Ever since 3rd year started I feel like I'm not studying nearly as much as I should. In turn, I feel guilty. I just don't have the motivation. Early on I figured it was step 1 burnout but that is long in the past. I don't really learn much on rotations either.There is no intellectual stimulation anymore and it's depressing. Just a bunch of algorithms to memorize. I feel like I'm just getting by based on my strong knowledge base from the first 2 years, but even that is dwindling away. Anyone feel similar?
Feeling guilty during third year
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Don't feel guilty. Third year is just stupid. You know nothing, sit in meetings all day knowing nothing, and flounder through and just hope there is a light. I hated it everyday. residents don't have time for you. The attendings are too busy, etc. Try to learn a good H&P, EKG basics, and what labs are important. Otherwise just get through without practicing the hangman's knot. I suffered with attendings younger than me and male *****es who thought I should be at home having babies and not learning medicine. It will be ok. I had an IM attending tell me that he questioned my commitment to medicine and felt I would fail out of residency because I wasn't willing to sleep at the hospital and round at all hours when I had toddlers at home and my husband worked 3 days a week (I'm talking 10pm rounding after being there at 7am each day). Just insane expectations.
4th year is much better since you know more of what to do and you can pick rotations that interest you.
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Sounds like you haven't found the right specialty just yet. If you have any elective time as a third year try to get some rotations in things you're not going to be exposed to otherwise (anesthesia, derm, surgical subspecialties, rads, pm&r, etc). The goal is to find something you like. If you can do that the studying will come easily.
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Feeling the same way everyday.
I find that attendings have entirely unrealistic expectations of students (either that or perhaps I'm in the wrong career) - after 12-16 hour workdays the expectation is to then go home and do "just a chapter" of a review book or "just a few questions." Obviously this is the key to success, but, obviously, it's much easier said than done.Work on being as efficient as possible, and make sure to bring a question book or review text with you. I've had variable amounts of free time to study depending on the service I'm on, but on some services I've had enough time to get all of my studying done at the hospital before I even go home. Ultimately though there will be times where you simply won't have time to study. Don't feel guilty about that. You're only human after all, and the person that can actually learn effectively after a super long day is the exception rather than the rule.
And, of course, balance this with your clinical duties, because we know you don't want to be perceived as "lacking initiative" and "not taking ownership of your patients."
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OP I felt similar to you until I did an out patient month and the attending gave me a lot of autonomy - I finally felt justified that I made the right career decision. I think most people before med school have experience with office medicine but very few really get what it is like to be a resident and working on the floors (which is what most of your training will be). That being said, toward the latter half of third year you will just naturally get more comfortable seeing patients, taking H&Ps, calling consults etc - its a gradual process but shockingly it happens. You will also pick up a great deal of clinical knowledge passively just by following a patient or two and listening in on rounds, lectures etc, its def a different type of learning. When you go home do some usmle world questions, doesn't have to be a lot but it'll help you for the shelf and for step 2. You will be amazed when your done with third year how smart you have become only to slowly lose the motivation and knowledge again in fourth year.
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I take it your school doesn't have shelf exams???
We have shelfs that are contingent (in part) on our grades for the rotation. Except electives, which I am in right now.
And I doubt you are alone in feeling "lazy". I want to let you know, that even if you find motivation to study, don't feel worse because you can't study like you used to. In my psych rotation, and in light of a shelf, I probably maxed out studying to 2 hrs. If I could muster the energy, mentally and physically.
We DO work everyday, albeit far less than the residents. Even if it's sitting observing a patient interaction, that takes SOME effort. At the end of 8-12 hrs doing that, coming home and wanting to curl up to a textbook is far from your mind!!!
Even if you don't have a shelf to worry about, maybe you can ask a resident if there is anything interesting to learn. Be more engaging that way. A resident will have no problems finding an assignment for you to do. You don't know everything and your Step 1 acumen will fail you. NO surprise you will see kids w/ 250's look utterly stupid when it comes to clinical medicine. Trust me.
My residents would give assignments by differentials. Say, someone shows up w/ a cough. Go look up differentials for cough! Then how to rule-in/out, and pre-test probability.
Still, in general. The whole not studying thing. Don't feel bad at all!!
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You're almost there. Light is at the end of the tunnel. Just don't screw up your Step 2 CS/CK and shelfs. Do whatever it takes.
Thanks so much for the replies everyone . Reassuring to hear that everyone else knows the feeling. Someone mentioned shelf exams. We have those. Thing is, I've been scoring 1.50-2 SDs above the mean on them. Somehow. Still feel like an idiot when it comes to managing patient. Come to think of it, I think that's where part of my guilt is coming from. I've become comfortable with doing well on them without busting my ass like I did for step 1. I just constantly worry about selling myself short by not working as hard as I can. Typing this, I realize I sound like a douche haha. I will try not to feel guilty anymore.
. Reassuring to hear that everyone else knows the feeling. Someone mentioned shelf exams. We have those. Thing is, I've been scoring 1.50-2 SDs above the mean on them. Somehow. Still feel like an idiot when it comes to managing patient. Come to think of it, I think that's where part of my guilt is coming from. I've become comfortable with doing well on them without busting my ass like I did for step 1. I just constantly worry about selling myself short by not working as hard as I can. Typing this, I realize I sound like a douche haha. I will try not to feel guilty anymore.OMG! MEEE TOO!!!! I think I'm still in step 1 burnout, but I'm not sure thats ever going to change. Luckily, everyone I meet is really nice and no one really seems to notice if I study or not. I have a year subscription to Step2 question bank, but I'm getting like 80 percent on all those questions, so I'm really feeling better about not studying because I'm doing fine. I also havent had a rotation with a test at the end, so I'll probably study for those rotations. One attending told me take it easy, they kill you during residency.
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Wow, that would be awesome.
Sounds like fourth year
Third year is a load is stinking ****. The grades are so arbitrary and subjective that anyone could fail you for wearing the wrong shirt. I can only comment about my experience at tufts but the bottom line is just do the minimum. Your grade was already determined the first day with the team. The blondes bitches that suck the residents dick (and I mean that literally) will always one up you. Unless of course you stoop to that level.
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Tufts sounds pretty crappy....or you just got dealt the wrong hand. Grades are subjective, but being friendly and being yourself can make most people like you without any effort needed.
Thinking about doing my residency at Tufts now lol
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Glad to hear someone else has the same opinion. I never ran into the gunning the first two years, but it has astounded me how big of douche bags people can become. The ass-kissing and throwing of peers under the bus is unreal. Also, I've been woken up to the harsh reality that some people can get easy attendings who hand out perfect evals to anyone regardless of competence or work ethic, and others can get notoriously difficult graders. So much of your grade is out of your hands and it's incredibly frustrating at times.
This wouldn't bother me if 3rd year wasn't so important, but apparently it's one of the first things residencies look at. How bad would all passes look if you had good preclinical grades and a very good board score?
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If you have strong comments, and a strong Step 1/Step 2, all passes might not be the kiss of death, contrary to what some people think it is. What specialty do you want to do? Did you do a rotation in that specialty?
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At least u r acing ur exams! I keep getting 100% on clinical grade but doing slightly below average on NBMEs lol. But I feel u completely! I feel so lazy because I'm not nearly studying as much as the first 2 years.
Everyone at my school says third year is awesome but I hate it. It's so subjective and all about luck. I hate it how when I ask questions they just tell me to go read.....I mean I can do that w/o paying tuition. I also hate how people always tell u to take more i initiative like it's my fault. Every rotation I take lots of initiative but my residents are lazy and just leave me hanging...I get nowhere most times.
On my elective I read up on every surgery I scrubbed into but no one asked me any questions. Then my last day my resident told me to scrub into a case I didn't plan on going. Then I went to help with a trach and then came to the OR right after. The attending asked me all these questions and I was like crrraaapppppp. He was super nice bt still I looked like an idiot. I'm like WTF I studied all month and never got to shine. Then of course on the last day...doh. Thankfully out of the four weeks only one attending grades me who I got to work with for a week. He told me he only honors black students and I wasn't sure if he was joking or not?! ugh this year bites lol.
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OMG! That is my experience EXACTLY! I thought it was just me because I am an older nontrad student! I came home yesterday from my IM rotation where they have me at the hospital 55 hours a week and went straight to bed at 6:30 PM. I didn't even eat dinner - I care more about sleep than food these days. I slept for 13 hours.
There is no downtime on this rotation at all and no one has time to teach me anything. They make me see patients on rounds and write notes in the chart. I get to the A and P part of the note and just have no idea how to manage all these diseases. I think my notes suck and I don't even want them in pt's charts! And it doesn't matter, anyway, really since a resident is also seeing the pt (thank God). If I do say something a lot of times the residents don't even respond. I don't think they are being rude intentionally, I just think I am at the outside periphery of their mental radar, like a mosquito whining in their ear.
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Protip: Wait till resident is done with own note. Copy assessment and plan. Alternatively, carry around pocket medicine/read uptodate and just copy whatever it says for the condition you're treating for the a+p. It's my experience that nobody really expects you to have an awesome a+p anyway on your own.
Of course the residents see the patients too, your notes dont't count for anything in the real world (nor should they). The hospital doesnt get paid if the residents and attendings don't sign off on notes.
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nothing
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i dunno....all passes across the board? That seems to indicate that your school is incredibly stingy or you really sucked on the wards/shelfs.
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I could possibly see this happening if someone did well on the wards but consistently sucked on the shelf exams for whatever reason. Just depends on your clerkship grading policy and if the shelf is actually weighted enough to have that kind of an effect on the final grade.
I have all passes during third year and am getting more interviews in Rads than I can go to. It's all about the school you're at - PD's know this.
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Rads is not a competitive field anymore unless you're going to top places. Obviously all passes isn't going to stop you from getting a residency, but it may make more competitive residencies harder to achieve.
I'm all for P=MD in the first 2 years, but I would sure as hell try my hardest to do well on clinical rotations.
I wasn't implying that rads is the be-all-end-all of competitive residencies. I was merely saying that clinical rotations are extremely subjective and that programs know that they are. Heck, at my institution, a max of 9 (!!!!!) students per rotation can honor...And we have three campuses. There's no way to standardize within one campus, let alone three. Compare that to other schools that honor half of the class in some rotations.
Do well on the standardized tests and show interest in your field by gathering quality LORs and research. If you're going into medicine or surgery, do your best to honor that rotation. The rest is bollocks.
BTW, I've gotten quite a few interviews at competitive programs. I'm not applying in the "north," so "top places" is kind of irrelevant to me.
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I have only taken internal so far, which is one of my interests. Also considering Family, Infectious Disease, and besides that I really don't know. I doubt I'll get ALL passes, but just like to look at it from the worst possible scenario. I've honored the Internal Shelf but got average on my evals from a notoriously difficult professor, so I ended up with Pass.
But I agree, it's so subjective and half of the time it's hard to know what they're even looking for. Sometimes the residents don't help in the least. Part of me is very stressed about it, and part of me just wants to give up, focus on the Shelf/objective portions of the classes, and not worry about the rest. I'm not interested in anything that competitive anyway.
But I agree, it's so subjective and half of the time it's hard to know what they're even looking for. Sometimes the residents don't help in the least. Part of me is very stressed about it, and part of me just wants to give up, focus on the Shelf/objective portions of the classes, and not worry about the rest. I'm not interested in anything that competitive anyway.
I too hate the subjectivity. For example, I scored in the 99th percentile on the psych shelf and worked hard on my rotation. Turns out that my preceptor just circles 10's for everybody and doesn't write any comments. So I end up with a high pass
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I will concede that the % of students that honor a rotation at your school is an important factor in your dean's letter if you aren't auto-screened for not honoring surgery/medicine/whatever.
However, at a larger school like mine, with many (8-10+) hospitals that take students every year, standardizing the % of students who get honors is impossible. Some sites (in the same specialty) give honors out to everyone and anyone, while others only give it to the top 2 of 10 students rotating through a particular site at any given time.
Also, sorry if I came off like I was trying to slam radiology at all. I know friends who are applying to competitive places with average stats. Best of luck.
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He circles 10's for everybody? How does that (+ your shelf score) not equal honors?
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Yeah, I was wondering the same thing. I'm guessing something wasn't included in the guy's story... it just doesn't make sense.
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10/100. 
That's not simply having insane expectations. That's hazing.
Without comments, automatic no honors
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That seems quite silly. I'd protest your grade.
Asinine is how I'd put it. Already tried with no success. I talked to 2 people who had all 10's circled. I'm pretty sure neither honored the shelf. And I know that one is pretty terrible at psych
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So you're saying if there are no comments then you don't get honors, even if you get the "super-best OMG THIS MED STUDENT IS SO GOOD" straight 10s? That sounds like the stupidest system ever. I would keep talking to someone, pointing out your psych shelf grade as evidence that at least YOU of all the people in that rotation deserve to get honors.
Believe me, I had the same thought. I could not even grasp the BS. I don't really know who to go to in these situations.The Dean? Seems like that would be quite a stretch. He did mark the "pass" box instead of honors, which specifies that comments must be provided. Seems lazy to me
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Sounds like he's one of those "give great ratings but is not actually impressed" types. You know, the all 5/5 or 10/10 across the board followed by not-honors.
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Sounds like he's one of those "give great ratings but is not actually impressed" types. You know, the all 5/5 or 10/10 across the board followed by not-honors.
Yep definitely had that happen to me too.
Yes that's what I initially thought too, and accepted it and moved on even though I really, really knew my psych and we got along well (or so I thought). But then I heard that he does to everyone apparently, even with people who deserve 4's. That's what makes me think the school should throw out his worthless evals and just use everyone's shelf grade if you had him.
