Inattentive ADHD, trouble memorizing, and Residency

[HonestAbe04]

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Hi everyone,

New here, decided to post to see if anyone else has anything to suggest? This is going to be long but I need to provide some background

I am a PGY-2 PMR resident. I feel like I scammed undergrad, did below average on the MCAT somehow got into a US medical school, scammed that by barely passing my tests, did below average on Step1 and 2, got into residency. Finished my transitional year, barely passed step 3. Now I'm starting my real residency and I feel like a huge scam artist!

I seriously have such huge problems with just sitting down and studying. I can't ever pay attention at noon conference or any other lecture. During medical school I had to watch everything double speed and even that I couldnt handle so I started to just read coursepack. Here are a few symptoms:
1. I feel overwhelmed in presenting multiple patients without first completing the note. Especially when I'm getting slammed on call or presenting in the AM. I try coming extra early but I have such tremendous organization problems

2. I seriously can't pay attention. WHen patients talk to me or when I have to listen in lecture I feel like I am zoning out unless Im super interested which is rare. I almost can hear myself having conversations with myself. And I get bored SUPER easily and figitty which has been present my whole life

3. I was a great student when I was younger and I did poorly in high school mostly because I didn't care and wasnt mature. In undergrad I did very well initially and then started to taper off towards the end. Medical school required too much organization and memorizing and sitting for long periods that I couldnt handle it. A lot of people who I out preformed my entire life were now doing so much better than me and I couldnt explain it

4. I can't memorize anything. I wish I could read and just have facts stick but it just doesnt. Anatomy was the hardest class ever for me, so was pharmacology. Strangely the subjects that I felt took least amount of memorization like Acid Base stuff, endocrinology, cardiology and some components of neurology were the easiest for me and the toughest for others.

5. I have a tremendous fear of failure and take critisicm very personally. This is why I hate presenting patients. I feel like all this lack of confidence has led to anxiety which has left me feeling stuck that eventually itll be found out that I don't know anything and I just barely got by and managed to become a physician.

I tried making lifestyle changes by sleeping more, exercising a lot, various changes in study habits but nothing has worked. I remember hating memorizing things since i was a little kid from the time I was in 4th grade i HATED classroom plays because I could never memorize the lines. I always hated foreign language courses for that same reason. I loved math, history, physics even.

After reading a definition of inattentive ADHD I feel like its describing me PERFECTLY! I have some comorbidities like anxiety issues including several bouts with panic attacks, and tricholotomania.

EVeryone in medical school seemed to have been taking adderall or some kind of supplements to get by. I feel like it would just drive my anxiety through the roof so I dont even want to mess around. I know there are things like Straterra but I don't want to be restricted from drinking and always be worried about interactions. It also has reportedly caused suicidal ideation which is too weird for me....

I want to go get checked out by a psychiatrist.... but before that any advice for me?! I am in desperate need of help because I feel like quitting residency everyday. I can't take the stress. Its not even the work load or the hours I care about. I just constantly feel stressed liek im being judged and its gonna be caught on that I dont know what Im doing and that I scammed everyone.

I just want to excel in my life again. In undergrad I was in the top 15% and I just want to feel like that again. I hate feeling like this and I can't concentrate ever. Even in the most crucial of situation my mind wanders and I can hear myself talking to my inner voice.

THANKS!!!

 

[shopsteward]

Hi everyone,

New here, decided to post to see if anyone else has anything to suggest? This is going to be long but I need to provide some background

I am a PGY-2 PMR resident. I feel like I scammed undergrad, did below average on the MCAT somehow got into a US medical school, scammed that by barely passing my tests, did below average on Step1 and 2, got into residency. Finished my transitional year, barely passed step 3. Now I'm starting my real residency and I feel like a huge scam artist!

I seriously have such huge problems with just sitting down and studying. I can't ever pay attention at noon conference or any other lecture. During medical school I had to watch everything double speed and even that I couldnt handle so I started to just read coursepack. Here are a few symptoms:
1. I feel overwhelmed in presenting multiple patients without first completing the note. Especially when I'm getting slammed on call or presenting in the AM. I try coming extra early but I have such tremendous organization problems

2. I seriously can't pay attention. WHen patients talk to me or when I have to listen in lecture I feel like I am zoning out unless Im super interested which is rare. I almost can hear myself having conversations with myself. And I get bored SUPER easily and figitty which has been present my whole life

3. I was a great student when I was younger and I did poorly in high school mostly because I didn't care and wasnt mature. In undergrad I did very well initially and then started to taper off towards the end. Medical school required too much organization and memorizing and sitting for long periods that I couldnt handle it. A lot of people who I out preformed my entire life were now doing so much better than me and I couldnt explain it

4. I can't memorize anything. I wish I could read and just have facts stick but it just doesnt. Anatomy was the hardest class ever for me, so was pharmacology. Strangely the subjects that I felt took least amount of memorization like Acid Base stuff, endocrinology, cardiology and some components of neurology were the easiest for me and the toughest for others.

5. I have a tremendous fear of failure and take critisicm very personally. This is why I hate presenting patients. I feel like all this lack of confidence has led to anxiety which has left me feeling stuck that eventually itll be found out that I don't know anything and I just barely got by and managed to become a physician.

I tried making lifestyle changes by sleeping more, exercising a lot, various changes in study habits but nothing has worked. I remember hating memorizing things since i was a little kid from the time I was in 4th grade i HATED classroom plays because I could never memorize the lines. I always hated foreign language courses for that same reason. I loved math, history, physics even.

After reading a definition of inattentive ADHD I feel like its describing me PERFECTLY! I have some comorbidities like anxiety issues including several bouts with panic attacks, and tricholotomania.

EVeryone in medical school seemed to have been taking adderall or some kind of supplements to get by. I feel like it would just drive my anxiety through the roof so I dont even want to mess around. I know there are things like Straterra but I don't want to be restricted from drinking and always be worried about interactions. It also has reportedly caused suicidal ideation which is too weird for me....

I want to go get checked out by a psychiatrist.... but before that any advice for me?! I am in desperate need of help because I feel like quitting residency everyday. I can't take the stress. Its not even the work load or the hours I care about. I just constantly feel stressed liek im being judged and its gonna be caught on that I dont know what Im doing and that I scammed everyone.

I just want to excel in my life again. In undergrad I was in the top 15% and I just want to feel like that again. I hate feeling like this and I can't concentrate ever. Even in the most crucial of situation my mind wanders and I can hear myself talking to my inner voice.

THANKS!!!

Self-diagnosis unchecked by independent advice is rarely a good idea. If you think you have a medical problem that you can't solve yourself, it's best to go to your PCP or a recommended psychiatrist to get their input. They might not suggest medication but something else, suggest a medication you haven't thought of, suggest ways of dealing with any side-effects you haven't thought of, or even say you don't have a medical problem at all. You won't know until you see someone who is qualified to help you.

You seem to have a habit (school, undergrad) of starting strong and finishing more weakly. You need to look at this as a habit of finishing rather than giving up, and give yourself credit for that. You just need to make sure that your habit of finishing carries on through to the end of your residency.

If you are anxious about your performance in residency, find someone in your residency you trust (residency adviser, trusted attending, chief resident) to talk to about your concerns, ask for an informal evaluation of your performance, and give you tips to help you. In nearly all workplaces there are people who are happy to help someone who genuinely tries hard and wants to improve, you just need to find them and then start talking to them.

Keep an eye on your formal evaluations. If they do start showing that the program has any concerns, deal with them immediately and make sure the program knows you are dealing with them.

Finally, please try to forget any idea that "in undergrad I was in the top 15% and want to feel like that again" or "people I outperformed all my life were now doing so much better than me". Undergrad was years ago, and is irrelevant to who you are now. So is who was where on med school ranking lists. Excelling for you now, as an adult professional, is about feeling good in yourself and making your contribution to society, it is not about your mythical place on an artificial ranking list of people you used to know when you were younger. I know far too many people for whom the highlight of their life was making it into [insert prestigious undergrad or grad school]. That's fine for someone in their twenties, but becomes progressively sadder as they move through their thirties, forties, fifties... Please don't become one of them.

 

[thesauce]

OP: All of this sounds normal. Everyone has difficulty paying attention to boring reading and lecture material. Sounds like you've adapted as the need arises - keep it up, work hard, and you'll be through it before you know it.

 

[Law2Doc]

OP: All of this sounds normal. Everyone has difficulty paying attention to boring reading and lecture material. Sounds like you've adapted as the need arises - keep it up, work hard, and you'll be through it before you know it.

Agreed. Most people who get through advanced education anywhere in the bottom 80% of their classes feel like they more or less scammed their way through without the same grasp or attentiveness of the other 20% who really know what's going on. So basically most doctors are scam artists. But they are elite scam artist -- most people get weeded out by college. Trying to diagnoses yourself with a disorder, despite having worked the system to a very highly advanced point, is pretty much a cop out.

 

[CDI]

OP sounds like me.

Hell of a hard time focusing a few hours at a time. Cant even do an entire UW block without getting distracted. Slid by my whole life in advanced/honors/etc. Not sure if dumbest of the smart kids, or smartest of the dumb kids.

Damn Imposter Syndrome...

 

[RadOncDoc21]

I definitely agree with the prior posts. I think as we get older, especially during residency we learn to focus on what's important and spend less time reading. I feel the same way, got by to do just good enough to maintain an adequate level of efficiency without stellar results. If you had any significant problems it would have shown already and prevented you from succeeding... Congrats on being a "wingman" it takes skill to do what you do!

 

[Buzz Me]

Please don't self-diagnose. Seek some professional help if you actually feel like you have some mental health issues. I would recommend NOT staying within your residency program's hospitals, though. Go to an outside facility where your records will stay confidential.

 

[Diagnose]

#Psychiatry consult #Stat

 

[Law2Doc]

#Psychiatry consult #Stat

Please. He doesn't need psych. And certainly not stat. Who among us hasn't had a time where we didn't come up short on an exam we thought we had prepared well for, or weren't jealous of others who seem to learn/retain things so much quicker and more effortlessly, or feel like our mind wanders during things we ought to be attentive in, and secretly wonder if we aren't suffering from an extremely mild attention or learning disability? the truth of the matter is that if you made it halfway through residency already, anyone who diagnoses you with an attention or learning disorder is highly sketchy. Diagnosing a grade school kid who can't progress and is lagging behind his peers is one thing, but diagnosing a resident who continues to progress on schedule is something totally different. I think most of what the OP describes is well within the range of normal professional anxiety.

 

[CDI]

Please. He doesn't need psych. And certainly not stat. Who among us hasn't had a time where we didn't come up short on an exam we thought we had prepared well for, or weren't jealous of others who seem to learn/retain things so much quicker and more effortlessly, or feel like our mind wanders during things we ought to be attentive in, and secretly wonder if we aren't suffering from an extremely mild attention or learning disability? the truth of the matter is that if you made it halfway through residency already, anyone who diagnoses you with an attention or learning disorder is highly sketchy. Diagnosing a grade school kid who can't progress and is lagging behind his peers is one thing, but diagnosing a resident who continues to progress on schedule is something totally different. I think most of what the OP describes is well within the range of normal professional anxiety.

I can't wait till I'm half way through residency so I can be cured of my ailment.

 

[Top Gun]

Please. He doesn't need psych. And certainly not stat. Who among us hasn't had a time where we didn't come up short on an exam we thought we had prepared well for, or weren't jealous of others who seem to learn/retain things so much quicker and more effortlessly, or feel like our mind wanders during things we ought to be attentive in, and secretly wonder if we aren't suffering from an extremely mild attention or learning disability? the truth of the matter is that if you made it halfway through residency already, anyone who diagnoses you with an attention or learning disorder is highly sketchy. Diagnosing a grade school kid who can't progress and is lagging behind his peers is one thing, but diagnosing a resident who continues to progress on schedule is something totally different. I think most of what the OP describes is well within the range of normal professional anxiety.

OK, I'm pretty sure what Diagnose said about the stat psych consult was sarcasm.

 

[username456789]

Please. He doesn't need psych. And certainly not stat.

facepalm.jpg

 

[VCorp]

OP sounds like me.

Hell of a hard time focusing a few hours at a time. Cant even do an entire UW block without getting distracted. Slid by my whole life in advanced/honors/etc. Not sure if dumbest of the smart kids, or smartest of the dumb kids.

Damn Imposter Syndrome...

lol this post sums me up right here...

 

[Raryn]

I can't wait till I'm half way through residency so I can be cured of my ailment.

No, what's he's saying is if you're functional enough you managed to make it through 22 years of formal education/training without picking up a diagnosis, you're functional enough to not legitimately get said diagnosis.

 

[CDI]

No, what's he's saying is if you're functional enough you managed to make it through 22 years of formal education/training without picking up a diagnosis, you're functional enough to not legitimately get said diagnosis.

I know, I was just joking.

 

[Law2Doc]

No, what's he's saying is if you're functional enough you managed to make it through 22 years of formal education/training without picking up a diagnosis, you're functional enough to not legitimately get said diagnosis.

Bingo.

 

[VentJockey]

No, what's he's saying is if you're functional enough you managed to make it through 22 years of formal education/training without picking up a diagnosis, you're functional enough to not legitimately get said diagnosis.

That's just not true. It is perfectly possible that he could have ADHD, and also have such a high IQ that he has up till now been able to compensate for it. It doesn't mean he doesn't have the underlying disorder.

These things are quite complicated, and I wouldn't dream of ruling it in or out based on a few posts on an internet message board. If the OP thinks he's got a problem, and is distressed enough to go see a psychiatrist about it, then for him, its a real problem.

So my advice for the OP: if its a big deal to you, go see a psychiatrist and solicit their expert opinion. My guess is that even if they don't think you are a candidate for medication, they probably have some useful advice for you.

 

[Diagnose]

Please. He doesn't need psych. And certainly not stat. Who among us hasn't had a time where we didn't come up short on an exam we thought we had prepared well for, or weren't jealous of others who seem to learn/retain things so much quicker and more effortlessly, or feel like our mind wanders during things we ought to be attentive in, and secretly wonder if we aren't suffering from an extremely mild attention or learning disability? the truth of the matter is that if you made it halfway through residency already, anyone who diagnoses you with an attention or learning disorder is highly sketchy. Diagnosing a grade school kid who can't progress and is lagging behind his peers is one thing, but diagnosing a resident who continues to progress on schedule is something totally different. I think most of what the OP describes is well within the range of normal professional anxiety.

I do suggest a psych consult.
Stat: that's not even possible at most places.

Are you a psychiatrist? This person self-diagnosed themselves with in attentive ADHD and shared it on a SDN forum. Dear OP, I suggest you see an expert and not a lawyer med student.

 

[Buzz Me]

Dear OP, I suggest you see an expert and not a lawyer med student.

Just FYI, Law2Doc isn't a med student.

 

[SomeDoc]

There's no harm in seeing a psychiatrist. If it's affecting your ability to function, it's probably a good idea to get things checked out and managed before they get worse. It would also be a good idea to see someone outside the program's network.

 

[SomeDoc]

That's just not true. It is perfectly possible that he could have ADHD, and also have such a high IQ that he has up till now been able to compensate for it. It doesn't mean he doesn't have the underlying disorder.

These things are quite complicated, and I wouldn't dream of ruling it in or out based on a few posts on an internet message board. If the OP thinks he's got a problem, and is distressed enough to go see a psychiatrist about it, then for him, its a real problem.

So my advice for the OP: if its a big deal to you, go see a psychiatrist and solicit their expert opinion. My guess is that even if they don't think you are a candidate for medication, they probably have some useful advice for you.

Well said.

 

[Medstart108]

Hi everyone,

New here, decided to post to see if anyone else has anything to suggest? This is going to be long but I need to provide some background

I am a PGY-2 PMR resident. I feel like I scammed undergrad, did below average on the MCAT somehow got into a US medical school, scammed that by barely passing my tests, did below average on Step1 and 2, got into residency. Finished my transitional year, barely passed step 3. Now I'm starting my real residency and I feel like a huge scam artist!

I seriously have such huge problems with just sitting down and studying. I can't ever pay attention at noon conference or any other lecture. During medical school I had to watch everything double speed and even that I couldnt handle so I started to just read coursepack. Here are a few symptoms:
1. I feel overwhelmed in presenting multiple patients without first completing the note. Especially when I'm getting slammed on call or presenting in the AM. I try coming extra early but I have such tremendous organization problems

2. I seriously can't pay attention. WHen patients talk to me or when I have to listen in lecture I feel like I am zoning out unless Im super interested which is rare. I almost can hear myself having conversations with myself. And I get bored SUPER easily and figitty which has been present my whole life

3. I was a great student when I was younger and I did poorly in high school mostly because I didn't care and wasnt mature. In undergrad I did very well initially and then started to taper off towards the end. Medical school required too much organization and memorizing and sitting for long periods that I couldnt handle it. A lot of people who I out preformed my entire life were now doing so much better than me and I couldnt explain it

4. I can't memorize anything. I wish I could read and just have facts stick but it just doesnt. Anatomy was the hardest class ever for me, so was pharmacology. Strangely the subjects that I felt took least amount of memorization like Acid Base stuff, endocrinology, cardiology and some components of neurology were the easiest for me and the toughest for others.

5. I have a tremendous fear of failure and take critisicm very personally. This is why I hate presenting patients. I feel like all this lack of confidence has led to anxiety which has left me feeling stuck that eventually itll be found out that I don't know anything and I just barely got by and managed to become a physician.

I tried making lifestyle changes by sleeping more, exercising a lot, various changes in study habits but nothing has worked. I remember hating memorizing things since i was a little kid from the time I was in 4th grade i HATED classroom plays because I could never memorize the lines. I always hated foreign language courses for that same reason. I loved math, history, physics even.

After reading a definition of inattentive ADHD I feel like its describing me PERFECTLY! I have some comorbidities like anxiety issues including several bouts with panic attacks, and tricholotomania.

EVeryone in medical school seemed to have been taking adderall or some kind of supplements to get by. I feel like it would just drive my anxiety through the roof so I dont even want to mess around. I know there are things like Straterra but I don't want to be restricted from drinking and always be worried about interactions. It also has reportedly caused suicidal ideation which is too weird for me....

I want to go get checked out by a psychiatrist.... but before that any advice for me?! I am in desperate need of help because I feel like quitting residency everyday. I can't take the stress. Its not even the work load or the hours I care about. I just constantly feel stressed liek im being judged and its gonna be caught on that I dont know what Im doing and that I scammed everyone.

I just want to excel in my life again. In undergrad I was in the top 15% and I just want to feel like that again. I hate feeling like this and I can't concentrate ever. Even in the most crucial of situation my mind wanders and I can hear myself talking to my inner voice.

THANKS!!!

You probably have ADHD, I have similar things to you but milder. I feel like ADHD is really just one end of a spectrum in development. You have very calm and attentive people and then you have people all throughout the scale and eventually at the extreme end you have inattentive and hyperactive people.

I'm someone who probably has problems but mild enough that i have compensated and more or less dealt with most. I think you should really go get checked out and maybe start dealing with it.

The problem with adderall abuse is when people who don't have ADHD take it, not when people who have ADHD take it.

 

[thesauce]

You probably have ADHD, I have similar things to you but milder. I feel like ADHD is really just one end of a spectrum in development. You have very calm and attentive people and then you have people all throughout the scale and eventually at the extreme end you have inattentive and hyperactive people.

I'm someone who probably has problems but mild enough that i have compensated and more or less dealt with most. I think you should really go get checked out and maybe start dealing with it.

The problem with adderall abuse is when people who don't have ADHD take it, not when people who have ADHD take it.

LOL. This reminded me of a quote from this article:

http://www.csmonitor.com/Commentary/Opinion/2010/0819/ADHD-Has-this-diagnostic-fad-run-its-course

"What started out as a theory articulated by professionals is now an urban legend. Parents, teachers, talk show hosts, friends, neighbors and even the person you’re standing next to in the grocery store each believe that they can diagnose and treat ADHD."

 

[prometheus09]

Hi everyone,

New here, decided to post to see if anyone else has anything to suggest? This is going to be long but I need to provide some background

I am a PGY-2 PMR resident. I feel like I scammed undergrad, did below average on the MCAT somehow got into a US medical school, scammed that by barely passing my tests, did below average on Step1 and 2, got into residency. Finished my transitional year, barely passed step 3. Now I'm starting my real residency and I feel like a huge scam artist!

I seriously have such huge problems with just sitting down and studying. I can't ever pay attention at noon conference or any other lecture. During medical school I had to watch everything double speed and even that I couldnt handle so I started to just read coursepack. Here are a few symptoms:
1. I feel overwhelmed in presenting multiple patients without first completing the note. Especially when I'm getting slammed on call or presenting in the AM. I try coming extra early but I have such tremendous organization problems

2. I seriously can't pay attention. WHen patients talk to me or when I have to listen in lecture I feel like I am zoning out unless Im super interested which is rare. I almost can hear myself having conversations with myself. And I get bored SUPER easily and figitty which has been present my whole life

3. I was a great student when I was younger and I did poorly in high school mostly because I didn't care and wasnt mature. In undergrad I did very well initially and then started to taper off towards the end. Medical school required too much organization and memorizing and sitting for long periods that I couldnt handle it. A lot of people who I out preformed my entire life were now doing so much better than me and I couldnt explain it

4. I can't memorize anything. I wish I could read and just have facts stick but it just doesnt. Anatomy was the hardest class ever for me, so was pharmacology. Strangely the subjects that I felt took least amount of memorization like Acid Base stuff, endocrinology, cardiology and some components of neurology were the easiest for me and the toughest for others.

5. I have a tremendous fear of failure and take critisicm very personally. This is why I hate presenting patients. I feel like all this lack of confidence has led to anxiety which has left me feeling stuck that eventually itll be found out that I don't know anything and I just barely got by and managed to become a physician.

I tried making lifestyle changes by sleeping more, exercising a lot, various changes in study habits but nothing has worked. I remember hating memorizing things since i was a little kid from the time I was in 4th grade i HATED classroom plays because I could never memorize the lines. I always hated foreign language courses for that same reason. I loved math, history, physics even.

After reading a definition of inattentive ADHD I feel like its describing me PERFECTLY! I have some comorbidities like anxiety issues including several bouts with panic attacks, and tricholotomania.

EVeryone in medical school seemed to have been taking adderall or some kind of supplements to get by. I feel like it would just drive my anxiety through the roof so I dont even want to mess around. I know there are things like Straterra but I don't want to be restricted from drinking and always be worried about interactions. It also has reportedly caused suicidal ideation which is too weird for me....

I want to go get checked out by a psychiatrist.... but before that any advice for me?! I am in desperate need of help because I feel like quitting residency everyday. I can't take the stress. Its not even the work load or the hours I care about. I just constantly feel stressed liek im being judged and its gonna be caught on that I dont know what Im doing and that I scammed everyone.

I just want to excel in my life again. In undergrad I was in the top 15% and I just want to feel like that again. I hate feeling like this and I can't concentrate ever. Even in the most crucial of situation my mind wanders and I can hear myself talking to my inner voice.

THANKS!!!

If you read up on ADHD you probably read that it should affect more than one area of your life. What you are describing is purely from your academic performance. Some food for thought:
- we all hate memorizing (even for dreaded school plays back in the fourth grade)
- we all feel like scam artists (look up impostor syndrome)
- we all can get lost in thought
- we all can daze out when the 1000000th patient is describing mundane symptoms
- we all feel under prepared to present on patients we don't know much about, especially when we are bombarded with other tasks
- organization is a skill you master throughout time, not something you are born with.
- you say you can't memorize anything, but in the same breath talk about doing well with acid-base and neurology...
- not "EVERYONE" in medical school is taking Adderall or taking supplements. Stop with the "but everyone else is doing it" excuse.
- you have a history of doing well in school. Sure you have had some struggles, but here is a secret: everyone has struggles.

I'm no psychiatrist, so enabling you to believe you have ADHD would be an injustice to you, especially without knowing your full history and only hearing your bias complaints. You describe going through some panic attacks or trichotillomania- those can be manifestations of an obsessive personality disorder or some kind of depression as well. Once again, you should go see a professional. Sounds like you need someone to confide in, especially since you are reaching out on a public forum on a very private issue. Good luck.

 

[gutonc]

Has anybody else noticed that the OP has been completely absent from the discussion?

Oohh shiny...look squirrel...wanna ride bikes?

 

[Par4thecourse]

OP sounds like me.

Hell of a hard time focusing a few hours at a time. Cant even do an entire UW block without getting distracted. Slid by my whole life in advanced/honors/etc. Not sure if dumbest of the smart kids, or smartest of the dumb kids.

Damn Imposter Syndrome...

I can't focus for fractions of a second at a time without help. Hours? Hours?

 

[Crayola227]

I can't focus for fractions of a second at a time without help. Hours? Hours?

not only a necrobump, but you're bumping just to talk about yourself, and what you're saying isn't even particularly relatable to the original thread

 

[Crayola227]

I can't focus for fractions of a second at a time without help. Hours? Hours?

not only a necrobump, but a necrobump to talk about yourself, and not only about yourself, but in a way that only superficially even relates to the OP

 

[Crayola227]

Hi everyone,

New here, decided to post to see if anyone else has anything to suggest? This is going to be long but I need to provide some background

I am a PGY-2 PMR resident. I feel like I scammed undergrad, did below average on the MCAT somehow got into a US medical school, scammed that by barely passing my tests, did below average on Step1 and 2, got into residency. Finished my transitional year, barely passed step 3. Now I'm starting my real residency and I feel like a huge scam artist!

I seriously have such huge problems with just sitting down and studying. I can't ever pay attention at noon conference or any other lecture. During medical school I had to watch everything double speed and even that I couldnt handle so I started to just read coursepack. Here are a few symptoms:
1. I feel overwhelmed in presenting multiple patients without first completing the note. Especially when I'm getting slammed on call or presenting in the AM. I try coming extra early but I have such tremendous organization problems

2. I seriously can't pay attention. WHen patients talk to me or when I have to listen in lecture I feel like I am zoning out unless Im super interested which is rare. I almost can hear myself having conversations with myself. And I get bored SUPER easily and figitty which has been present my whole life

3. I was a great student when I was younger and I did poorly in high school mostly because I didn't care and wasnt mature. In undergrad I did very well initially and then started to taper off towards the end. Medical school required too much organization and memorizing and sitting for long periods that I couldnt handle it. A lot of people who I out preformed my entire life were now doing so much better than me and I couldnt explain it

4. I can't memorize anything. I wish I could read and just have facts stick but it just doesnt. Anatomy was the hardest class ever for me, so was pharmacology. Strangely the subjects that I felt took least amount of memorization like Acid Base stuff, endocrinology, cardiology and some components of neurology were the easiest for me and the toughest for others.

5. I have a tremendous fear of failure and take critisicm very personally. This is why I hate presenting patients. I feel like all this lack of confidence has led to anxiety which has left me feeling stuck that eventually itll be found out that I don't know anything and I just barely got by and managed to become a physician.

I tried making lifestyle changes by sleeping more, exercising a lot, various changes in study habits but nothing has worked. I remember hating memorizing things since i was a little kid from the time I was in 4th grade i HATED classroom plays because I could never memorize the lines. I always hated foreign language courses for that same reason. I loved math, history, physics even.

After reading a definition of inattentive ADHD I feel like its describing me PERFECTLY! I have some comorbidities like anxiety issues including several bouts with panic attacks, and tricholotomania.

EVeryone in medical school seemed to have been taking adderall or some kind of supplements to get by. I feel like it would just drive my anxiety through the roof so I dont even want to mess around. I know there are things like Straterra but I don't want to be restricted from drinking and always be worried about interactions. It also has reportedly caused suicidal ideation which is too weird for me....

I want to go get checked out by a psychiatrist.... but before that any advice for me?! I am in desperate need of help because I feel like quitting residency everyday. I can't take the stress. Its not even the work load or the hours I care about. I just constantly feel stressed liek im being judged and its gonna be caught on that I dont know what Im doing and that I scammed everyone.

I just want to excel in my life again. In undergrad I was in the top 15% and I just want to feel like that again. I hate feeling like this and I can't concentrate ever. Even in the most crucial of situation my mind wanders and I can hear myself talking to my inner voice.

THANKS!!!

Since it was already bumped and there was so much debate what was up here and if it needed help, NO ONE mentioned simple burn out

I'm going to say to everyone that thinks this is "normal,"
I think if it is burn out it is "normal" in the sense that burn out is very common and so many of us are burned out we might read this and say, "so? sounds like me and all my co-residents"

Even if this represents burn out and nothing more specific in the DSM like ADHD or depression or other diagnoses,
it's never early to try to deal with burn out especially if it's impacting your ability to function at work

In my mind too, ability to function at work isn't just what is objectively observable, if you are near crapping your pants at any moment at work in my mind that needs addressing before you actually do

I really related to this post but I don't have ADHD, and while I was burned out there was more too

any number of psychiatric diagnoses can be coped with and need a certain amount of pressure to find the breaking point where it pops out and eats your face
for some high-functioning people that's undergrad, or med school, or maybe not even until residency
hell, I've seen a few things not become an issue until attending (some OCD cases)

this is a little off topic, but with ADHD remember you have to exclude other diagnoses
can anyone else guess what else can look a little like ADHD......
lol, this one's a doozy and if you give it stims there's no telling what can happen