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Kinda sorta a third year myself (I say kinda sorta because I'm still technically a 2nd year but more than half way through rotations): Take it 1 step at a time, and make sure you work with mentors who are understanding. The ability to publish this year esp as first author is...challenging, so I'd focus on low hanging fruit (ie case reports) and leave bigger chart review projects, and especially anything that would require extensive wet lab work, to the side