Scrambled into FM and worried

[DrMeowMeow]

Hello everyone,

I didn't match to Psychiatry and ended up scrambling to an opposed FM program. I'm very grateful to be able to do FM since I will still get a lot of psych exposure and I was wavering between psych and FM during my 3rd year. However, I'm terrified about my lack of preparation for this residency.

When I decided on Psychiatry, I chose all my 4th year elective rotations as many months of psychiatry, one outpatient FM, and the rest were either outpatient or "easy" inpatient rotations. Whenever attendings found out I was doing psychiatry they would have the attitude of not having me do procedures or teaching me much because "oh you're doing psych? You wont have to do any of this anyway." I haven't done an inpatient IM rotation in over a year and I haven't done as many procedures as I should have (Still terrible at sutures and pap smears). I thought this would be okay since I was dead set on psychiatry and never predicted I wouldn't match.

My evaluations for outpatient rotations were great so I am comfortable with that, but in residency there is a lot of OB and inpatient IM. I am very worried I'll be a loser resident because of my lack of experience while my other classmates did challenging rotations like ICU to prepare for their IM residencies.

I know everyone says that we should just relax and not do anything for the next 3 months until residency starts, but is it different for my situation? Should I study anything in this time to prevent being "that" intern who doesn't know anything and is the least prepared compared to all the other interns? I know I was stupid for not taking more challenging electives.

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[smq123]

Hello everyone,

I didn't match to Psychiatry and ended up scrambling to an opposed FM program. I'm very grateful to be able to do FM since I will still get a lot of psych exposure and I was wavering between psych and FM during my 3rd year. However, I'm terrified about my lack of preparation for this residency.

When I decided on Psychiatry, I chose all my 4th year elective rotations as many months of psychiatry, one outpatient FM, and the rest were either outpatient or "easy" inpatient rotations. Whenever attendings found out I was doing psychiatry they would have the attitude of not having me do procedures or teaching me much because "oh you're doing psych? You wont have to do any of this anyway." I haven't done an inpatient IM rotation in over a year and I haven't done as many procedures as I should have (Still terrible at sutures and pap smears). I thought this would be okay since I was dead set on psychiatry and never predicted I wouldn't match.

My evaluations for outpatient rotations were great so I am comfortable with that, but in residency there is a lot of OB and inpatient IM. I am very worried I'll be a loser resident because of my lack of experience while my other classmates did challenging rotations like ICU to prepare for their IM residencies.

I know everyone says that we should just relax and not do anything for the next 3 months until residency starts, but is it different for my situation? Should I study anything in this time to prevent being "that" intern who doesn't know anything and is the least prepared compared to all the other interns? I know I was stupid for not taking more challenging electives.

No, you will absolutely be fine. Incoming interns have varying levels of comfort, but everyone kind of evens out around January.

 

[SLC]

Everyone will expect that you, and your co-interns know basically nothing. If you show them that you do in fact know something it will just be bonus points.

Just be ready to learn, you'll do fine. You'll be shocked how quickly you get into the swing of things. The above poster is right, everything evens out around mid-year and you will all be more or less on the same page.

 

[Doctor4Life1769]

You should be okay.
You're coming straight out of Med school.
I was 3 years removed from Med school and doing a non-PC specialty and while it took some time as expected, I feel I've made it to the level of my colleagues. Just work hard and you'll be fine.

 

[Doctor4Life1769]

Hello everyone,

I didn't match to Psychiatry and ended up scrambling to an opposed FM program. I'm very grateful to be able to do FM since I will still get a lot of psych exposure and I was wavering between psych and FM during my 3rd year. However, I'm terrified about my lack of preparation for this residency.

When I decided on Psychiatry, I chose all my 4th year elective rotations as many months of psychiatry, one outpatient FM, and the rest were either outpatient or "easy" inpatient rotations. Whenever attendings found out I was doing psychiatry they would have the attitude of not having me do procedures or teaching me much because "oh you're doing psych? You wont have to do any of this anyway." I haven't done an inpatient IM rotation in over a year and I haven't done as many procedures as I should have (Still terrible at sutures and pap smears). I thought this would be okay since I was dead set on psychiatry and never predicted I wouldn't match.

My evaluations for outpatient rotations were great so I am comfortable with that, but in residency there is a lot of OB and inpatient IM. I am very worried I'll be a loser resident because of my lack of experience while my other classmates did challenging rotations like ICU to prepare for their IM residencies.

I know everyone says that we should just relax and not do anything for the next 3 months until residency starts, but is it different for my situation? Should I study anything in this time to prevent being "that" intern who doesn't know anything and is the least prepared compared to all the other interns? I know I was stupid for not taking more challenging electives.

Is it possible to switch a rotation with what time is left and to do an ICU or inpt medicine rotation?

 

[DrMeowMeow]

Is it possible to switch a rotation with what time is left and to do an ICU or inpt medicine rotation?

I'm completely done with my graduation requirements now

 

[Bluejay87]

I am in the exact same situation as the OP and just wanted to say that the responses here are very reassuring - I too have been worrying!

 

[azhrei]

I'm completely done with my graduation requirements now

Unless you've graduated already, you should still have the option of doing a rotation.

 

[Silent Cool]

Hello everyone,

I didn't match to Psychiatry and ended up scrambling to an opposed FM program. I'm very grateful to be able to do FM since I will still get a lot of psych exposure and I was wavering between psych and FM during my 3rd year. However, I'm terrified about my lack of preparation for this residency.

When I decided on Psychiatry, I chose all my 4th year elective rotations as many months of psychiatry, one outpatient FM, and the rest were either outpatient or "easy" inpatient rotations. Whenever attendings found out I was doing psychiatry they would have the attitude of not having me do procedures or teaching me much because "oh you're doing psych? You wont have to do any of this anyway." I haven't done an inpatient IM rotation in over a year and I haven't done as many procedures as I should have (Still terrible at sutures and pap smears). I thought this would be okay since I was dead set on psychiatry and never predicted I wouldn't match.

My evaluations for outpatient rotations were great so I am comfortable with that, but in residency there is a lot of OB and inpatient IM. I am very worried I'll be a loser resident because of my lack of experience while my other classmates did challenging rotations like ICU to prepare for their IM residencies.

I know everyone says that we should just relax and not do anything for the next 3 months until residency starts, but is it different for my situation? Should I study anything in this time to prevent being "that" intern who doesn't know anything and is the least prepared compared to all the other interns? I know I was stupid for not taking more challenging electives.

How did you not match Psych? I thought everyone matched psych. What were your boards?

 

[Silent Cool]

You should be okay.
You're coming straight out of Med school.
I was 3 years removed from Med school and doing a non-PC specialty and while it took some time as expected, I feel I've made it to the level of my colleagues. Just work hard and you'll be fine.

@Doctor4Life1769 , why did you switch out of anesthesia? That's a lot of extra loan compounding.

 

[Doctor4Life1769]

@Doctor4Life1769 , why did you switch out of anesthesia? That's a lot of extra loan compounding.

Not really.
It only kicks in when you finish residency. I still carve a portion into it, but I'm not sweating it.

 

[DrMeowMeow]

How did you not match Psych? I thought everyone matched psych. What were your boards?

I don't know why, I was shocked too. I'm a DO and had above average COMLEX scores but didn't take the USMLE and all the programs said my application was great with no flags. I had great post communication with some programs and felt blindsided. I think psych was more competitive this year.

 

[Doctor4Life1769]

I don't know why, I was shocked too. I'm a DO and had above average COMLEX scores but didn't take the USMLE and all the programs said my application was great with no flags. I had great post communication with some programs and felt blindsided. I think psych was more competitive this year.

Usually don't need usmle for psych.
It probably was, but it's probably a blessing in disguise.

 

[Ericslv]

Hello everyone,

I didn't match to Psychiatry and ended up scrambling to an opposed FM program. I'm very grateful to be able to do FM since I will still get a lot of psych exposure and I was wavering between psych and FM during my 3rd year. However, I'm terrified about my lack of preparation for this residency.

When I decided on Psychiatry, I chose all my 4th year elective rotations as many months of psychiatry, one outpatient FM, and the rest were either outpatient or "easy" inpatient rotations. Whenever attendings found out I was doing psychiatry they would have the attitude of not having me do procedures or teaching me much because "oh you're doing psych? You wont have to do any of this anyway." I haven't done an inpatient IM rotation in over a year and I haven't done as many procedures as I should have (Still terrible at sutures and pap smears). I thought this would be okay since I was dead set on psychiatry and never predicted I wouldn't match.

My evaluations for outpatient rotations were great so I am comfortable with that, but in residency there is a lot of OB and inpatient IM. I am very worried I'll be a loser resident because of my lack of experience while my other classmates did challenging rotations like ICU to prepare for their IM residencies.

I know everyone says that we should just relax and not do anything for the next 3 months until residency starts, but is it different for my situation? Should I study anything in this time to prevent being "that" intern who doesn't know anything and is the least prepared compared to all the other interns? I know I was stupid for not taking more challenging electives.

First. You're going to be just fine. Remember that even in Psych you would have to do an intern year and some medical training. If you want to keep your mind busy/active get copy of first aid for intern year or Family medicine review and go over some basics. But you don't even need that. Become an interactive sponge your first year. Learn and then learn some more.

But now to the bigger topic. You chose psych but didn't get in. There is a huge shortage of psych MDs. So you must have been too picky with your choices or just did something really wrong because otherwise psych is not too competitive.

I think if you want psych you should go into psych and (I know this will not be like by all) perhaps try again after your intern year. The FP program will hate you but only for a couple of years due to the shortage they have to fill. If your unhappy it will be for a lifetime.

 

[Ericslv]

Not really.
It only kicks in when you finish residency. I still carve a portion into it, but I'm not sweating it.

You must have really hated anesthesia.

 

[playingfrombehind]

there are alot of ppl giving false reassurance - how can they know you will be fine from the info you have given?

-my advice is try to find a family physician (i'm sure your school has lots of resources) and shadow as much as you can before starting residency
-pay attention to prescription, how to write orders, how office runs, so you aren't like a dog chasing his/her tail when you start residency
-simple things like being able to take a manual BP and pap-smear should not be overlooked. If you were the patient and you saw some intern fumbling with the BP cuffs how confident would you feel in the intern?

-I saw a reddit topic covering "must know topics" for interns
-i.e. fluid management, how to read EKG and CXR, etc.
-I think it is very important not to just "relax" before intern year but at the same time you want to be mentally/spiritually/physically prepared

-I am an off-cycle and have not been managin patients for a year so I took a ultrasound course to brush up on radiology and observed/shadowed any chance I got at the FM office.
-it was harder to shadow OB and peds and I was not allowed in any direct patient care for OB or GYN or Peds
-I also took my step 3 and am studying hard for the ABFM exam to solidify knowledge base

I highly recommend Graber and Wilbur - it is the FM board exam's First Aid. Its a questions and answer book that makes review efficient and fun.

 

[Doctor4Life1769]

there are alot of ppl giving false reassurance - how can they know you will be fine from the info you have given?

-my advice is try to find a family physician (i'm sure your school has lots of resources) and shadow as much as you can before starting residency
-pay attention to prescription, how to write orders, how office runs, so you aren't like a dog chasing his/her tail when you start residency
-simple things like being able to take a manual BP and pap-smear should not be overlooked. If you were the patient and you saw some intern fumbling with the BP cuffs how confident would you feel in the intern?

-I saw a reddit topic covering "must know topics" for interns
-i.e. fluid management, how to read EKG and CXR, etc.
-I think it is very important not to just "relax" before intern year but at the same time you want to be mentally/spiritually/physically prepared

-I am an off-cycle and have not been managin patients for a year so I took a ultrasound course to brush up on radiology and observed/shadowed any chance I got at the FM office.
-it was harder to shadow OB and peds and I was not allowed in any direct patient care for OB or GYN or Peds
-I also took my step 3 and am studying hard for the ABFM exam to solidify knowledge base

I highly recommend Graber and Wilbur - it is the FM board exam's First Aid. Its a questions and answer book that makes review efficient and fun.

So, a med student applying psych wouldn't know how to take a BP? Hell, not even a pap? I hadn't done a pap in 4-5 years when I had to do my first pap when I entered into FM. I honestly could not remember jack so I watched a YouTube video, had my attending in the room to ensure I did it right, did it, and was told "you did it right" as they walked out the door. It isn't hard.

Good programs will do a bootcamp/didactic session up front and then throughout the year have various didactics for their interns. Mine does. It'll be okay, she didn't just abandon medicine for 5 years and decide to get back into it. Like I said, if I could come from a completely different specialty and assimilate myself into FM, she shouldn't have issues unless she farted around during M3/M4 years. I worked my tail off as an M3/M4 and had all the hard working rotations (oh the misery it was, but it certainly helped me during my intern year).

I won't comment on the board review, it may not be a bad idea but honestly FM is so frikken broad that I don't even know.

 

[Doctor4Life1769]

You must have really hated anesthesia.

Lots at play, but I will say that since the switch I'm happy as a clam and I hadn't felt that way since intern year (which I'd loved).

 

[DrMeowMeow]

I have a one month orientation apparently so hopefully they'll go over a lot of things. I definitely know how to take a BP and I've done 4-5 paps before over the past 2 years, but still get nervous about it.

I highly doubt I will try to transfer back to psychiatry. I had 7 interviews (5 in state) and ranked all of them. Most of my interviewers were raving how great every aspect of my application was, so I was probably a bad interviewer and/or awkward. A couple PDs got my hopes up with post communication emails so I feel some resentment toward the field I guess. Don't really want to go for a specialty that didn't want me.

I'm pretty sure I'll be satisfied with FM. I had fun in my FM rotations and got 2 of my LORs from FM.

 

[playingfrombehind]

So, a med student applying psych wouldn't know how to take a BP? Hell, not even a pap? I hadn't done a pap in 4-5 years when I had to do my first pap when I entered into FM. I honestly could not remember jack so I watched a YouTube video, had my attending in the room to ensure I did it right, did it, and was told "you did it right" as they walked out the door. It isn't hard.

Good programs will do a bootcamp/didactic session up front and then throughout the year have various didactics for their interns. Mine does. It'll be okay, she didn't just abandon medicine for 5 years and decide to get back into it. Like I said, if I could come from a completely different specialty and assimilate myself into FM, she shouldn't have issues unless she farted around during M3/M4 years. I worked my tail off as an M3/M4 and had all the hard working rotations (oh the misery it was, but it certainly helped me during my intern year).

I won't comment on the board review, it may not be a bad idea but honestly FM is so frikken broad that I don't even know.

You would be surprised how many basics med students don't know - ABGs, blood draws, recording EKG, casting, ACE bandages, etc. the list goes on. I saw this on my E.D. aways. I did alot of E.D. away rotations to prepare for step 2 CS and the fact that you get a large volume of patients and lab results come back faster, etc.

 

[Doctor4Life1769]

You would be surprised how many basics med students don't know - ABGs, blood draws, recording EKG, casting, ACE bandages, etc. the list goes on. I saw this on my E.D. aways. I did alot of E.D. away rotations to prepare for step 2 CS and the fact that you get a large volume of patients and lab results come back faster, etc.

Fair 'nuff.
I'll concede that I didn't have a clue when it came to casting and splinting, and it's still not my thing, but I have a better idea of the basics now. We do an internship and residency for a reason. If we learned everything we needed to know while in med school then we wouldn't need to be hospital slaves for 3-7 years.

 

[Doctor4Life1769]

I have a one month orientation apparently so hopefully they'll go over a lot of things. I definitely know how to take a BP and I've done 4-5 paps before over the past 2 years, but still get nervous about it.

I highly doubt I will try to transfer back to psychiatry. I had 7 interviews (5 in state) and ranked all of them. Most of my interviewers were raving how great every aspect of my application was, so I was probably a bad interviewer and/or awkward. A couple PDs got my hopes up with post communication emails so I feel some resentment toward the field I guess. Don't really want to go for a specialty that didn't want me.

I'm pretty sure I'll be satisfied with FM. I had fun in my FM rotations and got 2 of my LORs from FM.

Atta girl.
Just have a good, positive attitude about the opportunity and you'll find it was a blessing in disguise.

 

[Ericslv]

I have a one month orientation apparently so hopefully they'll go over a lot of things. I definitely know how to take a BP and I've done 4-5 paps before over the past 2 years, but still get nervous about it.

I highly doubt I will try to transfer back to psychiatry. I had 7 interviews (5 in state) and ranked all of them. Most of my interviewers were raving how great every aspect of my application was, so I was probably a bad interviewer and/or awkward. A couple PDs got my hopes up with post communication emails so I feel some resentment toward the field I guess. Don't really want to go for a specialty that didn't want me.

I'm pretty sure I'll be satisfied with FM. I had fun in my FM rotations and got 2 of my LORs from FM.

Well that's great. You should do fine. I wouldn't worry about being ready. Just be aware and ready to learn and you'll do great. Good luck with everything.

 

[Ericslv]

there are alot of ppl giving false reassurance - how can they know you will be fine from the info you have given?

-my advice is try to find a family physician (i'm sure your school has lots of resources) and shadow as much as you can before starting residency
-pay attention to prescription, how to write orders, how office runs, so you aren't like a dog chasing his/her tail when you start residency
-simple things like being able to take a manual BP and pap-smear should not be overlooked. If you were the patient and you saw some intern fumbling with the BP cuffs how confident would you feel in the intern?

-I saw a reddit topic covering "must know topics" for interns
-i.e. fluid management, how to read EKG and CXR, etc.
-I think it is very important not to just "relax" before intern year but at the same time you want to be mentally/spiritually/physically prepared

-I am an off-cycle and have not been managin patients for a year so I took a ultrasound course to brush up on radiology and observed/shadowed any chance I got at the FM office.
-it was harder to shadow OB and peds and I was not allowed in any direct patient care for OB or GYN or Peds
-I also took my step 3 and am studying hard for the ABFM exam to solidify knowledge base

I highly recommend Graber and Wilbur - it is the FM board exam's First Aid. Its a questions and answer book that makes review efficient and fun.

Not giving false reassurance. Most FM programs give a lot of support to the interns. Especially to someone who scrambled into the program. This isn't the first time they have done this. What they are looking for is consistent progress throughout the year.

But if someone wants to read, then read topic in the washington manual or a fast quick fact guide for OB/Gyn. Read a book about ambulatory care and clinic topics etc.

Here is what's going to happen your intern year. During clinic you are going to see a few patients, take a history in detail, formulate a deferential and present it to the attending. He/She will then ask you questions and guide you to the correct diagnosis if you don't have it already. You will then mange the patient. Your notes will be looked at by an attending and they will give some criticism and advise some changes.

When on call you will admit patients and along with the 2nd year will be the first on the scene to to H&P and write up the patient. You will then have to present that to the attending (at my site most of the time that was over the phone) and make decisions that the attending will go over with you. The 2nd year is there to guide you and help.

The best time to learn and read is right after those admits or soon after because it's fresh and just you soak it right in.

So read the AAFP publication, read uptodate if you have it and stay alert. Most programs will get your ATLS, ACLS and peds covered by the end of the first year.

 

[saudades]

The same thing happened to me, didn't match psych (had a decent number of interviews but had red flags) and scrambled into FM. I was more prepared than I thought. OnlineMedEd has great section for interns, mostly intro to stuff like fluids, CHF, etc. Like others have said, be a sponge, read every day, stay up to date on USPSTF guidelines and things like that, and very importantly, have a good attitude. You will have plenty of clinic exposure and I think you will pick up on basic procedures pretty quickly.