don't think I can do this.

[DermViser]

I really don't know what I would do if my debt was 500k. I mean, it's not like I don't want to succeed in medicine. I'm trying as hard as I can. I'm just struggling. I don' t want to quit, I want to go to residency. The thing is I don't know if I can survive. There's no way I could have predicted things would have turned out this way. I did fine in college. I got into med school.

Hopefully not a lot of people end up in my situation with a 500k debt. If they do, and they end up not being able to complete a residency, I really don't know what they'll do. It's just really bad luck I suppose.

Psych is a thought, but unfortunately at this point I can't apply to psych since it's already extremely late and I have nothing prepared for a psych application. I'm just gonna have to send out IM applications and see what happens, and in the meantime try to get some help

Contrary to dogma, getting into med school is not the hardest part of med school. If that was in fact the case, BS/MD students would be the happiest med students in the U.S. I don't think sending out IM apps will help. Why not take time off, then when you come back do some Psych electives and then apply?

---

Members don't see this ad.

 

[Silent Cool]

I didn't struggle in college at all interms of grades. I had a 3.8/4.0 GPA. I've always found it difficult to concentrate and organize a lot of material, but I always managed to get it done and assumed that was normal.

Wow. I can hardly believe that you are struggling this much if your college grades were that high. What was your MCAT?

 

[Mad Jack]

PM&R and psych would give you good amounts of patient contact. There are specialties out there you could perform well at.

 

[tpn89]

Wow. I can hardly believe that you are struggling this much if your college grades were that high. What was your MCAT?

I got a 35 on the MCAT.

 

[DermViser]

Wow. I can hardly believe that you are struggling this much if your college grades were that high. What was your MCAT?

Depending on the undergrad, I could totally see that.

 

[Silent Cool]

I got a 35 on the MCAT.

DAMN. So we have a nearly 4.0 student with a 35 MCAT struggling.

Man, I would definitely see a second shrink and a learning counselor about a learning disability. You are definitely NOT stupid. I've met some incredibly bright people who have struggled with various academic pursuits, and they were eventually able to perform with modifying habits, etc...

 

[tpn89]

DAMN. So we have a nearly 4.0 student with a 35 MCAT struggling.

Man, I would definitely see a second shrink and a learning counselor about a learning disability. You are definitely NOT stupid. I've met some incredibly bright people who have struggled with various academic pursuits, and they were eventually able to perform with modifying habits, etc...

Thanks. I've felt pretty stupid for the past 3 years so it's nice to hear. I feel like college was a lot easier because the volume was so much lower and so was the rate that you had to learn things.

 

[StIGMA]

Thanks. I've felt pretty stupid for the past 3 years so it's nice to hear. I feel like college was a lot easier because the volume was so much lower and so was the rate that you had to learn things.

College was easier. And you are more than capable of succeeding right now. Try to be as OK as you can be with not knowing things. Try not to "think" so much during patient interactions- trust your intuition/"muscle memory" a bit more. Keep at it!

 

[Wordead]

DAMN. So we have a nearly 4.0 student with a 35 MCAT struggling.

Man, I would definitely see a second shrink and a learning counselor about a learning disability. You are definitely NOT stupid. I've met some incredibly bright people who have struggled with various academic pursuits, and they were eventually able to perform with modifying habits, etc...

Do you think academic success is really correlated with being able to take a history and form a differential....

 

[Silent Cool]

Do you think academic success is really correlated with being able to take a history and form a differential....

Academic success in this case is doing those things.

But I would imagine that a previously high level of academic success would predict that a student would have a relatively easier time completing those tasks. I mean that's the whole point of screening applicants based primarily on GPA/MCAT.....

 

[Wordead]

Academic success in this case is doing those things.

But I would imagine that a previously high level of academic success would predict that a student would have a relatively easier time completing those tasks. I mean that's the whole point of screening applicants based primarily on GPA/MCAT.....

You can teach a monkey to take a history at a medical student level. It has nothing to do with academic success.

And as for the second part....I mean, no. Just no.

 

[Silent Cool]

You can teach a monkey to take a history at a medical student level. It has nothing to do with academic success.

And as for the second part....I mean, no. Just no.

So why then do you suppose this student is struggling so much? What should he do?
Isn't it a bit surprising given his previously very high level of academic performance?

 

[Wordead]

So why then do you suppose this student is struggling so much? What should he do?
Isn't it a bit surprising given his previously very high level of academic performance?

No, my point is that the skillset that allowed him to succeed in academics has nothing to do with this task. I mean it's surprising since pretty much everyone knows how to take a reasonable H+P by 4th year, but I dont think an intelligent person is going to struggle less with H+Ps than a dumb one.

As for what should he do....well, people have suggested psych. Maybe that's a path; I don't know. I personally don't think this is psych related (purely conjecture) and think he has just hasn't had someone who could really identify where he was going wrong in his histories. My impression is that he allows patients to drive the conversation too much and doesn't have a good systematic way of taking a history, but again that's based on two sentences on the internet.

 

[DermViser]

So why then do you suppose this student is struggling so much? What should he do?
Isn't it a bit surprising given his previously very high level of academic performance?

You really think the metrics of multiple choice exams really predicts how well you can take an H&P and come up with an assessment and plan?

 

[Silent Cool]

You really think the metrics of multiple choice exams really predicts how well you can take an H&P and come up with an assessment and plan?

I suppose I don't know, but I'm just saying that I find it surprising that he is struggling this much in light of his previous academic success.

 

[DermViser]

I suppose I don't know, but I'm just saying that I find it surprising that he is struggling this much in light of his previous academic success.

Well he was struggling before this, if you look at his med school history.

 

[Silent Cool]

Well he was struggling before this, if you look at his med school history.

Right right, I'm referring to his undergrad/MCAT. Seems like he would be a good candidate based on that.

 

[Southplains]

OP is clearly intelligent and I know I have no clue what clinical half of med school is like, but taking a history really is very easy. OLDCARTS? Current meds, past dx's, social situation? I think this is a psych block, what's the alternative, that they're really too stupid to ask these questions and remember the answers?

A better question would be what would you do with ZERO debt right now? See a different psychiatrist. Could this be some monster performance anxiety?

 

[DermViser]

Right right, I'm referring to his undergrad/MCAT. Seems like he would be a good candidate based on that.

Yeah, undergrad GPA/MCAT aren't really good metrics for the last 2 years. More the first 2 years.

 

[chocomorsel]

Yeah, undergrad GPA/MCAT aren't really good metrics for the last 2 years. More the first 2 years.

You were a high achiever before med school. Used to feeling smart. Then you got in with a bunch of other high achievers. Tons of difficult material thrown your way and you had a hard time hacking it. Your self confidence goes down because you have never struggled. You doubt yourself, get anxious, anxiety leads to lack and inability to focus, you perform poorly due to lack of focus, anxiety worsens, you see my drift? Vicious cycle.
Get a different shrink and get started on psychotherapy and SSRIs. SSRIs get rid of anxiety pretty effectively.

Ask me how I know. Look up my old posts from residency circa 2010 to 2012. My struggle was in residency, not med school due to personality conflicts with evil PD and me not knowing how to keep my head down. I was under the false impression that I should be treated fairly by everyone. SSRIs and shrinks saved my career. The shrinks taught me how to perform like a circus monkey.

Thank me later and good luck. And send in your applications already. You have a whole year to sort things out. If the drugs and therapy don't do anything for you then withdraw. But I am pretty confindent I am right.

 

[DermViser]

You were a high achiever before med school. Used to feeling smart. Then you got in with a bunch of other high achievers. Tons of difficult material thrown your way and you had a hard time hacking it. Your self confidence goes down because you have never struggled. You doubt yourself, get anxious, anxiety leads to lack and inability to focus, you perform poorly due to lack of focus, anxiety worsens, you see my drift? Vicious cycle.
Get a different shrink and get started on psychotherapy and SSRIs. SSRIs get rid of anxiety pretty effectively.

Ask me how I know. Look up my old posts from residency circa 2010 to 2012. My struggle was in residency, not med school due to personality conflicts with evil PD and me not knowing how to keep my head down. I was under the false impression that I should be treated fairly by everyone. SSRIs and shrinks saved my career. The shrinks taught me how to perform like a circus monkey.

Thank me later and good luck. And send in your applications already. You have a whole year to sort things out. If the drugs and therapy don't do anything for you then withdraw. But I am pretty confindent I am right.

I'm not the OP, but I'm sure he appreciates the advice. Was your program a prominent top program? Don't SSRIs cause some sedation?

 

[chocomorsel]

Didn't mean to quote you. Sorry. was responding on my phone.

Not a prominent program at all. Used to be a rather chill, average clinical program till we got a new PD who's determined to make into a prominent big name program.
Trying to push research, changing its culture from friendly to scary and threatening, firing residents, putting them on probation etc. You get the drift. PD is ruling with fear and the atmosphere sure changed and resident morale when I was there sucked. I believe now though their cardiac program is better. But the environment is toxic.

Glad it's over.

 

[DermViser]

Didn't mean to quote you. Sorry. was responding on my phone.

Not a prominent program at all. Used to be a rather chill, average clinical program till we got a new PD who's determined to make into a prominent big name program.
Trying to push research, changing its culture from friendly to scary and threatening, firing residents, putting them on probation etc. You get the drift. PD is ruling with fear and the atmosphere sure changed and resident morale when I was there sucked. I believe now though their cardiac program is better. But the environment is toxic.

Glad it's over.

Wow, that's terrible. I'm guessing the PD change happened in the middle of the program vs. beforehand. Scary that a PD can have that much power vs. the rest of the faculty.

 

[chocomorsel]

Yup. In the middle. Most of the attendings didn't want to get involved. Some stood by what was right and continued to give me good evals and be supportive. Some just followed blindly what the PD requested which was to document every little thing and turn in to pad my file. Not saying I didn't screw up on occasion, but the punishment went above and beyond to make an example out of me. And I fought them for treating me that way. And it got worse, because I fought. In the end, sought help, because the anxiety kept leading to more and more screwing up. I fought to graduate, thankfully did and moved on. Clearly still have some issues with it. I had never been treated like that in my life and never had my life in someone else's control like that either. It was hard.

 

[saudades]

@tpn89, do you think that this could be a memory issue, at least in part? That could explain why you started struggling in med school since there is a ton more information you have to learn, although the material itself isn't necessarily more difficult that what you may have studied previously. Definitely undergo a full neuropsychological test. A psychologist or doctor at you school may even be able to administer it. That's what I did after I was diagnosed with a medical condition that totally screwed me up (and I started struggling academically) and it at least shed some light on what was going on. Depending on the results you may even qualify for some sort of special accommodations under the Americans with Disabilities Act.

 

[DermViser]

PM&R

They take histories in PM&R, you know.

 

[DermViser]

Yup. In the middle. Most of the attendings didn't want to get involved. Some stood by what was right and continued to give me good evals and be supportive. Some just followed blindly what the PD requested which was to document every little thing and turn in to pad my file. Not saying I didn't screw up on occasion, but the punishment went above and beyond to make an example out of me. And I fought them for treating me that way. And it got worse, because I fought. In the end, sought help, because the anxiety kept leading to more and more screwing up. I fought to graduate, thankfully did and moved on. Clearly still have some issues with it. I had never been treated like that in my life and never had my life in someone else's control like that either. It was hard.

Yikes! Wow, so scary. Good thing you didn't come to SDN for advice. All fingers would have been pointed at you as the problem.

 

[tpn89]

Hi guys, thanks for all your advice. On the urging of my advisor, I ended up submitting my residency applications. It's almost a month late so I'm not sure I'll get any interviews, but hopefully things will work out. I'm going to see another psychiatrist next week as well.

 

[FIREitUP]

Hi guys, thanks for all your advice. On the urging of my advisor, I ended up submitting my residency applications to Internal Medicine today. It's almost a month late so I'm not sure I'll get any interviews, but hopefully things will work out. I'm going to see another psychiatrist next week as well.

Did you apply broadly? I think your goal at this point is to make sure you will match.

 

[tpn89]

Did you apply broadly? I think your goal at this point is to make sure you will match.

Yeah I applied to about 80 programs so far. Should I apply to more?

 

[FIREitUP]

Yeah I applied to about 80 programs so far. Should I apply to more?

80 seems reasonable, just be sure many of those are attainable (not top heavy).

 

[hallowmann]

Thanks. I've felt pretty stupid for the past 3 years so it's nice to hear. I feel like college was a lot easier because the volume was so much lower and so was the rate that you had to learn things.

OP, no one on here can give you a clear diagnosis. I would definitely talk to another psychiatrist though. Med school is tough and stressful, and there are a lot of points along the way to stumble. You aren't the only one who's struggling. That said, you need to look out for what is best for you. Figure out where you want to be mentally, and if necessary take an LOA. Talk to your school about possibly taking an LOA and seeing what your options are.

I agree with the statements of others that you might like Psych, PM&R, etc., so you may want to look into those. They are also relatively laid back and short residencies, so that's a plus.

As far as what may be wrong, don't forget to take care of yourself physically. Your issue may be psychological or physical or both. Honestly, I know someone who had similar problems to yours and they didn't know what was going on. At one point in time, they just started having problems with memory and their ability to focus. It turned out to be a B12 deficiency (like a major B12 deficiency - talking levels ~100). After a series of shots, they were back to normal and the general "cloudiness" they kept on describing for over a year that no one diagnosed until a random blood test was suddenly gone.

Not saying that's what it is, but get yourself checked out by a psychiatrist and a good PCP if you can.

 

[tpn89]

80 seems reasonable, just be sure many of those are attainable (not top heavy).

Thanks. So I ended up applying to 120 programs. I've gotten a lot of rejections back, but no interview invites. Do you still think there's a chance I can get an invite? If I end up getting nothing what happens? I'm freaking out

 

[The new guy]

Hi. I'm not new here, I've been lurking, but this is the first time I've posted.

I'm currently a 4th year medical student at a school in the northeastern US. It's been almost 3 weeks since ERAS opened up and I still haven't sent out my residency applications. The thing is, I'm pretty depressed and feeling somewhat hopeless. I've been struggling with medical school since day 1. I repeated 2nd year and repeated the Step 1, barely passing the second time around. I barely passed every shelf 3rd year. I still haven't taken Step 2 CK because I keep taking NBMEs and not passing, despite doing Uworld almost twice.

My bigger concern is that I just can't perform well clinically no matter how hard I try. I'm 4 months into 4th year and I'm really struggling with things that pretty much all of my classmates are handling without a problem. This includes just getting a basic history from a patient, or presenting a patient. I just can't handle so much information at once. It all gets mixed up in my brain. I can't organize even the simplest of cases. When I'm talking to patients my thought process will just freeze. The same thing happens when I'm presenting cases. My brain just gets lost and stops and I can't think. I can't keep my focus when people are talking. I keep missing entire words and sentences and I don't even realize it. If I'm reading something I have to go over it numerous times before it will register what it means. I can't make obvious connections that seem obvious to all of the classmates that rotate with me. If I have several patients I keep mixing everyone up. I try to write things down and organize myself as much as I can, but I just can't get organized. It just takes me too long. I'm already incredibly slow.

I don't know what's wrong with me. I'm probably just not smart enough for this and somehow managed to slip through. I thought I'd be improving, but I'm just not. I've been told multiple times that my clinical skills are poor. We had an observed H&P exam, which I failed 2 times and passed on the 3rd because the attending felt bad for me. I also failed our Step 2 CS practice exam because I was incredibly disorganized. I'm honestly scared about residency (assuming I even match). It's coming quickly and I feel like I am so far behind where I need to be that I'll fail miserably. That's why I still haven't applied.

I've been seeing a psychiatrist who suggested that I might have performance anxiety. He prescribed me propranolol, but it really hasn't helped. I thought I might have an attention disorder given my symptoms but he assured me that if I did, I wouldn't have made it to medical school.

I'm not really sure what to do to improve my performance at this point, do any of you know? This is really depressing me. I'm honestly embarrassed to go in every day now because my performance is just so much worse than everyone else's.

Sometimes I just want to quit but I don't know what else I could do, or how I'd pay off my loans. I feel doomed to failure and I've gotten pretty depressed.

Have you seen a doctor about this? Seems like something a psychiatrist might be able to help you with.

Edit: I would look for a new shrink

 

[Mass Effect]

PM&R and psych would give you good amounts of patient contact. There are specialties out there you could perform well at.

Based on what?? Of all specialties, psych takes the most thorough history. Psych admission notes can be something like 3-5 pages long. If he has trouble taking a history, psych would be a huge problem for him.

OP, I would get a new psychiatrist ASAP. If yours is saying you wouldn't have made it to med school with ADD, he/she doesn't know what he/she is talking about. I don't know that you have ADD, but that declaration without testing is a red flag. Also, a number of treatable psychiatric conditions can present exactly as you're describing -- inability to focus, disorganized thoughts, lack of efficiency, etc. -- especially depression and anxiety. You need a full evaluation and possibly abbreviated neuropsych testing as well.

 

[FIREitUP]

Thanks. So I ended up applying to 120 programs. I've gotten a lot of rejections back, but no interview invites. Do you still think there's a chance I can get an invite? If I end up getting nothing what happens? I'm freaking out

well you did apply almost a month late. i'm not too knowledgable about this, but you could always look into doing some sort of research fellowship and reapplying next year if it comes to that. being a US medical grad should help you at least match.

Edit: An alternative if you do not hear anything would be to pull out of the match, put off graduation and working to get yourself better while doing some sort of BS research. this way you can possibly do well on step 2 CK and redeem yourself.

 

[tpn89]

well you did apply almost a month late. i'm not too knowledgable about this, but you could always look into doing some sort of research fellowship and reapplying next year if it comes to that. being a US medical grad should help you at least match.

Edit: An alternative if you do not hear anything would be to pull out of the match, put off graduation and working to get yourself better while doing some sort of BS research. this way you can possibly do well on step 2 CK and redeem yourself.

Which of these options do you think would be more likely to get me a match?

 

[FIREitUP]

Which of these options do you think would be more likely to get me a match?

i've heard of data that people who are independent applicants have more difficulty matching than US seniors do. So in theory it could help to withdraw and put off graduation but I'm not sure if in your situation it would matter.

 

[Giovanotto]

bumpty bump! @tpn89

 

[DrMcCoyDO]

bumpty bump! @tpn89

@tpn89 matched IM.

No interviews yet, what to do...