MS1 Qualms

[dumbquestionthrowaway]

Just beginning med school and am overcome by feelings of inadequacy; I had to work twice as hard as everyone so far to keep a good GPA/MCAT and am anxious about now that I'm in med school or even later down the line that I'll only be "weeded out" now - or even worse, when I'm working on something important and ending up being the cause of a patient death, messing up with malpractice, or just screwing up in general.
Did anyone else share these sentiments going into this?

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[sloop]

A few points here.

If you're at a U.S. med school, it is unlikely you will be weeded out. It is of course possible, but the graduation rate is extremely high. You may or may not be near the top of your class depending on how smart you are and how hard you work, but few people really get weeded out. If you are going to be one of these people, you will probably find this out quickly if you start failing lots of exams.

Everybody in medicine, no matter their specialty, will have patients die under their care at some point. Sometimes the cause will be totally out of your control and other times you will doubt yourself. This is not just with patient deaths, either. It's just the way medicine works. Ultimately these doubts serve as learning experiences. Learn your **** and be careful, but don't get sucked into a Hamlet-esque nihilism where you can't function because you're terrified of screwing up. While you're learning, you're supervised closely and informed of your mistakes so that you don't make many as an independent clinician. Even with all of this, mistakes will happen. Only in medicine do people have this fantasy of professionals batting 100% all the time. You just have to do your best and always try to do better. This is as good as you can do and it's no different than any other pursuit.

If you can't get over a fear of possibly hurting somebody, you are for sure in the wrong business.

 

[karayaa]

Just beginning med school and am overcome by feelings of inadequacy; I had to work twice as hard as everyone so far to keep a good GPA/MCAT and am anxious about now that I'm in med school or even later down the line that I'll only be "weeded out" now - or even worse, when I'm working on something important and ending up being the cause of a patient death, messing up with malpractice, or just screwing up in general.
Did anyone else share these sentiments going into this?

What do you mean by this? Does your school expell students if they have low grades?

 

[dumbquestionthrowaway]

I don't mean weed out as in dropped out or removed; im in US MD. I just meant unable to cope with the content, fall behind, perform poorly compared to my classmates, bomb usmle etc. and I know there'll be patient deaths, I just meant more than other docs. I'm just worried about screwing up excessively.

 

[Pierre Escargot]

I think it's natural to feel some apprehension. I've just begun MS1 as well, and I know what you're talking about. I'm sure you won't be weeded out since the vast majority of weeding out occurs during the application process, well before school begins. Just work hard and you'll be fine.

 

[sloop]

I don't mean weed out as in dropped out or removed; im in US MD. I just meant unable to cope with the content, fall behind, perform poorly compared to my classmates, bomb usmle etc. and I know there'll be patient deaths, I just meant more than other docs. I'm just worried about screwing up excessively.

It sounds like your hang-up is with comparing yourself to other people. This is something you will inevitably do in med school, but it's important to keep this in perspective. Just as with anything, some people will perform better than others in med school and in medicine. Where you fall on that curve is yet to be determined. Either way, that doesn't mean that people who are near the bottom of that curve don't still contribute a lot to patient health.

If you're accepted into a U.S. Allopathic med school, the chances are good that you can be a competent doctor. You were accepted for a reason. Just do your best and you'll serve your patients well. The thing with med school is that everybody screws up excessively. Everyone feels like an idiot a lot of the time. If you work hard at your weaknesses, you will get better and become more competent. Nobody can guarantee that you will wind up doing better or even as well as all your classmates. Those things just depend. You can only do your best and, like I said, in all likelihood your best will be good enough to serve your patients well.

 

[masaraksh]

Just beginning med school and am overcome by feelings of inadequacy; I had to work twice as hard as everyone so far to keep a good GPA/MCAT and am anxious about now that I'm in med school or even later down the line that I'll only be "weeded out" now - or even worse, when I'm working on something important and ending up being the cause of a patient death, messing up with malpractice, or just screwing up in general.
Did anyone else share these sentiments going into this?

May I interest you in psych or family medicine, where people are likely not going to die directly under your care.

 

[trino]

"Imposter syndrome" is common among med students. I even occasionally get it as a second year. You just have to realize that your feelings don't represent the whole truth. You are here for a reason, let it give you motivation to work harder and smarter

 

[sloop]

May I interest you in psych or family medicine, where people are likely not going to die directly under your care.

This is not true. I'm on family medicine right now and the residents staff the ICU, respond to RRT calls, codes, etc. As a PCP, you will be the initial point of contact for innumerate chest pain, SOB, focal neurological symptom cases. If you misdiagnose the patient with a DVT/PE with costochondritis because they have incidental point tenderness or something and you send them home where they throw another clot, that's on you. Granted you'd have to be a numbskull to miss this example, but it can happen.

If you're a psychiatrist, you could make a bad judgement call about somebody's suicidality, accidentally prescribe ziprasidone for somebody with heart failure and send them into torsades, diagnose unspecified delirium in an early sepsis patient because you failed to consider medical causes because the consulting team said they were medically cleared. Not to mention neuroleptic malignant syndrome, etc. The most prominent of these is the obvious fact that no matter what you do, if you're working with depressed patients every day eventually one of them is going to commit suicide.

No discipline is free of potential for oversights that can lead to patient deaths. Even in pathology, if you misdiagnose a tumor as benign, they can come back later with diffuse mets to the point that the case is basically palliative.

Perhaps anatomic/forensic pathology is the one exception because all of your patients are already dead.

 

[sunflower18]

I just started MS1 too, and believe me, all of my classmates and I seem to feel the exact same way that you do. I'd give yourself a bit of credit and just work hard, and things will more than likely be okay. The great thing about starting med school is that it's a new beginning, and everyone is starting fresh. Just because you experienced some difficulty in undergrad doesn't mean that you'll struggle in med school -- you're here now, and your past is in the past. That's how I'm trying to look at it anyway!

 

[AspiringERMD]

Only in medicine do people have this fantasy of professionals batting 100% all the time. You just have to do your best and always try to do better. This is as good as you can do and it's no different than any other pursuit.

I wish I could "like" this quote a million times. Thank you for putting it like this.

 

[PhillyMed777]

When I first started I thought wow everyone sounds and looks smart...but then I realized over time we're all ordinary enough. And anyways, most of the time it's just a question of whether you memorized something than a question of intelligence.

 

[Psai]

When I first started I thought wow everyone sounds and looks smart...but then I realized over time we're all ordinary enough. And anyways, most of the time it's just a question of whether you memorized something than a question of intelligence.

Memorization is just the first step. Then you put the picture together. Then you apply it to patient care. The more you know, the better you will be. Knowing more things is definitely a marker of intelligence. And we are not ordinary. You just get used to being around very smart people

 

[PhillyMed777]

Memorization is just the first step. Then you put the picture together. Then you apply it to patient care. The more you know, the better you will be. Knowing more things is definitely a marker of intelligence. And we are not ordinary. You just get used to being around very smart people

Maybe I'm used to it. I agree that knowing more is better. But most of our questions are memorization based. The concept of "understanding" is really just memorizing more in between. And i change my last statement that its a question of knowing something rather than reasoning, not intelligence.

 

[karayaa]

Maybe I'm used to it. I agree that knowing more is better. But most of our questions are memorization based. The concept of "understanding" is really just memorizing more in between. And i change my last statement that its a question of knowing something rather than reasoning, not intelligence.

Memorization is often presented as dichotomous to "higher" forms of learning/intelligence, but it's actually just a prerequisite. You can't understand a concept without remembering it, and you can't reason from a postulate or a principle that you can't remember.
The more you memorize, the greater your potential for reasoning and understanding and intelligence or whatever you want to call it.

I could say that it's "intelligent" to work hard enough to memorize (however hard that might be for an individual), and that people who are more "intelligent" simply have an easier job remembering info (regardless of how hard they had to work to reach that state).
Or are you thinking of a different type of intelligence?

 

[deleted564496]

Just beginning med school and am overcome by feelings of inadequacy; I had to work twice as hard as everyone so far to keep a good GPA/MCAT and am anxious about now that I'm in med school or even later down the line that I'll only be "weeded out" now - or even worse, when I'm working on something important and ending up being the cause of a patient death, messing up with malpractice, or just screwing up in general.
Did anyone else share these sentiments going into this?

A little anxiety is not a bad thing to have starting MS1, it keeps you motivated. None the less if that becomes overbearing and it's taking a significant toll on your life then seek some help. Most of your new classmates probably are feeling the same way. It's a new environment and absolutely nobody has any idea what the expectations are and what exactly life will be like. My advice is to take everything one day at a time and don't worry about what you cannot control now. You don't want to fail a class or be 'weeded' out? Work your *** off every day (but take some time to yourself and stay healthy). You have a long road ahead of you before you're the one making decisions/cutting into somebody, etc. 4 years of medical school and 3-7 years of residency + any fellowships is quite a ways down the road.

If you work hard and seek help when/if needed you will not fail out of medical school.

 

[Señor S]

Nothing thus far in 3rd year, including Step 1 and Surgery, has stressed me out anywhere near as much as I was those first couple of weeks. I think I've lost the capacity to feel that overwhelmed. Things do get better, for most of us anyways.