Feeling absolutely terrified of going back to medical school

[xc_stallion92]

I'm coming up on the end of my PhD, and will be defending my dissertation next Spring. It's been a reasonably productive 4 years (two 1st authors and one 2nd author), and I'm getting pretty burnt out so I know it's the right time to go back. However, I remember absolutely nothing about bugs, drugs, physiology, pathology, or pretty much anything that doesn't have to do with my extremely niche PhD project. On top of the general fear that every returning MD/PhD student has, this year my school is forcing us to go back off-cycle because of some fiscal year budgetary conflict between the grad school and med school, so my first rotation next Summer will be everyone else's third rotation. That's another point of terror considering everyone else will be right at peak form while I'm trying to remember how a stethoscope works, and our clinical grades are based solely on comparison between students in the same rotation block.

I've already accepted that it's happening, and that I'm going to be at a significant disadvantage, so now I'm trying to figure out what I can do to mitigate that as much as possible. I'm going to be doing about 4 weeks of a transitional clerkship in family med before officially starting with that as my first rotation next July. How neurotic would it be to basically study for Step 1 again between now and then? I was an exactly average medical student when I left for the lab, so it's not like I was starting with a world-class knowledge base to begin with. I've already watched a few sections of OME and started working through an Anki deck but am rapidly losing motivation for that. Would it be more useful to start studying for the family med shelf which is notoriously awful? Should I do neither of the above and enjoy what little free time I have left before leaving my relatively-unstructured PhD schedule behind? Thanks for any advice from those of you who have made this transition before.

---

Members don't see this ad.

 

[gbwillner]

You got this.

First, a lot will come flooding back with some review and exposure.

Second, you will be 100x more seasoned and mature than your med-only student colleagues. It will show.

 

[tr]

It's been quite a while now but I also went back off-cycle and started with family med, joining M3s who were 10 months into their third year. I looked terrible next to them. There was no way around it. However, by my third rotation, IM, I looked like a genius next to the incoming M3s.

Honestly a lot of what helps with M3 is just being an independent, motivated worker. Knowledge base is really much less important than being willing to jump in there and take the initiative to be useful in whatever way you can. Just get in there and start helping to take care of patients. When you don't know something, you ask. Having 4-6 years of having to function independently in the lab is actually great preparation for this.

I wouldn't re-study for Step I. 95% of that stuff is not clinically relevant. You have to pick up the clinically relevant stuff by clinical exposure, there's no other way. The main thing is to just sequence your rotations so that you start with something where your grade doesn't matter much and it will give you a good foundation for the remainder. The transitional clerkship sounds like a great help actually.

If you feel you must study something, study for the shelf exam for the rotation you are starting with. Really don't bother with Step I.

(edited to read M3 instead of PGY3. As I said, it's been a long time)

 

[xc_stallion92]

You got this.

First, a lot will come flooding back with some review and exposure.

Second, you will be 100x more seasoned and mature than your med-only student colleagues. It will show.

Thank you. It's reassuring to hear this. I suppose every MD/PhD student has to make the jump eventually, and very few fail out so it must be possible.

It's been quite a while now but I also went back off-cycle and started with family med, joining PGY3s who were 10 months into their third year. I looked terrible next to them. There was no way around it. However, by my third rotation, IM, I looked like a genius next to the incoming PGY3s.

Honestly a lot of what helps with PGY3 is just being an independent, motivated worker. Knowledge base is really much less important than being willing to jump in there and take the initiative to be useful in whatever way you can. Just get in there and start helping to take care of patients. When you don't know something, you ask. Having 4-6 years of having to function independently in the lab is actually great preparation for this.

I wouldn't re-study for Step I. 95% of that stuff is not clinically relevant. You have to pick up the clinically relevant stuff by clinical exposure, there's no other way. The main thing is to just sequence your rotations so that you start with something where your grade doesn't matter much and it will give you a good foundation for the remainder. The transitional clerkship sounds like a great help actually.

If you feel you must study something, study for the shelf exam for the rotation you are starting with. Really don't bother with Step I.

Thank you. It's good to see that going back off-cycle isn't the end of the world. And you're right, I guess I'll have two 3rd-year rotations on the back end with the brand new M3s so I'll have an advantage there. So I guess I'll cut the Step 1 studying out, and if I'm feeling particularly neurotic I'll take a look at some FM shelf stuff.

 

[ChordaEpiphany]

I'm in a similar boat. A guy from my lab who just matched a top IM residency and got all honors/AOA gave me the following advice.

1) No one knows anything. It's far more important to know your way around a hospital/clinic, be reliable, and be personable.

2) Your burnout/cynicism will help you build rapport with the residents. Misery loves company. Misery hates eager-beaver show offs who need you to know that they've memorized every drug on page 458 of First Aid. Like @gbwillner said, our maturity will show (hopefully).

He also said that there are some awkward attendings that don't know how to interact with med students, so they like to pimp on Step 1 material because everyone knows it. Basically, they don't want to make real conversation so they fill the air with generic pimping from their specialty. That said, he scored 265+ and had some weird tendencies. I'm not sure I'd take that piece of advice to heart.