M3 stress... already

[cushie]

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I am only 2 weeks into my M3 year and I am feeling stressed already. The rotation that I am on is supposed to be one of the easiest ones of the year, it's only 4 weeks long, and I'm nervous about the rest of the year.

The feedback I have gotten from my residents and attending so far has been excellent, but I feel like my life outside the hospital is suffering. I've become forgetful, crabby with my fiance and friends, and I feel like I am working so hard to make our future better that I will look back and regret not enjoying my youth more.

Deep down I love medicine, and I can't imagine doing anything else, but DAMN this is just not how I expected to feel in the third week of my M3 year.

Am I normal?

 

[Jolie South]

This is a completely normal reaction to starting rotations. It will get easier with time just because you'll be used to the system, how to get certain things done, etc.

Just hang in there and make sure you take time to relax.

 

[jakcat]

Ahh, I feel the same way, I never expected to work 10-13 hrs/day on FM rotation!

 

[cpants]

Ahh, I feel the same way, I never expected to work 10-13 hrs/day on FM rotation!

Man you screwed up on that lottery application. I worked 20/week max on FM, and got a fat honors. Easiest rotation of 3rd year.

 

[cushie]

This is a completely normal reaction to starting rotations. It will get easier with time just because you'll be used to the system, how to get certain things done, etc.

Just hang in there and make sure you take time to relax.

Thanks man. I'm feeling a little better about it all today, I had a long talk with my resident about expectations etc. I have to remember that this is just my first rotation and not much is expected of me, so it's OK to be confused, mess up, and ask a ton of questions without looking like a d-bag loser.

 

[BigRedBeta]

The other thing, which is probably more important is just making the transition from being a preclinical student. Given the things you've said about how this is affecting your life outside of the hospital, I think you need to recognize (as well as have your loved ones recognize), that there's been a fundamental shift.

Whereas before, you had a great deal of freedom and control over your time, this is no longer the case. Before you could cut out of a lecture early, decide to study at home or the library or the coffee shop, you could study for 30 minutes or 12 hours depending on what you had going on that day, and while you might have felt guilty about missing a chance to go over notes one more time, in the end it wasn't a big deal.

Now, as a third year student, you have to be where they tell you to be, when they tell you to be there. You can't just cut out early and you'll have a few overnight calls, and even if the residents are wasting your time, there's little you can do about it. You'll figure out quickly that it's difficult to commit to important events because you find out about them either too early (and have no idea what your rotation will be like), or too late (and thus know you're committed to being on call or giving a presentation or whatever). And while the studying of third year is much less stressful and time consuming, you'll likely feel like now you absolutely zero free time.

This can be a hard transition, one that some people continue to struggle with well into their residency (the being on time and on location aspect only gets worse). And to some extent, friends and family came make the transition a really easy one or an impossible one. But the sooner you come to grips with it, the sooner you find little ways to make time for friends and family, and the sooner you realize that your not choosing your career over loved ones, then the sooner your stress level will diminish.

These are the sacrifices you have to make for your patients, and unfortunately, your youth is the victim. There's no way around it. Every resident, fellow and attending has multiple stories about the things they couldn't do, or the way they let down this loved one or that friend because they were at the hospital or clinic.

That's not to be a downer, just reality. In return for these sacrifices and hard work, we get all the rewards that the pre-meds on this board dream about. And we get to do work that's far more meaningful and important than practically any other profession. But it comes down to attitude, accepting the sacrifices and making it over that mental hump.

 

[sideways]

The other thing, which is probably more important is just making the transition from being a preclinical student. Given the things you've said about how this is affecting your life outside of the hospital, I think you need to recognize (as well as have your loved ones recognize), that there's been a fundamental shift.

Whereas before, you had a great deal of freedom and control over your time, this is no longer the case. Before you could cut out of a lecture early, decide to study at home or the library or the coffee shop, you could study for 30 minutes or 12 hours depending on what you had going on that day, and while you might have felt guilty about missing a chance to go over notes one more time, in the end it wasn't a big deal.

Now, as a third year student, you have to be where they tell you to be, when they tell you to be there. You can't just cut out early and you'll have a few overnight calls, and even if the residents are wasting your time, there's little you can do about it. You'll figure out quickly that it's difficult to commit to important events because you find out about them either too early (and have no idea what your rotation will be like), or too late (and thus know you're committed to being on call or giving a presentation or whatever). And while the studying of third year is much less stressful and time consuming, you'll likely feel like now you absolutely zero free time.

This can be a hard transition, one that some people continue to struggle with well into their residency (the being on time and on location aspect only gets worse). And to some extent, friends and family came make the transition a really easy one or an impossible one. But the sooner you come to grips with it, the sooner you find little ways to make time for friends and family, and the sooner you realize that your not choosing your career over loved ones, then the sooner your stress level will diminish.

These are the sacrifices you have to make for your patients, and unfortunately, your youth is the victim. There's no way around it. Every resident, fellow and attending has multiple stories about the things they couldn't do, or the way they let down this loved one or that friend because they were at the hospital or clinic.

That's not to be a downer, just reality. In return for these sacrifices and hard work, we get all the rewards that the pre-meds on this board dream about. And we get to do work that's far more meaningful and important than practically any other profession. But it comes down to attitude, accepting the sacrifices and making it over that mental hump.

 

[MilkmanAl]

That's not to be a downer, just reality.

It can certainly be both. I'll be glad when I'm done with this nightmare surgery/OB tag team (consecutive rotations - ugh). I enjoy surgery but not for 14 hours a day.

 

[jackieMD2007]

Yes, you're normal.
Now you get to put your big boy/big girl panties on and actually work.
(And be so amazingly tired at the end of the day!)

You'll get used to it by the end of third year, balance better and feel better.
Be good to yourself.

You'll find it is amazing how much a difference having a great team (or interesting patients) to work with makes.

 

[Svidrillion]

These are the sacrifices you have to make for your patients, and unfortunately, your youth is the victim. There's no way around it. Every resident, fellow and attending has multiple stories about the things they couldn't do, or the way they let down this loved one or that friend because they were at the hospital or clinic.

This is the type of self-delusion that ultimately leads to unhappiness, regret, and multiple stores about the way you let loved ones and friends down.

We are not martyrs. Take a long look at those older physicians around you who have tried to be martyrs. "Helping patients" does not compensate for the bitter and personal failures of a physician's private life.

You do not make sacrifices for your patients, and your youth is no victim. We all chose to be in medicine. There are consequences to that decision, but there are no sacrifices here, only trade-offs (as with all other decisions in life). And you make those trade-offs for yourself, because you want to do, for whatever reason that may be.

Maybe you do it so you get the money. Maybe you do so you get the prestige. Maybe you do it because you feel good helping people heal. Maybe you do it because you like to saw bones. Or maybe (probably) it's multifactorial. But you do it for you. Don't use patients as scapegoats for things that don't work out in your life.

That said, medicine is no easy road, especially during clinical years and residency when you have given some of your autonomy over to a tyrannical and merciless (but more merciful than in times past) system.

I surmise that the OP is just feeling a bit of sticker shock from what's required to succeed in medicine. I suggest formally evaluating your values and preemptively coming up with ways to stay true to the things most important in your life despite the stress and time commitment of medicine. For some people (I have at least one such friend) that means leaving medicine altogether. But for most of us, I think we can find a way to manage if we commit to do so.

Good luck.

 

[ZagDoc]

One of the best pieces of advice I got during third year was from one of my general surgery chief residents: "The hours don't get better, but you get better at the hours."

Even when working 80 hour weeks, I've seen residents find time for hiking glaciers, running marathons, hosting parties. As a third year thrown into this world from the ultra-controllable hours of the pre-clinical years, it can come as a shock. But you learn, gradually, how to prioritize, multi-task. and generally get **** done in such an efficient manner that you find time for the other important stuff. The days of being a "student" are over. But life isn't!

 

[ACSurgeon]

This is a completely normal reaction to starting rotations. It will get easier with time just because you'll be used to the system, how to get certain things done, etc.

Just hang in there and make sure you take time to relax.

👍

 

[cushie]

Now that I'm done with the first rotation, I've definitely gained some perspective into what I can do to make an otherwise less than ideal rotation into a much more tolerable one.

1. Focus only on the rotation that I am currently on. I got overwhelmed thinking that I had 46 weeks of M3 year when I was struggling to adjust. Big mistake. I will just think about the next 4, 6, or 8 weeks at a time.

2. Find every way I can to connect the rotation that I'm on to the field that I am interested in (not something that we have during M3 year). I went to a resident lecture on the intersection between my rotation and my interest, and thoroughly enjoyed myself. I will go out of my way to find something that interests me in every rotation.

3. Lower my expectations for my own performance. I had a few days where I would beat myself up if I didn't get to look at every single note or lab, however extraneous, for all of my patients even if I arrived 2 hours early to pre-round. And still, I consistently received excellent feedback from my residents and attendings. I will work as hard as I can and know that it is enough.

This might not work for anyone else but that's my plan, at least for now!

 

[OnlyAnEgg]

as a nervous student starting rotations in ~ a month, who has been staying up too late (or too early) reading SDN forums about what to expect in clinicals.....

thanks ZagDoc for a breath of fresh air 👍 👍

and props cushie for your insights

One of the best pieces of advice I got during third year was from one of my general surgery chief residents: "The hours don't get better, but you get better at the hours."

Even when working 80 hour weeks, I've seen residents find time for hiking glaciers, running marathons, hosting parties. As a third year thrown into this world from the ultra-controllable hours of the pre-clinical years, it can come as a shock. But you learn, gradually, how to prioritize, multi-task. and generally get **** done in such an efficient manner that you find time for the other important stuff. The days of being a "student" are over. But life isn't!

 

[Perrotfish]

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