Humiliation

[Bernd]

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Im a first year. No matter how hard I work at understanding something, every time I get up in front of a group I turn into a bumbling idiot. My voice shakes. I can't answer questions. My heart is racing and in my mind I imagine myself from aerial view with my mouth wide open, tongue protruding and drool dribbling down. There is such a huge gap between my level of functioning in this situation and my level of functioning on paper or one-on-one with a friend. Eventually I do well on the tests, so why do I have to be the village idiot in front of my classmates all the time. Is there anything (drugs being a last resort) that I can do to stop the panic response so that I can have some dignity once in awhile. Third year is going to be hell if I can't get over this. Thanks for your advice.

 

[kutastha]

Practice talking through things in front of a mirror.

And keep talking. The more you do it, the more comfortable you'll feel.

 

[aphistis]

Therapy is one option, medication a second.

 

[Finally M3]

It get's easier with practice. If you have to commute anywhere, try practicing speeches or presentations to yourself out loud in the car. Or you can go see a psych. and try some cog/behav. therapy. Last resort would be to med you up....

I kinda have the same thing, and to be honest it's something you just have to get kinda used to doing.

Good luck

 

[daria]

I have had similar problems almost randomly - although I guess it's mostly when I feel like I don't know what I"m talking about and the people listening may "find me out". The randomness part is irritating, because I may be feeling perfectly fine, and then be struck with panic for no good reason 5 minutes before I get up to talk. I don't really have any advice aside from the usual "practice in front of a mirror" and "it gets easier the more you do it", the latter of which may not help everyone.

Once I did something that worked very well for me, but is not practical with people who know you, hehe. I had to give a talk at an undergraduate research symposium, and was quite nervous. So I did the "go into an empty bathroom and practice in front of a mirror" thing. I wasn't happy with how it sounded, so I tried it in an Irish accent - and whaddaya know, it sounded a lot better. God only knows what got into me, but I gave the talk in an Irish accent. I was so focused on getting the accent right that I didn't have any energy left to devote to being nervous. Went very well, I must say. To this day I wonder how many people were sitting in the audience going "what the heck - I KNOW this girl ain't Irish..." Sadly, this strategy has had very limited applications for me.

 

[ckent]

Something else that I wanted to add to the public speaking arena was that I have found it to be useful to keep track of how many speeches I have given. I used to be really nervous about public speaking too, I took a few 0's in middle school because I wouldn't get in front of the class to read aloud. In med school though, public speaking is an essential part of what you do on a daily basis, whether that be presenting your patients in rounds or making formal presentations on different patient topics. By making most of my "formal" presentations powerpoint presentations and keeping them on my hard drive, I can keep track of the number of presentations that I have completed. Even if you aren't doing powerpoint presentations, you might want to just try jotting down the name of your presentations or akeeping your notes of your past presentations around. This way, it becomes progressively more difficult to panic about something going wrong during your upcoming presentation because you have completed some 40 presentations that you can look over and remind yourself how they all went well. Remember to focus on the positives and how you "got through" your presentation. Also, your perception of how people are interpreting you as a speaker can often be misleading as well. I've found that a lot of people who say that they were nervous and felt like it was obvious that they were nervous and that it didn't look like they knew what they were talking about while giving their presentation don't come off as nervous at all during their presentation. Even if you do come off as nervous, I doubt if your classmates perceive you as the "village idiot" during your presentations too. Most people recognize that some people just get nervous when they are put on the spot, it doesn't mean that they're stupid. You can always ask for feedback from your friends after the presentation to see what they thought too. I agree with the practice before your present reccomendation too, that always helps the pre-presentation and mid-presentation jitters too. Also, don't be discouraged if you don't feel like your improving from presentation to presentation. I remember that it took some 20-30 presentations before I actually noticed that I was no longer even thinking about my presentation until I had to do it. I used to start worrying about presenting months in advance, but now, I might get the jitters just before starting my presentation, but usually not a lot sooner then that.

 

[Blade28]

ckent, that's great advice! Wish I had thought of it.

As with many things in life, it just takes practice. I used to freak out whenever I had to present in conference, in front of 50+ surgeons and all the residents and chiefs (and other med students)...but after a few times, it does get better.

 

[lowbudget]

If you're talking about presenting in small groups or teams where your classmates stay pretty much the same, get to know everyone. (Go out for a couple of drinks or something.) You'll feel more relaxed around them and so when you talk in front of them it feels less formal and more like you're just talking shop with a bunch of friends.

The other thing about talking in front of groups is that you have to know your stuff. Be prepared, be the most knowledgeable person in the room about what you're talking about, and just realize that people are all there to learn and not make you feel insecure.

Majority of people in med school are nice. So just relax and have a good time in class.

 

[PainDr]

The first several times I had to present, I experienced near syncopal episodes! Seriously, it was all I could do to maintain consciousness! LOL! My strategy was to memorize EVERY SINGLE WORD. The other posters are right, the more you do it, the easier it gets. Last week I had to give a formal presentation in front of about 20 attendings and 10-15 residents and I wasn't even nervous. People now ask me how I stay so calm and collected! I know it's painful, but you will become sensitized.😀

 

[velouria]

if i were you, i'd look for a local group like toastmasters. it'll usually be business people, they meet once a month or so (maybe more often), and everyone practices speaking skills by giving talks, hosting meetings, holding impromptu speeches (short ones, like 2 minutes), etc. there's also opportunities for others to give you feedback.
it might sound scary, but how much nicer would it be to get all of your freaking out done in front of a bunch of strangers, then be able to be all smooth in front of your classmates? 🙂

also, places like community colleges and business training centers always have public speaking classes. again, just a way to force you to get some practice in front of people you never have to see again!

good luck!

 

[nutmegs]

Originally posted by daria
Once I did something that worked very well for me, but is not practical with people who know you, hehe. I had to give a talk at an undergraduate research symposium, and was quite nervous. So I did the "go into an empty bathroom and practice in front of a mirror" thing. I wasn't happy with how it sounded, so I tried it in an Irish accent - and whaddaya know, it sounded a lot better. God only knows what got into me, but I gave the talk in an Irish accent. I was so focused on getting the accent right that I didn't have any energy left to devote to being nervous. Went very well, I must say. To this day I wonder how many people were sitting in the audience going "what the heck - I KNOW this girl ain't Irish..." Sadly, this strategy has had very limited applications for me.

this might be the best thing i've read, ever. I fully encourage you to try it sometime, as long as I'm in the audience 😀

 

[leorl]

I don't really have problems public speaking, so not sure if this would work or not. But over here, part of our exams have an oral component (they're called viva's) where the examiner grills you orally. This can cause people to panic because you only have a limited amount of time to show what you know and how well you know it, so in a way it tests how fast you can think and how confident you are with the material. There's an added fear factor in that if you get a question wrong, sometimes the examiner will just murder you. The thing I've found helps is just going through information with classmates orally and have them fire questions at you quickly, and you keep on going over the material all the time, always reiterating. That way you will spit out answers (and know them) without having to think, so that when you get to the point of having to display your knowledge publically, it'll be engrained into your mind. This really works in medicine since nearly everything is pathway-based.

 

[IrishOarsman]

Originally posted by nutmegs
this might be the best thing i've read, ever. I fully encourage you to try it sometime, as long as I'm in the audience 😀

Ditto. That ROCKS. A brogue in a scientific talk by someone who wasn't 50+, w/ a big belly, and a white beard? Precious.

 

[nutmegs]

Originally posted by IrishOarsman
Ditto. That ROCKS. A brogue in a scientific talk by someone who wasn't 50+, w/ a big belly, and a white beard? Precious.

100x better if you know her... so unexpected. BRILLIANT.

 

[DoctorDoom]

One other thing you might try:

Deliver the presentation to your friends in the audience. Focus on them. Look almost entirely at your classmates who are your friends. Remember they aren't there to judge you harshly, they want to hear what you have to say. They are on your side. That will help you relax, and remind you that med school is a collaborative learning effort, so no need for the anxiety! As you get more comfortable you will need to do this less and less. 🙂

Good luck!

 

[NMH2001]

I know that you are against using drugs if at all possible. But if you need to give a speach in front of a group and are really panicky ask your doctor for atenolol. it was the only thing that worked for me. Basically it keeps your heart fom racing and therefore nips the panic symptoms in the bud.

Aside from that definetly check out your local "toastmasters" group. It will give you all the tools and practice you need for overcoming your phobia.

Good luck!

 

[scrupulous79]

beta-blockers like propranolol and atenolol work pretty well...they stop the shaking/tremors and the increased heart rate that come with "stage fright".....also, when people take it in certain settings, once they've spoken a few times in that setting without tremors, they often won't need the propranolol anymore.....so its potentially a good way to solve your problem if nothing else seems to work....kinda like training wheels on a bicycle.....also, repetition couldn't hurt either.....practicing and reciting over and over again (verbatim) helps because you'll feel less like you're being put on the spot when you speak and you'll be a lot more sure of yourself (beta blockers will stop the shaking but won't give you the words if you are unsure of yourself).....after a few successes with speaking before others, the whole thing will be much less of a problem for you

 

[Lorraine]

wow - so i'm not the only one who feels like that?!!? seriously, it's strange but i started developing public speaking anxiety in college, i don't know why, but like you described happened to me whenever i gave honors seminar talks to the point i dropped out of upper division honors because i would get so nervous that i couldn't sleep for months thinking about it! and when i got to med school, I was scared that third year I would drop out - but i'm still here and i must admit that the only i got through was to learn biofeedback. It's almost like i am able to control the panic response - i still get nervous but it's like i can keep it in check instead of driving myself to the point of tears while presenting (which i came close to in the beginning after continuously trying to swallow my pride literally!) What works for me is if I am one-on-one because i don't have so many eyes on me - I love it when it's just me and the attending! If I know I have to present to a big crowd, I practice and even then, I always have something like a pen in my hand and i just try and focus on myself twiddling it or something so my mind doesn't start to panic. btw, practice does desensitize you too! most of the time you can't even prepare so just focus on what you need to say and that consumes much of your energy that you don't have time to worry. cheers, we can't let social anxiety keep us back!

 

[Wrigleyville]

Just gotta practice. It is a skill like anything else.