How do you reconcile ambition with the reality of performance/being a less than perfect human?

[evennotodd]

Hey everyone!

I’ve been wondering over the past few days whether I’m cut out for the rest of the journey (or perhaps more aptly, rat race) that is medicine. So I wanted to see how other people process it? I apologize for the long post (I have lots of feelings/questions, and yes I know some of this may be neuroticism), but appreciate any insight you can provide!

I’ve always been a bit of a perfectionist (or rather I believe that I should be/am capable of doing my best, which I also happen to believe is getting top grades/opportunities). I’m also someone who is indecisive and likes to have all the doors/opportunities open for me to choose from.

Unfortunately it seems to me that the top jobs are the ones that have the most opportunity and flexibility to pivot and go beyond just practicing clinically (which would hopefully still be figuring depending on specialty) into interdisciplinary projects (research, business, etc). In my mind the pathway that is the easiest way to open the door to getting a job like that (a job which opens pretty much any door you want) is to go to a top residency (and maybe fellowship depending on if that’s needed), which is easier from a top med school, which is easier from a top undergrad.

I’ve always been a strong student (outside of math which unfortunately translated to a dual credit A- and B in calculus 1 and 2, starting my college career off without a clean slate), so unfortunately that’s somewhat intrinsically instilled in my identity.

In college at my state school I got a string of B’s (2 B+, and a B-) in the organic/lab sequence. Both B+ were due to not knowing what to expect for the first exam of the course. I then turned both these around, but it wasn’t enough to compensate for ~60% on the first exam. I told myself I would kick ass in the rest of the sequence but then my extracurriculars made that hard because I was away for 1-2 weeks of the semester and the timing of exams sucked. There’s also definitely a psychological component where I might have burnt myself in HS and didn’t have to study my freshman year (which I really enjoyed and had a lot of fun with awesome people), so I simply haven’t been able to lock in (at least consistently) like I was able to in HS.

I transferred to a T20 (for a variety of reasons), and that adjustment has been rough since I didn’t realize just how much of my happiness comes from a social life (which I naively thought would be easier when I was back to living on campus) rather than academic validation/reaching my ambitions. Biochem is kicking my ass (it’s known to be bad here) and so I’m looking at a B realistically (maybe worse depending on how the chips fall, but I’m gonna work my ass off), with a B+ or higher being possible but definitely highly luck dependent (leaving my cGPA/sGPA lower than the 3.81/3.66 they currently sit at). Rather than dropping and retaking it next semester, I plan on taking upper levels to try and help my sGPA, but my trend certainly doesn’t look good as a string of classes rather than just one and learning from it (you’d think I would’ve learned my lesson by now but somehow something slight different always gets in the way). I’m also not super optimistic about the rest of the prereqs (namely physics).

I know that going to a T20/top medical school isn’t everything and doesn’t remotely guarantee being happy (as I’ve seen in my experience when I transferred as an undergrad), but I obviously want to do the best I can and have the option on the table if I want it (which who knows what I want). It certainly doesn’t help that my premed advisor said that while med schools give some grace (if only I could give that to myself) for applicants from my undergrad, that may not fully extend to those who only did a portion of their courses here. He also said “anecdotally, transfers get into top schools a lower rate than those who were here for 4 years since they aren’t as sure a bet”. This definitely pissed me off/left me discouraged.

How do you all balance (in my case seemingly sky high/outsized/unrealistic) ambition with the reality of being human (especially when you’re performance is a real reality check that you’re nothing special, and might even be less than average)? Not to mention the fact that there are just people who don’t have to work for it (which is certainly not me) or want it as bad that will sail through to the top while I’ll have to fight and may just land middle of the pack (which is contrary to the core of who I am).


Sincerely,
A (slightly) neurotic premed


Edited to add:
I definitely want to enjoy life (so less stress seems to be the key) but at the same time it’s hard not to be competitive/ambitious by my nature especially when it seems everyone else is that way.

It’s one thing to have options and decide on the easier/gentler path or school, it’s another to feel like that choice was ripped from your hands (or not attainable).

---

Members don't see this ad.

 

[Mr.Smile12]

Get a copy of

The Perfect Doctor

The Perfect Doctor: Forty Voices on the Imperfect Pursuit of an Ideal

theperfectdoctor.org

 

[AJS59]

I had a great lecture today by a cardio prof just before we begin cardiology next week. He gave a pep talk that I think is not only applicable for current med students but anyone at any point along this career, or really any career:

Everyone is going to have a bad moment. A moment where there's a failure. Some of these, in the grand scheme of things are relatively meaningless (i.e. scoring below the median on a cardio exam). Others may be truly catastrophic and hurt more than just you (i.e. having a patient die on the operating table despite your best attempts to save them).

At the end of the day, it is important to remember that this career is just one aspect of who you are. Your successes and failures, or how you stack up on the bell curve compared to your classmates, matters not one iota in the grand calculus of the universe. The fact that you're putting in effort, that you're trying to be the best YOU you can be for yourself, your family, and your patients IS what matters. And the best YOU isn't measured by an MCAT score, a shelf exam, the prestigiousness of your residency, the title in front of your name or the number at the bottom of your future paycheck. The best YOU is the you who can be there for yourself and others around you. We're not perfect, but we can always learn from our mistakes. Don't dwell on the past, for there is always a brighter tomorrow (this is more or less the gist of what he said).

Now what I'll say: I don't believe anyone, in any field, any discipline, can be perfect. It is simply impossible. The best way to approach life, in this career and all aspects is a growth mindset. Don't be upset that you failed an exam (as I did in organic chemistry), focus on what you learned from it and what you can do better for the next one. Don't be upset that you didn't get an internship or that a date didn't go well, focus on what you learned from those rejections about yourself. I think everything happens for a reason and that the failures we have guide us towards becoming our most complete

(*Gets off the proverbial soapbox*)

Tl;Dr You will be fine. You will figure it out. Just keep an eye to the future and know that you are enough, always.

 

[evennotodd]

I had a great lecture today by a cardio prof just before we begin cardiology next week. He gave a pep talk that I think is not only applicable for current med students but anyone at any point along this career, or really any career:

Everyone is going to have a bad moment. A moment where there's a failure. Some of these, in the grand scheme of things are relatively meaningless (i.e. scoring below the median on a cardio exam). Others may be truly catastrophic and hurt more than just you (i.e. having a patient die on the operating table despite your best attempts to save them).

At the end of the day, it is important to remember that this career is just one aspect of who you are. Your successes and failures, or how you stack up on the bell curve compared to your classmates, matters not one iota in the grand calculus of the universe. The fact that you're putting in effort, that you're trying to be the best YOU you can be for yourself, your family, and your patients IS what matters. And the best YOU isn't measured by an MCAT score, a shelf exam, the prestigiousness of your residency, the title in front of your name or the number at the bottom of your future paycheck. The best YOU is the you who can be there for yourself and others around you. We're not perfect, but we can always learn from our mistakes. Don't dwell on the past, for there is always a brighter tomorrow (this is more or less the gist of what he said).

Now what I'll say: I don't believe anyone, in any field, any discipline, can be perfect. It is simply impossible. The best way to approach life, in this career and all aspects is a growth mindset. Don't be upset that you failed an exam (as I did in organic chemistry), focus on what you learned from it and what you can do better for the next one. Don't be upset that you didn't get an internship or that a date didn't go well, focus on what you learned from those rejections about yourself. I think everything happens for a reason and that the failures we have guide us towards becoming our most complete

(*Gets off the proverbial soapbox*)

Tl;Dr You will be fine. You will figure it out. Just keep an eye to the future and know that you are enough, always.

Thank you! I appreciate the thoughtful response!

 

[Hollow Knight]

Getting divorced made me sit down and think about similar things. For one, I put a lot of my happiness/identity in being a father and a husband (partially as a cultural thing). For two, I had been living for other people and doing what I was "supposed to do" for so many years that I had to sit down and really think about what I valued in life. DO NOT put your joy in anything that can be taken from you, including your career. You can't control what happens in your life. You can only control your own actions.

I can't tell you what the answer is, but I think I can tell you what the answer is not. Putting your "happiness" (whatever that means) in wealth, or the approval of others, or prestige, or being at the top of a hierarchy- none of those things will make you happy in the end. There will always be someone who is more "successful" than you.

For me? My faith has a bit to do with it, but I've decided to focus on A) living with absolute dedication to my craft and B) focusing on nurturing good relationships.

With my academic performance, I could match into an easier specialty than Family Medicine that would also pay me more. Having said that, if I don't go work as a primary care physician where I grew up, nobody else will. Those people are counting on me. And the more I know, the better I can take care of them- there aren't any specialists out there. It's just family docs and a general surgeon. Of course working 36 hour shifts isn't worth it for the money. But it's worth it to go serve those people who loved me from the time I was a child.

All that being said- again, I can't tell you the answer. But I would advise you to find some sort of noble pursuit you can devote your life to and strive to use that for the benefit of other people. I think that will lead you to peace. Whether it's medicine or not.

And all of that to say- it really doesn't matter that you're getting Bs in biochem. Stop worrying about making as much money as possible and start worrying about how you're going to serve the world. And about the perfectionism thing- it's literally impossible and it's holding you back from achieving your potential. Go read the essay "A Way of Life" by Osler. If you live like that, the outcome will take care of itself.

Stop worrying about the outcome. Worry about the process. Be utterly disciplined (hence Rock Lee is my avatar haha). And then whatever the grade is, you can hold your head high and know you did a noble thing. Oh, and it's OK to have friends/a partner/whatever too. Medicine doesn't have to be your life.

 

[evennotodd]

Getting divorced made me sit down and think about similar things. For one, I put a lot of my happiness/identity in being a father and a husband (partially as a cultural thing). For two, I had been living for other people and doing what I was "supposed to do" for so many years that I had to sit down and really think about what I valued in life. DO NOT put your joy in anything that can be taken from you, including your career. You can't control what happens in your life. You can only control your own actions.

I can't tell you what the answer is, but I think I can tell you what the answer is not. Putting your "happiness" (whatever that means) in wealth, or the approval of others, or prestige, or being at the top of a hierarchy- none of those things will make you happy in the end. There will always be someone who is more "successful" than you.

For me? My faith has a bit to do with it, but I've decided to focus on A) living with absolute dedication to my craft and B) focusing on nurturing good relationships.

With my academic performance, I could match into an easier specialty than Family Medicine that would also pay me more. Having said that, if I don't go work as a primary care physician where I grew up, nobody else will. Those people are counting on me. And the more I know, the better I can take care of them- there aren't any specialists out there. It's just family docs and a general surgeon. Of course working 36 hour shifts isn't worth it for the money. But it's worth it to go serve those people who loved me from the time I was a child.

All that being said- again, I can't tell you the answer. But I would advise you to find some sort of noble pursuit you can devote your life to and strive to use that for the benefit of other people. I think that will lead you to peace. Whether it's medicine or not.

And all of that to say- it really doesn't matter that you're getting Bs in biochem. Stop worrying about making as much money as possible and start worrying about how you're going to serve the world. And about the perfectionism thing- it's literally impossible and it's holding you back from achieving your potential. Go read the essay "A Way of Life" by Osler. If you live like that, the outcome will take care of itself.

Stop worrying about the outcome. Worry about the process. Be utterly disciplined (hence Rock Lee is my avatar haha). And then whatever the grade is, you can hold your head high and know you did a noble thing. Oh, and it's OK to have friends/a partner/whatever too. Medicine doesn't have to be your life.

Thanks! Yeah it’s not like I’ve got lofty goals just for personal reasons, it’s so that I can do the greatest amount I can to benefit others and leave the world a better place. I absolutely value having a social life, enjoying myself, etc equally and almost certainly more than being the top/doing the best I can in my craft (it’s just that I want to try to do both since I try to be the best I can in every facet of my life, which includes both socially/family and career wise). I’ll give that essay a read!

 

[Hollow Knight]

Thanks! Yeah it’s not like I’ve got lofty goals just for personal reasons, it’s so that I can do the greatest amount I can to benefit others and leave the world a better place. I absolutely value having a social life, enjoying myself, etc equally and almost certainly more than being the top/doing the best I can in my craft (it’s just that I want to try to do both since I try to be the best I can in every facet of my life, which includes both socially/family and career wise). I’ll give that essay a read!

There seems to be a fault in your thinking here where you think better grades=more good to be done for the world. That’s not how that works.

Really what America needs desperately is more family docs, pediatricians, and general internists. The reason primary care isn’t competitive is that there are structural issues preventing you from doing the job you want; you get paid less for dealing with more BS than most other specialties.

You might think better med school = more good for the world, but that’s a fallacy too. If I had gone to Harvard I would have received inferior training for the work I’m trying to do in my rural hometown (and my MCAT score was well above their average)

You need to find where your passions and skills intersect with the world’s needs. And you also need to learn how to separate achievement from any kind of self worth.

But if it makes you feel better, from an evidence-based perspective, you’ll probably be doing more good per unit of your time if you’re the bottom of the barrel in med school and match family medicine. I’m pretty sure to date FM is the only specialty with a proven population-level mortality benefit.

We need dermatologists too because FM docs can’t know everything. I’m just pointing out that better grades does not necessarily equal better societal good

 

[Goro]

Lose the pathology of thinking grades and stats are reflections of your character and your worth as a human being

No one is perfect, and even the smartest dictors will lose patients.

All you can to is your best. That's all that's expected of you, and all that will be asked if you.

 

[anyonecandoctor]

We've all felt like this at one point OP. I guess how my mindset has changed is I don't want *getting into x medical school* to be the coolest thing I've done with my life.