Pre-PhD Clerkships...feeling burned out...is it safe to "high pass?"

[Datypicalpremed]

I'm in a bit of a unique situation...

I'm a MD/PhD student who has finished my step 1 exam and am taking the required clerkships before entering my PhD years. I seriously ****ed up in that I thought I didn't need a vacation before clerkships started and pretty much used the vacation time my school gave me to study harder for the step 1. I pretty much took the step, took the weekend off and began clerkships the next week. Genius, I know.

My first clerkship is Surgery.

Needless to say, I'm feeling pretty burnt out. I'm trying my best to "smile and wave" in my clerkship, but I don't know how much longer I can keep up the facade. I was never much of a morning person and adjusting to waking up at 4 AM in the morning has really messed me up. I was one of those people who actually didn't mind the mental grind of the first 2 years, but the constant pimping by attendings/residents alike and inflexible schedule of this clerkship has been a whole new level of hell that was more than I expected. I bet I'm not the only person who has felt this way at the start of clerkships...but I guess it just feels good to let it all out...

Anyways, my main concern is this: I'm interested in fields considered pretty competitive. This includes Ophthalmology, Plastics and Radiation Oncology (especially). I've been told you need honors/etc. to get into these specialties. However, I got a pretty solid step 1 score (250). I also don't mind spending more time in my PhD to get strong publications (I never minded staying late in lab cause I honestly enjoy research - the flexibility eg going to the gym next door while waiting for an experiment to end helped too I guess...).

With a solid step 1 and research, could I get by with a "high pass" in surgery and the clerkship after that (I need to complete another clerkship before I begin my PhD) and still be competitive for these specialties? I plan to spend my phd years slowly training my clinical skills to prep for the remaining clerkships...if that means anything. I've been told by my seniors that just getting along with the people and participating is enough to get "high pass" at my school, which I think I can manage...I just don't think I have the energy/willpower to impress my evaluators enough to get "honors"...

And yeah, totally my bad if this sounds like an overt gunner post. I'm actually looking for serious advice.

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[gcuddles]

Consider that, due to your PhD years, you'll be competing with students who take step 1 3-4 years after you. Average step scores creep up every year, especially for competitive specialties: based on Charting Outcomes in the Match, the average step 1 score for Rad Onc in 2014 was 241; in 2016 it was a 247. Plastics went from a 245-250 over the same time period.

Research done during a PhD unfortunately doesn't seem to get the recognition it deserves. Programs tend to weigh quantity over quality, so a student with 15 case reports/chart review papers may actually have the advantage over 1 PhD thesis/publication. I would try to keep this in mind during your PhD years: write reviews for your lab, maybe try to keep in contact with people running clinical trials in your department of interest, and finish as quickly as possible.

I applied MD/PhD to med school, and these were all things I heard from people coming out the other end, so I'm not just pulling this out of my a**. Your clerkship grades will be what they will be, but I'd try for the honors.

 

[Entadus]

... I was never much of a morning person and adjusting to waking up at 4 AM in the morning has really messed me up. I was one of those people who actually didn't mind the mental grind of the first 2 years, but the constant pimping by attendings/residents alike and inflexible schedule of this clerkship has been a whole new level of hell that was more than I expected. I bet I'm not the only person who has felt this way at the start of clerkships...but I guess it just feels good to let it all out...

Anyways, my main concern is this: I'm interested in fields considered pretty competitive. This includes Ophthalmology, Plastics and Radiation Oncology (especially)

These 2 paragraphs are contradictory. You're talking about completing a surgical residency, yet you are already having problems waking up early and working long hours? It's normal to feel burnt out after step 1, but how do you feel about being inside the OR and actually being in the hospital/actually seeing surgical patients?? I mean, at least at some level you should be THRILLED to be there, otherwise why would you be considering a field like plastic surgery?

I doubt my post will be very helpful and the OP sure sounds confused. I mean, who would subject themselves to a PhD/MD program? If you are more interested in research, why add the enormous task of clinical education/MD. If you want to be a surgeon(MD) and thrive in the clinical environment, why add years of brutal hellish research and PhD woes? Talk about biting off more than you can chew.

 

[eteshoe]

Aim for as many honors as you can OP. Your clinical interests will most likely change in the next 5 yrs or so just keep an open mind and try your best to power through your clerkships. I'd say the pain ends one day but we signed up for one of the most painful paths lol.

Also forget the whole "training your clinical skills during the PhD" - there will literally be no time for that. Be efficient during your research years and focus on the task at hand. This means you'll be putting in 60-80 hrs/wk for 4-6 yrs - you won't have time for much else. Good luck and keep on grinding!

 

[Datypicalpremed]

Thanks for the advice so far...guess I'll try to pull through with everything I got.

As for my experience in the OR, I definitely find it enjoyable and it's the best part of the day, but I can't help but feel my experience is being overshadowed by the aforementioned burnout. As you mentioned, I really feel the source of the problem is taking step 1 immediately before I started. If I had taken my 2 week vacation (which I plan to do after these clerkships are over) after step 1 to refresh, I feel I would have had no problem adjusting to these hours and would be enjoying this clerkship a lot more. Probably did myself a big disservice here.

And yeah, I'm definitely trying to keep an open mind and realize my interests will probably change. I actually meant that some of my interests are in competitive fields - I also have strong interests in less competitive fields like IM (and the subspecialties) and path. I guess I just have this constant anxiety that some time in the unforeseable future I will decide I want to do <insert competitive specialty>, but at that point it will be too late to change these clerkship grades...

Again, thanks everyone and I'm open to more advice/experiences...

 

[sliceofbread136]

Just do your best man. I was the same way with surgery and it made me miss out on AOA

 

[MSTP18]

These 2 paragraphs are contradictory. You're talking about completing a surgical residency, yet you are already having problems waking up early and working long hours? It's normal to feel burnt out after step 1, but how do you feel about being inside the OR and actually being in the hospital/actually seeing surgical patients?? I mean, at least at some level you should be THRILLED to be there, otherwise why would you be considering a field like plastic surgery?

I doubt my post will be very helpful and the OP sure sounds confused. I mean, who would subject themselves to a PhD/MD program? If you are more interested in research, why add the enormous task of clinical education/MD. If you want to be a surgeon(MD) and thrive in the clinical environment, why add years of brutal hellish research and PhD woes? Talk about biting off more than you can chew.

MD training enhances your knowledge base when it comes to human health and disease. A PhD simply doesn't require the same breadth of knowledge. Even with just the pre-clinical years under my belt I knew more about the human body than anyone in my lab. If you don't know anything beyond your own little knowledge bubble you might miss an opportunity to bring your expertise to a new area and push that knowledge forward.

Having almost done all of M3 now, I can say that w/o a doubt the PhD has provided me with a better understanding of the molecular underpinnings of diseases and testing as well as a better background in finding relevant research and critiquing/synthesizing/applying it.

It's a tough program to get into, and there's a reason our interview days are actually interview 2 or 3 days. They make sure we have big mouths before making it rain NIH dollars on us.

On the other hand: with regard to the contradiction of not being a morning person and wanting to be a surgeon you are spot on.