bottom quintile in preclinical grades, should I just quit

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mopitup85

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I've been feeling extremely stressed lately. I hate almost everything about med school except when I'm in real hospital shadowing. I feel burnt out and I'm tired of studying. I'm in the bottom quintile of my class based on my first two years (Pre-clinical grades) and maybe the bottom 10%. My grades are mostly B's, but I have a few C's as well. I'm in a long distance relationship which is also stressful and I don't feel like I can relate to the majority of my classmates. Most of them to seem to have very fortunate lives and come from well off families and they tend to reward themselves frequently with trips abroad and shopping sprees. My motivation is dwindling. I'll probably finish my pre-clinical years. I only have a couple months left.

I don't know if it's worth finishing my MD though considering how miserable I am all the time. I can't make time to cook for myself or work out and it sucks. I think the best plan is to go through a couple of rotations 3rd yr and see if I want to quit based on that. I really don't know what to do and being bottom of my class I'm not sure what my residency options will be. I want to have the option of doing pediatrics in Southern California where my family is, but I don't know if it's possible with my bad pre-clinical grades. I'm not sure if I can live with family medicine being my only option. I don't think I'd be happy.

Any advice? Will bad pre-clinical yr grades keep me out of a peds residency in California? Can I redeem myself with a decent step score and better 3rd yr grades? Should I just quit and do an MBA or something?
 
Try to stick it out, preclinical years are nothing like the practice of medicine. Clinical rotations can be crappy, but for different reasons. Would hate to quit now and then always wonder if you would have liked it.
 
I don't know much, but I would wager that a solid step and clinicals would make cali peds a strong possibility. It sounds like you're going through a lot of situational stressors though that are impacting both your performance and your outlook. I would take a minute to breathe and speak with your school's counseling services. It's not going to get better if you continue the burn out.
 
you sound depressed. go to see a therapist and/or pych and work on your mental health. it is very important and if you dont take care it can really sneak up on you.
 
Do you know what they call the person in his med school class who graduated last?







Doctor.


Take the Step and do as well as you can. Do some 3rd year rotations. Clinical rotations are a different world that it sounds like you will be much more comfortable in. Peds isn't that competitive although I'm not intimately familiar with Cali programs. Graduate from a solid Med school and have good step scores and you will have plenty of interviews.
 
organdonor said:
Do you know what they call the person in his med school class who graduated last?







Doctor.


Take the Step and do as well as you can. Do some 3rd year rotations. Clinical rotations are a different world that it sounds like you will be much more comfortable in. Peds isn't that competitive although I'm not intimately familiar with Cali programs. Graduate from a solid Med school and have good step scores and you will have plenty of interviews.
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Not to be the debbie downer in the room, but noone seems to be addressing one key issue here. Everyone says "just do well on step 1 and you'll be fine." This is completely true. That said, if you're struggling to pass your preclinical exams, then your current study habits aren't likely to land you a solid step 1 score. This in of itself isn't going to prevent you from matching into peds, but you are also looking at one of the most competitive regions in the country.

Long story short: poor preclinical grades aren't going to keep you from your dream job, but you need to have a better study plan for step 1 than you've had for your classes.
 
BoardingDoc said:
Not to be the debbie downer in the room, but noone seems to be addressing one key issue here. Everyone says "just do well on step 1 and you'll be fine." This is completely true. That said, if you're struggling to pass your preclinical exams, then your current study habits aren't likely to land you a solid step 1 score. This in of itself isn't going to prevent you from matching into peds, but you are also looking at one of the most competitive regions in the country.

Long story short: poor preclinical grades aren't going to keep you from your dream job, but you need to have a better study plan for step 1 than you've had for your classes.
Click to expand...

You mean OP might have to do peds residency somewhere other than California, and then come back to work there afterwards?

The horror.
 
1. peds isn't competitive, just graduate and pass your steps....
2. you are almost out of the phase of education you hate the worst....ride this thing out
3. if your relationship is stressful...consider moving on, there are other nice people who actually live near you
4. debt on two years of med school is expensive...finish and go to residency
5. see a therapist/pysch about possible depression issues, you need some coping mechanisms
 
sb247 said:
1. peds isn't competitive, just graduate and pass your steps....
2. you are almost out of the phase of education you hate the worst....ride this thing out
3. if your relationship is stressful...consider moving on, there are other nice people who actually live near you
4. debt on two years of med school is expensive...finish and go to residency
5. see a therapist/pysch about possible depression issues, you need some coping mechanisms
Click to expand...
You think as you progress it gets easier?
 
DermViser said:
You think as you progress it gets easier?
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Not easier, different. And none of it is as difficult as paying off loans with no medical degree. Maybe i have a high tolerance for suffering but that would be my perspective.
 
sb247 said:
Not easier, different. And none of it is as difficult as paying off loans with no medical degree. Maybe i have a high tolerance for suffering but that would be my perspective.
Click to expand...
Correct, but paying off 5 figure debt at 2 years, is easier than paying off 6 figure debt at 4 years. When you're in a hole, you stop digging.
 
DermViser said:
Correct, but paying off 5 figure debt at 2 years, is easier than paying off 6 figure debt at 4 years. When you're in a hole, you stop digging.
Click to expand...
If OP doubts they can pass steps or endure then yes...if OP can do it, but just won't be cheerful for a few years, they should consider sticking it out

i don't think this is a "i failed my first semester at a 2nd tier carribean" situation
 
mopitup85 said:
I've been feeling extremely stressed lately. I hate almost everything about med school except when I'm in real hospital shadowing. I feel burnt out and I'm tired of studying. I'm in the bottom quintile of my class based on my first two years (Pre-clinical grades) and maybe the bottom 10%. My grades are mostly B's, but I have a few C's as well. I'm in a long distance relationship which is also stressful and I don't feel like I can relate to the majority of my classmates. Most of them to seem to have very fortunate lives and come from well off families and they tend to reward themselves frequently with trips abroad and shopping sprees. My motivation is dwindling. I'll probably finish my pre-clinical years. I only have a couple months left.

I don't know if it's worth finishing my MD though considering how miserable I am all the time. I can't make time to cook for myself or work out and it sucks. I think the best plan is to go through a couple of rotations 3rd yr and see if I want to quit based on that. I really don't know what to do and being bottom of my class I'm not sure what my residency options will be. I want to have the option of doing pediatrics in Southern California where my family is, but I don't know if it's possible with my bad pre-clinical grades. I'm not sure if I can live with family medicine being my only option. I don't think I'd be happy.

Any advice? Will bad pre-clinical yr grades keep me out of a peds residency in California? Can I redeem myself with a decent step score and better 3rd yr grades? Should I just quit and do an MBA or something?
Click to expand...

Mostly Bs and not failing anything? I think you're fine. Stop worrying about everyone else and focus on yourself. Go to your school's academic services to get suss out some study strategies that can help you and grind it out. Also, counseling.
 
DermViser said:
You think as you progress it gets easier?
Click to expand...

It definitely gets easier as you go. There will always be challenges and you never get to the point where you can sleep walk through your training, but the stakes drop and the likelyhood of a decent life improve.

This is coming for a surgical trainee where responsibilities rise exponentially as you advance. The reward/respect and sense of security also become infinitely higher when you're no longer at the mercy of PhD educators and have an unrestricted medical license.
 
lazymed said:
It definitely gets easier as you go. There will always be challenges and you never get to the point where you can sleep walk through your training, but the stakes drop and the likelyhood of a decent life improve.

This is coming for a surgical trainee where responsibilities rise exponentially as you advance. The reward/respect and sense of security also become infinitely higher when you're no longer at the mercy of PhD educators and have an unrestricted medical license.
Click to expand...
I don't know what your basic science education was like but you're not "at the mercy" of PhD educators. Unless you're a complete douchenozzle or a gunner, you're treated with respect and like an adult. Your job is to take notes, read the course pack, listen and watch streaming video from home, and regurgitate on multiple choice exams. You've had had practice at doing this from secondary school till the end of college. Whoop-ti-do.

As you go thru your medical education, the challenges from MS-3 onwards are just different, not necessarily "easier". The only thing is you're expected to do those things many times with added sleep deprivation, exhaustion, and without complaint no matter what your workload may be. The stakes don't drop, they increase, bc you have people's lives in your hands, as you well know, as do your responsibilities since residency training is as much education as it is service.
 
Sounds like you're in the plight of many medical students - myself included. It's hard to go from being relatively successful academically and personally in undergrad to getting the snot kicked out of you in med school. The way I see it, you have two choices:

1) Be motivated by the fact that you're not happy where you are right now and be willing to put in the time and make the sacrifices necessary to achieve your academic goals, whatever they are, or

2) Suppress your ego and accept that you're not going to be the best student in your class - a position that you're likely uncomfortable with and not used to experiencing. It doesn't take being in the top quartile/quintile/whatever to be a competent, caring, and effective position. Yes, your career options may be limited to some degree in that you likely won't be able to do the very competitive specialties, but you will still be a physician and, barring a tragedy, you will still be able to match at a decent program that will train you well.

I agree that you might also want to seek out counseling services at your school - not necessarily because you might be depressed or whatever, but simply because it can be helpful to debrief and talk about your experience with someone other than your classmates, faculty, etc.. Don't be too proud to go see a psychiatrist or even a therapist. Unfortunately the culture of medical training doesn't welcome open and candid discussion of academic struggle or difficulty. It sounds like you just need to vent and perhaps come to some kind of understanding or acceptance about your experience. This is where talking to someone can be hugely helpful.

And to echo what others said: pre-clinical work =/= clinical medicine by any stretch of the imagination. If you still think you'll enjoy working with patients and being a physician, keep your nose to the grindstone and do the best you can. Things will get better - if only after they get a little worse.

Good luck.
 
DermViser said:
I don't know what your basic science education was like but you're not "at the mercy" of PhD educators. Unless you're a complete douchenozzle or a gunner, you're treated with respect and like an adult. Your job is to take notes, read the course pack, listen and watch streaming video from home, and regurgitate on multiple choice exams. You've had had practice at doing this from secondary school till the end of college. Whoop-ti-do.

As you go thru your medical education, the challenges from MS-3 onwards are just different, not necessarily "easier". The only thing is you're expected to do those things many times with added sleep deprivation, exhaustion, and without complaint no matter what your workload may be. The stakes don't drop, they increase, bc you have people's lives in your hands, as you well know, as do your responsibilities since residency training is as much education as it is service.
Click to expand...

My preclinical experience was actually uneventful and flew by. Still more stressful and I'd much rather repeat a year of reaidency than a year of preclinical stuff.

Different people stress about or struggle with different things. my life got easier as I progressed through my training. I don't care that I'm working more hours. I'm stressed less and have more control of my life. I'm sure others feel like the challenges become harder as you progress. To each their own.
 
lazymed said:
My preclinical experience was actually uneventful and flew by. Still more stressful and I'd much rather repeat a year of reaidency than a year of preclinical stuff.

Different people stress about or struggle with different things. my life got easier as I progressed through my training. I don't care that I'm working more hours. I'm stressed less and have more control of my life. I'm sure others feel like the challenges become harder as you progress. To each their own.
Click to expand...
No, I realize that. Reread what I wrote and realized it might have come off mean, which wasn't my intention. Just saying that the abilities that make you successful in the preclinical years is not necessarily the same abilities that make you successful in the clinical years although there is some overlap (i.e. Yearly in-training exams).
 
mopitup85 said:
Should I just quit and do an MBA or something?
Click to expand...

There are myriad ways to make a decent living in this world that don't require expensive (time and money) graduate degrees. I don't know what it is about this select group of people that can only see their options in life as MD vs. MBA vs. JD.

OP, if you are having serious doubts, I recommend you take a year off, find some part time work and evaluate your options. Schools frequently let students do this. They'd rather you not fail step 1 and your clerkships, and if you tell them you are depressed and need some personal time to make sure you want to keep going, they'll probably give it to you.

But please don't fall into the trap of thinking that x graduate degree wasn't so great, but y graduate degree might be better.
 
OP -

Things to do:

1) Get off SDN. Now. Well, as soon as you finish reading this post. While often helpful, this place can warp your perspective. There is a powerful selection and reporting bias at play, the end result of which is the sense that anything less than junior AOA = FM in BFE. This is simply not true. Sure, we should all aim to be the best we can be, but mathematically half of us will go from being top of the class to below average on day 1 of M1. Very little is written in stone and there are many roads to get where you want to be.

2) Find a mentor. ASAP. If you want peds, you need to find some peds faculty who have experience mentoring med students. Talk about your goals and your current thoughts and get some perspective from people in the know. There are some great people on here too, but the anonymity of the internet is a double edged sword and prevents giving any truly personalized advice. Mentors at YOUR school will be able to give perspective on how previous students at your school have done and what it took to get there. I can't stress enough how important good mentors are. Good ones are people you will continue to turn to for advice even after you're an attending. Building those relationships can start today.

3) Meet with someone at your school's student mental health service to talk about what you're going through. Doctors are notoriously bad patients because they don't seek help early enough. Don't be that guy/girl. If nothing else, it's another person you can talk to and you can be assured it stays confidential.

4) Take advantage of any and all tutoring and other academic support services available to you. Give them ALL a fair shot. You're far from failing and actually doing pretty well, but definitely take advantage of all the services your tuition is already paying for. I've worked with repeating students who never even took advantage of tutoring their first time through; many barely failed and would probably have passed the first time with only a handful of additional right answers! Again, that's not your situation, but don't leave any easy points on the table.

5) Don't assume you can simply rock Step 1 and clinicals. Do your best and work hard, but don't be surprised if you continued performing at roughly the same level. You may find after talking with people that you're on track to do just fine and get where you want to go. Grades and boards are important, but never forget that on day 1 of residency, they mean about as much as your SAT/ACT, high school GPA, college GPA, and MCAT mean right now. They are a means to an end, not a measure of your worth as a person or a physician.
 
mopitup85 said:
I've been feeling extremely stressed lately. I hate almost everything about med school except when I'm in real hospital shadowing. I feel burnt out and I'm tired of studying. I'm in the bottom quintile of my class based on my first two years (Pre-clinical grades) and maybe the bottom 10%. My grades are mostly B's, but I have a few C's as well. I'm in a long distance relationship which is also stressful and I don't feel like I can relate to the majority of my classmates. Most of them to seem to have very fortunate lives and come from well off families and they tend to reward themselves frequently with trips abroad and shopping sprees. My motivation is dwindling. I'll probably finish my pre-clinical years. I only have a couple months left.

I don't know if it's worth finishing my MD though considering how miserable I am all the time. I can't make time to cook for myself or work out and it sucks. I think the best plan is to go through a couple of rotations 3rd yr and see if I want to quit based on that. I really don't know what to do and being bottom of my class I'm not sure what my residency options will be. I want to have the option of doing pediatrics in Southern California where my family is, but I don't know if it's possible with my bad pre-clinical grades. I'm not sure if I can live with family medicine being my only option. I don't think I'd be happy.

Any advice? Will bad pre-clinical yr grades keep me out of a peds residency in California? Can I redeem myself with a decent step score and better 3rd yr grades? Should I just quit and do an MBA or something?
Click to expand...

Listen dude you're passing and that's all that matters. P= MD end of story.
Now will you end up going to Harvard, Hopkins, UCSF, Uchicago? Maybe not but who the hell cares.
Don't quit now. Just figure out what you're doing wrong in your study habits and try to improve. Sit down your your counselors, fellow classmates and fine tune your study techniques and then you'll be perfectly fine.
I didn't care about preclinical grades at all and so I ended up in the bottom 25 percentile but I scored pretty well on USMLE Step 1 (top 30 percentile) so don't let anyone tell you that you won't do well on Step 1.
Bad preclinical grades don't mean much. 3rd year is going to be much more fun if you enjoy the hospital and the clinical/3rd year grades matter so much more than preclinical grades so don't stress at all.
If you're passing that means you can pass Step 1 and that's all you need to be a licensed doctor anywhere in this country. You're passing your classes, you're doing great so keep your chin up. Regardless of how much you feel like you don't like medicine, there's always a specialty that will suit your personality and likes so keep on trucking.
 
Thanks for all the encouraging comments. I have a full tuition scholarship so I'm not too worried about debt. I'm paying for living expenses though. I guess I just have to keep pushing, but I'm glad it's not all over. I just want to be able to find a specialty that I like/be happy in and can get into hopefully in California but I guess thats up in the air. Career counseling is pretty awful at my school. Too few people doing to many things. They don't even reply to email. I try to have mentors but I feel ashamed telling them about my grades.
 
what about talking to some older students. I am constantly talking to a few select people ahead in school of me about my grades. I'm sure they are sick of my be now but it is very reassuring to me 🙂
 
mopitup85 said:
Thanks for all the encouraging comments. I have a full tuition scholarship so I'm not too worried about debt. I'm paying for living expenses though. I guess I just have to keep pushing, but I'm glad it's not all over. I just want to be able to find a specialty that I like/be happy in and can get into hopefully in California but I guess thats up in the air. Career counseling is pretty awful at my school. Too few people doing to many things. They don't even reply to email. I try to have mentors but I feel ashamed telling them about my grades.
Click to expand...

You'll need to get over the shame thing right now. Making Bs in med school is nothing to be ashamed of, especially if you're working hard and giving it your best. I can promise you that almost all of your faculty earned similar grades when they were med students. Most of the current residents also. I'm 100% positive that if you start talking to people you'll find you are part of a very very large club. Again, SDN and your undergrad academic experience (which must have been good to yield a full scholarship) are skewing your view and blinding you to the fact that you're doing just fine and no doors are closed to you yet.

Just bypass the career counseling at your school and go straight to seeking mentors in individual departments. If it were me, I would set up an apt with the peds (or whatever you're thinking of at the time) residency program director and ask him what it takes to be a successful applicant. As people who see 100s of apps each year, they can give you some really good up to date information. I think you'll really feel better after talking with people like that. Just imagine how it would feel to tell your tale of woe and have them look you in the eye and say, "yeah, that's pretty common in most of our successful applicants. Just keep passing, get a decent score on Step 1, work hard during 3rd year, and you'll match just fine."
 
starstarie said:
what about talking to some older students. I am constantly talking to a few select people ahead in school of me about my grades. I'm sure they are sick of my be now but it is very reassuring to me 🙂
Click to expand...
Probably the best advice here. There is a lot of good general advice to be had on SDN... but you talking to people who (at least 20%) will have been through the same thing could be very helpful. I also agree that even just talking to someone in your personal counseling office for a few minutes could be beneficial. 🙂
 
operaman said:
OP -

Things to do:

1) Get off SDN. Now. Well, as soon as you finish reading this post. While often helpful, this place can warp your perspective.
Click to expand...

Yes. It's also very effective for wasting time, and if you're struggling with your classes, you should be spending time studying instead of reading forums. Sorry, I know it's a lot more fun to read forums, but studying is what will help get you a residency spot.

Now go hit 'dem books! =)
 
I'm not sure how getting consistent Bs in medical school puts you in the bottom 10% of the class.

Regardless, if you're gettin gmostly Bs, then you are passing quite safely. I think you have some underlying depression or are being affected by the impostor effect, and the first thing I'd do if I was you would be to student health services for a psychological evaluation.

However, if you don't want to do that, I think you need to accept that you were likely at the 95th percentile in high school, 95th percentile in college, and thus you expect to be at the 95th percentile in medical school. However, only 50% of people in medical school (who have been in the 95th percentile for all their lives) can be in the top 50% of their med school. Sometimes you need to accept that you are no longer at the top of the class, but as long as you are learning the material and NOT FAILING as a student of a US MD school, you will get an MD and likely get a pediatrics residency somewhere (can't 100% guarantee it will be in California, however).
 
mopitup85 said:
I've been feeling extremely stressed lately. I hate almost everything about med school except when I'm in real hospital shadowing. I feel burnt out and I'm tired of studying. I'm in the bottom quintile of my class based on my first two years (Pre-clinical grades) and maybe the bottom 10%. My grades are mostly B's, but I have a few C's as well. I'm in a long distance relationship which is also stressful and I don't feel like I can relate to the majority of my classmates. Most of them to seem to have very fortunate lives and come from well off families and they tend to reward themselves frequently with trips abroad and shopping sprees. My motivation is dwindling. I'll probably finish my pre-clinical years. I only have a couple months left.

I don't know if it's worth finishing my MD though considering how miserable I am all the time. I can't make time to cook for myself or work out and it sucks. I think the best plan is to go through a couple of rotations 3rd yr and see if I want to quit based on that. I really don't know what to do and being bottom of my class I'm not sure what my residency options will be. I want to have the option of doing pediatrics in Southern California where my family is, but I don't know if it's possible with my bad pre-clinical grades. I'm not sure if I can live with family medicine being my only option. I don't think I'd be happy.

Any advice? Will bad pre-clinical yr grades keep me out of a peds residency in California? Can I redeem myself with a decent step score and better 3rd yr grades? Should I just quit and do an MBA or something?
Click to expand...

i will echo what others have said:

number 1 - take some steps towards getting your depression under control. you cannot think clearly or study or make good decisions until this is done. exercise can help. see someone - get some help (most med schools have a counselor that can point you in the right direction.) take a year off if you need to to clear your head. don't read the rest of this post or any other parts of this thread until you have done this. you need to assess your next step with a brain that is clicking on more cylinders (you have the horsepower above the neck - it's just veiled by your depression).

number 2 - you're back? i hope you feel better - hopefully you are now seeing a counselor, are maybe on some meds, getting some exercise, got some outside perspective/help on your relationship/stresses/issues. maybe your situation looks a bit clearer, and everything is a bit easier and clearer now. the closer you get to finishing, the more your training will resemble your future occupation. the nonclinical med school years have very little to do with most MD jobs (just prerequisite knowledge). I hated med school. i disliked residency. i love my job. i look forward to (almost) every single shift. my profession fulfills me.

don't let depression or the nonclinical years make you forget why you wanted to be a doctor. there is hope for you.
 
Last edited:
evilbooyaa said:
I'm not sure how getting consistent Bs in medical school puts you in the bottom 10% of the class.

Regardless, if you're gettin gmostly Bs, then you are passing quite safely. I think you have some underlying depression or are being affected by the impostor effect, and the first thing I'd do if I was you would be to student health services for a psychological evaluation.

However, if you don't want to do that, I think you need to accept that you were likely at the 95th percentile in high school, 95th percentile in college, and thus you expect to be at the 95th percentile in medical school. However, only 50% of people in medical school (who have been in the 95th percentile for all their lives) can be in the top 50% of their med school. Sometimes you need to accept that you are no longer at the top of the class, but as long as you are learning the material and NOT FAILING as a student of a US MD school, you will get an MD and likely get a pediatrics residency somewhere (can't 100% guarantee it will be in California, however).
Click to expand...

It could be that they're getting in the low 80s consistently where the average is typically in the mid to upper 80s. Happens at my school. Obviously, it doesn't mean they're doing poorly. Bs are just fine.
 
CrimsonKing said:
You mean OP might have to do peds residency somewhere other than California, and then come back to work there afterwards?

The horror.
Click to expand...

apparently you did read my other glorious ~ 2000 posts, being rational here is just unacceptable. don't bring that kind of unprofessionalism around here anymore.
 
nap$ter said:
i will echo what others have said:

number 1 - take some steps towards getting your depression under control. you cannot think clearly or study or make good decisions until this is done. exercise can help. see someone - get some help (most med schools have a counselor that can point you in the right direction.) take a year off if you need to to clear your head. don't read the rest of this post or any other parts of this thread until you have done this. you need to assess your next step with a brain that is clicking on more cylinders (you have the horsepower above the neck - it's just veiled by your depression).

number 2 - you're back? i hope you feel better - hopefully you are now seeing a counselor, are maybe on some meds, getting some exercise, got some outside perspective/help on your relationship/stresses/issues. maybe your situation looks a bit clearer, and everything is a bit easier and clearer now. the closer you get to finishing, the more your training will resemble your future occupation. the nonclinical med school years have very little to do with most MD jobs (just prerequisite knowledge). I hated med school. i disliked residency. i love my job. i look forward to (almost) every single shift. my profession fulfills me.

don't let depression or the nonclinical years make you forget why you wanted to be a doctor. there is hope for you.
Click to expand...

are you sean parker's twin brother that also founded napster but became a doctor instead of a douche?
 
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