Looking mediocrity in the face

[Gem134]

I am finishing up third year and I have no idea what I want to do. So far, I don't like anything. Or, I like things like ortho/neurosurg/ophtho/ENT where I have like, NO chance in a million years of even coming close to getting into.

I used to be a smart person but I have no idea what has happened to me over the last three years. I have slowly become a very dumb person apparently. I have a very average step 1 score, have done no volunteer work, nor have I published any research/found a cure for cancer/helped poor children in Somalia. I have tried to be a well rounded person with decent grades and maintain my modest personal life and friendships. I haven't tried to buff my med school persona, however.

So I am looking at the final shute of fourth year and I am clueless. Added to this misery, is the fact that I have some average evals and one that is actually negative. I am a nice person and get along with most people and yet I have the blandest evals. Where is that funny, smart person I used to be? Third year has been hard and I seem to have lost all my confidence. So, what do average people do with average comments and so far, no idea what to do or any letter writers? Some days, I think I should just quit now. I just can't seem to shine the way some of my classmates do on their rotations, no matter what I do. I have tried to learn from my evals, including the negative one but I feel discouraged. I have been thinking about taking a year off to somehow 1) get more experience, 2) improve my evals/comments 3) do some research in something I actually care about. 4) Do away rotations and 5) help poor kids in Chad (or wherever). I am not saying that I could actually make a huge difference, but right now my application is not very strong and I just don't know what sort of programs will be interested in me. Problem is, our school is not very willing to let people take time off.

I feel like I am smart, neat person who will make a terrific doc but so far none of that comes through in any of my application stuff. Have other people felt like this, and yet were able to improve their applications? I worked hard to get to this point and yet, now I feel stuck at an impass.

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[luvOB]

hi there, so sorry things aren't better for you. but you know what? it's very common! you're just going through post-3rd year blues! third year is tough (esp. if you go to a malignant school) and you're just burnt out. med school can be demoralizing. it's not uncommon to have self-doubt and feel inadequate. but think back to when you were applying for med school and remember how fortunate you are to have come this far when many didn't even make it! you are still smart even if you don't feel it, just beaten down. study hard for step 2 and work hard during fourth year. you can still get all your letters in fourth year. things will look up. and maybe you'll find something you enjoy like anesthesia or something you haven't come across.
but if things don't get better, there's nothing wrong with taking a year off. you can also beef up your application during this time. many people do it and a year flies by! talk to your advisor and family. but know that you are not alone!

 

[AmoryBlaine]

Speaking as a fellow 3rd year it can suck your soul. I have actually done very well with everything so far (grades, evals, numbers) and I have felt like the lowest of the low. I, like you, am not entirely sure what to do with my life - although I think I have a pretty good idea.

1. One thing that helped me decide what to check out was reading journals.
It sounds super nerdy (ok, it is super nerdy) but go to the library or use the internet at school and surf the professional literature. Everyone used to tell me "oh Student Doctor Amory, you should do specialty X, you are totally suited for it." It really messed with my head. So I started reading the monthly journals about X and I found them hugely boring. In the process I wandered over to the literature of specialty Y and was totally into it. I still need to do a rotation in Y and make sure it is for me, but at least I have a plan.

2. Another thought: many specialties are not nearly as competitive as we make them out to be. During my first two years I had the genuine impression that you needed a 250 and AOA to even get interviews in radiology. Guess what? I you look at the recently released data, the avg board score is like a 233. That means alot of people with scores in the 220s are getting into radiology!

3. Sit down with your advisor (or a friend or a 4th year or whoever) and start going through the really basic questions...

Do you want to work with patients? Rads/Path vs Everything else
Do you want to be a surgeon? Surg vs Everything else
Do you want to work with kids? Peds/MedPeds/FP/EM vs Everything else
Do you want to do some OB? FP/OB vs Everything else
Do you really like a certain organ system? Med subspecialties etc
Do you want to do alot of procedures? Surg/Gas/EM vs others

 

[Littlemantate]

Listen dude-medschool is NO measure of someones smartness. Undergrad grades and mcat and stuff is a much better indicator of how intelligent someone is overall. Medical school tests the following things

Years 1 and 2-MEMORIZATION-if you do not memorize you will not do any better than average most times. I never memorized a thing in undergrad (I mean the bare minimum) and figured things out by learnin concepts etc and I graduated with a 4.0. I worked hard at it but learned concepts and succeeded. Medschool however I used the same tecniques and while I felt I had a better understanding of everythign than 99 percent of my classmates who usually memorized, I was not rewarded with high test scores, AOA, monster step 1 etc. I had average grades, average step 1(220 which is virtually the average)-all this yet in a discussion I could always outthink or explain why things happened which is a HELL of a lot more useful in practice down the line since you can look the crap you had to memorize up. Now the downside is you will not be able to practice what you want if you do not succeed in years 1-3 so you are almost forced to memorize. I refused.

Year 3-it is all about kissing ass and be lucky. You can work hard, answer tons of questions and never get noticed and receive totally average evals or even poor evals. Other times you can do nothing at all, be lazy but get along with your team better and you get great evals. It is really out of your control with all the variables and none of the variables having anything to do with intelligence

I think the most fair guages of intelligence, although still not great are your steps 1 and 2. I should have forced myself to memorize a bit more or concentrate on step specific info but all through my first 3 years I always wanted to learn topics in depth and probably 80 percent of what I enjoyed learning about was irrelevent for steps yet it was interesting to me since it was the pathophys of diseases, genetics of disease, MECHANISMS of everything and anything. I personally cannot sit down and study for more tahn an hour if I am just memorizing compared to I can sit down for 10 hours and read about something interesting.

So in the end am I sorry I did not memorize and use a different strategy? Well sometimes, especially when I see the AOA awards come out and see peoples monster step 1s etc-sure it would have made the whole residency match less stressful-however I happened to like one of the least compeititive specialities so it did not end up mattering much. But had I really wanted to do rads, neurosurg or something, I sure would have been sorry but would have felt it was a no win situation for someone like me who never learned by memorization.

I also had no research, great EC's etc-I enjoyed living a balanced life and all to which meant I studied hard and spent the rest of my time working out,w ith friends etc rather than spending my only free time doing something I hated.

So in the end-it sucks-you have to memorize and kiss ass to succeed in medical school and the fact of the matter is some of us who have never done that do not have the skills to all of a sudden do it. I cannot memorize a thing without knowing a mechanism-nemonics do not even help me much.

So you are not dumb, you will shine in residency and 4th year where nobody cares about pimping you all that much and if they do it is about more in depth things relating to your field or related fields. I have stood out and looked like an all-star 4th year compared to 3rd year where I always looked like a ******* for not being able to name the 10 causes of appendicitis or something.

Now if you neither like memorizing or learning concepts and you just are mediocre because you did not really get by-then no good came of medschool. I still am happy I learned things.

oh well its over now and moving on!

 

[Chancre]

This is specifically directed to GEM 134,

After reading your post, I felt the need to reply because when I was a third year, I probably would have written the exact same e-mail. In fact, I think my situation was a bit more dire in that I faced being kicked out of med school. I had a very successful career before med school and thought that med school would just be a continuation of the prior. Shocked to find myself at the bottom third of the class, struggling to just maintain that fact. During the beginning of third year, a close relative developed cancer and died my the end of my third year. I was crushed to hear of the diagnosis and went into a deep funk and failed almost every shelf exam I took and I too, had bland to negative evaluations. I had to go before a student promotions committee where it was decided that I would repeat a year. I didn't care if they kicked me out or not by that point because I just felt so dumb. At any rate, I discussed it with my family and decided to continue with a newfound feeling that I would try the best that I could and if it didn't work out, I would be happy knowing that I just did my very best. Slowly but surely, I began to pass all my shelf exams, barely at first but then I kept working and found that slowly but surely, the information that I could never keep in my head before began to stick. My the time I took my last shelf exam, I was scoring in the 90th percentile and I slowly began to regain my confidence and find myself again. During that year, I rotated in an AOA field and fell in love with the specialty so I decided to take a second rotation in that field. I knew I would never match but I actually enjoyed the work. Surprisely, my newfound confidence and my attitude that I wasn't going out of the way to impress anyone, actually impressed someone...someone who would help back me in my application and help me to match in that AOA field. In retrospect, as I complete my intern year and am about to start in a specialty that only AOA types get into, I look back and see myself in what you have written. The advice that I have for you is to take one day at a time but keep applying yourself like that day is the last day you will ever have in medical school. Don't look back and don't look forward. Just concentrate on trying your best for that day. If you don't get through everything you wanted to, don't be disappointed, just be happy that you lived through that day. Slowly, but surely, people will see that you are working your ass off and you don't care what other people think of you...that's when things will start clicking and your personality...the one that got you into med school will shine through. I know I will probably take a lot of flak for saying what I'm saying from doubters who think I'm making all this up, but this thread is for you because I know that you're going through. I wish you the very best and hope you continue to pursue the dream that you carved out for yourself.

Feeling your pain,
Chancre

 

[loveumms]

I really think that almost everyone gets these feelings some time during medical school ... those who "don't" are just lying to save face.

First, every one of us is smart - not to toot our own horn but, physicians are at the top 5% - 10% of the population in intelligence. We have to be to do what we do. Of course there are a few who are highly intelligent but, have no common sense and there are some who probably are not as smart as the med school comittee though but, on average we are a smart group of people.

Second, when you were in undergrad you were competing against a lot of bright people but, you were competing against a lot of not so bright people too. What happens - you feel really smart. That paired with having more time to volunteer and do ECs = you feel like you've accomplished something.

Med school is a little harder. You are expected to know so much more. You are competing against a group of people that for the most part graduated cum laude from college (aka - they are all the smart ones from college). On top of that, you are stretched so thin. You are expected to study enough to get good grades which amounts to much less time to yourself. Then third year comes and your schedule is completely different. You are in the hospital all the time, doing some things you would rather stick your hand in the garbage disposal then do. All the while having to keep a smile on your face and pretend that it's the best thing ever.

That all being said - hang in there. You are getting to the best part - fourth year. Try and find someone who can guide you in making a decision. If you really like a competitive field (ortho/optho/neurosurg/rads/ect) then find a mentor in that field who is understanding and can help you make the dream come true. You might have to take a uncommon path to get there but, just because you are not AOA with a six sheet page of ECs doesn't mean you can't do it. Pick yourself up off the floor and realize that you're a great person and you didn't get into med school by accident.

 

[Gem134]

Wow, thank you everyone for these responses. I was sort of debating whether to even post my thread but now I am glad that I did. I will send some pm's too, if that's ok.

I feel like I have done my best to be a decent person and student, but classmates who are better at memorizing things than me seem to outshine me at every turn on rotations. I am slow, and thoughtful and prefer to think through the mechanisms (yes! I agree Littlemantate). I am sometimes unsure of myself, and hesitate to blurt out things. I often find myself pushed aside in favor of those students who are superficially brilliant and quick, and can recite lists of stuff or present a polished progress note. I am trying to learn how to 'suck up' but you know, it just doesn't work so well for me. People seem to tell I am not being sincere, and it just doesn't fly. At least, I am trying to smile alot more which has a better effect.

I think what I resonate most with is Chancre's post, for almost the exact same reasons. I was hauled into the dean's office for the bad eval and threatened with terrible consequences. So yes, I really do feel like every day is a gift. I try and do my best every day, one day at a time.

I know we should do our best and be true to ourselves, and in the end it will turn out ok. When I am happy and just being myself, wow! the whole room lights up. It's an unbelievable feeling. So far, in third year I have often felt just beaten down with the criticism or disregard. Well, I came this far by trusting in my instincts, I am hoping that they will continue to guide me for the rest of the journey. I would like to find the nitch where I can be myself and fit in well. Thanks everyone for the great advice and comments.

 

[Tigger14]

I'll add another thought to the mix. Even those of us for whom the light "went on" in the third year do not always have it easy. I had vague ideas about what I might do, but fell in love with my surgery rotation. Easy enough, right? The feedback I got was not supportive at all. First, did I want to work long hours? Why not ENT or ophtho? Also, as a woman, everyone felt free to comment on my gender (I guess since they can't in the interviews) and ask whether I wanted to have a family or be able to recognize my kids in a line-up. Some were downright rude and said that women don't belong in surgery, period. For that matter, some of my surgery attendings have said that women don't belong in surgery.

My point is, medicine is not an easy field to be in. Take your time, find something you enjoy, and find a mentor who can help you. Good luck!

 

[mlw03]

Gem -

have you ever thought about pathology? if you like to really think through things, that's what pathology is all about. plus, a nice bonus is that while it's getting more competitive, it's still much less so than many other fields. if you're an american allopath, matching somewhere is almost guarenteed. however you need to be sure you can live without patient contact because you'll have virtually none.

another thing i would say is that almost every american grad matches, so to think you won't just because your application is "average" is probably overly pessimistic. best of luck to ya.

 

[dynx]

I'll add another thought to the mix. Even those of us for whom the light "went on" in the third year do not always have it easy. I had vague ideas about what I might do, but fell in love with my surgery rotation. Easy enough, right? The feedback I got was not supportive at all. First, did I want to work long hours? Why not ENT or ophtho? Also, as a woman, everyone felt free to comment on my gender (I guess since they can't in the interviews) and ask whether I wanted to have a family or be able to recognize my kids in a line-up. Some were downright rude and said that women don't belong in surgery, period. For that matter, some of my surgery attendings have said that women don't belong in surgery.

My point is, medicine is not an easy field to be in. Take your time, find something you enjoy, and find a mentor who can help you. Good luck!

Have you considered radiology? There is a lot of anatomy and procedures (if its IR) stuff and you can still get your kids to and from school. Just a thought. Good luck.

 

[Tigger14]

Have you considered radiology? There is a lot of anatomy and procedures (if its IR) stuff and you can still get your kids to and from school. Just a thought. Good luck.

I am a chief resident in surgery now. However, your point about IR is well taken, and it is something I like about vascular, which is the fellowship into which I matched.

 

[Gem134]

Chief Resident in surgery???? Right on girlfriend!!

Yep, I am working on thickening my skin, I am not sure how else you can survive all this. And Dynx, I sort of do like radiology. I thought you had to be a superstar for that? I would love to be able to have a great job and still be able to see my kids in their school play.

I have a good friend going into path. She loves it! I love it too, but I think I would miss the patient contact. I don't want too much patient stuff, like I just don't think I can take 150 patients a week in a clinic. I like being friends with path people, and taking the time to go and see the heme slides. I like hospital work because then you get to interact with all different kinds of docs.

I may have an average application so far - hooray for average people! - but I certainly don't feel average.

 

[LovelyRita]

Chief Resident in surgery???? Right on girlfriend!!

Yep, I am working on thickening my skin, I am not sure how else you can survive all this. And Dynx, I sort of do like radiology. I thought you had to be a superstar for that? I would love to be able to have a great job and still be able to see my kids in their school play.

I have a good friend going into path. She loves it! I love it too, but I think I would miss the patient contact. I don't want too much patient stuff, like I just don't think I can take 150 patients a week in a clinic. I like being friends with path people, and taking the time to go and see the heme slides. I like hospital work because then you get to interact with all different kinds of docs.

I may have an average application so far - hooray for average people! - but I certainly don't feel average.

I've always had a hard time with fathoming the fact that during 3rd year you're expected to be a psychic and see 7-8 years into the future and decide what you will be happy doing at that time.

Don't worry about the mediocre evals, etc.

If you still can't nail down your "dream career" you could always start out with an internal medicine residency as a building block toward something else. Stuff you learn in IM will be useful for everything--ER, FP, even things like gen surg, anesthesia or psych....and you could always do a fellowship after IM like cardiology or GI or heme/onc.

Do you like being in the office setting or in the hospital setting or neither? Use that to guage what you should be gravitating toward.

And of course don't forget about path and rads. AWESOME careers, I never really considered radiology, but did a rotation and absolutely loved it. I myself am doing gen surg, because I want to apply a little bit of knowledge from all fields and I love the OR.

I can't deny though that I meet people who are going into the "lifestyle" careers like radiology or ER or derm and am a little jealous.

This career seems to demand your life overall....spoken by an intern so take it with a grain of salt.

 

[me454555]

Hi my name is Scott and I'm an average medical student. I've been an average studet for 4 years now and I'm ok with that. My board scores are average, my grades are average, and my resume does not include speaking 4 different languages or a medical mission to chad, and I'm an osteopathic student.

After reading SDN and hearing about all the 250+ AOAs I started to get worried about residency. But, a funny thing happened when I applied. I actually got interviews. 11 of em for anesthesiology. It turns out that being average is good. Most of the student body is actually average and most residencies realize it. No you might not land @ a top 10 program in rads but its still dooable w/some research and an away rotation. So keep your hope up and shoot for the field you love. You just might get it.

BTW, my g/f also has a similar application and she got plenty of interviews to ER another reasonably competitive speicalty.

 

[Mayhem]

...have done no volunteer work, nor have I published any research/found a cure for cancer/helped poor children in Somalia.

I don't want to sound mean but I had to laugh at this line. Because, although some of us won't admit it, a lot of med students seriously believe that these things are expected of us and that we would do them. Now, mine was AIDS, not cancer, but apart from that it reads like a line from my journal. I really don't know where we get these ideas. People should volunteer because they want to and because they enjoy it. Same for research because there's nothing more soul-killing than churning out research that you're not interested in and truly don't want to do.

Be that as it may, I have a few months of med school left and with virtually no training in immunology and not even an ID rotation, I'm still gunning for that AIDS cure.

 

[musm2008]

"People should volunteer because they want to and because they enjoy it. Same for research because there's nothing more soul-killing than churning out research that you're not interested in and truly don't want to do."

I'm glad someone else has thought this. I've seen some of the most un-dedicated, superficially caring, students do all kinds of humanitarian things. They are so fake to me, because the do a half-@$$ job. They're annoying. It It makes them look like great applicants because they've done about 6 milion volunteer projects even though they did not act as dedicated as others who were only doing one or two. I hope this kind of thing is apparent to residencies. The person I'm thinking of told me that they want to spend half of their time doing mission work, but they want to go into neurosurgery. Get real!

 

[Tigger14]

This career seems to demand your life overall....spoken by an intern so take it with a grain of salt.

Second that. The trick is learning to balance an outside life with the hospital. Mine is almost never balanced... some weeks I am free, get things done, get sleep. Some weeks, I can barely crawl home. Remembering during the busy weeks that there are lighter weeks helps.