risk-benefit in terms of time, money investment, etc. is worth it for you. The key is to make sure what are the exact reasons you are pursuing the physician pathway vs. alternative pathways to relatively the same destination. Ego is not a valid reason (not saying yours is) to pursue it, so just make sure your reasons are sound AND you're aware of the pros/cons.

    You would definitely not be the first person to have anxiety or depression in medical school (there are some who enter med school perfectly fine and are diagnosed in medical school), so no need to feel like you're alone.
     
  13. AspiringERMD

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    I think you're absolutely right that a big part of it is the fear of the unknown. When I had my first interview last week, the anxiety was gone for several days because med school just kind of came to life on interview day. I got to talk to people who were in the middle of it. They retained their friendliness and senses of humor; that is, it didn't seem like school has made them dead inside or anything like that. I can't tell you how much better I felt after meeting them and taking a tour. Perhaps med school will be stressful, but as soon as I understand the demands, some of this fear of the unknown will dissipate.

    I agree that ages ago (literally half my lifetime ago), it seemed treatment-resistant. But Wellbutrin isn't an SSRI, and switching drug classes made all the difference in the world. You can't succeed in undergrad as much as I did (if you'll excuse the lack of humility for a second) with the level of uncontrolled anxiety I had way back in high school, and that's why I was previously unconcerned about my emotional stability... it had been seriously great for a long time. It's just been this past month that I've started freaking out about it.

    You make a valid point about the difficulty of the career itself, but that just isn't particularly anxiety-inducing right now. I think it's possible that my problem is more one of perception as opposed to the reality of what I'm likely capable of. That is to say, if anxiety doesn't get in the way, I should be able to do it.
     
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  14. AspiringERMD

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    This is beautiful. Thank you :)
     
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  15. IslandStyle808

    IslandStyle808 Akuma residency or bust!
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    The biggest truth in life.
     
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  16. DermViser

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    Not to be a negative nelly, but remember that those who are "dead inside" aren't going to be giving your tours or come up to meeting applicants. The only ones the med school trots out for applicants on interview day are the happy medical students. Just like the only residents who are trotted out by residencies on interview day are the happy residents and chief residents or those who volunteer to do it (many of whom are doing it to kiss butt to act like they care/are involved). Interview days are a lot of Kabuki theater and are not necessarily representative of day-to-day life. Hence why second looks after acceptance help.

    A lot of anxiolytics (SSRIs, benzos) have sedation as a side effect, which can be a problem esp. during rotations. I'm surprised you're using Bupropion for anxiety as it's usually used to treat depression. Anxiety is a life-long ailment. The best you can hope for is to control and manage it, but it doesn't go away. If it's not med school, there will be another stressor in your life that will trigger just as much of an anxiety response.

    While the career itself isn't particularly anxiety-inducing to you NOW, it's something important to think about now, while you can still change course with no repercussions, vs. say 3 years in, where changing course is pretty much closed off to you. Medical school shouldn't be a bunch of ticking time bombs ready to go off once you get past each hurdle.
     
  17. AspiringERMD

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    I had the same thought about them cherry-picking happy students, but even seeing that it's possible to turn out that way made a huge difference in anxiety levels.

    I do agree once again with your solid observations on the future career itself. Maybe I'm just having a hard time accepting that something I thought was semi-permanently controlled is back after all these years. I survived the tremendous orgo stress like a champ! :)

    I do appreciate everyone's candid answers, and the fact that nobody has been the slightest bit mean about anything. Thank you guys. I'm going to see if the Wellbutrin increase fixes it over the next month, and if not, maybe talk in detail with my doctor about whether this is realistic. I know I have most of the ingredients it takes to be a good doctor (with certain areas that need improvement, like anyone). It's going to boil down to anxiety control, I think.

    Thanks again :)
     
  18. optimistic3

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    This is basically my sentiment as well. I'm terrified of the volume of information that I'll have to learn quickly and retain. I'm desperately trying to find more efficient study methods now during my post-bac so that I don't fail my exams in med school. I have yet to find something better that works for me than what I'm doing now and that scares me. As hoihaie said, I'm also scared that someone may die under my care due to my wrongdoing.

    OP, I'm definitely anxious about medical school as well (though I am not diagnosed with anxiety). You're not alone!
     
  19. IslandStyle808

    IslandStyle808 Akuma residency or bust!
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    Same here. Been looking into a lot of memory techniques.
     
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  20. optimistic3

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    Found anything good? If so, share it with us : )
     
  21. IslandStyle808

    IslandStyle808 Akuma residency or bust!
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    I'm currently in the beginning stages of the techniques. I suggest looking into the "memory palace" and "major system." I am currently working on the memory palace and am amazed at how much I can remember things (I did this a little for my MCAT for my acids and bases). I am just trying to remember lists of things.

    Joshua Foer and Memory Palace (Also a winner of the USA memory competition)


    This gives an intro into the memory palace, but there are other videos on this (more indepth). The way it works is to take a space you are familiar with and try to picture it (home or university campus etc.). Now if you want to remember a list with cheese, shampoo, and cereal (I'll keep it short); you have to make the image bizarre and relate it to a space in your palace (lets make it your house for example). First think of your drive way and image a giant rat with a big block of cheese. Then as you enter your house imagine a famous actor or actress covered in shampoo, just drenched,and it has a distinct smell in your mind (try to use your other senses too). Then for the last image just go into your kitchen and imagine opening the cereal box and serial numbers are flying out of it.

    When you retrace your steps, you will be surprised at how much you remember (memory masters can remember thousands of words and numbers with variations of the techniques I have mentioned). However, the technique takes a great deal of work. People have had problems with it such as abstract word or remember commas, and periods. However, you can remember those things as long as you can assign a picture to them. There are a lot of techniques out there, so try find them.

    EDIT: Some of these techniques are taught in medical school also.
     
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  22. ridethecliche

    ridethecliche Meep Meep Meep
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    From what I've been reading lately, and I think part of the OP's post was probably brought on by the Physician suicide article in the NYT, is that it is normal to feel woefully inadequate and unprepared.

    I think schools and residency programs are starting to get much better about supporting those in training deal with the harsh transition. Things like this are SO much harder when you think you're completely alone, but when you start to realize that many others feel the same then it can be a bonding experience instead of an alienating one. So much of how we conceptualize strength is so incredibly flawed...
     
  23. AspiringERMD

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    I never even read that article, actually. I just know that med school, and the job itself, are incredibly difficult. Good to hear that resources are increasing/improving.

    I definitely have days when I'm freaking out and days when I think that, while it will be quite an epic challenge, I'll be able to handle it on par with everyone else. Luckily, today is the latter type of day :)
     
  24. ridethecliche

    ridethecliche Meep Meep Meep
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  25. DermViser

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    Resources are highly dependent on the medical school in question. Not every medical school can be like Vanderbilt with respect to looking out for wellness in their students. Even then, a medical school can't control culture in your student body, defend you against bad faculty, etc.
     
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  26. Great White Buffalo

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    Checking in as a computer science major and 6 weeks into M1. First 3 weeks were rough for me, as a CS major, use to figuring out stuff, not memorization or sheer volume of material. After the first 2 weeks I advised my sister to NOT apply to med school next year, as it was so intense, and she had a bit of a delayed processing speed learning disability. In the first couple of weeks I had to have a tutorial on genetics from my Dad (a med school faculty member), as I never had genetics and they blew through a semester's worth of material in a few days. He had to review the material, and joked that he did med school already, an didn't want to do it again!! It was a big adjustment (and I'm coming off just a 6 month gap from undergrad).

    Now that I'm in the swing of things, I take back my initial impressions. After lots of quizzes/tests, it is doable, but is all consuming during the week. You just think the first 2 weeks will be how it is forever, and it is not true. Somehow, you get the pace of what you need to do, and how to do it. It is fast paced, just keep up and you should be fine. I still have time for some extra curriculars (not even remotely related to medicine) on the weekends.
     
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  27. DermViser

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    To be fair, you go to a "true" P/F school in the first 2 years.
     
  28. Great White Buffalo

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    Yes, but we get the scores on the tests/quizes, the class average and the stan. dev. on each (have lots of quizzes and tests, probably about 10 already). Pretty high averages (usually between 88 - 92% is the average, with a stan dev of 3-4%). Not the usual undergrad bell shaped curve, to say the least. Most folks are coping well, with lots of group activities too, so you aren't alone with this stuff.
     
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  29. ridethecliche

    ridethecliche Meep Meep Meep
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    Do you think this helps collaboration vs competition or will gunners be gunners no matter what?
     
  30. Great White Buffalo

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    Seems like our school chooses collaborative folks, but that may be a value of what they seek in applicants (per a twitter from Ad com last year, there was a lot of discussion between Exec. Ad Coms about an applicant who used "I" too much). With test averages in a really tight distribution (but pretty high range), being a gunner doesn't buy you much here.
     
  31. DermViser

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    I think it helps greatly with collaboration at least in the first 2 years where everyone is trying to get to know each other initially, friendships start building, and everyone wants to master the material. People make and share study guides, class notes, old exams, you're more likely to help someone struggling with the material that you're good at, esp. if you remember when they helped you when you were having trouble with the material.

    Will there be a few people who are always competitive on everything, including points on a class exam? Yes, but they will be quickly ostracized and shunned by the class which just hurts them later when they enter clerkships and they'll get no real benefit out of it in terms of ranking.
     
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  32. DermViser

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    All medical schools choose "collaborative" people. No medical school will come out and say they choose competitive people. It's a major faux pas in admissions if you're recruiting for med school these days. With so many choices, students will just go to the better, more collaborative school if they have that option.

    There are certain medical schools (known on SDN) that divide the class into quartiles and do it by the number of points achieved on the exam, so the difference btw quartiles is a matter of a few points. It's absolutely ridiculous. No way people won't be competitive.
     
  33. DermViser

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    I didn't say people don't try hard. However, overall anxiety will be less.
     
  34. optimistic3

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    Wow, that is incredible and fascinating. Thank you so much for sharing that with us. I will have to try this technique for my MCAT for sure!
     
  35. AspiringERMD

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    Bump. I was doing SO well for so long. Now I'm starting to freak out a little bit again (not as badly). Anybody matriculating this fall feeling the same way?
     
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  36. vellez

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    It takes a lot to be a successful applicant--that you got in shows that you can handle a lot of pressure. Don't let your worries keep you from doing your best or keep you from getting everything you can out of medical school.
     
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  37. skougess

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    You're not alone. I very have a similar story as you and am starting in a month. I know that words can't make anxiety go away, but just knowing you are not alone should help some. We can do this!!
     
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  38. Dormouse

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    Think of it this way, no one ever fails out of med school :p
    (Well, not "no one", but you get the idea.)

    From what I've been told, even if your school is not P/F, pre-clinical grades matter very little in the end. Step I is not for another year and half for us. Enough time to not be stressed out in the meantime.
     
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