I don't feel ready for residency (re: did I do 4th year wrong?)

[Seaunicorn]

I finally made an account on here because I've been feeling down since submitting my rank list. It hit me that I'm going to be a doctor in months and I'm wondering who in the he** decided this was a good idea?! I don't feel ready at all. I tried to commiserate with my best bud at school today, thinking that I'm probably not alone in this. Unfortunately his response was essentially, "You're fine. BTW, today I corrected my attending regarding management of an ICU patient. Look how smart we are!"

Today I forgot how to reverse warfarin vs heparin. Suffice it to say that his response did NOT make me feel better.

I'm an average student overall at a US MD school: <230 step 1, average step 2, passed CS first try, top 1/3 of students for class rank. That said, I can't shake the feeling that I've somehow tricked people into thinking I'm smarter than I am. I feel like I've spent 4 years hiding what an idiot I actually am. One of my biggest concerns is that didn't try hard enough, and that I somehow didn't learn enough on clerkships. I always passed the shelves (average scores) and got good to strong evals. But I also feel like as a 3rd year and sub-i, I worked pretty hard to try to look good on the floors, which didn't always make for the best learning. Admissions would scare me because I didn't want to look like an idiot. I tried to do the best I could with the patients I had and not get overloaded so I wouldn't look bad. Things like that.

I've also recently become concerned that my 4th year has been too chill. I started out the year with Ck, sub-i, and a month of radiology elective. Then I essentially did nothing clinical from mid-october to Jan in order to focus on applications/interviews. Since Jan, the only clinical stuff I've done has been 4 weeks of heme 'cause I like it and now I'm getting ready to start EM clerkship, nephrology, ID, and cards.

To summarize the feelings I've been having lately:
1) Been worrying that I'm going to get fired from residency/perform poorly
2) Scared that I don't know medicine anymore - been awhile since sub-i and CK and any real patient responsibility. I feel like I don't even remember how to present/do an exam.
3) Scared that I'm going to fail my upcoming EM clerkship because of said medical ineptitude.
4) Scared that I'm going to be an awful doctor. I'm going into IM and I still get scared working up new patients. Medicine is just so broad, I wonder if I'll ever be good at it.

Sorry for such a whiny post. I just was hoping my elders/peers might have some advice. I so badly want to feel a little excited about residency but right now all I feel is dread.

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[Raryn]

You'll be fine.

No one expects the interns to know much of anything in July. All that knowledge is somewhere in the back of your mind but the purpose of residency is to connect the dots and solidify it. Just be able to take a history, follow instructions, and read up on your patients. The rest will follow with some time.

 

[McNCheese]

Your 4th year actually sounds more useful than most! I'm also in my 4th year. I did nothing clinical between September and February, and I'm finishing my EM clerkship tomorrow. I was positive I'd forgotten everything, but I was surprised at how much came back.

And to make you feel better about your schedule, I have a non-clinical elective next month and then I am done until intern year. Surely you are going to pick up some useful skills on those last few rotations you have!

Everyone is nervous, so don't stress too much. I've talked about this with many friends and they all express the same doubts.

Sent from my Nexus 5X using SDN mobile

 

[Domperidone]

It's not whiny at all.
Actually, what you're feeling is normal and universal.
Probably better to be scared than overly confident (potentially reckless).
It's okay to not know everything, and it's okay for you to be asking questions when you do start, even about the most trivial things like doses.

I knew people who didn't start to feel a sense of dread until the week before. Also knew people who started to feel it the first week on the job. At least you're dealing with it now? You probably won't feel fine about it for a while, that takes time.

Generally expectations are low that first rotation, particularly the first weeks in. You won't be the first intern starting their very first rotation ever either, so everyone will know what to anticipate. They won't give you massive responsibilities beyond your level, actually most of what you'll do is paperwork or scut (nice and simple). As long as you work hard (which fear is a good motivator for), people will notice and appreciate that you're making an effort and taking it seriously.

Matters more how you improve over time, not how you start necessarily.

 

[da8s0859q]

I tried to commiserate with my best bud at school today, thinking that I'm probably not alone in this. Unfortunately his response was essentially, "You're fine. BTW, today I corrected my attending regarding management of an ICU patient. Look how smart we are!"

1. You're fine. You will be fine. You're not the first. You won't be the last.

2. If your paraphrased tone is the same as your best bud's actual tone in whatever he said, he has absolutely no clue what he doesn't know, and he's the exact kind of resident/student I don't want on my shifts as an ED attending. So don't worry there, either.

 

[backcountryrez]

I agree completely with the above. You will do just fine. BTW, I am a PGY1.

I have an attending who has taken me on as her "personal project" because I was (in her words) a cowboy and dove into everything headfirst.

It's okay to defer during your intern year and take on the roles your mentors would have you take. I consider residency an extension of my MS years since I am still learning, and as you move on in years, you will over analyze past scenarios and wonder what you could/would have done better.

It's normal! What you have basically told us is that you will be a great doctor in the future!

 

[TUGM]

Seriously: enjoy as much of the remainder of your fourth year you have. You will cherish those memories, and those will carry you through the rest of residency, which is going to be tough, regardless of your specialty of choice.

As an intern, no one will expect you to know anything, except you will excel if you can get a pertinent history and do a proper general physical examination that can be reliably reproduced. If you are really stressed about it, read some treatment guidelines for bread and butter diseases you will be treating, and that'll either have you relax subconsciously or make you fall asleep, both of which will be beneficial.

I agree, better to have a scared intern who is going to be meticulous than an over confident one who is going to be reckless.

 

[ProfMD]

You'll be fine. What you are experiencing is normal. And, spoiler alert, when you finish residency, you'll be nervous about being an attending.

 

[rokshana]

1. You're fine. You will be fine. You're not the first. You won't be the last.

2. If your paraphrased tone is the same as your best bud's actual tone in whatever he said, he has absolutely no clue what he doesn't know, and he's the exact kind of resident/student I don't want on my shifts as an ED attending. So don't worry there, either.

agree with this...to the OP, i too would rather have someone like you as my intern rather than your friend...his arrogance will ultimately hurt a patient...hopefully he changes his tune.

 

[Psai]

You're doing just fine. I felt the same way as did most of my peers.

 

[Seaunicorn]

Thanks everyone. I had a little panic moment again after seeing some SDN post about a resident not getting their contract renewed so I think I've just gotta avoid looking at stuff like that. I really appreciate hearing that I'm relatively normal in these fears though.

 

[Ismet]

Echoing what has already been said, you'll be fine. You'll always be nervous for the next step, but a bit of nerves is much better than overconfidence. There will always be stuff you don't know, and it's okay to not know things or forget things or need a refresher. And if your friend really said something like that, I'd much rather have you as an intern than him.

Heck when I started intern year, I couldn't fathom how in a year I'd be a senior supervising other interns. Still nervous for July 1 but it's amazing what a difference 8 months of intern year makes in that mentality.

It'll be fine!

 

[Raryn]

Thanks everyone. I had a little panic moment again after seeing some SDN post about a resident not getting their contract renewed so I think I've just gotta avoid looking at stuff like that. I really appreciate hearing that I'm relatively normal in these fears though.

The 95%+ of residents who get through without any issues whatsoever don't post long stories on SDN about it. We just get the few basketcases that stick out.

 

[J ROD]

Yeah, we all feel that way. Like we are not prepared and then most of us do just fine.

However, most of us do not post such a post....sounds like some borderline traits coming out.

 

[MediCane2006]

Everyone has already said it, but do not worry. (Obviously you are going to worry, we all did). I was the intern (and subsequent resident) who was convinced I was somehow sliding by because literally everyone was smarter than me. As it turns out, that feeling is good. It motivates you to double check things, read at night when you go home, internalize constructive feedback because you KNOW you need to get better (as opposed to feeling everyone is out to get you).

Don't lose that feeling. It's the humility that keeps us honest as doctors, reminds us that we are not necessarily the smartest person in the room, and motivates us to always get better.

 

[Seaunicorn]

The 95%+ of residents who get through without any issues whatsoever don't post long stories on SDN about it. We just get the few basketcases that stick out.

Don't lose that feeling. It's the humility that keeps us honest as doctors, reminds us that we are not necessarily the smartest person in the room, and motivates us to always get better.

Good points. Thanks again. If you all are any indication, I'm gonna have a great bunch of seniors to look up to/work with next year

 

[Bartelby]

These feelings are so common among professionals they have a name: imposter syndrome. As everyone has said, don't worry. Until you hit the wards and start developing the skills to manage a floor (under *supervision*), of course you will not feel comfortable about doing so.

 

[JP2740]

Sounds better than my 4th year

 

[CypherA]

If anything you might even be more prepared. I know the 4th years at my med school only have 1 rotation left and will be done by the end of the month. You, on the other hand, have 4 more rotations so you should feel somewhat fresh with the material by time intern year starts (assuming your last rotation finishes up in May)

 

[Seaunicorn]

(assuming your last rotation finishes up in May)

Actually am done done at the end of April. And I had a 4 month hiatus from anything clinical at all. Really it was 5 months because radiology was basically a holiday.

Didn't want any other 4th years reading this and feeling bad!

 

[zyx189]

Have not done anything since September... had advanced medicine last block which confirmed that I don't remember ****. Now I'm practically off again until graduation in April.

In short, I have succumbed to the fact that I will be suckiest intern of all time.

 

[studyaholic]

I finally made an account on here because I've been feeling down since submitting my rank list. It hit me that I'm going to be a doctor in months and I'm wondering who in the he** decided this was a good idea?! I don't feel ready at all. I tried to commiserate with my best bud at school today, thinking that I'm probably not alone in this. Unfortunately his response was essentially, "You're fine. BTW, today I corrected my attending regarding management of an ICU patient. Look how smart we are!"

Today I forgot how to reverse warfarin vs heparin. Suffice it to say that his response did NOT make me feel better.

I'm an average student overall at a US MD school: <230 step 1, average step 2, passed CS first try, top 1/3 of students for class rank. That said, I can't shake the feeling that I've somehow tricked people into thinking I'm smarter than I am. I feel like I've spent 4 years hiding what an idiot I actually am. One of my biggest concerns is that didn't try hard enough, and that I somehow didn't learn enough on clerkships. I always passed the shelves (average scores) and got good to strong evals. But I also feel like as a 3rd year and sub-i, I worked pretty hard to try to look good on the floors, which didn't always make for the best learning. Admissions would scare me because I didn't want to look like an idiot. I tried to do the best I could with the patients I had and not get overloaded so I wouldn't look bad. Things like that.

I've also recently become concerned that my 4th year has been too chill. I started out the year with Ck, sub-i, and a month of radiology elective. Then I essentially did nothing clinical from mid-october to Jan in order to focus on applications/interviews. Since Jan, the only clinical stuff I've done has been 4 weeks of heme 'cause I like it and now I'm getting ready to start EM clerkship, nephrology, ID, and cards.

To summarize the feelings I've been having lately:
1) Been worrying that I'm going to get fired from residency/perform poorly
2) Scared that I don't know medicine anymore - been awhile since sub-i and CK and any real patient responsibility. I feel like I don't even remember how to present/do an exam.
3) Scared that I'm going to fail my upcoming EM clerkship because of said medical ineptitude.
4) Scared that I'm going to be an awful doctor. I'm going into IM and I still get scared working up new patients. Medicine is just so broad, I wonder if I'll ever be good at it.

Sorry for such a whiny post. I just was hoping my elders/peers might have some advice. I so badly want to feel a little excited about residency but right now all I feel is dread.

I matched, and then now that it sunk in...I'm scared too. Actually, it came up in one of my interviews...and the program director told me "You'll always feel this way...I feel this way...you just learn to be comfortable with that feeling." It was re-assuring, and he said "It's one thing you can't teach...compassion, and that's what you have."

I think we're going to be extra careful b/c we're scared...and we'll ensure our patient's best interest first. I'm just studying Step 3 now, and reviewing just basics...We got this!

 

[docdionne]

I finally made an account on here because I've been feeling down since submitting my rank list. It hit me that I'm going to be a doctor in months and I'm wondering who in the he** decided this was a good idea?! I don't feel ready at all. I tried to commiserate with my best bud at school today, thinking that I'm probably not alone in this. Unfortunately his response was essentially, "You're fine. BTW, today I corrected my attending regarding management of an ICU patient. Look how smart we are!"

Today I forgot how to reverse warfarin vs heparin. Suffice it to say that his response did NOT make me feel better.

I'm an average student overall at a US MD school: <230 step 1, average step 2, passed CS first try, top 1/3 of students for class rank. That said, I can't shake the feeling that I've somehow tricked people into thinking I'm smarter than I am. I feel like I've spent 4 years hiding what an idiot I actually am. One of my biggest concerns is that didn't try hard enough, and that I somehow didn't learn enough on clerkships. I always passed the shelves (average scores) and got good to strong evals. But I also feel like as a 3rd year and sub-i, I worked pretty hard to try to look good on the floors, which didn't always make for the best learning. Admissions would scare me because I didn't want to look like an idiot. I tried to do the best I could with the patients I had and not get overloaded so I wouldn't look bad. Things like that.

I've also recently become concerned that my 4th year has been too chill. I started out the year with Ck, sub-i, and a month of radiology elective. Then I essentially did nothing clinical from mid-october to Jan in order to focus on applications/interviews. Since Jan, the only clinical stuff I've done has been 4 weeks of heme 'cause I like it and now I'm getting ready to start EM clerkship, nephrology, ID, and cards.

To summarize the feelings I've been having lately:
1) Been worrying that I'm going to get fired from residency/perform poorly
2) Scared that I don't know medicine anymore - been awhile since sub-i and CK and any real patient responsibility. I feel like I don't even remember how to present/do an exam.
3) Scared that I'm going to fail my upcoming EM clerkship because of said medical ineptitude.
4) Scared that I'm going to be an awful doctor. I'm going into IM and I still get scared working up new patients. Medicine is just so broad, I wonder if I'll ever be good at it.

Sorry for such a whiny post. I just was hoping my elders/peers might have some advice. I so badly want to feel a little excited about residency but right now all I feel is dread.

This is like it came from my actual brain. I feel the exact same! What even is a stethoscope?
But we'll pick it up again, I think. Like riding a $400,000 bike.

 

[Radignator]

I did not feel ready on day 1 of internship and neither did any of my co-interns. The bar is very low when you start out and the assumption is that you know nothing. Work hard, be pleasant, and you will pick up what you need to know quickly.

 

[bannie22]

You dont have to think in intern year. You are just a glorified scut monkey. So dont worry too much. You will get there.