How did you guys like third year of med school?

[i61164]

I have heard some people say third year was better than the first two. You finally get to put knowledge into practice. Then there are others that say it is the worst year of their lives. Crying a lot, feeling stupid all the time, being humiliated in front of your peers, etc. I'm really looking forward to my psych rotation, but I'm a little worried about 3rd year overall. Do I need to start preparing myself emotionally now? I start third year on April 9th.

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[OldPsychDoc]

"It was the best of times, it was the worst of times."

 

[i61164]

So would third year be an indication for an SSRI? I'm not sure how I will handle the verbal and emotional abuse and the sleep deprivation.

 

[maranatha]

Generally 4th year is a lot better....But I'm on a rotation right now and I'm getting pimped-out like I'm the only piece of a#@ this side of nowhere.

I actually don't mind the pimping. It's not getting tipped if the customer (i.e. pissy attending) is dissatisfied with services rendered that really sucks!

 

[i61164]

Generally 4th year is a lot better....But I'm on a rotation right now and I'm getting pimped-out like I'm the only piece of a#@ this side of nowhere.

I actually don't mind the pimping. It's not getting tipped if the customer (i.e. pissy attending) is dissatisfied with services rendered that really sucks!

By not getting tipped do you mean not getting positive evals? At this point (with match day around the corner) you don't need good evals anymore, right?

 

[maranatha]

By not getting tipped do you mean not getting positive evals? At this point (with match day around the corner) you don't need good evals anymore, right?

No...I have an attending right now that when I don't get a question correct during rounds (being pimped), she rolls her eyes, looks at the fellow like "what a stupid medical student", and then sometimes makes a sarcastic comment.

Being that I was out of school for 5 years and worked part of that time in the business world, I have a low tolerance for that kind of behavior. It is just unprofessional behavior and it really pushes my buttons...The bright side is that this is very, very rare at my medical school and 95% of the attendings have never done this.

 

[Anasazi23]

MSIII can be tough....and very much tougher if you have a rougher schedule or get bad luck of the draw attending and resident wise.

But personally, even with the scut, general disrespect, getting paged by a surgery attending at 3am for the specific purpose of pimping us on CT scans, and more, it was 1000x better than sitting my butt in a classroom, listening to endless lectures - half of whom from people who have never seen an actual patient in their lives.

 

[i61164]

No...I have an attending right now that when I don't get a question correct during rounds (being pimped), she rolls her eyes, looks at the fellow like "what a stupid medical student", and then sometimes makes a sarcastic comment.

Being that I was out of school for 5 years and worked part of that time in the business world, I have a low tolerance for that kind of behavior. It is just unprofessional behavior and it really pushes my buttons...The bright side is that this is very, very rare at my medical school and 95% of the attendings have never done this.

Do you ever call them on it like "gee that was a really unprofessional sarcastic comment you just made." or would that be too wreckless?

Sazi - I hope I have a good experience like you did (except for the part about getting paged at 3 a.m.).

 

[Dartos Vader]

I had a great time in third year. It's all so exciting and new. I found that most of the time, a willingness to work and learn was something that really impressed attendings. I felt like getting pimped was being on the show jeopardy, it was kind of fun. You just can't take it too hard if an attending gives you a verbal beatdown. Water off a ducks back my friend.

 

[whopper]

I thought 3rd year was much better than the 1st 2.

But I'm a hands on guy, not a book guy. It was nice to work the stuff for real instead of memorizing it.

 

[DebDynamite]

I found that most of the time, a willingness to work and learn was something that really impressed attendings. I felt like getting pimped was being on the show jeopardy, it was kind of fun. You just can't take it too hard if an attending gives you a verbal beatdown. Water off a ducks back my friend.

I agree with the above, except that overall I have not enjoyed 3rd year. The only things I have enjoyed have been #1. my Psych rotation, and #2. any rotation where I am there 4-8 hrs a day if I'm not into it. I can be mildly interested up to about 8hrs tops, I've found. If you're in a rotation that you have no desire to go into, it's rough. Because you can be there anywhere from 4-30 hrs at a time, you may not even know when how or where your next meal is coming from, etc.. and you're getting this huge chunk of your grade on appearing interested. A lot of it is completely random, depending on who you end up working with, and that's frustrating. I'm glad it's winding down and I can spend more time in Psych, which I like.

 

[i61164]

Yeah, I was talking to a third year that said it is really hard to pretend like you are interested during a long surgery. When you have been holding a retracter for 5 hours and you could fall asleep from the boredom except that you are in too much pain (feet/back) and if you don't strike up conversation about surgical stuff than your evaluation will read "student seemed uninterested."

Well, if I get an evaluation like that I won't be able to deny the veracity of the statement. Not only am I uninterested in spending time in the OR, I heard that in surgery, students are basically "cannon fodder," whatever that means.

 

[Littlemantate]

Third year was the worst day of my life-I litereally dreaded waking up most mornings. I LOVED the first 2 years. I did not go to class, I slept in until noon and studied the day away in the undergrad library with tons of hot girls that seemed to be impressed-LOVED it.

Now third year-what to say, it is TOTALLY dependant the residents you get stuck with. REgardless of what rotation I was on-I enjoyed the day and experience when I was with a great group of residents. I totally do not mind attendings pimping you but when they pimp and you get it wrong and they chuckle sucks.

The only rotation I enjoyed was psych, however it was largely due to the fact I got out at noon everyday for 6 weeks. I hated the fact you have to study for shelfs which are pretty hard when you are dead tired from doing nothing but sitting/following a resident around when time would have been much better spent studying.

Just knowing you are crap to most in the hospital-constantly having nurses and other docs coming up to you and asking you something, only to follow with "oh your just a medical student" and then walk away.

And being there for rotations you hate just suck what can I say.

4th year rocks, atleast my place which is all electives. And you are treated a little better as a fourth year, especially after xmas since you are almost done.

I cannot tell you how excited I am to graduate and have my MD and atleast go by Dr. and feel USEFUL to a degree. I guess my biggest beef with clinicals if I had to sum it up would be you are and feel USELESS. Virtually everything you do matters very little since most has to be checked/repeated by residents-it is just hard to work hard and be tired when you know nothing you do matters. Many time the residents or attendings do not even notice extra work you did or writing good notes etc.

basically it sucks

 

[jjbmsiv]

I have to agree with that. I think medical education would benefit greatly from a revamping- I mean, outside of some physics, and some minor biochem, how much of what your studies for your MCAT has had any impact at all on your medical education? And I don't even mean the first 2 years of med school either: those seem to exist SOLELY to provide cushy, tenured positions to old science blowhards who, as stated before, have never treated a patient. When do you really learn pathology, pathophysiology, pharmacology? It's when you are DOING it, and that means clinical work.

I think a move to whittle away much of the first two years of uneccesary "medical" lecture, and replacement with more clinical years would vastly improve the "third year experience" that we all have to go/have gone through. Anatomy, physics, micro, a couple weeks of biochem, and you're ready to go!

It's also similarly frustrating to have to take a shelf exam or boards that are 3-5 years behind your clinical practice experience, be it with new drugs, imaging, or other management techniques. You learn to go, 'Oh, well in real life I would do this, but I have to answer C here because this is what my Pre-test books tell me is the correct answer.' It's rediculous! Why shouldn't the STEP exams let us use palm pilots for drug information, or uptodate, or similar? In a clinical scenario, which we all work in, that is what the experience is like. It seems that those who memorize the most the fastest get the 98%s, no matter how intelligent you are. Isn't that a problem?

Revamp all of it, stop using the MCATs to simply take the smartest, and instead invite those who are, yes, gifted, but personable, and able to _connect_ with people. We all know that a good doctor in any field is one who is capable of fostering relationships with his/her patients. You don't have to have an IQ of 158 to do this, or have perfect memorization skills.

Heh, sorry, I guess I got off track here. Hope some of my rant helped, at least!

 

[jjbmsiv]

...guess I killed the thread. crap.

 

[DebDynamite]

...guess I killed the thread. crap.

Well, your post was just so honest, real, and rational, it about sums it all up. Strong work.

Too bad "the powers that be" won't listen to this advice.

 

[Littlemantate]

Basically I disagree with every point you make

1. Cutting down the basic science year-for me and most people we already felt overwhelmed with the material. It is not that we remember the details but we learned the foundation of pathology and medicine in real life. Covering the topics we did at the speed of 2 years was overwhelming and I found I did not have enough time to master any of the concepts. I later during step 1 study and third year was able to back over pathology and tie it into medicine, pharm etc and realized I really knew **** back then.

I do think, atleast at my school it was a good set up-you used the first year for every topic except path and pharm-second year was all path and pharm-and I found a year to take that all in was good.

I think, again atleast at my school where 4th year is completely electives and I have learned nothing new this year-4th year could be cut out and medschool down to 3 years-maybe by taking out your first summer vacation so you would have a couple extra months to do your sub-is' and stuff that are important fourth year-but the rest of the year I have been doing prety much nothing and paying 40 k for it-

The MCAT does either have or is going to have some section that is objectively scored that is supposed to somehow take into account someone who can deal with people-how I do not knwo but it is on their site. Other than this how can you ever quantify something like that? And to be honest would you not rather have a smarter bunch than a social bunch-the best socializers are people who party etc-which is not bad but the socialites in undergrad are not usually the brains-actually are at the other end-so I think MCAT (even though I hated it and did not do great) is the best measure along with your GPA-

 

[jjbmsiv]

Learning path and pharm is going to be overwhelming no matter what speed you do it at. My point is that is seems for the large majority of people that learning the pathology and pharmacology is easiest when done in a clinical setting, because you have a real life person's experiences to take it from! Would you rather have that for your first encounter with mananging, say, CHF, or your experience of sitting in a library and learning stiffly from a book? That's the point I'm trying to make.

Yes, you can argue that you need to be introduced to the material before you get into a clinical setting, and that's certainly the basis for education as it exists right now, but I don't believe that it has to be done that way. I still insist that the folks who do the best in the first two years are the ones capable of memorizing and regurgitating the most drivel. I would rather spend that 40k a year, as you put it, in with patients, who are going to be my best teachers!

As for this new mcat section, hearing of this objective section on dealing with people is making me laugh myself silly. What a crock! I don't think that needs further commenting, it's too obvious. However, in terms of being sociable, I was referring to changing some of the ways medical schools do interviews. Yes, of course you have to be of a certain intelligence to do this job, no doubt. No question! Taking it to the extreme of the drunk party dude applicant being superior to an intelligent applicant is a bastardization of my point. There are smart people who can comminicate well with others, there are smart people who are insular, there are smart people who are total arrogant dinguses. There are also smart people who wear shoes, and those who wear sneaker, and those who eat broccoli for breakfast. You have a large pool of applicants. Med schools can at least try to make an effort at selecting the more compassionate, rounded folks. I do not expect 100% success at this; but I think a reliance mostly on MCAT scores and a GPA should not be where the emphasis is on accepting a person into your medical school class.

I'm sorry you disagree, but, I think a lot of people are tired with the way things are right now. I know the actual path of learning to do medicine is a HUGE undertaking no matter how it is accomplished. I just think that a lot of the politicking that goes on for many a third year student is total BS, and I believe that a revamp of the system, with much earlier routine exposure to the clinical setting would ameliorate a good deal of this. Not all of it, of course, as hospital politics is a big chore in the daily MD/DO's life, but some of it is just too much.

 

[Littlemantate]

applicant being superior to an intelligent applicant is a bastardization of my point.
quote]

haha damn dude-you obviously were one with good mcats and such as that I had never heard of that phrase and it reminds me of someone very well educated-I myself am a common man-so the system works. I was a finance major (then added bio when I turned premed) but got my finance, I had nothing to do with premeds-I was in a frat (so I do not like the diss on the party frat guys cause lots of them are smart) and I was quite a socialite so to speak-and I also got decent mcats and a 4.0-I got in and I think I was always different then most of my classmates-so the system works, it just there is probaly a lack of the different type of people applying.

and as for ciriculum-hell I hardly remember anything from the past 3 years, especially as I am headed towards psych-so you are probably right but in my eyes no matter how you cut it-you do not remember much for your 150k in the end-oh well, gotta jump through the hoops. I mean you can make an arguement for only doing Medicine and then your speciality rotations and eliminating peds, obgyn, surg, etc if you are not going into those fields. You need medicine as a background for most things so it would be required. But for psych for example, you could do 3 months of IM third year and spend the rest of the year doing pscy and graduate.

 

[jjbmsiv]

I got a 27 on my MCAT. *laughs* I seem to struggle now with standardized tests, starting with that one and the shelf exams and steps that have followed (great SATs, though). So, yeah, in the interest of full disclosure I guess I have an axe to grind with those STEP exams and shelfs, huh?

EDIT: Oh, I never said we shouldn't rotate through surgery or ob/gyn or peds, no no no. Those are all necessary for ALL doctors. We need to learn the language that other specialties speak in, and walk a couple blocks (if not a mile) in their shoes. Medical school is a great time to do that, and it's how most people decide their careers. My argument has been to INCREASE the amount of time spent clinically doing those very rotations, and to do them earlier in the medical school curiculum. I want to eliminate a lot more of the lecture/college type learning, and to maximize learning from patients. It's harder to learn from your dry stale textbook in the library than it is to see it in front of you every day.

 

[i61164]

I also think that changes could be made to improve medical education (though I am not a trained educator so how would I know?). It seems to me like many schools are making changes and integrating some clinical experiences into the first two years. Duke even compresses the first 2 years into one year, so maybe that is a reasonable approach. Personally, I wish my school would drop "honors" and just be pass/fail in the first two years. But...that is another topic. Anyway, the reality of medical education is what it is and currently I am really just focused on getting through it. So back to the issue at hand here: can I get some SSRI's to help me cope with third year? I really identify with patients that just want a pill to fix their problems, because that's what I want too.

 

[jjbmsiv]

You're a second year, right? I think?

It's okay to be nervous. I remember my first two weeks of third year- inpatient peds. What a crazy situation! I felt in so over my head, trying to do a quick exam and writing a note that wouldn't get me excommunicated by a dictator-ish attending. Thing is, I had a cool sub-I, and a nice resident, and I learned by doing. As did my classmates. As does every third year med student... it's okay to feel anxious- this is unlike everything you've ever done before!

But you don't have to pill pop, either! Every first week (or two) of a new rotation can be intimidating- OB writes their notes different from surgery, which is different from medicine, which is different from psychiatry... but you read the notes of those who came before you, or you buy a book, or you ask a friend who rotated on this before, and you put things together. The best thing to do is relax, and coming from an anxious person myself I know that isn't easy. There are those days you hate yourself, hate that you came in at 6am, know that you're going home after 6pm just to do it over again four more times this week PLUS call! But there are the happy days, too, and you build up some fortitude, and you really do undergo that trial by fire that the lay-person will never understand, never know the truth of what it is to become a doctor. And THEN there's your residency!

Even so, one step at a time, my man. Breathe. Don't pill pop (unless medically indicated!). And try to have fun when you can have it. It won't be every day... but even though you hate your rotation you may just love your patients. And that makes one hell of a great doctor.

 

[tennreb]

Third year is much better than the first two, but it can be challenging at times depending on the rotation. When you have to wake up at 4 am to get to the hospital for another 14 hour day, you begin to hate your life. This is especially bad when you feel useless. At my medical school, surgery is the most difficult rotation. We work 90-100 hours a week and take call every 2-3 nights during part of it. However, the trauma portion is a lot of fun. I actually feel useful. When trauma patients come in, medical students do the H&P, which the resident trusts was done correctly. Students do all the wound care and suturing and have specific responsibilities for shock traumas (cutting clothes off, getting the abg and venous sticks, putting in the foley, etc.). Students are used as unpaid employees, but we are learning. The OR can be boring. Our duties include driving the camera in laproscopic surgeries, cutting the suture, holding retractors, and helping close the incisions. It depends on the residents and attendings. If they ignore you or just pimp, then it can suck. If they take the time to teach, then it can be rewarding. When you are in the clinic on any rotation, you decrease the time that the doctor has to see the patient because you have already determined what is important. The hard part about third year is the ridiculous hours that you have to work, especially when you are supposed to study on your free time. The work isn't difficult at all, and few of the attendings and residents are malignant because they are constantly being evaluated by students.