burnout?

[tomplatz]

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Maybe this is wimpy, but is anyone else totally burned out after 3rd year? I really thought I wanted to go into surgery, now that I'm on that rotation, I'm just not excited about it or anything else. I'm hoping this is just burnout, but it really worries me.

Anyone else feel like this? Has it resolved?

Worried.

 

[r90t]

Depressed???? It could be a real possibility.

Third year is hard, fourth year easier. If you bust your butt during these two years, internship is a breeze.

 

[scootad.]

Third year is hard, fourth year easier. If you bust your butt during these two years, internship is a breeze.

LOL Good one. I doubt internship is ever a breeze.

 

[lf777]

Hi

If you are feeling like that, make sure you are not depressed. And if you are, seek help. Medicine is already difficult enough if you are healthy. Believe me, internship will be worse than Medical School.

lf

 

[irlandesa]

Yeah, I know how you feel; I plan on going into IM and even though I enjoy the rotation most of the time right now, I have sometimes felt burnt out to the point of just throwing in the towel and walking out the door. Third year is long and emotionally draining, and >12% of students at the end of the year have major depression requiring treatment (I don't know where the study was published off the top of my head, but I can find it for you I'm sure). I do agree that if you have been feeling this way for a while and meet the criteria for major depression (good old SIGECAPS), then it would be good to consult with a psychiatrist. I disagree with the notion often presented on this board that burnout and depressed mood are a sign of weakness and that any person who feels this way will choke in residency.

 

[tomplatz]

thanks. especially for the last sentence of your reply irlandesa. much appreciated.

 

[Masonator]

I'm going to go even further and say that what you are feeling is totally normal. When I finished Surgery, I was so burnt out that I wanted to do surgery, but I didn't want to do general surgery. I played around with some of the subspecialties, but ultimately decided to go into general. My 4th year electives helped me to confirm this decision. I wouldn't base your decisions based on how you feel at the end of a brutal rotation.

At the end of 3rd year I was so burnt out and bitter at how crappy the medical education system is, that I took a nice vacation. This helped me a lot. I would recommend treating yourself to a good week long vacation somewhere awesome.

 

[Jaded Soul]

I'm definitely suffering from burnout too. Some days, I wake up feeling like I have no energy and it probably comes across as lack of interest during rotations. Other days I feel like I don't care at all and I know it comes across as lack of interest. I wish I could spare about 3 weeks for vacation right about now.

 

[fuzzyerin]

I'm with you all on the burnout. Anyone who tells you they're still excited about third year is either lying or a masochist. And it's not that I don't love medicine - third year has shown me that there's nothing else I'd rather be doing. It's the fact that nothing I do actually matters - I have to get a resident to put in orders for me, 75 other people are going to examine my patient (though, that's not such a bad thing at times - I still can't hear murmurs to save my life) and I've really maxed out my brain at this point. I'm up for vacation...oh wait, I still have to take Step 2. 😱

 

[Meritina]

MS BURNOUT IS HERE...

Yes, looking back on this 3rd year, I realize what a pathetic experience i have had this 3rd year and what disappointment it has brought to my thoughts of medicine - bad attitude residents, attending that seem like they want to screw with you, crap evals despite hard scut and intelligent work.

I could care less about studying now. Why work hard when it doesn't help my grades and i'm only hurt when a resident shatters me - at least if i put minimal effort then it wouldn't matter what the hell a resident says or does.

in fact, i used to show up early daily, and leave late daily, and never missed a freaking day. now with the such pathetic loser attitudes i get in medicine, i show up on my own time baby. no, sorry, i may not be there exacty at 6am for rounds, it might be 6;15 or maybe 9;30 as i've done several times lately. oops, i dont feel like showing up today, think i'll just call sick - these people are driving me ill anyways - never had so many freaking somatic problems in my life.

And i'm told this tough love attitude i get is to make me work harder and 'reach my potential' - what a 'great job' they are of doing that. another says that getting roughened so much will make me 'stop caring about what other people think' - interesting that people in medicine are trying to promote such thick skin.

but really, i don't want to waste my educational expenses this year, and therapy/meds haven't done diddly-squat to make me tolerate the bullsh-t i've had to put up with from residents and malignant attendings - they act like children who were beaten up in high school and now they have to beat up med-students to get back at the world.

so what is this frustrated, given-up, beaten-up, used-up, unmotivated student to do now - live in my own place of peace. i've decided to change my environment, live in a new area where it's nice with probably decent people, stop living alone, get some pets, and dump all these old JAMA magazines and school notes that I'll probably never use or look at again.

I have seen others try smaller changes, like new wardrobes, hairstyles, dating, etc - some people need a more massive rehaul than this.

i'm sure many have had frustrations during the first 2 years, but i think most students walk out thinking that education was worth it, glad they tried to drill that info in for the sake of our patients. i certainly will not walk out of the 3rd year thankful of much... so better get my life as s'well as it can be so i can get the most i can out of this year without going insane or considering giving up.

 

[floweree]

this is so depressing to read. is it really that bad out there? i have seen our third years come back for call-backs and they look so much better or maybe i just hoped they did. i hope this isn't what i have to look forward to.

 

[Al Pacino]

I have seen others try smaller changes, like new wardrobes, hairstyles, dating, etc - some people need a more massive rehaul than this.

Interesting, I've noticed these things among my soon-to-be MS4 classmates. A few go clubbing every weekend. Others have dyed their hairs different colors. And some are blatantly asking out some of the young nurses and receptionists...it's almost like after having undergone through the clinical year, people are trying to find some meaning or fun in their lives?

 

[Masonator]

Third year can suck bad unless you are very lucky with your residents and rotations. I think the majority of people would sympathize with what is said on these boards. I know I do.

 

[Meritina]

masonator,

you make a very good point not to base your decision on how brutal a rotation was for you. many 3rd yrs are treated like sh-t in the 3rd year, maybe the only rotation i can see people treated humanly is on Outpatient rotations and probably because this is a professional environment [i no longer consider the hospital much of a 'professional environment'].

i was gun ho on a surgical subspec with research and on that track for a long time, the rotation went well, but the general surgery rotation itself was terrible as i dealt with people who seemed absolutely miserable in their lives. i just had to drop the surgery idea altogether as i can't stand to be around these kind of people every day [obviously not everyone is like this, just too many people were overworked]

for others out there to avoid my kind of experience - i made a big mistake of selecting rotations and attendings who were 'the best teachers' and 'worked the students hardest or taught the most'. i would avoid these kind of people and rotation sites - it's just a silly thought people have thinking since they were treated roughly in the rotation, they probably got a good education. this is NOT TRUE, you will get a good education in many different sites or with other attendings, I DON'T RECOMMEND THE 'TOP GUY' [really they're often potential as-holes] in a field so you can get a letter while you are trying to learn in the 3rd year - SAVE IT FOR THE 4TH YEAR OR YOUR AI's when you have the experience and more respect.

beware of 'top gun' sites or attendings, you're 3rd year experience can go so much better without it and you can study when coming home without staying up all night wondering why you're attending used the 'f word' at you all day, only to drive you nuts. if it's not the 'f word', it's some other form of emotional torcher, so beware...

just my 2 cents

 

[cdreed]

LOL Good one. I doubt internship is ever a breeze.

I would take r9ot's advice to heart. r9ot is already a physician. Just about to start a fantastic RadOnc residency. I cannot offer my personal opinion of MSIII... I am merely a MSII.

 

[Masonator]

Depressed???? It could be a real possibility.

Third year is hard, fourth year easier. If you bust your butt during these two years, internship is a breeze.

Are you high?

 

[Yosh]

It is interesting to read about different experiences that people have had during 3rd year. I am officially done. I really had an amazing year. I busted my butt, and really learned a lot. I am feel sorry for the people that had such bad experiences. My psych rotation sucked with a bipolar CRAZY attending...but other than that....I LOVED it.

Anyone else out there have a good experience??

 

[r90t]

Let me rephrase it, internship is a breeze compared to the BS of MS3 year. It's the power of a positive attitude. No more chasing down a physician to write an order, countersign your charts, scut you out. You work harder than you probably ever have, but you control your life, your orders and the direction of your patient's care. That makes any "bad" rotation much better because you are a physician rather than a poor student.
I did a transitional year. With that in mind, my friends in IM/GS were much more frustrated. Peds were happy. Psych were quirky. OB/GYN, well, living on the labor deck. We worked the same hours, had the same call schedule, but were a happier intern group as a whole, as we were owned by no single service for the year. No rivalries/competition and we were a tight group picking up for each other when overloaded.

As for depressed, we had one guy stop internship for a couple of months due to SI. Another dropped out all together, after being found non-functional/incompetent. Another who was gung ho IM, dropped out late in PGY2 because she couldn't handle the stress of being a resident and a single mom. This is out of 85 interns, so, health care professionals do have real problems during training. Recognize your burnout/depression and deal with it properly. Don't gloss it over as a weakness or a shortcoming.

 

[irlandesa]

Let me rephrase it, internship is a breeze compared to the BS of MS3 year. It's the power of a positive attitude. No more chasing down a physician to write an order, countersign your charts, scut you out. You work harder than you probably ever have, but you control your life, your orders and the direction of your patient's care. That makes any "bad" rotation much better because you are a physician rather than a poor student.
I did a transitional year. With that in mind, my friends in IM/GS were much more frustrated. Peds were happy. Psych were quirky. OB/GYN, well, living on the labor deck. We worked the same hours, had the same call schedule, but were a happier intern group as a whole, as we were owned by no single service for the year. No rivalries/competition and we were a tight group picking up for each other when overloaded.

As for depressed, we had one guy stop internship for a couple of months due to SI. Another dropped out all together, after being found non-functional/incompetent. Another who was gung ho IM, dropped out late in PGY2 because she couldn't handle the stress of being a resident and a single mom. This is out of 85 interns, so, health care professionals do have real problems during training. Recognize your burnout/depression and deal with it properly. Don't gloss it over as a weakness or a shortcoming.

After third year, I hardly see how intern year can be worse. Sure you work more hours, but you are no longer the bottom person on the totem pole anymore, and your future probably seems a bit clearer. At this point, I am a complete mess at times. Much as I still have a passion for the subject material and seeing patients, I find myself asking why I chose to go 200K into debt when my resident's gf works as a writer and is able to play squash 3 hours a day and be in oh so perfect physical shape without anything near the same debt. If I knew I had a decent chance at getting a somewhat reputable IM residency (I'm not talking Brigham or MGH here, any university-based program at all would be swell with me), I'd not be so bitter and worried. But, I appear to have blown it with those 2 big Passes and zilch in the Honors category thus far, and have to listen to people on here (and at school to some degree) going "oh I got a 250+ on my Step 1 and all Honors, you will never get anything and you are a dummy with bad interpersonal skills!" I'm almost 27 years old, worried that my job prospects are crap, hugely in debt, single with no prospects in sight, and wondering why the **** I did this to myself. And it frusturates me to no end that there is nothing I can do to help the demented, terminally ill patients that come through this hospital. I feel like I am living right out of the House of God with the gomers and gomeres. One of my current patients has both ARF and CRF and hypernatremia that won't correct no matter whether we use D5W or 1/2 NS (she has severe dehydration and is completely demented as well). Sure, I learned all about hypernatremia and hematuria, but the patient hates being here (wouldn't you?), she only knows our team as the people who "don't know what they're doing" and wake her up from a pleasant sleep every morning.. I know, I should have expected this fully.. My idealism and altruism got the best of me when I applied back in 2000. I'm praying that I'll get some of it back before internship and that I'm just having a bad day today. I really don't feel this way every day, just more than I like to admit. peace and hang in there, it's almost over!

 

[scootad.]

Irlandesa, dont fret. I would not count myself out of university IM programs if I were you. I remember you having good board scores. IM is not very competitive, I would apply broadly, you might surprise yourself.

 

[Whisker Barrel Cortex]

While I sympathize with those who have had a terrible time in third year, I wanted to tell those who see this and get worried that the problems mentioned in this thread are not universal. I loved third year. And no, I am not a masochist. I learned a lot, got to actually apply some of what I learned, got to do things instead of just read about them. Sure there were hard times here or there (OB was no picnic), but overall it was a great experience. Most of my residents and attendings were really cool. Some tried to teach, others didn't.

Internship on the other hand, was utter hell. I did a prelim medicine year prior to radiology (not a cush transitional year) and had the hardest year of my life. Sure, you're not the very bottom of the totem pole, but you're at the bottom when it comes to things that matter and the hours are atrocious (a little better now with the 80 hour rule). As far as radiology residency, its been amazing so far and I've learned so much this year. Still got a LOT to learn though.

 

[Gynogirl]

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I just wanted to confirm that feeling that by the end of the 3rd year you feel like you want to quit, esp. if you are doing a gen. surg rotation where the chief resident snaps at the whole team every day like we are a bunch of monkeys. I know that people are overworked but that is no excuse to treat people like poop. This whole year ,at least once, on most rotations I have been humilated for no reason; and to think that I pay for the privilege. My new fear is that I have stopped liking talking and working with patients. This has started with surgery in the last few weeks. The hospital is starting to feel like hell on earth. The only reason why I'm staying is the fact I have one year and a huge amount of debt.

And to think that 35,000 bright minds want to get into med school every year. Yes, I do get to see and do some interesting things, but when I'm 80 yrs old, will I regret this choice?

Also just sweeping these issues and getting it treated as depression does not address the issue as a whole. I wish med schools at the beginning of third year would give us a warning and some guidance on how to survive. I wonder how many out there have thought of killing themselves at one point or another. MSIII's are human; we are not hospital whipping boys.

 

[DOtobe]

I have officially finished MS-III and have 2 weeks off, and I am so relieved. I was starting to get so burnt out when there was about a month left in my rotation. My last rotation was an easy one (Peds), so I had a lot of time to do extra reading, but I just did not feel like it. I think it's natural for us to feel burnt out. I mean, most people work 40 hours a week. On rotations we are there probably 50-60 hours. I think we have a right to be tired! I think the burnout also has something to do with the fact that our ideas regarding patient care really don't mean much of anything. I'm sure it will be better as an intern when we don't need someone to co-sign our orders, our progress notes, etc.

Although I enjoyed MS-III for the most part, I'm glad to be heading into MS-IV. Everyone says fourth year is like a vacation compared to MS-III, so I can't wait... 😎

 

[Hercules]

I mean, most people work 40 hours a week. On rotations we are there probably 50-60 hours.

I (as well as many others I'm sure) am very jealous if you guys are putting in 50-60 hours/week. I've noticed that the 80 hour work week and 24 hour shift rules do not apply to medical students.

 

[Meritina]

the 80 hr work week and 24 hr rule does not apply to med students here either. it amazes me on days when i was post-call, it was 5pm, and the intern left 7 hours ago. it also amazes me that we are treated like grade-schoolers again.

i'm burned out enough that i really don't care if i don't show up at times, hardly read, and get warnings from attendings and residents about it. i hope some of the major changes i make to my environment will help with this, cuz nothing else helped.

couple of more months to go...

 

[r90t]

Wow, MS3s thinking about killing themselves, even intermittantly, is not good. We had a mental health professional available for all med students. I'm not sure how much it was utilized. We mainly got together, had some drinks, and vented about the week. That was a big relief in itself. 2 quick points to bring up:

1. If you are really having thoughts of SI, even intermittant, get help. That tells me that you are having a very bad experience and may need professional help to cope with the pressure and long hours. May I emphasize, GET HELP!

2. The residents that are abusing the med students were in your shoes just a few years ago and had the same complaints. Try not to pass the abuse to your MS3s that you are encountering today. You don't have to badger or humiliate a student in order to be a good resident/staff.

Congrats to the MS3s. Third year should be just about over for everyone! Help out your MS2 counterparts in their transition from academic medicine to clinical medicine.\

Rob

 

[Gauss]

2. The residents that are abusing the med students were in your shoes just a few years ago and had the same complaints. Try not to pass the abuse to your MS3s that you are encountering today. You don't have to badger or humiliate a student in order to be a good resident/staff.

This is what surprised me the most about 3rd year. Residents can be your worst enemy! Of course there were a few attendings that made me feel I was walking on glass trying not to tick them off, but a lot of residents wanted to just **** on me from day1. No effort to teach or show any interest in me as something more than a 'student'.

Rotations are set up in an archaic fashion. THere are sooooo many specialties that you never get the chance to see until 4th year, if you're lucky. THere are a lot of areas I would like to just rotate through for a week if I could, just to get an idea what goes on. Oncology, Infertility, Urology, interventional rad, endo, Anesthesia, etc are just a few that I won't get to see 4th year. I think for the >$200k I'm plopping down for this crap, I should be allowed flexibility to pick things. Also, CALL is ridiculous. WHat can I possibly learn at 3AM???? I'm delirious at that point and even more useless than usual. I'm not even convinced that this is somehow raising my tolerance to sleep deprivation for intern year. Float systems are becoming more common and will eventually replace call. As a resident, I would be scared for my students driving home on such little sleep. I have heard of so many residents/students getting into car accidents due to sleep deprivation. There will be lawsuits because of this. Its not safe.

 

[r90t]

The 80 hour work week, no new pts in the am post call, home by 1200 post call, night floats, etc. All done to improve intern/resident lifestyle. I think someone realized (after legal challenges) that a intern/resident seeing a pt after 24+ hour of continous work is probably a bad idea. The learning curve is flat by that time and you are doing whatever you have to, so you can go home and sleep. It is a good change for medical education. We didn't have any fatalities, but we did have several post-call accidents.

 

[DOtobe]

I (as well as many others I'm sure) am very jealous if you guys are putting in 50-60 hours/week. I've noticed that the 80 hour work week and 24 hour shift rules do not apply to medical students.

Yeah, I've been pretty lucky in rotations. My longest hours were during surgery, at about 60 hours a week. I take that back, I took call for Ob/Gyn q4, so that was about 80 hours. But that was only for 6 weeks - I can't imagine doing that the whole year.

Oh, well, MS-4 is on its way for us, and it'll be much better (especially for you 80+ hour guys and girls!)

 

[Meritina]

i wonder how to make it through each day without craping out. at this point i need to try to make a promise to myself each morning that i just need to get through today, and stop focusing on anything else but this day so i can make it through.

i'm amazed (and fortunately) that many have not had the bad experiences working with residents/attendings like i have been treated. I have heard that certain types of people are more subject to poor treatment in addition to being exposed to residents who are prone to abusing med students.

if anyone has suggestions on ways to behave to avoid being treated like **** from residents, please lend me your suggestions. It seems like the obvious things such as working hard, trying to be of help, and being responsible are of no use here, nor does chilling out seem to work either.
thanks

 

[r90t]

Tell the IM guys that you want to do rads and don't ever want to touch another patient. Wait, that's how you get tooled on.

Not quite sure. I'd ask the lowest guy in the totem pole above you i.e. MS4/intern how the rotation is going and things you can do to avoid getting slammed the the residents.

 

[medstudent2005]

man, you know what ticks me off the most? well, one of the posters already said it: when you work your F-ing A$$ off, and the residents keep telling you how great you are, and then give you a crappy, SI-invoking evaluation, whereas someone who ended up with the "easy" resident, didn't do jack, gets a glowing, full honors evaluation! oh, it just pisses me off!

 

[gwyn779]

I'm with you all on the burnout. Anyone who tells you they're still excited about third year is either lying or a masochist. And it's not that I don't love medicine - third year has shown me that there's nothing else I'd rather be doing. It's the fact that nothing I do actually matters - I have to get a resident to put in orders for me, 75 other people are going to examine my patient (though, that's not such a bad thing at times - I still can't hear murmurs to save my life) and I've really maxed out my brain at this point. I'm up for vacation...oh wait, I still have to take Step 2. 😱

I still have 4 1/2 weeks left and I am so ready for it to be over. I still love medicine and 3rd year is WAY better than 1 or 2, but I really need a break. What sucks is that I know it's coming across as laziness or disinterest or something. Then this week I got more info about my mother-in-law partially failing the 1st treatment for her lymphoma, so I was even more distracted. My resident actually took me aside today to discuss my "performance" or whatever. So of course I had to bring up the stuff about my mother-in-law which I hate doing because I know that if I weren't burnt-out, it wouldn't be a noticable issue. I just need a break.

 

[Harrie]

Do you get a break after third year? We don't have any vacation, unless you count the switch weekend.

 

[gwyn779]

Do you get a break after third year? We don't have any vacation, unless you count the switch weekend.

We don't get an official break, but we have 6 more weeks in the year than we need to schedule rotations in, so those tend to be vacation whenever someone wants to schedule it. I'm taking July off, but I'm also taking step 2 then.

 

[tomplatz]

Thanks for the posts guys. I think it's just burnout in my case. I am still interested in medicine, just need a break. My last service is general surgery A, and I've been putting in over 100 hours/week all month (no, I'm not exaggerating) - under a very malignant attending. But very cool residents. I guess it just gets to you after a bit.

A week of R&R and 4th year will be a welcome sight, I'm sure. Good luck all!

 

[deleted4401]

I wonder how many of us are straight through to med school without taking a year off, and how many are non-trads? I think the non-trads have had a little less to complain about, and here's why:

As a guy who didn't take more then 7 weeks off between college and med school, I have a sneaking suspicion that third year is a year for me to learn "LIFE IS NOT FAIR". Most of my upper middle class life, including high school and college has had it's share of issues, but it's been mostly fair. However, most of the year has pretty much stunk, except for a few high lights of doing some minor procedures or hearing the nice things a patient may have to say about you. And the enormous injustices - bad evals for good work, staying longer than an intern, sitting around on call with absolutely nothing to learn or do, and getting yelled at or humilated without reason! Man, this year just was plain unfair, and good riddance to it. One thing I'm sad about is that I just wasn't nice at times this year ... and I think it's cause of all these mini-battles that I lost all year.

E.g. - this last rotation, I got tired of making patient chart copies for my resident for M&M b/c the nurse would tell me it's a HIPAA violation, and I also knew better than to make chart copies and carry them all over the hospital without asking the patient. So, I stopped doing it, and the resident SLAMMED me on the evals. Took me to task for following Federal and hospital rules! And, to make it even better, word got around, and the department quit making the students do these copies 3 days after I got killed on the eval.

I wonder if I get my humanity and niceness back during the 4th year.

Not to say that I'm happy you all are going through it, but there is a sense of 'misery loves company' for me ... And, my other friends that are in consulting and finance have been working long hours and getting chewed out for almost 3 years now! So, except for their huge paychecks, that's sort of comforting ...

15 days, and counting.

Simul

 

[Gauss]

I've been out there in the "real world" and don't remember being this down-trodden and burntout.

Well at least I'm not alone on the Peds/OB front....
as a male I honestly didn't know squat about OB/gyn, and there was no understanding of this - I got laughed at by nurses and shat on by female residents. Then with peds again, nurses never took me seriously and my ignorance seemed to know no bounds according to female residents. Give me a kid in DKA or acute abdomen I can handle, ask me about different types of baby formula or breast pumps and I haven't got a clue.

Also, when you get a Pass/very good/B eval and a letter of rec that says you were amazing on the rotation, wtf is that? Doesn't anyone realize how contradictory that is?

 

[raspberry swirl]

i was just wondering why everyone keeps saying that 4th yr is so much better than 3rd. is it just because you get to chose your electives? i would imagine if someone was interested in surgery and picked surgery electives, 4th yr could still potentially suck . . .no? maybe i'm missing some key point . . .

 

[DOtobe]

raspberry swirl -
Yeah, that's why everyone says fourth year is better, pretty much. Since you are a LECOMer, I can tell you that in MS-4 we have:

4 electives (can be whatever and wherever you want)
3 selectives (medical, primary care, and surgical) that can be whatever you want as long as they are at LECOM affiliates

So that is 28 weeks of pretty much whatever you want to do. Most people pick easy or fun electives during MS-4.

 

[Molly Maquire]

In addition to finally having some control over your rotatations, here are some more reasons why fourth year is going to rock:

No more shelf exams (at least at NYCOM, where I go)
No more osteopathic manipulation classes (again, at least at NYCOM)

Unless you are doing an audition elective, the pressure is really off in terms of grades and evaluations. The second half of the year won't matter, and even the first half probably won't count for your transcript/Dean's Letter.

 

[Zeffer]

Motivation at this point is < 0. I have finally hit the wall today. I have one more week to go then the Medicine shelf exam. I just hope to pass this rotation so I never have to do it again. Before med school I thought 3rd year would be the greatest, everything would excite me. Now that year 3 is almost done the only thing I am passionate about is Surgery (ironically before med skool this is the one field I thought I would not like). Now that I have found the one thing I enjoy it makes studying the other aspects of medicine even that much more difficult.