MS3: Anyone else miserable & depressed?

[getunconcsious]

This thread was inspired by the "MS3: anyone else not learning anything?" thread. For the record, I feel that despite its numerous problems and learned helplelssness, I have actually learned a lot thus far in MS3, though I've only completed two rotations.

The point of this thread is to ask if anyone else liked MS1 and MS2 better? MS3 is more interesting in its own way I suppose, but I feel like the politics makes it damn near unbearable. I feel like one of those dogs in the cage in Seligman's famed experiment that gets shocked no matter what it does. Day-to-day politics, especially on rigid rotations like surgery and OB/Gyn really suck. You have to spend your whole day trying not to get yelled at and just basically cowering from everyone. Don't get me wrong--I will readily admit that I am rightfully the lowest person on the totem pole, but does everyone have to be so mean about it? I can't be in OB triage, L&D suite, and the OR all at the same time so I'd inevitably have to pick one and get yelled at later. I didn't show up to my first rotation magically knowing how to do gen surg assist on episiotomies, deliver placentas, scrub in, remove staples, or anything really. Don't people know that they don't teach us these things? At least OB/Gyn gave me reasonable and fair evaluations....

Then came psych, which was a great demonstration of the other political demon: uncontrollable grades. I really loved psych workwise and told the attending that I was seriously considering entering the profession. I volunteered to pick up extra patients, write extra learning issues, generally do any extra work that she needed, etc. I regularly asked her how I was doing and if there was anything I could improve on. (I wasn't being a gunner, btw b/c she only has 1 student at a time so i was not screwing anyone over). She always said I was doing great, doing top level work, etc. My evaluation came back a bit later: 85/High Pass. She also said that my "weakness was clinical interviewing" I had never heard this before from her, and I felt it was a pretty damning comment especially if I did try to match in psych. I tried to ask her to meet to discuss her eval of me, and she stood me up or cancelled 3 times. The only saving grace was that I completely threw her under the bus at the attending evaluation session. Basically I told the course director in nicer language that she was a backstabbing b*tch on wheels. They said they'd look into it, but who knows what will really happen. Just my luck to get one of the nation's only malignant psychiatrists.

Anyways the point of this whole rant is to ask if anyone else thinks that third year just kind of sucks and feels helpless. I'm learning a lot and really enjoyed the work on psych, but damned if i'm not taking double dose of antidepressants! At least in the first two years, you can do your own thing and aren't made to feel like **** every day. I also felt I had control of my grades b/c I could just study really hard and almost always get the grade I wanted! Now it seems like no matter what you do or how hard you work, some attending can just unilaterally screw you over, which is especially awful if they happen to be in a field that you're interested in! Has this happened to any other MS3's yet this year?

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[Acherona]

dude you got a high pass, what are you bitching about. The attending is allowed to put her observations of you in the eval. It kinda sucks that she didn't bring that up to you before since you asked specifically, but she probably would have put it in the eval anyways. She has likely seen dozens of med students pass through and has some basis for that comment. I doubt it will ruin your chances for psych or anything, esp if that kind of comment doesn't show up in evals from your other rotations as well.

 

[getunconcsious]

dude you got a high pass, what are you bitching about. The attending is allowed to put her observations of you in the eval. It kinda sucks that she didn't bring that up to you before since you asked specifically, but she probably would have put it in the eval anyways. She has likely seen dozens of med students pass through and has some basis for that comment. I doubt it will ruin your chances for psych or anything, esp if that kind of comment doesn't show up in evals from your other rotations as well.

The high pass itself was a bit bitchy on her part, but not terribly distressing. The comment really bothered me since obviously clinical interviewing is so important in psych. I may be overreacting because I don't really know what such things would do to one's chances of matching? My other attending gave me honors so I may be able to honor the clerkship overall but am very concerned about her comment.

 

[Acherona]

The high pass itself was a bit bitchy on her part, but not terribly distressing. The comment really bothered me since obviously clinical interviewing is so important in psych. I may be overreacting because I don't really know what such things would do to one's chances of matching? My other attending gave me honors so I may be able to honor the clerkship overall but am very concerned about her comment.

understandable, but it doesn't sound that bad to me the way it's worded. if she had said you were bad at interviewing that would be one thing, but she said it was your weakness, and most people have one. who knows maybe she mentions a weakness on everyone's eval. isn't psych like the easiest specialty to match into anyway.

 

[lord_jeebus]

I've seen people fail clerkships and match at desirable psych programs so I wouldn't worry about your prospects in that specialty.

I would not stress over a high pass in any clerkship in any circumstance, unless you go to a school where 95% gets honors.

 

[153445]

Chin up, getunconscious. Dr. S pulled a lot of other bullsh*t on you, and she shouldn't be breaking promises of writing excellent evals when she is only a freshly minted attending. Dr. P should get on her case about that and her generally unprofessional behavior. I think you ended up liking her as a person and developed a great rapport with her, so it's only natural that you feel especially unhappy about this. Try not to let this bitterness ruin the next month for you just as I let my bullsh*t OB Gyn attending eval ruin the first part of psych for me. If anything, you should feel sorry for Dr. S since she uses students for advice on life!

This year is going to be unfair by nature, and it's not in our control. Maybe we need CBT to deal with the anxiety of not knowing whether we will be treated and evaluated fairly, but we'll need to get through it. The thicker our skin gets now, the better we'll be able to deal with even sh*ttier politics later during residency and when we are trying to excel at our jobs. As long as you're pleasant and likeable to your team, you'll probably end up getting good evals. If you want to do psych, you will be able to do it and match into a good program, especially since it looks like you'll most likely honor the rotation and since your Step 1 score is at least a couple of standard deviations above the average score for psych matching. At our institution, there are plenty of benign psych attendings who would give you great evals during 4th year and really advocate for you. So don't worry!!! You'll be fine!!! This will not be a miserable year ... just a hectic one with a few bumps in the road.

 

[Miami_med]

I was told I was doing fine on OB/GYN, received a 40% on an Eval, and only ended up passing due to a surprisingly decent shelf score. Unlike everyone else, I was never yelled at on OB/GYN. Infact, I received no negative feedback whatsoever. It was my first rotation, so I really had no way of knowing what I was doing wrong (if anything).

 

[Syranope2]

Getunconscious -

Everyone always talks about how third year is twenty times better than the first two years. It took me a loooong time to adjust to clinical rotations and I remember feeling like crap about it, wondering if I wasn't cut out for clinical medicine or what, wondering why everyone else was apparently having so much fun and I was so miserable.

It gets better. And even if it doesn't necessarily get better, it does end. The subjective evaluations may continue, but you learn not to care as much. And then fourth year comes and you don't have to care as much.

As for your psych comments, I really wouldn't worry too much about it. You will have plenty of time to do a sub-i in psych and impress the pants off of them. Try to take the constructive criticism as just that - constructive criticism. Now you have something to work on before a sub-i.

Keep your head up. As I said, even if it doesn't get better, it will eventually be over.

 

[domer621]

I've seen people fail clerkships and match at desirable psych programs so I wouldn't worry about your prospects in that specialty.

Exactly. Psych isn't exactly hard to get into.

 

[RockShox]

The only saving grace was that I completely threw her under the bus at the attending evaluation session. Basically I told the course director in nicer language that she was a backstabbing b*tch on wheels.

Sounds like you are learning a good skill set right here. I would say academic medicine is in your future.

 

[smq123]

The point of this thread is to ask if anyone else liked MS1 and MS2 better? MS3 is more interesting in its own way I suppose, but I feel like the politics makes it damn near unbearable.

Anyways the point of this whole rant is to ask if anyone else thinks that third year just kind of sucks and feels helpless. I'm learning a lot and really enjoyed the work on psych, but damned if i'm not taking double dose of antidepressants! At least in the first two years, you can do your own thing and aren't made to feel like **** every day. I also felt I had control of my grades b/c I could just study really hard and almost always get the grade I wanted! Now it seems like no matter what you do or how hard you work, some attending can just unilaterally screw you over, which is especially awful if they happen to be in a field that you're interested in! Has this happened to any other MS3's yet this year?

YES! I was starting to think that I was the only one who looked back on MS2 with a sense of nostalgia. Yeah, studying everyday for 4-5 hours a day had its downsides, but I agree - I never felt like a completely *****ic piece of crap every single day.

I didn't show up to my first rotation magically knowing how to do gen surg assist on episiotomies, deliver placentas, scrub in, remove staples, or anything really. Don't people know that they don't teach us these things?

No, they don't know that we don't learn these things - and, for me, this has been one of the worst parts of third year. One of the uro-gyn surgeons asked me if I knew how to suture. (At least he asked first!) When I said no, he asked me "Didn't they teach you that during orientation? What, you weren't paying attention?!" When I answered with "No, I went - and they taught us how to tie knots, but not how to suture," he rolled his eyes and said, "Good Lord. Like that's going to be helpful." The disconnect between what they teach us and what the attendings think that we learn is frightening. The attendings have no f*ing clue what we are taught.

 

[diosa428]

OP, are you sure that your school is even going to include that quote on your dean's letter? Our deans told us that if we randomly get negative comments that only exist on one eval for one rotation, they will give us the benefit of the doubt and not include it in our letter. If the comment gets repeated multiple times, then they will include it, as it is then seen as an accurate representation of us.

 

[OldPsychDoc]

....Then came psych, which was a great demonstration of the other political demon: uncontrollable grades. I really loved psych workwise and told the attending that I was seriously considering entering the profession. I volunteered to pick up extra patients, write extra learning issues, generally do any extra work that she needed, etc. I regularly asked her how I was doing and if there was anything I could improve on. (I wasn't being a gunner, btw b/c she only has 1 student at a time so i was not screwing anyone over). She always said I was doing great, doing top level work, etc. My evaluation came back a bit later: 85/High Pass. She also said that my "weakness was clinical interviewing" I had never heard this before from her, and I felt it was a pretty damning comment especially if I did try to match in psych. .... Just my luck to get one of the nation's only malignant psychiatrists.
...

The best way to overcome this, if you are still interested in psych, is to do an elective in some other psych setting and demonstrate that you have grown and developed over the course of MS3 in an area identified as a "weakness". A letter from a psych attending that indicates that you can develop good rapport with patients and elicit detailed historical information will go a long way in overshadowing a one-liner on the dean's letter (if it even makes it that far).

In spite of your disappointment about the grade, I agree with the others--a High Pass is hardly damning. I'm not sure that your attending deserves the invective you are returning to her either. Remember in all fields attendings can vary widely in the stringency of their grading. And just as you don't show up to a rotation magically ready to first-assist a procedure, neither do attendings get a formal course on how to mentor and evaluate students!

 

[Thievery Corp.]

OP, I think most people at some point during third year feels frustrated with trying to impress everyone all the time, and then when you get the feel for a rotation, it's time to start over. It sucks but everyone has to do it. So you have two choices:
let it bother you or don't. (I'm not saying that's easy.)

Don't let one person decide what you can or cannot do. If you really like psych, F*@# 'em. Do it.

I realize that the statments I'm making a rather simplistic but the more that you choose to complicate how you feel about this, the harder it is to make desisions for yourself.
Good luck to ya.

 

[lumbering]

What I don't like about 3rd year is the fact that half of your grade is your ability and willingness to "play the game." I wish I could just focus on learning and taking care of patients without having to worry about looking good in front of certain people.

 

[Ypo.]

Yeah, third year isn't all it's cracked up to be. Every rotation I start out fresh and eager to learn and by the end of the rotation I'm just waiting for it to get over. No matter how hard I try, I'm always going to get owned.

There is a sense of powerless to it. I think several other posters wrote that already.

The thing I'm having the hardest time with right now is oral presentation, and then coming up with an assessment and plan that satisfies the attending. I feel incredibly awkward trying to come up with a differential and then which tests to order and saying it in a coherent way. But I'm starting to think that maybe part of the difficulty may be because of difference of opinion between professionals. For example, today I had a 66 yr old male caucasian patient who presented to the ER yesterday with back pain that radiated to his chest. The ER did a work up for an acute coronary syndrome, which came back negative. I spent quite a bit of time with him today and I'm pretty sure it's musculoskeletal with a psych component. The chest pain is atypical, not worsened with exercise, and two series of cardiac enzymes and an EKG have been normal. The patient himself thinks the pain is due to stress and anxiety. On PE, the guy has wounds and scars from scratching himself compulsively and I was the first one to pick up on this. I wasn't able to determine his capillary refill because his nailbeds were completely white. His lungs and chest were clear. Incidentally while in the ER we found he had a Hb of 8.6 and an HCT of 25. His TIBC is low, and ferretin is pending. His calcium is low as is his albumin. He has a history of NSAID use. He's never had a history of ulcers and has never had a colonoscopy. He had a fever yesterday with a mild leukocytosis (12.5) and neutrophils 70%, today the leukocytosis has resolved. His BUN and Cr were slightly elevated yesterday. Today his Cr has normalized. PMH siginificant only for HTN, depression and hyperlipidemia. He has a 4o yr history of smoking a pack/day. He denies any weight loss, history of ulcers, melena, hematemesis or history of trauma.

Well the intern and the attending focused in on multiple myeloma as something that could explain all of his findings (kidney dysfunction, back pain, anemia) which I put way lower on my differential because I don't believe his back pain is due to fractures, and in addition his calcium should be high and not low. In addition his cxr didn't pick up on any fractures. They were concerned about his fever yesterday and possible borderline prerenal failure today, worrying about possible source of infection and being immunocompromised due to cancer.

I wanted to focus on the source of bleeding. He had never had a colonoscopy before so I wanted to get a GI consult for colonoscopy which the attending agreed with. I might have been concerned about lung cancer, but his cxr was clear. I suggested that he may have GI bleeding due to chronic NSAID use, but the attending didn't think that was very likely because he didn't report any melena on ROS. However the occult blood was still pending, and I really thought it was too soon to dismiss this and would have pursued this as a more likely option than multiple myeloma. They went ahead and ordered a serum and urine electrophoresis and an MRI to look for lytic lesions or cancer.

So the attending goes in and tells the family we're thinking about cancer. The guy's daughter starts crying because her paternal grandfather had died of cancer and she was worried about her Dad. The pt had divorced three years ago after 40 years of marriage and according to the daughter he got the short end of the stick in the divorce and hasn't been taking care of himself.

Personally I wouldn't have said we were looking for cancer. I would have said that we were looking for a source of blood loss, which could be due to various reasons, but that it is definitely abnormal in a man his age.


Third year can be frustrating because you constantly second guess yourself and get contradicted, interupted, and basically proven wrong every two seconds. Some attendings don't necessarily want you to be able to always get the right diagnosis, though. Like the attending I had this morning, I think she likes to be able to teach me something. And yesterday we had a student education day and one my attendings presented the case of a patient he had. I suspected Hep C after seeing the liver enzymes and said so when he asked us our theory. He challenged me on it but I held my ground. It turns out that months later he finally thought to get a RNA HCV and the patient did have hep C. So I think he didn't like me coming to that conclusion so quickly since it took him months to think of it in real life, but the point I think is to not let attendings completely derail you from your gut instincts, because even if you are wrong it's important to follow your train of thought because in the end you're going to be relying on your own clinical reasoning and not someone elses. At least I think so.

 

[elwademd]

Yeah, third year isn't all it's cracked up to be. Every rotation I start out fresh and eager to learn and by the end of the rotation I'm just waiting for it to get over. No matter how hard I try, I'm always going to get owned.

There is a sense of powerless to it. I think several other posters wrote that already.

The thing I'm having the hardest time with right now is oral presentation, and then coming up with an assessment and plan that satisfies the attending. I feel incredibly awkward trying to come up with a differential and then which tests to order and saying it in a coherent way. But I'm starting to think that maybe part of the difficulty may be because of difference of opinion between professionals. For example, today I had a 66 yr old male caucasian patient who presented to the ER yesterday with back pain that radiated to his chest. The ER did a work up for an acute coronary syndrome, which came back negative. I spent quite a bit of time with him today and I'm pretty sure it's musculoskeletal with a psych component. The chest pain is atypical, not worsened with exercise, and two series of cardiac enzymes and an EKG have been normal. The patient himself thinks the pain is due to stress and anxiety. On PE, the guy has wounds and scars from scratching himself compulsively and I was the first one to pick up on this. I wasn't able to determine his capillary refill because his nailbeds were completely white. His lungs and chest were clear. Incidentally while in the ER we found he had a Hb of 8.6 and an HCT of 25. His TIBC is low, and ferretin is pending. His calcium is low as is his albumin. He has a history of NSAID use. He's never had a history of ulcers and has never had a colonoscopy. He had a fever yesterday with a mild leukocytosis (12.5) and neutrophils 70%, today the leukocytosis has resolved. His BUN and Cr were slightly elevated yesterday. Today his Cr has normalized. PMH siginificant only for HTN, depression and hyperlipidemia. He has a 4o yr history of smoking a pack/day. He denies any weight loss, history of ulcers, melena, hematemesis or history of trauma.

Well the intern and the attending focused in on multiple myeloma as something that could explain all of his findings (kidney dysfunction, back pain, anemia) which I put way lower on my differential because I don't believe his back pain is due to fractures, and in addition his calcium should be high and not low. In addition his cxr didn't pick up on any fractures. They were concerned about his fever yesterday and possible borderline prerenal failure today, worrying about possible source of infection and being immunocompromised due to cancer.

I wanted to focus on the source of bleeding. He had never had a colonoscopy before so I wanted to get a GI consult for colonoscopy which the attending agreed with. I might have been concerned about lung cancer, but his cxr was clear. I suggested that he may have GI bleeding due to chronic NSAID use, but the attending didn't think that was very likely because he didn't report any melena on ROS. However the occult blood was still pending, and I really thought it was too soon to dismiss this and would have pursued this as a more likely option than multiple myeloma. They went ahead and ordered a serum and urine electrophoresis and an MRI to look for lytic lesions or cancer.

the best way to look for an occult gi bleed is to stick your finger in the patient's ass! that way you'd be able to give that as part of your physical exam.

given your story as the way you tell it, it sounds like chronic nsaid use exacerbating/causing an ulcer.... which eventually bled... causing anemia... and the chronic nsaid use also causing renal insufficiency... also contributing to the anemia.

unfortunately, a lot of 3rd/4th year is, as my mom said when i was a kid, being seen and not heard. sometimes as a resident, it can be the same thing! i suppose the best advice i can give is to pick and choose your battles. also, be polite, as it's not what you say, but how you say it.

with the patient above, it seems as though the attending and resident had a decision already made about what their likely diagnosis was.

Third year can be frustrating because you constantly second guess yourself and get contradicted, interupted, and basically proven wrong every two seconds.

residency sometimes like that, lol.

 

[Ypo.]

the best way to look for an occult gi bleed is to stick your finger in the patient's ass! that way you'd be able to give that as part of your physical exam.

True that! Crappy thing is we're not allowed to do breast, genital or rectal exams without supervision and my intern had about 6 patients to see this morning while I only had the one. The attending got down on him for not doing a rectal exam, poor guy.

given your story as the way you tell it, it sounds like chronic nsaid use exacerbating/causing an ulcer.... which eventually bled... causing anemia... and the chronic nsaid use also causing renal insufficiency... also contributing to the anemia.

unfortunately, a lot of 3rd/4th year is, as my mom said when i was a kid, being seen and not heard. sometimes as a resident, it can be the same thing! i suppose the best advice i can give is to pick and choose your battles. also, be polite, as it's not what you say, but how you say it.

with the patient above, it seems as though the attending and resident had a decision already made about what their likely diagnosis was.



residency sometimes like that, lol.

Ha ha. So true about the being seen and not heard. I figured that out kind of quick.

 

[getunconcsious]

The best way to overcome this, if you are still interested in psych, is to do an elective in some other psych setting and demonstrate that you have grown and developed over the course of MS3 in an area identified as a "weakness". A letter from a psych attending that indicates that you can develop good rapport with patients and elicit detailed historical information will go a long way in overshadowing a one-liner on the dean's letter (if it even makes it that far).

In spite of your disappointment about the grade, I agree with the others--a High Pass is hardly damning. I'm not sure that your attending deserves the invective you are returning to her either. Remember in all fields attendings can vary widely in the stringency of their grading. And just as you don't show up to a rotation magically ready to first-assist a procedure, neither do attendings get a formal course on how to mentor and evaluate students!

Thanks for your advice. I was afraid that an HP in psych would pretty much take me out of the running for the better programs, but maybe I was being paranoid. I guess I was so upset with her b/c I felt that the feedback she gave me was disingenuous. As far as her not deserving the invective, I haven't really said as much about her as I could say on here for not wanting to be completely mean. Suffice it to say that her teaching methods are...questionable.

 

[CanIMakeIt]

I don't know about depressed and miserable but I sure do miss my getting up at noon days and not going to classes if I didn't want to but now I have to be there bright (or not so bright) but surely early everyday

 

[kat82]

third year is hard- dont worry. its really tough dealing with all of the politics and being at the bottom of the totem pole and constantly being reminded of that. some residents and even interns will make you feel stupid to boost their own egos. they were 3rd years not long ago. residents and attendings are usually too busy to even realize that as a 3rd year, you dont know how to scrub in, and maybe you dont know what a "pick up" is or what 5-0 ethilon means. unless your school does a good job with orientation, you are stuck kind of learning on your own.

hang in there. you will realize after a while that everyone goes through this as a 3rd year and you are having a very normal experience.

and if it makes you feel any better, i felt like you alot of the time 3rd year (you can even go back and see my posts) but now as a 4th year life is SO MUCH BETTER. i dont know what it is, but you instantly feel more confident after you look back and realize how much you learned 3rd year (its really amazing how much you'll learn, you'll see). you also realize not to sweat the small stuff- now if a resident or nurse is rude to me, i kind of laugh to myself because i can see when its uncalled for

hang in there

 

[PeeWee137]

dude, it takes YEARS to be good at interviewing psych patients. YEARS. you are a 3rd year, you cant expect to be great at it already? its an art that even residents are still trying to master. and its not something that can easily be taught.
and sometimes attendings just have to write something in the comments. on just about all my 3rd year evals, even though i got great grades, it said "needs to read more", like my nose wasnt already in a book 24-7.
there's always something we can improve on, and thats not just about being a 3rd year, thats about being a doctor.
dont take it so hard, people find joy in yelling at 3rd years, and we've all gotten yelled at.. so just remember this when you are a resident, you can either yell at the students to make up for all the times you got yelled at, or you can choose to be nice to give a student a better experience than you had.

 

[MrBurns10]

Sigh, yes rotations are frustrating and depressing. I thought being outgoing and friendly would help me, but so far that's actually hurt me...apparently, it's better to just keep your head down, keep your mouth shut, and not try to make friends on surgery. Are all rotations like this?

 

[elwademd]

True that! Crappy thing is we're not allowed to do breast, genital or rectal exams without supervision and my intern had about 6 patients to see this morning while I only had the one. The attending got down on him for not doing a rectal exam, poor guy.

can't get around doing a rectal in a patient with anemia... unless of course you see the red or black stool coming out! lol.


just keep your head up, keep learning about your patients.

 

[getunconcsious]

Sigh, yes rotations are frustrating and depressing. I thought being outgoing and friendly would help me, but so far that's actually hurt me...apparently, it's better to just keep your head down, keep your mouth shut, and not try to make friends on surgery. Are all rotations like this?

OB/Gyn is like that for sure. Psych is better in terms of the people being much more friendly on a day to day basis. Can't say on the others.

 

[Ambs]

The best way to overcome this, if you are still interested in psych, is to do an elective in some other psych setting and demonstrate that you have grown and developed over the course of MS3 in an area identified as a "weakness". A letter from a psych attending that indicates that you can develop good rapport with patients and elicit detailed historical information will go a long way in overshadowing a one-liner on the dean's letter (if it even makes it that far).

In spite of your disappointment about the grade, I agree with the others--a High Pass is hardly damning. I'm not sure that your attending deserves the invective you are returning to her either. Remember in all fields attendings can vary widely in the stringency of their grading. And just as you don't show up to a rotation magically ready to first-assist a procedure, neither do attendings get a formal course on how to mentor and evaluate students![/QUOTE]

But attendings were ALL students once... and must have at least once felt absolutely horrible, *****ic, misjudged, nervous, tense, and sometimes a waste of space even when trying very hard and keeping up with the reading... Students don't know what it's like to be an attending... we've never been there. The best residents and attendings I have had so far teach me not just by quizzing me and giving me assignments but also by showing me that they respect me and my level of understanding... My learning increases exponentially when the attending maintains a comfortable, welcoming environment--though still firm and very goal-oriented-- because that attending recognizes that I am getting an education, being trained, and evolving rather than already possessing expertise and with my game face on 24/7. It makes the experience so much more real and rich when I'm comfortable with and around my attending.

 

[Ambs]

What I don't like about 3rd year is the fact that half of your grade is your ability and willingness to "play the game." I wish I could just focus on learning and taking care of patients without having to worry about looking good in front of certain people.

Seriously. It pains me. I just want to learn... not sell a car.

 

[smq123]

And just as you don't show up to a rotation magically ready to first-assist a procedure, neither do attendings get a formal course on how to mentor and evaluate students!

But attendings were ALL students once... and must have at least once felt absolutely horrible, *****ic, misjudged, nervous, tense, and sometimes a waste of space even when trying very hard and keeping up with the reading... Students don't know what it's like to be an attending... we've never been there.

I've actually heard a few residents say, "No, I don't remember what it's like to be a student." Great. I don't understand how this is something to brag about in front of a student, but whatever.

Is it really that hard for a resident or an attending to be moderately civil to the med student? Honestly, I find myself working harder and with more enthusiasm when I work with the residents that I like. If I see that the resident is having a tough day and is swamped, I'll stay late and bend over backward to help him/her out as much as I can. However, if I'm paired with a resident who treats me like crap, I have to force myself to look mildly awake. (I probably don't succeed well either.) Don't the residents and attendings make the connection?

 

[DOCTORSAIB]

I LOVED the first 2 years of med school!

Got plenty of sleep, lived a relatively low-stress life, partied on the weekends, studied as much/as little as I wanted/needed, and managed to get great grades. Your only responsibility is to freakin study for the next exam! Honestly, those were/will be probably 2 of the best years of my life.

Third year, IMO, sucks. I'm not sure why so many students claim "3rd year is so much better." How the hell is it better to wake up at 4am for Surgery, get yelled at by disgruntled Ob/Gyn residents, round for 5 hours on FAT, non-compliant IM patients, or have to "act" interested when you know you'd rather DIE than spend 1 minute longer than you have to in _____ rotation.

Am I the only one who thinks this way guys?

ps...4th year, despite the anxiety revolving around residency applications, is MUCH better than 3rd year.

 

[MrBurns10]

or have to "act" interested when you know you'd rather DIE than spend 1 minute longer than you have to in _____ rotation.

Am I the only one who thinks this way guys?

haha, not at all. I was yelled at once for making conversation with an attending anesthesiologist during the closing of a surgery I wasn't even scrubbed in on because it showed "disinterest." It's gotten a little annyoing having to pretend I'm in awe every minute of every 3-4 hour surgery. Oh well.

 

[hopefulmed]

.

 

[Old_Mil]

or have to "act" interested when you know you'd rather DIE than spend 1 minute longer than you have to in _____ rotation.

Am I the only one who thinks this way guys?

Nope. The only thing that surprises me is that anyone calls this "school" given the complete lack of instruction and learning that occurs. 3rd year not only makes you wish you were back in anatomy lab - it makes you wish you were the cadaver.

 

[surrender903]

It's gotten a little annyoing having to pretend I'm in awe every minute of every 3-4 hour surgery. Oh well.

amen brother.

 

[jones173]

amen to that my brother. I was torn apart today on a pyelonephritis presentation. I feel like every damn attending has their own way of presenting and doing PEs. It just depends who you get.

 

[OddNath]

dude, it takes YEARS to be good at interviewing psych patients. YEARS. you are a 3rd year, you cant expect to be great at it already? its an art that even residents are still trying to master. and its not something that can easily be taught.
and sometimes attendings just have to write something in the comments. on just about all my 3rd year evals, even though i got great grades, it said "needs to read more", like my nose wasnt already in a book 24-7.
there's always something we can improve on, and thats not just about being a 3rd year, thats about being a doctor.
dont take it so hard, people find joy in yelling at 3rd years, and we've all gotten yelled at.. so just remember this when you are a resident, you can either yell at the students to make up for all the times you got yelled at, or you can choose to be nice to give a student a better experience than you had.

This is really good advice.

But yeah, I agree, I miss 2nd year. There was no such thing as q3 call.

 

[domer621]

so just remember this when you are a resident, you can either yell at the students to make up for all the times you got yelled at, or you can choose to be nice to give a student a better experience than you had.

I can't wait to be nice to the med students when I'm a resident. I've been really lucky with my residents so far, but there have been a few that just don't see what's wrong with having me stick around doing nothing.

 

[chicamedica]

I med students!! I always enjoyed having MS3's as an intern. Unfortunately now as a CA-1 I'm not entrusted with med students anymore because I am the newbie again . I miss you, med students!!

 

[getunconcsious]

I med students!! I always enjoyed having MS3's as an intern. Unfortunately now as a CA-1 I'm not entrusted with med students anymore because I am the newbie again . I miss you, med students!!

Awww...that's sweet of you to say It seems like it would be fun to have a med student as a resident cuz you can try to help them and teach them and stuff. I will be nice to mine, but I'm not sure how it works when you have a lazy student that has no interest in your field. I could see if you're a psych and someone is like "I want to be a surgeon, this is so boring, I like more scientific stuff, etc." I can imagine it would be grating. Everyone on my OB/Gyn rotation knew there was no way I was gonna do OB/Gyn due to personality mismatch (It was almost a joke among residents), but I worked very hard and tried to make connections to fields I was interested in (Path, Psych) so I got along with most of them. Also, becoming 95% mute helps on OB, and I would imagine surgery.

 

[Mallory Weiss]

Also, becoming 95% mute helps on OB, and I would imagine surgery.

Yes. The best decisions I ever made on surgery were those where I opted not to speak.

 

[cbass1350]

My MS 3 year was pretty terrible to say the very least. I felt completely like a fish out of water. In retrospect, an MS3 is like a foreigner who moves to a new country without knowing anything about its language, religion, law or culture.

All that being said, I still liked my clinical years way more than my basic sciences. Yes I was a nobody who got yelled at. But at least I was in a hospital, learning practical everyday medicine, instead of in some classroom learning about the freakin' krebs cycle and watching dead cells on slides.

 

[Colba55o]

I just finished my first rotation, surgery, and it was 8 weeks of hell. Think about it..you are paying thousands of dollars to get the opportunity to kiss residents and attendings asses so hopefully they will write you a good eval. Yeah its easy to get depressed and pity yourself, but like others have said you just have to deal with it till it passes. it will not be forever.
And just think how much better off we are, than these sick people we are taking care of

 

[t33sg1rl]

Well the intern and the attending focused in on multiple myeloma as something that could explain all of his findings (kidney dysfunction, back pain, anemia) which I put way lower on my differential because I don't believe his back pain is due to fractures, and in addition his calcium should be high and not low.

This really tripped me up for a long time... If your hospital lab is like ours the calcium value reflects free plus bound. Basically every patient on our service has low albumin, so that translates to every single patient having artificially low calcium values. There is a formula you can use to get the actual free calcium level. Check the labs, your guy might actually have high calcium.

 

[Roy7]

I hate third year.

I miss the schedule, material, and flexibility of first and second year.

Third year is much more wasting time, sitting around, following people around, menial labor, and just straight up busy work.

Second year - everything different every day, interesting new material all the time, and you can leave class whenever you feel like it, wear whatever you want and do whatever you want.

 

[SoCuteMD]

Second year - everything different every day, interesting new material all the time, and you can leave class whenever you feel like it, wear whatever you want and do whatever you want.

If you want freedom and flexibility in your schedule as well as the ability to wear whatever you want to work, then why did you go into medicine?

 

[Roy7]

If you want freedom and flexibility in your schedule as well as the ability to wear whatever you want to work, then why did you go into medicine?

What?! I cant do that in medicine ?! OMG what a mistake I've made!! Good call pointing out, I cant believe I totally missed that.

Hate was a strong word - third year has it's plusses and minuses and I probably should have said I "Miss" second year. That being said, I was/am ready to move on.

 

[domer621]

If you want freedom and flexibility in your schedule as well as the ability to wear whatever you want to work, then why did you go into medicine?

Maybe he wants to do derm or rads?



As for me, I just don't like being a med student. I hate the short white coat. I hate being at the bottom of the food chain. I hate the fact that we have to take orders from everyone else in the hospital, save the janitor. I realize that we all have to start out at the bottom, but I can't wait to be real doctor.

 

[Vader]

Whenever I get down about 3rd year (and it happens often), I recite the magic formula:

P=MD

 

[fakin' the funk]

I can't wait to be nice to the med students when I'm a resident. I've been really lucky with my residents so far, but there have been a few that just don't see what's wrong with having me stick around doing nothing.

My mission as an intern/resident:
1) for the med students: teach them, involve them, encourage them, challenge them, and let them go home early
2) for the staff, nurses, etc, who are intrusive/annoying/lazy: BERATE THEM

MUWAHAHAHA!

 

[Ypo.]

This really tripped me up for a long time... If your hospital lab is like ours the calcium value reflects free plus bound. Basically every patient on our service has low albumin, so that translates to every single patient having artificially low calcium values. There is a formula you can use to get the actual free calcium level. Check the labs, your guy might actually have high calcium.

Yes, our lab measures total (not free) calcium. His albumin was actually slightly low (2.9), yet he had an elevated total calcium, so I didn't bother to calculate free calcium.


Anyways, the urine and serum protein electrophoresis was negative for multiple myeloma.

 

[smq123]

As for me, I just don't like being a med student. I hate the short white coat. I hate being at the bottom of the food chain. I hate the fact that we have to take orders from everyone else in the hospital, save the janitor. I realize that we all have to start out at the bottom, but I can't wait to be real doctor.

I hate this too. I recently got off my required week of L&D night float, where you work from 6:30 PM until 8:00 AM the next morning. Our unit triages patients and delivers babies, so it can get VERY crazy at night. One night, there was a rare moment of downtime at 4:30 AM, and I finally sat down (for the first time in 5 hours) to monitor the fetal heart tracings for a while. My eyelids started fluttering when the desk clerk walks by, tickles my ribs, and says, "HEY! You haven't been working that long!" Coming from a woman who spent the last 3 hours sitting on her butt, working her way through the world's biggest collection of Sudoku puzzles, I was ready to start screaming. (Oh, and her shift runs from 11 PM until 7 AM.)

P.S. But the nurses on L&D were fabulous. I just had issues with the desk clerk.