Not directly mentioned yet, you want your mental health under the best control possible before starting internship.
Absolutely, but I'd also argue that a gap year, as many others have suggested, may not be the solution for fine-tuning mental health. 4th year will allow for some decompression time. Upon returning from a PhD, the transition back into medical school-level work/expectations was jarring enough to leave me feeling absolutely hopeless during the first 2-3 rotations. On a more relatable scale, while we absolutely need breaks every once in a while, I often come back from vacations more stressed than when I left. Vacations are necessary long term, but the true benefit is felt when you get off work and realize you have a full week of nothing ahead of you. If OP wants to be primed for intern year and is experiencing
burnout (vs. depression or another mental health crisis), I don't know if extended time off will solve the problem or set them up for success starting intern year.
@Lifeblood_20, I'm also feeling this way. I'm on my last rotation in a specialty I have no interest in, and I can barely motivate myself to prep for clinic. The days of frantically parsing through an UpToDate article to try to present the perfect HPI and generate the perfect differential/plan are fading fast. M3 is a demoralizing year, regardless of how poorly or how well you perform. I'm so sick of being quantitatively evaluated on minimal performance with next to zero chance to correct and show growth. We have rotations where, for 5-6 weeks, you rotate on a different service/clinic every day (e.g., colpo clinic, L&D triage, prenatal clinic, gyn onc, L&D floor, back to L&D triage with a whole new team, gyn surg, community gyn, etc...). If I've done well, it's never been for the right reasons. If I've done poorly, it's always been nearly 100% out of my control (e.g., attending mixes me up with someone else, I get paired with the salty resident who gives everyone dead average evals with no comments, etc...).
It sucks being the lowest on the totem pole. It sucks feigning interest in something you could care less about. It sucks going home every single day and having a new exam hanging over your head. It sucks knowing that the results of your performance this year can dictate the rest of your career. However, it will get better. Years from now we won't care that Dr. So-and-So gave us 3s despite never meeting us even once. We'll settle into whatever career works out for us, and the people around us will judge us on our interactions with them and our overall character, not the name on our diplomas. If this is burnout, trust that a year of M4'ing will get you right again. If it's something that needs dedicated psychiatric work, then I'd consider a research year.
