Fellow slackers, how do you handle 3rd year?

[Trismegistus4]

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I've got a major motivation problem. I've always been like a rivulet of water running down a mountainside, or a bolt of lightning, taking the path of least resistance. Since my school's curriculum is strictly pass/fail for the first 2 years, this means that I wind up barely studying at all. I do the bare minimum necessary to pass, so I don't retain much and there's much that I never learn in the first place.

While this is serving to advance me through the first 2 years of school just fine, I'm really starting to worry about what it's going to be like on the wards, especially when I look at my classmates, most of whom are really highly motivated and study their tails off just because they want to. It's apparent from our discussions in our PBL sessions that they really know and have retained a lot of what we learned 1st year, whereas I haven't. I'm really worried about the (as much as I loathe this term and hate on principle to use it) "pimping:" they're going to ask me question after question and my only possible response will be "I don't know."

Based on my experience with my classmates, most med students are ambitious gunners, but there must be some fellow slackers out there. My kindred spirits, how did you cope with 3rd year?

 

[DoctorFunk]

Based on my experience with my classmates, most med students are ambitious gunners, but there must be some fellow slackers out there. My kindred spirits, how did you cope with 3rd year?

The term "gunner" should be reserved for only the most heinous students that actually work to hold others back academically while working to put themselves on top. I think the term you were actually searching for was "responsible future physicians".

I would probably forget about the wards just now, and focus on the fact that if you retain as little as you claim, Step 1 is going to be a harsh awakening.

 

[lilnoelle]

I advise learning as much as you can about clinically relevant material because it will be very difficult if you don't. I performed decently in first and second year and did very well on step I and I feel like I know nothing this year. Besides, a lot of what your learning really is important.

 

[smq123]

I've got a major motivation problem. I've always been like a rivulet of water running down a mountainside, or a bolt of lightning, taking the path of least resistance. Since my school's curriculum is strictly pass/fail for the first 2 years, this means that I wind up barely studying at all. I do the bare minimum necessary to pass, so I don't retain much and there's much that I never learn in the first place.

So, basically, one of two things will happen.

1) You will continue on the "path of least resistance," scraping by Step 1 with a 186, coasting through MS3/MS4, and landing straight in the arms of the least competitive PM&R residency you can find. You're not wild about PM&R, but hey - it pays the loans and your bar tab, and you're out the door by 4:30 most days. So who cares, right?

2) You will continue on the "path of least resistance," scraping by Step 1 with a 186 (if you pass it on the first try!), coasting through the first half of MS3....until you hit your ortho / ENT / urology / anesthesia / derm / rads rotation. And you realize that THIS is what you were meant to do with your life - that this field interests you, and motivates you, and excites you. And it kills you to realize that the average Step 1 scores for people who apply to these fields is a good 50 points higher than your Step 1 score, and that the door is effectively closed to you. Bonus points if you don't post a veiled cry of despair on SDN at the moment of this epiphany.

I don't want to be harsh, but the chances that option #2 will accurately describe your future are surprisingly high. It's not too late to put your butt into gear. Since the vast majority of Step 1 covers 2nd year topics anyhow, you still have time.

I've got a major motivation problem.

I'm really worried about the (as much as I loathe this term and hate on principle to use it) "pimping:" they're going to ask me question after question and my only possible response will be "I don't know."

If you were truly "really worried" about being pimped, then you wouldn't have a major motivation problem!

Based on my experience with my classmates, most med students are ambitious gunners, but there must be some fellow slackers out there. My kindred spirits, how did you cope with 3rd year?

Stop being a slacker, and start reading. It's pretty simple.

If you think that being pimped is scary, imagine THIS scenario: you're the intern on call, it's 2 AM, your senior resident is busy with another patient, and you have no one to help you. And the nurses are paging YOU because poor old Mr. Smith in room 5 is having chest pain, and they're waiting for you to tell them what to do next.

 

[medicomel]

So, basically, one of two things will happen.

1) You will continue on the "path of least resistance," scraping by Step 1 with a 186, coasting through MS3/MS4, and landing straight in the arms of the least competitive PM&R residency you can find. You're not wild about PM&R, but hey - it pays the loans and your bar tab, and you're out the door by 4:30 most days. So who cares, right?

2) You will continue on the "path of least resistance," scraping by Step 1 with a 186 (if you pass it on the first try!), coasting through the first half of MS3....until you hit your ortho / ENT / urology / anesthesia / derm / rads rotation. And you realize that THIS is what you were meant to do with your life - that this field interests you, and motivates you, and excites you. And it kills you to realize that the average Step 1 scores for people who apply to these fields is a good 50 points higher than your Step 1 score, and that the door is effectively closed to you. Bonus points if you don't post a veiled cry of despair on SDN at the moment of this epiphany.

I don't want to be harsh, but the chances that option #2 will accurately describe your future are surprisingly high. It's not too late to put your butt into gear. Since the vast majority of Step 1 covers 2nd year topics anyhow, you still have time.



If you were truly "really worried" about being pimped, then you wouldn't have a major motivation problem!



Stop being a slacker, and start reading. It's pretty simple.

If you think that being pimped is scary, imagine THIS scenario: you're the intern on call, it's 2 AM, your senior resident is busy with another patient, and you have no one to help you. And the nurses are paging YOU because poor old Mr. Smith in room 5 is having chest pain, and they're waiting for you to tell them what to do next.

i completely agree with the above poster. at some point you're going to have to answer to somebody and it won't be a PIMP question. you will either end up looking like a complete idiot or you'll kill somebody. what did you go into medicine for? did you not realize that one day you'll be the person in charge? 🙄

we all love to party and goof off, but at the end of the day you have to know the fundamentals. if you don't already, get cracking.

 

[Trismegistus4]

I would probably forget about the wards just now, and focus on the fact that if you retain as little as you claim, Step 1 is going to be a harsh awakening.

I undertsand the emphasis people are putting on Step 1, but my school has a nontraditional curriculum. I'm going to have a 3-month clinical block and a 3-month research block before Step 1. So I won't be taking Step 1 for more than a year, while I'll be hitting the wards in less than 6 months.

I don't want to get too far afield, but I'm not too happy with my school's nontraditional curriculum, which includes the following features:

• Strictly pass/fail, as I mentioned
• Exams only every 13 weeks or so
• No syllabi, and lots of independent study, so we're on how own to figure out exactly what we have to learn and how to learn it

I think I'd be a lot better off with the motivating factors present in a traditional curriculum, where I had a test every 2 weeks on which I actually had to worry about getting a good grade. And with the syllabi I'm always hearing about on SDN, it would be possible to claim to have made a reasonable effort at studying just by reading the syllabus. But when class lets out and you're sitting there thinking, "I should study, but I don't even know where to start," and meanwhile the test is 12 weeks away, and no matter how much you tell yourself you want do to well you know at some subconscious level that you only have to pass, it's easy to find yourself at the end of the day having done nothing but surf the internet. That's why I called my classmates gunners: the people who are truly learning are the ones who genuinely enjoy combing through the textbooks, figuring out what they're supposed to know and how best to learn it. Actually enjoying reading biomedical textbooks is something I can't identify with. Perhaps that's an unconventional use of the term "gunner," but I used it because of the connotation of overzealousness.

I think the term you were actually searching for was "responsible future physicians".

Believe me, I'm already thinking about non-clinical careers.

I don't want to be harsh, but the chances that option #2 will accurately describe your future are surprisingly high. It's not too late to put your butt into gear. Since the vast majority of Step 1 covers 2nd year topics anyhow, you still have time.

Another aspect of my school's nontraditional curriculum is that we learn normal phys and pathophys of each system/organ at the same time, so the traditional 1st year/2nd year divide doesn't apply.

But yeah, knowing me, while I might do a lot of complaining, when push comes to shove I will probably start studying hard for Step 1 with enough time left to do decently.

If you think that being pimped is scary, imagine THIS scenario: you're the intern on call, it's 2 AM, your senior resident is busy with another patient, and you have no one to help you. And the nurses are paging YOU because poor old Mr. Smith in room 5 is having chest pain, and they're waiting for you to tell them what to do next.

So, when do you learn that?

 

[Trismegistus4]

what did you go into medicine for?

Bad reasons, but it's too late to back out now. Besides, I thought the school was going to actually teach us medicine, instead of handing us the books and saying, "here, go learn it yourself."

 

[Tiger26]

Bad reasons, but it's too late to back out now. Besides, I thought the school was going to actually teach us medicine, instead of handing us the books and saying, "here, go learn it yourself."

I paid like $100,000 over the first two years to teach myself medicine--best investment I've ever made

 

[lilnoelle]

Yeah, I think the people who figure out how to teach themselves medicine are best off. That is basically what we are going to have to do our whole lives. Not to say I don't understand. I certainly have had my share of lazy days (weeks, months)

 

[smq123]

I think I'd be a lot better off with the motivating factors present in a traditional curriculum, where I had a test every 2 weeks on which I actually had to worry about getting a good grade. And with the syllabi I'm always hearing about on SDN, it would be possible to claim to have made a reasonable effort at studying just by reading the syllabus. But when class lets out and you're sitting there thinking, "I should study, but I don't even know where to start," and meanwhile the test is 12 weeks away, and no matter how much you tell yourself you want do to well you know at some subconscious level that you only have to pass, it's easy to find yourself at the end of the day having done nothing but surf the internet. That's why I called my classmates gunners: the people who are truly learning are the ones who genuinely enjoy combing through the textbooks, figuring out what they're supposed to know and how best to learn it. Actually enjoying reading biomedical textbooks is something I can't identify with.

So it sounds like you need more structure, and you need more of a consistent, frequent challenge. And yes, maybe you would have been better off if you had gone to a differently structured school, but there's not a lot you can do about it now.

So look for ways to challenge yourself. Maybe buying a long subscription to QBank, and doing weekly quizzes to test yourself would be useful. Reading case-based questions, and asking yourself, "How would I manage a patient like that if I were the attending physician?" may also help. That is most likely what your classmates are doing, and that's why they "enjoy" reading those textbooks - because they're finding ways of challenging themselves.

So, when do you learn that?

You learn that stuff in MS3, MS4, and intern year - but using the knowledge that you gained in MS2. For instance, in MS3 and MS4, you learn that a patient with new onset chest pain should get an EKG....but you interpret that EKG based on what you learned in your cardiology unit in MS2.

Besides, I thought the school was going to actually teach us medicine, instead of handing us the books and saying, "here, go learn it yourself."

Honestly, that's what happens in MS3 and MS4. No one hands you a syllabus in MS3....and if you're VERY lucky, they'll hand you a list of topics. (At my school, we got zilch. No list of topics, and no syllabus.) But knowing what will be important to learn is up to you.

 

[Pewl]

I think what it comes down to is waiting until you finally get a chance to rotate through the specialty you desire. Many of the competitive specialties won't even read letters of rec from other rotations... such as letters from psych, neuro, surgery, etc. When you get to that specialty you do very much enjoy, I think you will naturally feel more engaged.

 

[45408]

Bad reasons, but it's too late to back out now. Besides, I thought the school was going to actually teach us medicine, instead of handing us the books and saying, "here, go learn it yourself."

On the bright side, that's a lot more than you'll get as an M3/M4.

 

[QofQuimica]

I'm really worried about the (as much as I loathe this term and hate on principle to use it) "pimping:" they're going to ask me question after question and my only possible response will be "I don't know."

You *should* be worried. You think your attendings and residents are going to pat you on the back when you tell them you don't know over and over? Or that they'll smile and say, "well, that's all right, ol' chap. We'll just go hit the golf course now." Dude, wake the heck up. You're in medical school, not at a country club. If you constantly don't know anything when you get pimped, guess what you'll be spending what little spare time you have doing? Yeah, looking up all that s*** and reporting back on it so that you can get pimped on it again the next day. Never mind scraping by on Step 1. You're in danger of repeating rotations, repeating third year, or flunking out of school if you don't get it together.

First, you need to decide if you really want to finish med school. If you don't want to do this, well, it's not a prison sentence. Drop out and go do something else instead of flushing more of your (or your parents') money down the toilet. But if you are going to stick it out, you need to light a fire under your rear end. Figuring out what to read isn't rocket science. If you're not given reading assignments, then what you need to do is read something for every subject. You go by organ systems at your school, so you have two options. One option is to get yourself a book for each subject (ex. cardio, neuro, etc.) and read it during the block. Alternatively, you can get a general physio and a general path book and read the appropriate chapters for each block. Ask the upperclassmen at your school (or some of your more motivated classmates) what books they think are helpful. Lots of people in my class liked Costanzo's physio and Rapid Review path.

 

[Trismegistus4]

You *should* be worried. You think your attendings and residents are going to pat you on the back when you tell them you don't know over and over? Or that they'll smile and say, "well, that's all right, ol' chap. We'll just go hit the golf course now."

Where on earth did you get the idea that that's what I thought? Why else do you think I said I was worried, and asked about what to do?

 

[dphoenix]

I think given all the posts above, you can see what kind of respect most medical students give to their fellow "slacker" students. And given that all attendings were medical students at one point, this should also give you an idea about how you will be perceived on the wards if you do not change.

From the OP, I gather that you are looking for one of two answers: 1) that MS3/4 and residency aren't really all that bad and there are people who "get by" or 2) what you already know, which is that medicine is one of the hardest working fields out there.

I think ultimately you need to figure out what you want to pursue to make you not a "slacker" and more a "hard-worker" and goal-directed person. Whether this means you pursue non-clinical activities (business is no walk in the park either), or find a clinical specialty (ophtho, rads, whatever), you got to find what floats your boat. My suspicion is that perhaps you don't know what you want yet, and that the lack of motivation may be more related to lack of goals.

Also just keep in mind, all the "slacker" specialties (derm, rad, gas) require high step 1 scores and honors in MS3, so even if you want that type of life, you got to make a downpayment first.

 

[peppy]

The good news is that a lot of the stuff you will get pimped on will be stuff that's clinically relevant to that particular rotation, so it's not likely that you will meeting an attending that randomly wants to pimp you on, say, the Krebs cycle (though anything is possible). If you decide to get serious about things now and try to read about the specialties you're rotating through in advance, I think you can catch up and be okay.

 

[medicomel]

. . .Also just keep in mind, all the "slacker" specialties (derm, rad, gas) require high step 1 scores and honors in MS3, so even if you want that type of life, you got to make a downpayment first.

I love this. It's so true. Work hard now so you can slack off later is my motto. 😀

 

[smq123]

From the OP, I gather that you are looking for one of two answers: 1) that MS3/4 and residency aren't really all that bad and there are people who "get by" or 2) what you already know, which is that medicine is one of the hardest working fields out there.

I totally agree. Trismegistus - the basic gist of your OP seems to be along the lines of, "I know I'm a slacker and I know it's bad....but I'm not sure how to change....and I'm kind of hoping that people will tell me that you can survive MS3 while still being a slacker, and therefore I won't need to change."

Could you slack off during MS3 and still survive?

Sure. It's possible. You'll end up paying for it one way or another, though. Whether it's during the Match (when you end up with the least desirable residency possible), or during internship (when your lack of knowledge and meaningful clinical experience puts patients' lives at risk).

Where on earth did you get the idea that that's what I thought? Why else do you think I said I was worried, and asked about what to do?

You already know what to do. You already know that you need to work harder than you are currently working. And you already know that your current work ethic is not going to help you during your rotations. And you already (subconsciously, maybe) know what the answer is - start making goals. Start reading more. Start structuring your study time more effectively.

I think you know what needs to be done. So sit down and do it.

 

[QofQuimica]

Where on earth did you get the idea that that's what I thought? Why else do you think I said I was worried, and asked about what to do?

All of your posts are about sliding by, not learning much, and wanting to continue on in that path of least resistance. If you're not spending much of your time studying like most of your classmates are, what *are* you doing with it? I don't know whose intelligence you're trying to insult here: mine or yours. Are you trying to tell us that you are smart enough to make it through four years of college plus one year of med school, but you honestly can't figure out how you find out what books to read? Come on, you have at least 200+ people at your school whom you can ask (all of the third and fourth years, not to mention your classmates). Just grab one of them in the hallway or student lounge and ask! Good grief, I have to ask people what to do just about every single day, and by the time I finally start "getting it" for one rotation, I'm on to the next one where I start with everything being new all over again.

Someone said people are being harsh because other med students don't like slackers. That's totally true. You may hate your curriculum, but do you ever think about the fact that you're not hurting only yourself, but also your fellow students? You're dead weight for your PBL group if they know more about everything and you have nothing to contribute. You'll make more work for everyone on your team next year when you hit the wards if you don't know anything and you're not willing to work hard. That will piss people off, b/c they're all going to be tired and would rather not be working that hard too. I'm sorry that you hate your school's curriculum so much; it's obviously not a good fit for you. But lots of other people feel that way about their schools. Hating your school's independent study doesn't absolve you of all responsibility to make the most of the situation and be as well-educated as you can be. If you've decided that you really do want to be a doctor three years from now, then do what you know is necessary to make it happen.

 

[Birdeee]

After reading through this I wonder if the OP might want to consider

1) transferring to a more traditional type of school, preferably one with attendance requirements and more frequent tests.

2) be evaluated for depression

I have to add that I am not a medical student or pre-med (practiced as a midwife for 12 years however) but my husband is a med student and from what I see, it seems that the first two years of medical school is basically a structured study for Step 1. If you cannot create structure yourself you need to find a situation that creates the structure you need.

Try to take some of the sample tests for Step 1 and see how that works out - it may give you an objective understanding of where you are and where you need to be, then you can speak with your dean to figure out a plan that you can be successful with.

 

[45408]

You'll make more work for everyone on your team next year when you hit the wards if you don't know anything and you're not willing to work hard. That will piss people off, b/c they're all going to be tired and would rather not be working that hard too.

Thank God that other people know the answers to some pimping questions. Today's teaching rounds would've been a train wreck if I didn't have another student who knew a bunch of questions that I didn't know. I answered the ones I knew, and he filled in the gaps.

 

[xanthines]

I would like to offer a different opinion.

You got into med school which means you're pretty smart to begin with. You're passing your exams (right?) despite the fact they are P/F. You are meeting the med school's requirements to continue, so this confirms you're probably pretty smart. You confess that you will probably do OK on Step 1. I interpret this to mean you either like pressure situations, work better under pressure, or lack motivation while getting by on smarts. In any of these cases, the third year of med school will probably motivate you to work and study. This will be uncomfortable in the beginning as you may arguably be starting with a lower fund of knowledge, but you'll be motivated soon enough. Whether it's an attending/resident/student/nurse yelling at you or the nervousness that accompanies actual resposibilities (ie, patient care), you'll get motivated. Either that, or you'll fail in which case you will have unconciously made your decision!

Anyway, you'll probably fine as far as getting through med school. However, another poster was correct that you might be screwed if you want to get into something competitive.

-X

 

[Anka]

Yeah, P may = MD... but there are some really scary MDs in the world. You don't want to be one of them. So buckle down and get to work. You're still pretty early in the game, you have time to pull this together.

Anka

 

[Trismegistus4]

I was just thinking about this thread again.

I think given all the posts above, you can see what kind of respect most medical students give to their fellow "slacker" students.

Someone said people are being harsh because other med students don't like slackers.

I noticed that in this thread from 2003, a poster asked much the same question--i.e., self-identified as a slacker and expressed concern about getting his "gluteus maximus handed to him" starting 3rd year--and the response was not the same. Although he didn't make any explicit references to not retaining basic science knowledge.

 

[smq123]

I noticed that in this thread from 2003, a poster asked much the same question--i.e., self-identified as a slacker and expressed concern about getting his "gluteus maximus handed to him" starting 3rd year--and the response was not the same. Although he didn't make any explicit references to not retaining basic science knowledge.

The OP in that post was different.

For him, the fact that he skipped class was his biggest concern. So what - I skipped class too. But he didn't mention that he wasn't studying, or lacked motivation to really learn the material.

Your OP explicitly mentioned that not only were you not studying as hard as you thought you could be, but also that you lacked the motivation to learn more than the bare minimum. Your post seemed more along the lines of "Well, I'm kind of lazy, and I know I should change....but I'm kind of hoping that people will tell me that I won't have to change."

People in medicine don't think that you need to kill yourself, and study every moment of the day (or even attend every lecture/class). But they do care if you seem complacent with a lack of knowledge.

 

[LauraMac]

so i was also a HUGE slacker the first two years of med school as were the majority of my friends. my school is also p/f, and by the end of 2nd year i was barely passing everything, not even watching some of the lectures and studying less than half as much as i should have to truly learn things. for me, i think it may have affected my step I score a little, but not much. one piece of advice is to start using study aids for step I now. as a fellow slacker, i can tell you trying to study 12 hours a day for many, many weeks in a row is tough (especially when you have never seen some of the material before), and spreading it out over more time may help. don't worry about trying to do well in classes now or reading extra books. just memorize the living hell out of first aid and other step I study books, and start now. while it is true that doing really well the first two years helps you on step I, it certainly is not necessary to ace the exam. and step I is the only thing that actually matters from those 2 years.

as for 3rd year, if you're like me, you will find new motivation to work harder. having grades really does help - especially because these grades actually matter quite a bit to residencies. not wanting to be embarrassed on rounds or when giving presentations also helps. and most importantly, having real patients really helps. a lot of times i wanted to learn about something so that the next time i had a patient with the same thing i would know what to do and be better at explaining things to them. you just need to know from day 1 that you have to spend the vast majority of your free time studying. i didn't learn that until my 3rd rotation, which is coincidentally when my grades starting getting better. and study when you are at work as much as humanly possible. despite knowing that you are supposed to study with all of your free time, you will inevitably end up on the internet or watching tv instead, so try to use your time on the rotations as efficiently as possible since you are stuck there anyway.

if you don't care about grades 3rd year or step I scores, you can just continue being a slacker. i had friends who called in sick at least once per rotation, and you can also skip certain clinics and things if you figure out whether or not they know you are supposed to be there. just know that you will have no chance in matching in a competitive specialty and will also probably have problems getting one of your top choices in even the not so competitive specialties. if you end up doing something other than practicing clinical medicine, i guess it really doesn't matter.

hope that helps! and don't feel bad about being a slacker. i often do and then realize i work way harder than 99% of the population. you probably do, too.

 

[Pewl]

as for 3rd year, if you're like me, you will find new motivation to work harder. having grades really does help - especially because these grades actually matter quite a bit to residencies. not wanting to be embarrassed on rounds or when giving presentations also helps. and most importantly, having real patients really helps. a lot of times i wanted to learn about something so that the next time i had a patient with the same thing i would know what to do and be better at explaining things to them. you just need to know from day 1 that you have to spend the vast majority of your free time studying. i didn't learn that until my 3rd rotation, which is coincidentally when my grades starting getting better. and study when you are at work as much as humanly possible. despite knowing that you are supposed to study with all of your free time, you will inevitably end up on the internet or watching tv instead, so try to use your time on the rotations as efficiently as possible since you are stuck there anyway.

if you don't care about grades 3rd year or step I scores, you can just continue being a slacker. i had friends who called in sick at least once per rotation, and you can also skip certain clinics and things if you figure out whether or not they know you are supposed to be there. just know that you will have no chance in matching in a competitive specialty and will also probably have problems getting one of your top choices in even the not so competitive specialties. if you end up doing something other than practicing clinical medicine, i guess it really doesn't matter.

hope that helps! and don't feel bad about being a slacker. i often do and then realize i work way harder than 99% of the population. you probably do, too.

Intriguing... I'm finding the exact opposite happening for me. I absolutely went nuts and worked ridiculously the first two years and ended up with the exact step I score I wanted. I'm still working my butt off 3rd year now but I'm finding the grading to be incredibly subjective and whimsical. I had this resident that I enjoyed working with who ended up not spending any time on my eval. She checked the middle box straight down the eval and wrote "Student did a great job on the rotation." And there have been a number of attendings who really don't care about student evals and just write a generic comment and send you on your way. I've gotten great comments and written evals so far but I'm finding it quite difficult to break through and get the highest clinical eval marks. Shelf exams count for a relatively small portion of our grade so even if you score well, it's no guarantee at all about getting honors.
I'm also not sure about your assertion regarding not being able to match into a competitive specialty. I know a number of colleagues who have matched into very competitive specialties even without many honors at all. It all came down to board scores and publications and additional degrees (phd/ms) for them. (as I hope will be the case for me!)
I've talked to the deans before about this. They pretty much just tell all students to keep their head up and just keep working hard.

 

[dilated]

I'm still working my butt off 3rd year now but I'm finding the grading to be incredibly subjective and whimsical. I had this resident that I enjoyed working with who ended up not spending any time on my eval. She checked the middle box straight down the eval and wrote "Student did a great job on the rotation."

Exactly. At my school only like 15% of the class (or so) will get an honors. Separating this from the high pass you get from showing up, doing all your work and knowing a lot appears to be almost solely due to who the people grading you are. There are people who think honors = doing everything expected of you really well and there are people who think honors = somehow amazing them with something they've never ever seen from a third year before.

 

[Trismegistus4]

I had written a much better post than this, but my connection timed out and it was lost, so this will have to do.

So it sounds like you need more structure, and you need more of a consistent, frequent challenge. And yes, maybe you would have been better off if you had gone to a differently structured school, but there's not a lot you can do about it now.

So look for ways to challenge yourself. Maybe buying a long subscription to QBank, and doing weekly quizzes to test yourself would be useful.

I realized this after attending a Kaplan presentation at my school a few weeks ago. After hearing all the talk about Step I, I left much more motivated to study than I had been since school began. And it wasn't out of a fear of not doing well enough on Step I, but rather that preparing for a test is what motivates me to study; it's the milieu in which studying comes naturally to me.

I realized this again today when a classmate said that one of the reasons he appreciates the infrequent testing of our school's curriculum is that it allows him to spend most of his time in "just learning mode" instead of "test prep mode." I replied that for me, unless I'm in "test prep mode" I just wind up not doing it.

Of course, this realization has both a postive and a negative side. The positive side is that now I know that, if my school doesn't (as I wish it did) force me to spend more of my time in test prep mode, I can simulate test prep mode for myself and thus learn the material better. The negative side is that the fact that, at least when it comes to the subject of biomedical science, I don't have a "just learning mode," would for many people raise the question of whether I should be here. If, as it seems, I'm not as interested in this stuff for its own sake as many of my classmates, am I taking up a spot in medical school that should have gone to someone else?

I would like to offer a different opinion.

You got into med school which means you're pretty smart to begin with. You're passing your exams (right?) despite the fact they are P/F. You are meeting the med school's requirements to continue, so this confirms you're probably pretty smart. You confess that you will probably do OK on Step 1. I interpret this to mean you either like pressure situations, work better under pressure, or lack motivation while getting by on smarts. In any of these cases, the third year of med school will probably motivate you to work and study. This will be uncomfortable in the beginning as you may arguably be starting with a lower fund of knowledge, but you'll be motivated soon enough.

I think this is accurate, and after rereading the thread, I'm kind of surprised someone didn't say earlier, look, despite your saying you haven't learned much, you're passing, and reputable US medical schools don't let people pass unless they're meeting what they consider the minimum requirements to become a reasonably competent doctor, so that must count for something, right? It's possible that I've learned more than I think I have, or am letting on, but I'm complaining because of guilt over 1) comparing myself to my classmates, most of whom seem to be really, really INTO this in a way I'm not, and 2) knowing that even if an external observer would consider me to have done pretty well so far, I haven't worked nearly as hard as I personally know I could have.

At any rate, I think that I usually do work better under pressure, and historically have lacked motivation while getting by on smarts. In everything I've done in life so far, including taking the premed courses and preparing for the MCAT, I've felt like I started out as a procrastinator and a slacker, but when the going got tough, I always wound up turning up the heat and coming out pretty well. So, I suspect that for all my complaining, as 3rd year and Step I approach, I will inevitably find myself studying more and doing what I need to do.

 

[smq123]

I think this is accurate, and after rereading the thread, I'm kind of surprised someone didn't say earlier, look, despite your saying you haven't learned much, you're passing, and reputable US medical schools don't let people pass unless they're meeting what they consider the minimum requirements to become a reasonably competent doctor, so that must count for something, right?

Yeah, it counts for something....but I think people in medicine are hypersensitive whenever they feel like someone is saying "Well, I've learned enough to pass, and that's good enough." I think that's the main reason why your OP got the response that it did.

I replied that for me, unless I'm in "test prep mode" I just wind up not doing it.

If, as it seems, I'm not as interested in this stuff for its own sake as many of my classmates, am I taking up a spot in medical school that should have gone to someone else?

Well, if you're "taking up a spot in medical school that should have gone to someone else," then so am I.

I have very little interest in learning this stuff for its own sake. If I were interested in learning for the sake of just learning it, I would have gone to grad school or something.

I AM interested in learning it, though, because I can see how it's clinically relevant. It gives me the knowledge that I need in order to navigate clinical situations and help patients - so that's why I learn it. Otherwise? It's interesting, and I enjoy hearing it, but....that'd be about it.

So you work better under pressure. Great! Now you know which specialties you might like, and which you should probably avoid. OB, emergency medicine, surgery, anesthesia/critical care all require people who can do well under pressure. PM&R, psych, and certain IM specialties are more for people who would enjoy "learning for learning's sake."

 

[emidesu]

Look, I had a traditional curriculum and I would have preferred to have PBL, since I am an independent learner.

My advice is pick a few high-yield topics in each rotation and know them well. For example, you could study diabetes management for IM and EKG's for cardio. For family medicine, you can't go wrong with sinus/ear infections. When you study a topic, make sure to review the relevant anatomy and physiology. Use review books (I like the "secrets" series) for each specialty.

I have found that many med students are insecure and like to feel better than their peers. Practice positive thinking, be helpful and cooperative, and you will be fine.

 

[socmob]

To the OP - I'm pretty sure we go to the same school - and as a "slacker" MS3 who's friends with a few other slacker MS3s here, I can officially say that you'll probably be more than fine w/ Step 1 & on the wards. We're doing just as well grade/evaluation wise as our non-slacker friends. Everyone has different skills...us smart slacker types can study/absorb/learn like none other WHEN we're truly motivated. When you discover whatever field you're passionate about, you'll be a great doctor. Until then, yeah your base of knowledge may be less than other med students. But you'll pick up a lot on the wards and read on your patients while you're there, and a lot of being a med student is about how good your exam/H&P/etc. is so if these are solid, you'll be ok. See my PM for more info. And yeah, people will be jealous, but it goes both ways...I'd like have a better base of knowledge; it'd make things easier for when I do go to study for the nbme/shelf exams or the occasional pimp question but it honestly comes up less than you'd expect.

 

[45408]

To the OP - I'm pretty sure we go to the same school - and as a "slacker" MS3 who's friends with a few other slacker MS3s here, I can officially say that you'll probably be more than fine w/ Step 1 & on the wards. We're doing just as well grade/evaluation wise as our non-slacker friends.

Everyone has different skills...us smart slacker types can study/absorb/learn like none other WHEN we're truly motivated.

Like none other, huh? I think that the smart studious types do a lot better than the smart slacker types.

When you discover whatever field you're passionate about, you'll be a great doctor. Until then, yeah your base of knowledge may be less than other med students. But you'll pick up a lot on the wards and read on your patients while you're there, and a lot of being a med student is about how good your exam/H&P/etc. is so if these are solid, you'll be ok. See my PM for more info. And yeah, people will be jealous, but it goes both ways...I'd like have a better base of knowledge; it'd make things easier for when I do go to study for the nbme/shelf exams or the occasional pimp question but it honestly comes up less than you'd expect.

That's the problem - this thread is about people who WON'T pick up a lot on the wards and who won't read about their patients.

 

[socmob]

Like none other, huh? I think that the smart studious types do a lot better than the smart slacker types.

That's the problem - this thread is about people who WON'T pick up a lot on the wards and who won't read about their patients.[/quote]

Well, it depends on how you're assessed and what the motivation is. But I do contend that the smart slacker types I'm thinking of, when they are motivated to study, study better/quicker/whatever than most of the smart studious types. The smart studious types wouldn't have to study as hard if they learned as well as the smart slacker types. But b/c of this, the smart slacker types tend to do even less studying w/o the right motivation. Now, does this mean the smart slacker types come up on top every time? Hell no. I agree that they will always be bested by smart studious types and they won't ever have the highest grade in the class. But that doesn't mean that they can't still do well or really well. (ex. yeah maybe they won't get a 260 or AOA, but a 235 w/o AOA is still pretty good)

Regarding working on the wards, it's all about your definition of a slacker. I'm not talking about slackers who don't care about patients and really want to do nothing but play xbox all day. I'm talking about a specific type of person...and I know that the folks I know take great care of our patients when we're on the wards. We have motivation then to read and do well. But when we go home, it's rare that we crack a book. That's all. (just a note: we have shelf exams rarely and we can take them multiple times, so studying for those is a seperate thing)

 

[volcanicglass]

The volume of information crammed into the first two years of medical school is huge. But, it's just the tip of a very, very large iceberg. You're not expected to know it all.

Just because some of your classmates go far more into detail doesn't mean that detail is important or useful. You have to draw the line: what's critical, what's trivia?

Some people posting on this board seem to think that endless studying is worth far more than efficient studying. I disagree.

Are you passing your exams? That suggests you know what your professors think is important. Do you understand the broad themes presented in each committee? That's enough to put you on solid footing for third-year.

During your third year, you'll discover that "success" on the wards has very little to do with book smarts. More critical to success is a good work ethic and team spirit -- show up on time, offer to help the residents, write good notes and perform good physical exams. Show you care about what you're doing, and your team will like you.

At the end of the day, as a third-year medical student, you'll always be the least-experienced, least-knowledgable person on the team. You can't read your way out of that.

 

[Bleurberry]

So, basically, one of two things will happen.

1) You will continue on the "path of least resistance," scraping by Step 1 with a 186, coasting through MS3/MS4, and landing straight in the arms of the least competitive PM&R residency you can find. You're not wild about PM&R, but hey - it pays the loans and your bar tab, and you're out the door by 4:30 most days. So who cares, right?

I absolutely get your point, and I appreciate the accuracy of your scenario, but I don't have to like it.
For my part, it stings a bit to know guys and gals who haven't applied themselves will end up somewhere giving sub-standard service to a vulnerable population, like our servicemen and women, our friends and family members post-stroke, post-TBI, post-chemo, etc. PM&R has wide breadth and vast scope, and again, because of it's low-profile through the decades, hasn't risen nearly as competitive as it could, and should be. That's save the top 10 or so physiatry programs, and it's just my 0.02.

 

[Bleurberry]

so i was also a HUGE slacker the first two years of med school as were the majority of my friends. my school is also p/f, and by the end of 2nd year i was barely passing everything, not even watching some of the lectures and studying less than half as much as i should have to truly learn things. for me, i think it may have affected my step I score a little, but not much. one piece of advice is to start using study aids for step I now. as a fellow slacker, i can tell you trying to study 12 hours a day for many, many weeks in a row is tough (especially when you have never seen some of the material before), and spreading it out over more time may help. don't worry about trying to do well in classes now or reading extra books. just memorize the living hell out of first aid and other step I study books, and start now. while it is true that doing really well the first two years helps you on step I, it certainly is not necessary to ace the exam. and step I is the only thing that actually matters from those 2 years.

as for 3rd year, if you're like me, you will find new motivation to work harder. having grades really does help - especially because these grades actually matter quite a bit to residencies. not wanting to be embarrassed on rounds or when giving presentations also helps. and most importantly, having real patients really helps. a lot of times i wanted to learn about something so that the next time i had a patient with the same thing i would know what to do and be better at explaining things to them. you just need to know from day 1 that you have to spend the vast majority of your free time studying. i didn't learn that until my 3rd rotation, which is coincidentally when my grades starting getting better. and study when you are at work as much as humanly possible. despite knowing that you are supposed to study with all of your free time, you will inevitably end up on the internet or watching tv instead, so try to use your time on the rotations as efficiently as possible since you are stuck there anyway.

if you don't care about grades 3rd year or step I scores, you can just continue being a slacker. i had friends who called in sick at least once per rotation, and you can also skip certain clinics and things if you figure out whether or not they know you are supposed to be there. just know that you will have no chance in matching in a competitive specialty and will also probably have problems getting one of your top choices in even the not so competitive specialties. if you end up doing something other than practicing clinical medicine, i guess it really doesn't matter.

hope that helps! and don't feel bad about being a slacker. i often do and then realize i work way harder than 99% of the population. you probably do, too.

I think "slacker" is one of these designations that really isn't well defined, and so I'm not going to pursue any point along those lines. But when you say you barely passed your classes, doesn't your school have analysis of each of the classes you take, and don't they forward that information to your residency programs? I'm asking, I don't know that's standard protocol or not, but I was under the impression that programs did such things, even if they don't rank students against one another, even.

 

[Bleurberry]

I would like to offer a different opinion.

You got into med school which means you're pretty smart to begin with.

-X

Xanthines? My nickname is Xan! Woah... I may have to usurp your alias. 👍👍👍

 

[Pinkertinkle]

But when you say you barely passed your classes, doesn't your school have analysis of each of the classes you take, and don't they forward that information to your residency programs? I'm asking, I don't know that's standard protocol or not, but I was under the impression that programs did such things, even if they don't rank students against one another, even.

Residency programs don't care about preclinical grades, they don't have time to figure out all the different grading systems each school has, and a lot of schools really don't send them anything regarding performance beyond p/f. They just look at Step I which is a reasonable and standardized proxy for performance first two years. Third year grades on the other hand, are very important. However there is still the same issue of diverse grading systems making it difficult to compare students.

 

[Saluki]

Some of the responses here seem a little harsh, so here's a "fellow slacker" trying to answer....

I had a lot of trouble with motivation to study my first two years, because I'm in a PBL school without tests... If a topic was interesting to me, I'd read a bunch extra on it, but memorizing what each of the different interleukins did or the urea cycle when there wasn't going to be an exam was really hard... My school is great, but I probably would have done better in a more structured environment, and it sounds like you're the same way. Unfortunately, though, it's too late to go back and change that decision, so you've got to do what you can now...

I just started rotations recently, so I don't have a ton of great advice to offer... Maybe, though, a good place to start would be picking out a review book on the topic of that rotation and reading a chapter each night NO MATTER WHAT... Then, on top of that try to find reading material related to the rotation that's interesting to you and do that reading as you find time... The idea that one of the previous posters suggested of doing a question set each week also seems like a good idea if you can afford a Q-bank...Maybe you won't be as good at answering the pimp questions as your classmates who studied consistently throughout MS1 and MS2, but you'll be better prepared than if you're doing nothing and in the end you'll be better prepared for step II and your future patients...

 

[Trismegistus4]

That's the problem - this thread is about people who WON'T pick up a lot on the wards and who won't read about their patients.

No, it's not. It's about people who won't study for a pass/fail test that's 13 weeks away. It may very well be about people who will pick up a lot on the wards and who will read about their patients, when the consequence for not doing so is the much more tangible reality of being chewed out and humiliated by their superiors on a daily basis.

 

[Bleurberry]

No, it's not. It's about people who won't study for a pass/fail test that's 13 weeks away. It may very well be about people who will pick up a lot on the wards and who will read about their patients, when the consequence for not doing so is the much more tangible reality of being chewed out and humiliated by their superiors on a daily basis.

I feel you, but your OP was self-deprecating to the point where it worried me, know what I mean? I think you're probably really bright and have been driving in neutral, but once you hit in into drive, you'll feel better and do better. But I'm not implying you have to measure your progress by comparing to others, just do more than you've asked of yourself and you won't live in chronic fear of failure in the future. THAT is more work that work itself.

 

[45408]

No, it's not. It's about people who won't study for a pass/fail test that's 13 weeks away.

🙄 Nobody considers that a slacker. Give me a break.

That's also entirely different than:

I wind up barely studying at all. I do the bare minimum necessary to pass, so I don't retain much and there's much that I never learn in the first place.

 

[themudphud]

as most others probably have pointed out, i think it is a rather well known fact that medical school requires hard work. and, your fellow classmates will also work hard to learn and look good in front of the residents, which will make you look bad if you don't know jack. if you need motivation to work hard, think about the fact that in a short 1.5 years, you will be an intern who will be *expected* to know how to take care of a patient. it's crazy. just take 1 minute to think about it. it scares me to death. i will be starting internship in about 7 months.

that said, there are things you can do to not go out of your way to make life hard on yourself. if a resident dismisses you, ask once if they are sure, then leave. don't insist on staying and don't ask more than once. those are invitations for catastrophic things to happen. every time i have insisted on staying, instead of 5pm i ended up going home at 11pm. and that time was not spent learning, it was spent waiting on someone to do something else. that's the biggest thing and i think in a lot of ways separates the experienced students from the inexperienced ones. that's just my two cents.

 

[Trismegistus4]

I'm bumping this thread because now that I'm almost at the end of 2nd year I've had a couple of experiences that made me rethink this.

1. I failed the last block and have to remediate. This was entirely due to my slacking (i.e., I was more than capable of passing if I'd just put in a modicum of effort.) Because of the remediation process, I have to re-schedule my 3rd year such that I'm now going to have to choose an easy research project that allows me spare time to study for Step I, instead of a really good project that I might get a paper out of.

2. In my peer feedback from last block's PBL group, I received comments that I often seemed unprepared. This was highly embarassing.

3. Biggest of all: someone upthread mentioned being "dead weight" in one's PBL group. That didn't mean much to me at the time, but in my current group, there's a guy who's much like I was in my last group: you can tell he's unprepared. Just by the way he acts, the things he says, it's obvious he has usually done no research and doesn't know anything about the case. And, to my surprise at first, I've found that it's highly irritating. I almost feel contempt for him in a way. Before having been in this situation, I wouldn't have thought I'd react this way, but it's incredibly frustrating and almost offensive when we're reading through the case and it's his turn and he clearly doesn't know what to say. Now I know how I looked to last block's group.

So, I'm sorry for making it sound as though I thought I was justified in being a slacker.

From where I am now, I wish I'd worked just a little harder over the past 2 years. I wouldn't have had to kill myself, just dedicate myself to, say, 4 hours of solid, undistracted studying every afternoon. I could have taken the evening totally off after 7 or 8pm, and still learned a lot more than I wound up doing.

For any slackers out there who may be reading this, especially ones who, like me, are at a school where the curriculum doesn't provide a lot of built-in accountability, that's what I'd recommend doing. You'll do a lot better than if you give in to your slacking, and you'll be able to sleep better at night knowing you're making a reasonable effort.

 

[QofQuimica]

I was the one who said you'd be dead weight to your PBL group. I'm sorry you have to remediate, but I'm glad you understand now why a few of us were pretty harsh on you. FWIW, you get props from me for manning up with that last post, Tri. That took courage. Best of luck to you; I know you'll kick butt now that you want to do well. 🙂

 

[monkeydoctor]

"...and so, boys and girls, Trismegistus learned that slackers are BAD and hard-working med students are GOOD, and that the scorn of your peers is the strongest motivating factor of all... and after realizing his peers were kind of nuts, he lived happily ever after as a psychiatrist. THE END!"

 

[Trismegistus4]

"...and so, boys and girls, Trismegistus learned that slackers are BAD and hard-working med students are GOOD, and that the scorn of your peers is the strongest motivating factor of all... and after realizing his peers were kind of nuts, he lived happily ever after as a psychiatrist. THE END!"

Funny you should say that; we're learning psychiatry this block and while I never would have considered it before, I find myself interested in it as a career. Now, get over here and take your Haldol before I have you restrained. 😉