In my final year, all exams done, and I feel completely incompetent.

[Cordic]

I'm honestly not sure where to put this, but it is hard to open up and vent elsewhere, so...

I'm an Australian medical student, and I'm in the final year of my degree. Our final examination was last year, and I scored slightly above the class average, so... Yay? (to explain: we do three years undergrad / premed, two preclin, an intensive clinical year, our final examination, and then a full year of on-wards assessment (where I am now ) )

But the thing is, I've just started an elective placement in a large general practice... And I feel completely and utterly useless. And stupid. And all manner of other things.

I get to parallel consult which is great, but... So often, I hit things that I just never was taught about (perhexaline associated neuropathy, for example) , or that I learned, for my exams last year, but haven't used in practice since and have forgotten.

On previous rotations, I've always been able to revise and study the area and know at least the common and 'red flag' presentations... But here, when I'm being exposed to so many different things, I'm just feeling overwhelmed. I've been doing stupid things like mistaking mildly inflamed glue ear with OME, or forgetting acceptable variances in PSA levels, or even forgetting that I need to get urine protein and albumin for a patient with slowly declining renal function. I just can't help but think that the GP I'm with (who is amazing) must think I'm the most inept medical student ever. Nobody ever says anything, but I just feel as if I'm almost too dangerous to be where I am in my degree.

I just have to ask... How do others cope with these feelings? What can I do to get ontop of and deal with the sheer variance associated with a GP placement, where it is so hard to study for what you might expect to see?

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[Serous Demilune]

Well we don't use perhexiline here in the US so we can't relate to what you're going through...

But seriously, you're a medical student. You aren't supposed to know how to diagnose and treat every single thing that comes across your path. And I bet your not even thinking about the 95% of cases you see that are simple and your nailing. And that's also exactly why there's a three year residency for family medicine after medical school (at least in the US). So if you're not getting negative feedback, you're probably fine. Relax and enjoy your test-free year!

 

[TraumaLlamaMD]

I think the best way to give yourself a broad, varied knowledge base is to pay attention and see a broad, varied range of patients - which is what it sounds like you're doing now. As long as you learn from each mistake and remember what to do the next time you see a patient in a similar situation, it sounds like time well-spent.

(Ha, I've also never heard the term "glue ear" before, and was hoping you didn't mean someone put a hot glue gun in their ear or something!)

 

[22031 Alum]

Not Australian, but it seems like you are exactly where you need to be at this point in training. You may feel like your mistakes are dumb, but as long as they are not careless, and you are learning from them, you're fine.

 

[cabinbuilder]

We have all felt that way. It gets better. An Internist friend once told me that becoming a doctor is like forming an onion. You learn in layers and when the layers are complete you are ready to practice. Just know that you cannot know everything. No one can. Just be aware of what you don't know and look it up. Always make sure that your decisions don't jeopardize care of the patient. You will get the hang of it.