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Did you get happier once you got into residency?

Discussion in 'Emergency Medicine' started by beansandgreens, May 28, 2017.

  1. beansandgreens

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    As we all know, third year blows hard. I really hate it. I won't go into detail but I'm sure a lot of people have felt the way I feel. I don't have MDD and I'm not suicidal or anything, but I'm definitely at one of the lowest points in my life. Only 3 weeks left but it's taking everything I have to finish third year. I know 4th year is generally considering to be great, so I'm looking forward to it. I have my EM rotations squared away and I'm looking forward to getting back into the ED and actually doing/learning stuff that I find interesting.

    My question to you guys/gals... once you got into residency did you find that you became happier? Obviously a resident is much busier with loads more responsibility than a medical student, but hopefully doing something you actually enjoy and feel is important with your time will make all this worth it.

    Thanks!
     
  2. Belleza156

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    Definitely not happier. As an intern life sucks. Even though you aren't working as hard as when you are more senior, it's a big adjustment and a huge stressor. It may be an even lower point for you. Make sure you are mentally capable of it, you don't want to be one of the people that commit suicide while in residency. The last 2 years of medical school are great, make sure you take the time to enjoy the last few low stress years of your life. Once you have finished interviewing in 4th year, you have done all you can. Put your feet up, have some mai tais and travel.
     
  3. Dannyboy676

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    Yeah, but just because you're working harder and longer doesn't mean you'll be less happy.
    Currently, I can't stand going to pointless lectures for my FM rotation and all the busy work


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  4. BoardingDoc

    BoardingDoc Don't worry. I've got my towel.
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    I completely disagree with Belleza above. I was vastly happier as an EM intern than I was as a MS3. Being an EM intern can suck, yeah... but at least you're doing something you like. I was infinitely happier working 6 days a week as an EM intern than I was working 4-5 days a week as a MS3 doing OB/Gyn, or gen surg, or rounding for 5 ****ing hours on IM.
     
  5. Venko

    Venko True to self
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    In my experience, happiness is more a reflection of myself than of my situation or others. When I have been really unhappy, the solutions were internal rather than external.

    In general, having purpose, autonomy, and pride are three factors that relate to happiness in your work place. It's tough in school and residency where autonomy is hard to come by. I believe, You need to augment those hours by finding time for things where you are in control.

    I have also found that Dr Soods advice works wonders too:


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  6. sonofva

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    I am in the military, and because of how things work in the military, i had to do not one BUT TWO internships. I have worked very hard in both, but my job and life satisfaction was way improved in my em internship over my ty internship. Take that for what you will

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  7. DokterMom

    DokterMom SDN Gold Donor
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    @Venko brings up an excellent point about happiness being internally driven. Do also take some dedicated reflection time to determine what it is that makes you feel happy. Is it interesting work? Knowing that you've made a difference? Feeling competent? Relationships with colleagues? Helping patients? Time spent outside of work with loved ones? Hobbies?

    Some of these factors will be more under your control; others less so. If feeling competent and spending time outside of work with loved ones are most important to you, expect intern year to suck big time. But if it's doing interesting work and relationships with colleagues, then you might find residency much more satisfying.

    The point is - whatever works for you. Identify it. Find it. Recognize it when you do find it. And most importantly, know that the suck is probably time-limited.
     
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  8. Dannyboy676

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    Thanks for pointing out the competency aspect.
    I found that one of the most demoralizing things about third year rotations and med school in general. Still don't know how to battle it, and frankly, one reason I liked my EM rotation a lot is because I felt competent in it.


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  9. TheComebacKid

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    Absolutely, positively, I am significantly happier as an EM resident than I was as a third year med student.

    I absolutely hated medical school. I hated the majority of my rotations. I wanted to get in the thick of things, do stuff, make a difference, be involved. It was the constant feeling of trying to peek over people's shoulders to see what was going on, the feeling like I wanted to offer to help and be engaged, but not too eager because higher ups seem to frown upon that too. Don't even get me started on the evaluations/shelf exams which make med school so unnecessarily painful and detract from actual learning. I felt like I was a fly on the wall and when I started buzzing to see what was going on, people tried to swat at me. This could just be my isolated medical school experience, other classmates I know loved it.

    Enter residency. I'm seeing patients on my own. I'm making my own plans. I'm doing my own lines, my own procedures. I'm actually involved in resuscitations and not just the guy who cuts off the clothes. Sure, the hours are long. Sometimes the excess responsibility can get overwhelming. But I feel like the support structure in residency is way better too. Our class routinely grills burgers, grabs beers after a crazy shift, hangs out at each other's houses. The big difference is our attendings are involved in these activities too. We get to know them outside of work, and when things get crazy in the ED, they get our backs. Also, when you come home from work, you are reading about stuff that pertains to your interests, your shift, making yourself better. I remember on FM coming home and having to read about fasting glucose tolerance tests and literally passing out from boredom and drooling all over my Case Files book.

    As a resident now, part of me realizes how difficult it is to invest in medical students. They are there for a few weeks. I don't often get to know them that well as I want to. A lot of the times they are doing this rotation because it's a required part of the curriculum, not because they are interested in learning what's going on. When you are in residency, your attendings are more invested because they see you on their team, they want to teach you so you become better, and they want to get to know you.

    Intern year has definitely posed some huge challenges, I've seriously doubted myself at times, came home after a rough shift really unhappy with how things went, replayed my mistakes in my mind over and over. But the growth as an intern over 1 year is massive when you compare it to all 4 years of med school. If you end up doing general surgery residency on the other hand, that's a different story.

    There's light at the end of the tunnel for us.
     
  10. Petypet

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    Grass is always greener. I tolerated school and I enjoy residency, however I would say I'm not happier because I've reached my goal. If you are unhappy, find out why, and do what you can to improve the situation.

    Keep in mind, emergency medicine is the best and worst of every medical speciality, try your best to learn and enjoy aspects of every rotation. Venko is absolutely right, try and find things you can control and make the best out of them!
     
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  11. engineeredout

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    Residency definitely better. Not easier, but better.
     
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  12. MSmentor018

    MSmentor018 Hooah!
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    I had a good med student and residency experience. it's better because you're getting to a more focused point in your career but I can say the easiest time of my life was after matching and before residency. that few months from mar-jun was a great time, I did a procedure/research mo, ultrasound/radiology, mandatory FP, anesthesia. no more stress of interviews, papers, monthly travel...etc. hang in there, write everything down that you need to do, get things in order. it'll help with that overwhelming sense of chaos that ms4 yr brings. take a little time to relax in between. you gotta give yourself time to breathe. it's still a marathon. the finish line is coming up. keep going
     
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  13. exsanguination

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    In residency with one year left: I have to agree that happiness stems from within. If you are not happy as medical student during MS3-4, then I posit you will not be the happiest resident either.

    You didn't like your OB, IM, or FM rotations? Well, I hate to break the news, but you will be seeing all kinds of patients in similar settings. There's no difference between a low acuity first trimester vaginal bleed coming into the OB office or the ED fast track area. You didn't like your psychiatry rotation? I'd wager beyond the gobs of mismanaged and hard-to-manage primary psychiatry patients that comorbid psychiatric illness complicates over half of the routine bread and butter that I see on a daily basis. There's chest pain in a 59 year old diabetic with multiple stents and unequal pulses, and there's chest pain in the 20 year old repetitively anxious patient.

    That said I loved every rotation during MS3 and MS4 for what it was worth, and I loved intern year for what it was worth. But I also loved organic chemistry and calculus during my undergrad years (physical chemistry major). If you are not happy now, the chances that residency will magically make it all better are low.

    What may change is the stress of the next step. After EM residency I hear the tables turn remarkably. You control the conversation. The autonomy is yours. Directors want you for jobs, and you can say "no" as you please to anybody or anything because as an EM doctor you are mobile and can "vote with your feet." Good luck!
     
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  14. HooliganSnail

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    You remind me of.....ME

    I think 3rd year of medical school is one of the most soul sucking experiences to endure. I am in constant awe that we continue to train medical students the way we do......it's like, sure your going to learn SOMETHING, but it is the most inefficient way to learn.......like ever. It's simply amazing just how mind bogglingly idiotic it all seems looking back. Golden years of my youth, spent standing around in a stupid short coat, while the attending asks you about chloride metabolism or something else inane.

    I mean who came up with this education plan.......Let's make the students just.....STAND THERE. They will stand there, and do nothing, and not be allowed any real responsibility, and not even come close to making any real decisions, and so really you learn very little. We treat medical students like they are children, and not surprisingly, they act like children.

    If training to become a doctor is like filling a giant tub of water to the top, then clerkship years is like starting to fill it up with a teaspoon, one SLOW, meandering spoonful at a time. Sure there some water getting in there (and always remember to be grateful for EVERY DROP). Then suddenly you become an intern, and you are allowed to use a 5 gallon bucket, and then things really start getting filled.....

    Intern year is hard, it is long hours, it is mistakes made. It is telling family members their loved one died, and doing it badly because it is your first time. It is dropped lungs doing central lines, and awkward calls to the surgery resident after the less than ideal placed chest tube thereafter. It is endless pages about endless needs for endless nurses. It is the patient can't poop, now they can't stop pooping, they are in pain, then they are not breathing from the pain meds. It is too many admissions, too many hours worked, too many crappy meals, too many lbs gained. IT IS HARD.

    However, intern year is so amazingly glorious, because you are actually a DOCTOR. You are actually in the game. You are actually doing what you trained for.

    It is 1 thousand million fafillion times better than being a 3rd yr medical student.
     
  15. fahimaz7

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    I liked it more than ms4. Finally doing the job you want (minus off service fun). Getting paid helps too
     
  16. HooliganSnail

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    You are forgetting yourself. Not liking the rotation does not necessarily mean not liking the subject.

    FM rotations are tedious because your attending knows all the patients like the back of their hand, and the patients often don't really want to talk to you, but are just being polite.

    IM rotation means you have to ROUND!!!! Rounding is the worst experience ever, and as an ER doctor, you should know how much you hate it.

    Ob/Gyn is the nastiest, most horrible, most awful experience of EVERYONE's training. Don't even try to argue against that point. Just don't even go there.

    Psych sucks, you hate pysch patients too, stop lying to yourself.
     
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  17. Cinematographer

    Cinematographer More chill in real life
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    Preach
     
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  18. OP
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    beansandgreens

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    This may sound weird, but I just miss being around the people of the ED. I never knew how special it was until third year. I was a scribe for a year before medical school and really liked the ED environment. It's so weird how different the people in each specialty are. Most are ok, or at worst tolerable, but I just find I enjoy being around ED people. My best friend in medical school is also doing EM. You guys just rock. Calm, smart, hard-workers that don't take **** too seriously.
    Thank you all so much for the thoughtful replies, I really appreciate the input.

    Hooligan, I can't tell you how much better your post makes me feel. I just feel like the worst part right now is essentially my viewpoint of "life being on hold." I know that's just perspective, but the severe lack of purpose and income have gotten really draining. I'm just looking forward to waking up and feeling like I'm doing something useful with my life while getting paid. Paying to go do nothing all day has taken its toll.
     
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  19. HooliganSnail

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    Good.

    I think that the medical school process is especially toilsome for people who love EM, because EM is such a "do something" specialty. We are hands on people. We like to be in the action, we want to make the calls.

    I promise you it will get better.
     
  20. swamprat

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    I think residency sucked way more than medical school (I am finished in 1 month, have about 10 shifts left). It got better as I got more senior and it is possible that this last year may have been better than medical school. For me I think there are several big reasons why this is.

    1) I did not like being an idiot, not knowing anything intern year. Failing at procedures, differential diagnosis, missing big things, getting yelled at (my program has a few attendings who are very "old school" when it comes to teaching residents) in front of other people and belittled. This really was mostly intern year.. but a majority of it I'd say.

    2) Responsibility as a student when it comes to work and other life things is minimal. My job was to pass tests and show up. Part of me wanted to be wanted so I felt a purpose showing up on those rotations where you were ignored. In residency you better have your hang chopped off to call out (no not really but we have to pay every shift back to the jeopardy resident for taking off unless its a major family or medical emergency).

    3) Had a lot more friends, more time to hang out, less time on a night schedule or wacky shift-work type schedule = better mental health, happier me. At least for me, I am an extrovert, like hanging around a lot of people, and enjoy being awake when other people are awake (which is a reason that didn't become that apparent to me until I started residency)

    So what did I like better? Well I got to do the procedures now rather than watch, once I knew what I was doing the responsibility is kinda cool at first, your more targeted to your career desires than medical school, you get paid something which def allows you to spend a little money here and there to buy things (I used to hem and haw about whether to buy a video game, now, its 50-60$, I buy it NBD), and lastly..your that much closer to being done.
     
  21. lactomar

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    In the same boat myself and vastly looking forward to my second intern year compared to my first (first was also a TY). For what it's worth, I also was not doing well in 3rd and 4th year and found my intern year to be much better. Despite being the "lowest on the totem pole", I found much more autonomy during my intern year than as a medical students as I at least owned my patients and had some little decisions every day that I affected.
     
  22. The White Coat Investor

    The White Coat Investor Practicing Doc and Blogger
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    Residency was my favorite job I ever had. But I loved MS3 too because I was finally doctoring. I wouldn't say being an intern is dramatically better or different than MS3. You're still doing off-service rotations in other specialties. You still function pretty close to the bottom of the food chain. You're still working pretty hard. There's still "busy work."

    The fact that you hate MS3 could be a major shot across your bow. Not sure what to do about it at this point other than plow ahead, hope you love residency/EM, and then figure out after that what to do with your life. Quitting now and walking away isn't a great option due to the debt you've likely already accumulated unless your mental illness is so severe that it will keep you from finishing residency and working in EM for 5 years or so to get a return on your med school investment.
     
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  23. onlyletters

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    I absolutely hated 3rd year and find being an intern to be so much more fulfilling than a medical student. Being a ****ty doctor (an intern) is way more interesting than being the best 3rd year medical student bc you're actually getting your hands dirty and really learning.

    That being said, others in my intern class have definitely had different experiences than me. There were two in my intern class who openly contemplated quitting. Another one told me this was the hardest year of their life (although that person never mentioned quitting).

    I think how intern year affects you mostly depends on how your personality is built and how you view yourself. If you're not okay being wrong, if you have a grandiose opinion of yourself, if you already think you have mastered anything in medicine, if you went into EM for any other reason than you love EM; then intern year might be even more tough for you.

    Be humble, work hard for your patients, make everything a learning opportunity (especially when you're wrong or even if someone (a consultant) thinks you're wrong, but you're not) and you'll be fine.
     
    #23 onlyletters, May 29, 2017
    Last edited: May 29, 2017
  24. Apollyon

    Apollyon Screw the GST
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    That's coincidental that your say that, as I described you specifically today to a colleague as having the "unicorn job", and how I wish I had such a thing.
     
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  25. exsanguination

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    For sure! WCI, I love you and your teachings to death, I've become "financially literate" as a result of your posts and your website.

    However let's be very clear, he has a very "unicorn job" that's not available or achievable by a majority of emergency physicians. He also makes probably more money from his website, book, articles, and presentations/speeches than he does from grinding out patients.

    I am jealous!
     
  26. Birdstrike

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    For me, yes. Things got progressively better each year as I progressed through medical school, and through residency. Now, at 43, my life has never been better. I consider myself very fortunate. Although there are no guarantees, if you hang in there and give it your best shot, there's a good chance things will get progressively better. Not much in life that's worth anything, is easy.


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  27. EMDOC17

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    Everyone is probably different but on a whole residency>>>>>>>>>>>>>>>all of medical school. I really was unhappy as an M3 mostly for some of what you said. No one knew who I was and no one really cared. I was there for maybe a month and then gone. At best as a medical student you barely got in the way. It honestly didn't get all that much better for maybe the first 6 months of residency as it felt much like medical school with a ton more stress and expectations. I got my feet about 6 months into residency and it literally go so much better. I was now functioning as a physician and finally felt that if I wasn't there it would actually be a problem instead of a blessing. As I went through residency it was no longer showing up to an unfamiliar place and not knowing what to do. I rotate at 3 places and now the other staff ask where I have been. The further I went in residency the more I was the one taking care of the patient instead of saying "ill go talk to the doc". What I wanted was usually what happened. I got to know the staff, the attendings, the fellow residents ect. It is sometimes more stressful knowing that you are the one taking care of the patient but it is soooo much more enjoyable than feeling like you are wasting space. I would do residency 3 times again than have to go through medical school again.
     
  28. Trail Blazer

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    Third year does suck, but you're right that 4th year is going to be awesome. Although I don't start PGY1 until July so I can't comment on being happier in residency, I will say that any time I was bummed during third year I just thought back to the dark, dark times of studying for step 1 and biochem. I'd rather be stepping on toes and a human gauze/tape/lube stock closet than sitting in lecture for 4 hours only to have to go home and sit on my butt for at least another 2 hours studying each day. Perspective is everything my friend.
     
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  29. TeddyBoomBoom

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    Well said... my man... well said.
     
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  30. goodoldalky

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    I was personally much happier in residency than in medical school. Yeah, I worked harder than I thought I would, but I also had way more fun than I thought I would and took much more enjoyment in my work.
     
  31. YOUR MINDSET SUCKS.
    Every day you wake up, you have a choice. You can choose to find value in every rotation, knowing that it will add to your overall medical knowledge, which will make you a more competent physician...... Or you can bitch about how its not the stuff you want to do. Maybe it sucks and maybe it feels like a waste of time, but your perspective is a choice.
     
  32. MirrorTodd

    MirrorTodd It's a gas.
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    I'm one month in and ****ing loving every second of it. Yes, I am stressed and feel like I don't know anything half the time, but I actually feel important to the team. I feel like my work matters. That is a feeling that I RARELY had on clinical rotations.
     
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  33. lucid_leprechaun

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    Totally agreed, it's a huge relief to actually do things. So far it's been fantastic. Also you become first in line for procedures.
     
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  34. dadaddadaBATMAN

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    I would take my most worthless, scut filled/long hour off service month over medical school on an easy rotation any day of the week.

    I like being a resident. I'm not happy all the time, but it is so much better to have a purpose for being in the hosptial
     
  35. Angry Birds

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    I agree. From a self fulfillment perspective it feels good to be actually useful. From a time perspective the schedule sucks and is soul sucking. Basically Med school and residency both suck. Undergrad on the other hand is the best.

    So you become more self fulfilled but miserable nonetheless.
     
    #35 Angry Birds, Jul 27, 2017
    Last edited: Jul 27, 2017
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  36. Angry Birds

    Angry Birds Angry Troll
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    Ok Dr phil
     
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  37. tux4

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    Couldn't be happier in residency. Actually being part of the decision making in patient care, knowing you are actually helping others, feeling like you are important in the team, the list goes on. Living in the location you want also helps a lot.


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  38. witzelsucht

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    far happier in residency. the ****ty off service days go by faster because you are actually doing work, not pretending to do fake work. the EM shifts are amazing. there's tough days for sure, but i always go home feeling like i really helped at least a few people, and learned a bunch.

    i actually had serious reservations about EM in med school because of the night shifts, but when you are actually cruising in the pod, banging out patients left and right, its not that hard to stay up. come home tired and ready to crash, still excited to go back though.

    med school blew. even alleged "great 4th year". no interview stress, just show up and work.
     
    Retart13 likes this.

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