MD Failed at life 2.0: Disillusioned after Step 1 and first clerkship

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Foot Fetish

Foot Fetish

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I'm about 1 week out from my first shelf exam, and I haven't read a single book, flipped a single flashcard, or answered a single practice question. I am completely disillusioned with medical school after my Step 1 experience, and I can't bring myself to study. It just feels pointless when, after putting in 14 hour days for the better part of a year, answering over 12,000 q bank questions, and doing nearly half a million Anki reviews, I ended up with the same (or worse) score as people who put in half the effort and just crammed near the end. On top of that, I was lucky enough to get placed with an attending who is a notoriously harsh grader and "doesn't give honors" even though I'm busting my ass on the wards and essentially operating at the level of an intern. Kissing ass, grade-grubbing, or complaining to the administration are simply not in my nature...so it looks like it's going to be a very long year for me.

At this point, I don't know what specialty I'll end up in, but I do know that I will do everything in my power to "sell out" once I'm there. In fact, at this point, I am seriously considering taking my MD and doing something outside of medicine altogether. The "culture" of medicine so far has simply disgusted me. On the one hand they promote this culture of martyrdom where you are considered unfit if you don't put up with borderline inhumane (and sometimes outright illegal) working conditions...and on the other hand they use an archaic evaluation system that rewards unctuous showboats while punishing those diligent students who prefer to simply put their head down and work. If their goal is to kill whatever genuine enthusiasm one has for patient care, then they are doing an excellent job.

TLDR: Step 1 is fake, and third year is making me hate medicine

Shout out to @failedatlife
 
Bruh.

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Get over it dude.

You are making your life miserable by yourself. “Medicine” didn’t do this to you - you did this to you. Anyone would feel like crap after forcing themselves to work like slaves for a full year. Everyone here told you you would burn out - guess what, you did. This is what burning out feels like.

You got a great step 1 score and now you are feeling the consequences of running on “E” for the better part of a year. Instead of lashing out at medicine, take a minute to think about what you want out of your life and stop moping around like a loser. This was YOU that put yourself in such a miserable place. At least a 257 step 1 is a top-teir score. Thank goodness you didn’t drive yourself into the ground to get a 240.

Start treating yourself correctly so you don’t get to this angry and crappy place in your life again. We’re all rooting for you.



Foot Fetish said:
I'm about 1 week out from my first shelf exam, and I haven't read a single book, flipped a single flashcard, or answered a single practice question. I am completely disillusioned with medical school after my Step 1 experience, and I can't bring myself to study. It just feels pointless when, after putting in 14 hour days for the better part of a year, answering over 12,000 q bank questions, and doing nearly half a million Anki reviews, I ended up with the same (or worse) score as people who put in half the effort and just crammed near the end. On top of that, I was lucky enough to get placed with an attending who is a notoriously harsh grader and "doesn't give honors" even though I'm busting my ass on the wards and essentially operating at the level of an intern. Kissing ass, grade-grubbing, or complaining to the administration are simply not in my nature...so it looks like it's going to be a very long year for me.

At this point, I don't know what specialty I'll end up in, but I do know that I will do everything in my power to "sell out" once I'm there. In fact, at this point, I am seriously considering taking my MD and doing something outside of medicine altogether. The "culture" of medicine so far has simply disgusted me. On the one hand they promote this culture of martyrdom where you are considered unfit if you don't put up with borderline inhumane (and sometimes outright illegal) working conditions...and on the other hand they use an archaic evaluation system that rewards unctuous showboats while punishing those diligent students who prefer to simply put their head down and work. If their goal is to kill whatever genuine enthusiasm one has for patient care, then they are doing an excellent job.

TLDR: Step 1 is fake, and third year is making me hate medicine

Shout out to @failedatlife
Click to expand...
 
If it makes you feel any better, I can guarantee you with 100% certainty that you aren't "operating at the level of an intern" in the first few weeks of your very first M3 rotation.

If it makes you feel better still, if you weren't satisfied with a 257, you were never going to be satisfied regardless of what your score was. You built a single (albeit important) exam into something that's simply more than it really is, and now it's over, and you have to continue with your life just every single other medical student in the world.
 
Wait. Wtf. You got a 257 and are mad other people scored near you? Now you’re afraid someone might do better than you on clerkships. Wow dude. You have some serious issues. Get over yourself. You are not a special snowflake and need to stop comparing yourself to everyone else. I read this the first time and assumed you got a 220 or something, which is not an easy score to get.
 
bananafish94 said:
If it makes you feel any better, I can guarantee you with 100% certainty that you aren't "operating at the level of an intern" in the first few weeks of your very first M3 rotation.

If it makes you feel better still, if you weren't satisfied with a 257, you were never going to be satisfied regardless of what your score was. You built a single (albeit important) exam into something that's simply more than it really is, and now it's over, and you have to continue with your life just every single other medical student in the world.
Click to expand...

Well, I am carrying the same number of patients, writing the same number and quality of notes (worked as a scribe before med school), and am always prepared to offer a thorough differential and treatment plan during rounds. The only thing I'm not doing that the interns do is putting in certain orders, and that's simply because the EMR doesn't let me. Even if I'm not at the level of an intern, I think I'm certainly exceeding expectations, yet I am being graded as though I am a dead average M3. Meanwhile my fellow M3s on the same exact clerkship are carrying half the number of patients, yet they are getting better evaluations simply because they lucked out with an easy grader attending. Accepting my Step 1 score is one thing. As @Gurby mentioned, some people are just naturally smarter and can beat my score with half the effort, and that's just the way it is. That's fine. I can rationalize it because they are simply using their God-given ability, and they earned their scores at the end of the day. But when it comes to these utterly subjective clerkship evaluations, it really isn't fair, and there is no way to justify or rationalize it. I am simply getting screwed here.
 
Many people work as hard or harder than you and they don't all get 257s. Some people do as much work and beat you. Some people are smarter and beat you with less work. You are not unique in the amount of effort you put into Step. You put your best foot forward, so be happy with that and move forward

You likely aren't working at the level of an intern. If you're on medicine, for example, you would need to be managing 8-10 pts with good plans for each of them. Humility will do you some good.

You are obviously smart and a hardworker. Be humble and realize that as long as you continue working hard, you will do well. No one wants to work with someone arrogant
 
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Only on SDN. Good Lord.

Your post doesn't make sense to me. Having an unacceptable (for you) score on a standardized exam and being assigned a tough attending in your first how many ever weeks of M3 year (when you're at the absolute bottom of the totem pole regarding your role and importance on the team) are not even remotely the types of things that should be driving you to want to just get an MD and get out and do something else. Why did you go to medical school in the first place then? Surely you knew going in that studying for a 280 question multiple choice exam and being an M3 are temporary parts of the training process and not at all characteristic of what you're going to be doing as an attending on a daily basis?
 
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Foot Fetish said:
Well, I am carrying the same number of patients, writing the same number and quality of notes (worked as a scribe before med school), and am always prepared to offer a thorough differential and treatment plan during rounds. The only thing I'm not doing that the interns do is putting in certain orders, and that's simply because the EMR doesn't let me. Even if I'm not at the level of an intern, I think I'm certainly exceeding expectations, yet I am being graded as though I am a dead average M3. Meanwhile my fellow M3s on the same exact clerkship are carrying half the number of patients, yet they are getting better evaluations simply because they lucked out with an easy grader attending. Accepting my Step 1 score is one thing. As @Gurby mentioned, some people are just naturally smarter and can beat my score with half the effort, and that's just the way it is. That's fine. I can rationalize it because they are simply using their God-given ability, and they earned their scores at the end of the day. But when it comes to these utterly subjective clerkship evaluations, it really isn't fair, and there is no way to justify or rationalize it. I am simply getting screwed here.
Click to expand...
Some people have easy graders now, you will have easy graders later. By the law of large numbers that will all balance out. Literally every other student goes through the exact same thing. Letting this kind of attitude shine through on your rotations is a great way to get terrible evaluations, too.
 
Third year is always about which attending/residents you get assigned to. Every rotation that random assignment will be the most predictive aspect of your grade. That's third year and it happens for everyone. It's not fair for life, but that is life. It is absolutely relatively fair, because it happens to everyone. Your classmates lucked up this time, it'll be you next time.

Edit: bananafish said the same thing at the same time.
 
This is what spoiling and coddling and giving trophies for everything dies to your children.

OP this is not how life works. Sometimes you put in the effort and don’t get a commensurate reward. That’s life. Deal with it. Learning how to deal with it is how you grow and become stronger. Or you can just cry about how it’s not fair that you’re not THE BEST and quit. You’ll get no sympathy from anybody other than your Mom (maybe).

Those of us who have worked before, ran a business, etc have all been through much worse s***

Sometimes you do everything right, make all the right moves, work your butt off and some other jackoff gets your business. It’s really unfortunate that you are just now learning this.
 
Foot Fetish said:
I'm about 1 week out from my first shelf exam, and I haven't read a single book, flipped a single flashcard, or answered a single practice question. I am completely disillusioned with medical school after my Step 1 experience, and I can't bring myself to study. It just feels pointless when, after putting in 14 hour days for the better part of a year, answering over 12,000 q bank questions, and doing nearly half a million Anki reviews, I ended up with the same (or worse) score as people who put in half the effort and just crammed near the end. On top of that, I was lucky enough to get placed with an attending who is a notoriously harsh grader and "doesn't give honors" even though I'm busting my ass on the wards and essentially operating at the level of an intern. Kissing ass, grade-grubbing, or complaining to the administration are simply not in my nature...so it looks like it's going to be a very long year for me.

At this point, I don't know what specialty I'll end up in, but I do know that I will do everything in my power to "sell out" once I'm there. In fact, at this point, I am seriously considering taking my MD and doing something outside of medicine altogether. The "culture" of medicine so far has simply disgusted me. On the one hand they promote this culture of martyrdom where you are considered unfit if you don't put up with borderline inhumane (and sometimes outright illegal) working conditions...and on the other hand they use an archaic evaluation system that rewards unctuous showboats while punishing those diligent students who prefer to simply put their head down and work. If their goal is to kill whatever genuine enthusiasm one has for patient care, then they are doing an excellent job.

TLDR: Step 1 is fake, and third year is making me hate medicine

Shout out to @failedatlife
Click to expand...

I've seen a lot of your posts in this site about step 1 and radiology/dermatology from way back when I was just a lurker.

I can empathize with not being happy with your good score because you feel like it should have been a few points higher. Unfortunately the USMLE has a large standard error and some of us will fall +/-12 points from where we should be, some people even further. If you took Step 1 10 times, I bet you'd continue to fall anywhere between 255 and 270, and probably average a 263. You just got unlucky on test day and fell at the lower end of your range. I was high 250s as well and super salty

Honestly, if you can't suck it up and fake it through third year, which in some aspects I admire, I think you should do the next best thing. Just give up, relax, become a radiologist, don't deal with the BS, make 400-600k, and enjoy 10 weeks vacation per year. You don't have to destroy yourself just to match derm especially if you don't care about the human interaction piece anymore. You'd be miserable in 6 years knowing that you worked so hard to become a dermatologist only to realize that dermatology isn't the cush care-free job it's made out to be.

You need to make a decision and make it soon:
Coast into radiology and relax for the rest of your schooling
Never stop gunning, try your best, fake smile about everything, and push through for derm

Either way you'll get through it, but it's better to figure that out now
 
Come here to say that I put in only about 3rd of the effort on Step 1 and scored only a few points lower lol! Jk!
Functioning at the intern level as a fresh-faced 3rd year. What a crock of ****! What is your plan of selling out? I want to hear the plan from the best and brightest in medicine
 
Foot Fetish said:
On top of that, I was lucky enough to get placed with an attending who is a notoriously harsh grader and "doesn't give honors" even though I'm busting my ass on the wards and essentially operating at the level of an intern. Kissing ass, grade-grubbing, or complaining to the administration are simply not in my nature...so it looks like it's going to be a very long year for me....

TLDR: Step 1 is fake, and third year is making me hate medicine
Click to expand...

Just wanted to point out that your feelings about third year are pretty common. Third year can be a pretty miserable experience due to subjective clinical evaluations and being paired with harsh attendings/residents who grade so arbitrarily. It sucks and I'm sorry. Hopefully, the rest of third year will be more pleasant for you.
 
Foot Fetish said:
Well, I am carrying the same number of patients, writing the same number and quality of notes (worked as a scribe before med school), and am always prepared to offer a thorough differential and treatment plan during rounds. The only thing I'm not doing that the interns do is putting in certain orders, and that's simply because the EMR doesn't let me. Even if I'm not at the level of an intern, I think I'm certainly exceeding expectations, yet I am being graded as though I am a dead average M3. Meanwhile my fellow M3s on the same exact clerkship are carrying half the number of patients, yet they are getting better evaluations simply because they lucked out with an easy grader attending. Accepting my Step 1 score is one thing. As @Gurby mentioned, some people are just naturally smarter and can beat my score with half the effort, and that's just the way it is. That's fine. I can rationalize it because they are simply using their God-given ability, and they earned their scores at the end of the day. But when it comes to these utterly subjective clerkship evaluations, it really isn't fair, and there is no way to justify or rationalize it. I am simply getting screwed here.
Click to expand...

I worked as a scribe before med school too. I have also previously been an MS3, MS4, and an intern. You are definitely not "operating at the level of an intern" despite how you feel. Putting in orders and dealing with all of the ramifications of those orders (including endless calls and pages from nursing staff) is a huge part of being a resident and something you won't appreciate until you're actually a resident. I'm sure you are working hard, but at the end of the day you have a very limited impact on patient care as a medical student.

MS3 grades don't matter very much when it comes to matching (unless you fail or end up with negative comments). Everyone understands that Ms3 grades aren't fair. It is what it is. Program directors understand this as well. What does end up mattering are letters of recommendation and the comments in your dean's letter. I didn't "honor" my surgery rotation as an MS3 despite working extremely hard and doing very well on the shelf. But I did get great comments and feedback as well as good LORs which helped me match at my number one program.

At the end of the day, it doesn't matter that anyone has a higher step 1 than you, because you've already surpassed the point of diminishing returns. Having a higher step 1 score won't help you when you eventually enter the match.

You need to stop worrying about other people and start focusing on what specialty you want to pursue. I thought third year was significantly harder than the first two, but it was also an invaluable experience.
 
@Foot Fetish You need to care less. You have made medicine the epicenter of who you are which is why you aren't happy with anything other than perfection. I understand why you are frustrated because you feel like you put 100% of your life into medical school and even though you are doing very well it just doesn't seem like enough reward compared to what you put in. Find a counselor or find a hobby; mine is trouncing people anonymously online, but I'll spare you today because I just had a hash brown from McDonald's so I'm in high spirits.
 
Lol at functioning at the level of an intern early in first rotation as 3rd year. I’ve never seen such delusion.

These are the guys that kill people first couple of months of internship because they think they don’t need supervision. Chiefs know about this type and have to watch out for them carefully.

In the aviation world, these are the *******es that get a perfect score on their instrument exam, think they’re the shyt then go out solo into the clouds with zero hours of actual time and crash into a mountain.
 
At my medical school, virtually everybody got the same points from attending feedback because the comments were all the same, unless there was a major problem. The distinction between pass, high pass and honors came from the shelf score nearly entirely. My impression is that this is common.
 
Foot Fetish said:
Well, I am carrying the same number of patients, writing the same number and quality of notes (worked as a scribe before med school), and am always prepared to offer a thorough differential and treatment plan during rounds. The only thing I'm not doing that the interns do is putting in certain orders, and that's simply because the EMR doesn't let me. Even if I'm not at the level of an intern, I think I'm certainly exceeding expectations, yet I am being graded as though I am a dead average M3. Meanwhile my fellow M3s on the same exact clerkship are carrying half the number of patients, yet they are getting better evaluations simply because they lucked out with an easy grader attending. Accepting my Step 1 score is one thing. As @Gurby mentioned, some people are just naturally smarter and can beat my score with half the effort, and that's just the way it is. That's fine. I can rationalize it because they are simply using their God-given ability, and they earned their scores at the end of the day. But when it comes to these utterly subjective clerkship evaluations, it really isn't fair, and there is no way to justify or rationalize it. I am simply getting screwed here.
Click to expand...

Lol, brand new m3 thinking he's performing at the level of an intern, with the exception of entering orders, because the "EMR doesn't let me". You can't make this **** up.

So you got a score you didn't like (even though it was good) -> started whining and complaining. Think you're not receiving the clinical grades/evaluations you deserve? Join the club. Stop whining and complaining, and certainly stop saying you're doing double the work as your classmates.

To put it frankly, sounds like you're gonna have a tough time in medicine due to your ****ty ass attitude, not your abilities.

Also sounds like it would be an absolute nightmare to work with someone as entitled, melodramatic, and annoyingly intense as you.

"failed at life" ... Jesus ****ing christ what a diva.
 
Lawper said:
But do strict/harsh grader attendings and residents give out honors for this reason though? Or is that exaggerated on SDN?
Click to expand...

Pretty sure that this bs is exaggerated on sdn

Every place does things differently. The only things to do as a MS-3 is to come in with a good attitude, work hard, study for shelves, ask for weekly feedbacks, and let the chips fall where it may. As long as I do these things, I dgaf about my grades bc I can happily go to sleep knowing that I try my best.

I thought that Foot was a funny dude. Now, I would hate to be stuck on a 24 hr shift w/ someone like him. Color me unimpressed by this pathetic imitation of faileddatlife 1.0. At least that dude got a 222 on Step 1 and aimed for ENT.
 
I have a hard time believing that someone who is in his/her first M3 rotation is performing at the level of an intern. I guess it can happen since med school has a lot of gifted people.
 
If you are seriously complaining about a 257, I don't even know what to tell you... I scored lower than that and matched into derm and we had many people in my class lower than that match IR and other competitive specialties -- third year sucks in general and most people hate it and many people question their will to live and desire to be in medicine... stop complaining and get through it... dropping a 257 and getting paired with a cranky attending is not something to complain about
 
This has to be the longest-con troll ever, right? You literally have zero doors shut with a 257, no one in their right mind would be dissatisfied with that score. If this is for real, you should honestly take a leave of absence from medical school and do some serious self-reflection, because at this rate you will never be satisfied.
 
Foot Fetish said:
Well, I am carrying the same number of patients, writing the same number and quality of notes (worked as a scribe before med school), and am always prepared to offer a thorough differential and treatment plan during rounds. The only thing I'm not doing that the interns do is putting in certain orders, and that's simply because the EMR doesn't let me. Even if I'm not at the level of an intern, I think I'm certainly exceeding expectations, yet I am being graded as though I am a dead average M3. Meanwhile my fellow M3s on the same exact clerkship are carrying half the number of patients, yet they are getting better evaluations simply because they lucked out with an easy grader attending. Accepting my Step 1 score is one thing. As @Gurby mentioned, some people are just naturally smarter and can beat my score with half the effort, and that's just the way it is. That's fine. I can rationalize it because they are simply using their God-given ability, and they earned their scores at the end of the day. But when it comes to these utterly subjective clerkship evaluations, it really isn't fair, and there is no way to justify or rationalize it. I am simply getting screwed here.
Click to expand...
Lol stop
 
The thinking you're at the level of an intern thing is classic for "you don't know what you don't know."

I mean, it's July, the interns probably aren't necessarily killing it right now. But you're not operating on their level unless they're fantastically bad. You worked as a scribe, but that was basically learning the alphabet for a language you don't understand. There are probably times where you hear two pieces of information back to back, and think to yourself, "I have those things written down, too." But the intern/resident said them because sentence one was concerning for something, and sentence two lets the senior know it was considered but considered less likely just by mentioning the second piece. This is probably happening all around you.

Nobody wants to work with someone with your lack of self awareness. You'll think it's because they're jealous of you, but it's not that. You don't see the world well. That's an intelligence you don't have. So it's a situation where you'll need to just universally listen to the advice of people you trust that do.
 
First of all, if it is not the specialty you want, why does it matter? I assume it is not derm because derm is not one of the required rotations.

Second of all, first you came off as a gunner...but I admired your hardworking. I am the same but not as hard as you...you totally deserve to score higher than most of us.

But now, you keep complaining about your 257 step 1, you came out as arrogant and selfish. I do not know why you keep posting and expecting people to be empathetic with you. I scored around my average while others with my average score 20 points higher or 20 points lower. It is the nature of how stupid and random with step 1. I am limited with some specialties but not all...I will suck it up and live with it or take my chances. I do not think 257 keep you out of any specialty so just shut up already. There are people who work as hard as you or maybe a bit less and they are not scoring anywhere near average, and have to give `up their dreams after going through medical school...while you non-stop complaining.

Have you ever think maybe the problem is not the hard-ass attending, but it is YOU? If I was your classmate or your attending, I can not imagine working with someone like you who always think they deserve the best and know more than others.

Chill out and think of other people for once.
 
Foot Fetish said:
I'm about 1 week out from my first shelf exam, and I haven't read a single book, flipped a single flashcard, or answered a single practice question. I am completely disillusioned with medical school after my Step 1 experience, and I can't bring myself to study. It just feels pointless when, after putting in 14 hour days for the better part of a year, answering over 12,000 q bank questions, and doing nearly half a million Anki reviews, I ended up with the same (or worse) score as people who put in half the effort and just crammed near the end. On top of that, I was lucky enough to get placed with an attending who is a notoriously harsh grader and "doesn't give honors" even though I'm busting my ass on the wards and essentially operating at the level of an intern. Kissing ass, grade-grubbing, or complaining to the administration are simply not in my nature...so it looks like it's going to be a very long year for me.

At this point, I don't know what specialty I'll end up in, but I do know that I will do everything in my power to "sell out" once I'm there. In fact, at this point, I am seriously considering taking my MD and doing something outside of medicine altogether. The "culture" of medicine so far has simply disgusted me. On the one hand they promote this culture of martyrdom where you are considered unfit if you don't put up with borderline inhumane (and sometimes outright illegal) working conditions...and on the other hand they use an archaic evaluation system that rewards unctuous showboats while punishing those diligent students who prefer to simply put their head down and work. If their goal is to kill whatever genuine enthusiasm one has for patient care, then they are doing an excellent job.

TLDR: Step 1 is fake, and third year is making me hate medicine

Shout out to @failedatlife
Click to expand...
Are we supposed to be feeling sorry for you?

Stop feeling sorry for yourself, get off your butt, and start acing your clinicals.

Don't be one of those people who think that life ends with Step I.
 
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I don't understand why you're upset with your score, which was within a standard error (6 points) of your practice scores. Even if you were 99th percentile in terms of work put in for step 1, you were above the 91st percentile for score. That's not a large discrepancy. If you scored 3 points higher, would you feel such despair? Your disillusionment is not rational and is thus difficult to empathize with.
 
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Oh my sweet Jesus. I scored less than that on my step 1 and was THRILLED. I will spare you the tongue lashing that others have given, mostly because I’m not sure you get it, but I do want to comment on the bit about functioning at the level of an intern.

NO medical student functions truly at the level of an intern. That would require you, at least on a medicine rotation, to be in house at 5:30, rounding on your patients while answering incessant pages, putting in early orders on all 8-10 patients you are carrying, writing your plan/notes and preparing for rounds, putting out fires with sick patients or coding sick patients, etc, staying until 9 pm (often later) on call nights finishing up working up admits, and trying to teach your medical students in between. When I give a comment about “functioning at an intern level”, this is usually a reflection on them being enthusiastic and helpful, and taking ownership of their patients, not actually functioning at an intern level.

I suspect that you are trying hard on a medicine rotation but people can probably tell you don’t enjoy direct patient care. So hence your mediocre evals. I just have no sympathy for medical students finding out that they are working hard and turn out to be...average. Life is not an exam.
 
Foot Fetish said:
Well, I am carrying the same number of patients, writing the same number and quality of notes (worked as a scribe before med school), and am always prepared to offer a thorough differential and treatment plan during rounds. The only thing I'm not doing that the interns do is putting in certain orders, and that's simply because the EMR doesn't let me. Even if I'm not at the level of an intern, I think I'm certainly exceeding expectations, yet I am being graded as though I am a dead average M3. Meanwhile my fellow M3s on the same exact clerkship are carrying half the number of patients, yet they are getting better evaluations simply because they lucked out with an easy grader attending. Accepting my Step 1 score is one thing. As @Gurby mentioned, some people are just naturally smarter and can beat my score with half the effort, and that's just the way it is. That's fine. I can rationalize it because they are simply using their God-given ability, and they earned their scores at the end of the day. But when it comes to these utterly subjective clerkship evaluations, it really isn't fair, and there is no way to justify or rationalize it. I am simply getting screwed here.
Click to expand...

It's pretty apparent from the attitude you are displaying in your posts that you come off very entitled. Your attendings and residents can probably smell this from a mile away. There were plenty of very bright students in my class who did poorly M3 year due to a bad attitude. Now I don't know how you are in real life but if your posts mirror how you come off on rotations then poor evals/grades are not surprising.
 
Lmao 257 is above the mean for EVERY SPECIALTY!

The only way OP can justify the disappointment in his/her score is if he/she had forsaken any attempts to publish research in order to get the (still awesome) score he/she got.
 
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