discouraged by 3rd year

[copes]

Hey guys,

I've done a couple rotations by now. I love the medical aspect and the interactions with people in the hospital. However my clinical evaluations have been below average and my shelf exam scores have been above average but nothing great. I have been working hard in the hospital and studying hard when I come home. I allow myself a solid 8 hours of sleep but otherwise I barely have a social life or do anything for fun. I just feel like I could put in half the effort and still pass like I am now. I know that is not a good attitude but that is how I feel. I was ambitious at the beginning of 3rd year but now I don't enjoy being in the hospital if I am just lousy at what I do. I did well on step 1 and I thought I would have a shot at some good residency programs but I feel like that is all slipping away. Just wondering if anyone else out there feels the same way or could share some advice.

Thanks.

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[smq123]

Hey guys,

I've done a couple rotations by now. I love the medical aspect and the interactions with people in the hospital. However my clinical evaluations have been below average and my shelf exam scores have been above average but nothing great. I have been working hard in the hospital and studying hard when I come home. I allow myself a solid 8 hours of sleep but otherwise I barely have a social life or do anything for fun. I just feel like I could put in half the effort and still pass like I am now. I know that is not a good attitude but that is how I feel. I was ambitious at the beginning of 3rd year but now I don't enjoy being in the hospital if I am just lousy at what I do. I did well on step 1 and I thought I would have a shot at some good residency programs but I feel like that is all slipping away. Just wondering if anyone else out there feels the same way or could share some advice.

Thanks.

What kind of feedback are you getting on your evaluations? And what steps have you taken to address them?

 

[winkleweizen]

The biggest piece of advice I can give you is to always have your evaluators tell you what they expect from you on the first day of the rotation and always always always schedule a mid rotation feedback session with your intern, residents, attendings, and whoever else is going to be evaluating you. Have them give you specific feedback...if they are saying you are doing a swell job, then great but try to press for more substantial feedback. Not only will it give you things to work on, but I think if someone tells you to your face that you are doing a good job then they are going to have a tough time not giving you decent evals in the end.


(yes its sort of a game, but this has worked for me).


As far as shelfs go...well, they suck. Find one decent resource and study it real well, and make sure you subscribe to UWorld...i have found it awesome for alot of my rotations (neurology and medicine were great, Surgery was ok...most of the rest I have next semester).

 

[copes]

What kind of feedback are you getting on your evaluations? And what steps have you taken to address them?

On my evaluations and on the floors I am getting positive comments. In person, some honest feedback has been to be more assertive and that I may seem disinterested to someone who doesn't get to know me. I have been working on appearing more confident and speaking up more, but it's not like I don't participate in discussions. I know I have some things to work on and it is good to know what some of them are, but I still feel discouraged.

 

[Bacchus]

On my evaluations and on the floors I am getting positive comments. In person, some honest feedback has been to be more assertive and that I may seem disinterested to someone who doesn't get to know me. I have been working on appearing more confident and speaking up more, but it's not like I don't participate in discussions. I know I have some things to work on and it is good to know what some of them are, but I still feel discouraged.

I feel like I'm in your boat. My residents are more giving with the evaluations than my attendings are. I've had a few tell me halfway through I'm doing great and offer areas of improvement. By the end of the rotation they still have good things to say. However, I've come to notice a few tell me this now: "Its a shame your school doesn't offer a high pass." I know I'm not honoring all of the rotations and I don't expect honors on all of them. However, like you said, I could be putting in less effort and get the same result. I'm not like that and you don't appear to be either. As long as you have substantiated evaluations, I'd imagine those great comments will be incorporated into your Dean's letter (or something comparable). Its unfortunate how grading works sometimes.

 

[copes]

winkleweizen - I will try to incorporate some of that advice. Thank you.
bacchus - Thank you for the encouragement. I am glad someone else out there can relate. It definitely makes me feel better.

On one hand I want to tell myself to just chill out. Residents coming out of non-name brand residencies still get good job offers, so what is the big deal? P=MD? On the other hand stress pushes me to perform better, so it's actually a good thing. I am very thankful to be in med school and I want to make the most out of this opportunity. But I am not sure all of this stress is good for me. When my last evaluation came out I was so worried I could not sleep and I was having heart palpitations. Has anyone out there purposely limited or sacrificed your academic achievement at this point in medical school just to be happier in other areas of your life?

 

[thes_hunter]

Some advice for someone who is getting high grades in their clinicals, and not necessarily high grades on the shelves.

1. Smile - all the time. Like smiling is your favorite, smiling. It works so freaking well it's amazing.

2. Say hi and get to know the nurses. Try to remember names. They will save your butt if they like you, this also carries a lot of weight with the attendings.

3. Find something you like about every patient. This helps you be caring even with the most difficult patients, and then the patient may even tell your attending 'you're a sweetheart'. How can they argue with that?

4. Speak up. Even if you're wrong, it's better to speak and be wrong, and go "hrm... looks like I have some reading to do" then to be quiet.

5. Say Yes. - If anyone ever asks if you want to do or learn something, there is only 1 answer.

6. Ask how you can help. Not only do you learn more, but it shows you are also interested in being a team player.

And also pick up books like 250 mistakes medical students make, nerds guide to pre-rounding and etc. They are both very good books of both general and specific advice.

Which mostly boils down to be confident, and humble.
Part of my confidence isn't that I know I'll get everything right, but I know if I get something wrong, how to go about finding the answer to what I need.

I hope this helps.

 

[smq123]

On one hand I want to tell myself to just chill out. Residents coming out of non-name brand residencies still get good job offers, so what is the big deal? P=MD? On the other hand stress pushes me to perform better, so it's actually a good thing. I am very thankful to be in med school and I want to make the most out of this opportunity. But I am not sure all of this stress is good for me. When my last evaluation came out I was so worried I could not sleep and I was having heart palpitations. Has anyone out there purposely limited or sacrificed your academic achievement at this point in medical school just to be happier in other areas of your life?

For me, it wasn't that I limited "academic achievement" in order to become happier, it's that I started focusing on the bigger picture. I started to realize that, in less than 2 years, I wasn't going to be doing this stuff for a grade or for an eval, but that I'd be doing it "for real." So even if I didn't get a glowing evaluation, if I knew that I had done my best, pulled my weight on the team, and really learned something about how to take care of patients, then I was happy.

No grade is worth your health. If you're having palpitations because of anxiety, that's not good. .

 

[copes]

Thank you all for your wonderful advice.