Should I take a leave of absence from medical school (2nd year)?

[WanderingMan]

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I am coming up to the 3/4 mark of my second year, and frankly I feel as if the past year and a bit has been me "phoning it in" 8 or 9 days out of 10. I hate myself for doing this, because it isn't fair to anybody--not to the future patients, not to the other students, not to our instructors and support staff, not to my family and friends, and not to myself. All passion seems gone from my pursuit of medicine about 95% of the time, whether it is lectures, labs, case based learning (CBL) sessions, or clinical skills sessions (my school has a CBL and systems-based curriculum). I kept thinking that it was a bad unit, or I was experiencing a bit of depression, or I was being lazy, or...I don't know what else. None of these explanations hold water after more than a year. I have never consistently felt this way before, not even in the worst period of grad school when I was suffering from very bad depression (suicidal, barely able to get out of bed, crying at my desk), and it seemed like my projects were going nowhere. I still thought it was important to show up to the lab and give it my best.

I have begun to seriously reflect on my personality, strengths and weaknesses, and passions. My passions are how the mind works, politics and policy, and teaching. I also still have an interest in chemistry and the physical sciences (but I think pursuing a PhD would be the wrong thing to do--I left with a masters degree after deciding against this). None of these subjects, outside of the two week block of psychiatry and some aspects of immunology and (integrated) pharmacology, ever come up in any sustained way during the first two years of medical school. A 1 year masters in public policy is starting to look very attractive as a springboard to an alternative career that I actually care about.

I came into medical school, in my mid to late 20s (after a change from a PhD career track in chemistry and some additional preparation), with what I believed were the right reasons--a mix of motives including intellectual curiosity about a challenging field, making a difference in the lives of people, a passion for psychiatry, and a well-paying and secure profession. What I thought was a mature, robust, and realistic mix of motives. My interest in psychiatry was reinforced through a small research project in the area last summer: my favorite part of that job by far was talking to the psych. patients in interviews. I have been told that I have great analytical and critical thinking skills, as well as a nice bedside manner. But I hate, hate, hate the mountains of memorization--the brachial plexus isn't harder than quantum mechanics or advanced organic chemistry (easier, if anything), but it is soul crushingly boring.

I have heard from some people that clerkship and beyond, despite their significant challenges and stresses, are far more satisfying than the preclinical years. Others have said that preclinical students don't realize how easy they have it and that "you ain't seen nothing yet". It seems to depend on the person, the school, and the chosen specialty, from what I can piece together. Is clerkship still mostly memorizing mind numbing information in between scrambling to learn how to navigate the hospital's records, professional hierarchies, doing "real" histories and exams, and doing the occasional procedure? Is 95% of medicine shoveling tedium into your mind, mixed with a robotic application of probability algorithms?

I realize that neither life, nor especially medical school, is all puppy dogs and rainbows for 99.9% of people, but at what point does it go beyond "sucking it up" to unnecessary self-punishment, as well as the wrong career path? What if I stick with this, survive, and then emerge from it in my mid to late 30s still hating my life? I refuse to believe that all jobs/life in the "real world" must make a person miserable.

I have been speaking with a psychiatrist, a counselor, my school's director of student affairs, and will be speaking to the assistant dean in the near future on this subject. In the meantime, any constructive and mature input would be appreciated.

 

[JackShephard MD]

I am coming up to the 3/4 mark of my second year, and frankly I feel as if the past year and a bit has been me "phoning it in" 8 or 9 days out of 10. I hate myself for doing this, because it isn't fair to anybody--not to the future patients, not to the other students, not to our instructors and support staff, not to my family and friends, and not to myself. All passion seems gone from my pursuit of medicine about 95% of the time, whether it is lectures, labs, case based learning (CBL) sessions, or clinical skills sessions (my school has a CBL and systems-based curriculum). I kept thinking that it was a bad unit, or I was experiencing a bit of depression, or I was being lazy, or...I don't know what else. None of these explanations hold water after more than a year. I have never consistently felt this way before, not even in the worst period of grad school when I was suffering from very bad depression (suicidal, barely able to get out of bed, crying at my desk), and it seemed like my projects were going nowhere. I still thought it was important to show up to the lab and give it my best.

I have begun to seriously reflect on my personality, strengths and weaknesses, and passions. My passions are how the mind works, politics and policy, and teaching. I also still have an interest in chemistry and the physical sciences (but I think pursuing a PhD would be the wrong thing to do--I left with a masters degree after deciding against this). None of these subjects, outside of the two week block of psychiatry and some aspects of immunology and (integrated) pharmacology, ever come up in any sustained way during the first two years of medical school. A 1 year masters in public policy is starting to look very attractive as a springboard to an alternative career that I actually care about.

I came into medical school, in my mid to late 20s (after a change from a PhD career track in chemistry and some additional preparation), with what I believed were the right reasons--a mix of motives including intellectual curiosity about a challenging field, making a difference in the lives of people, a passion for psychiatry, and a well-paying and secure profession. What I thought was a mature, robust, and realistic mix of motives. My interest in psychiatry was reinforced through a small research project in the area last summer: my favorite part of that job by far was talking to the psych. patients in interviews. I have been told that I have great analytical and critical thinking skills, as well as a nice bedside manner. But I hate, hate, hate the mountains of memorization--the brachial plexus isn't harder than quantum mechanics or advanced organic chemistry (easier, if anything), but it is soul crushingly boring.

I have heard from some people that clerkship and beyond, despite their significant challenges and stresses, are far more satisfying than the preclinical years. Others have said that preclinical students don't realize how easy they have it and that "you ain't seen nothing yet". It seems to depend on the person, the school, and the chosen specialty, from what I can piece together. Is clerkship still mostly memorizing mind numbing information in between scrambling to learn how to navigate the hospital's records, professional hierarchies, doing "real" histories and exams, and doing the occasional procedure? Is 95% of medicine shoveling tedium into your mind, mixed with a robotic application of probability algorithms?

I realize that neither life, nor especially medical school, is all puppy dogs and rainbows for 99.9% of people, but at what point does it go beyond "sucking it up" to unnecessary self-punishment, as well as the wrong career path? What if I stick with this, survive, and then emerge from it in my mid to late 30s still hating my life? I refuse to believe that all jobs/life in the "real world" must make a person miserable.

I have been speaking with a psychiatrist, a counselor, my school's director of student affairs, and will be speaking to the assistant dean in the near future on this subject. In the meantime, any constructive and mature input would be appreciated.

Why not finish the semester and then take a research year or something. Buys you some time.

Sorry things aren't working out.

 

[GladifImakeit]

The vicious cycle: depression --> problems in school --> depression --> problems in school (or substitute whatever you care about if not school)

I have disappointed everyone who ever believed in me to the extent that I can look no one in the eye. No self-confidence at all. This just creates more problems, and on and on I go, spiraling downwards. Don't make the mistakes I did. Stay in school or you could end up hating yourself like me.

 

[Chakrabs]

To be quite honest, it sounds very typical of second year. I certainly felt horrible and burnt out at that stage. A good friend of mine was very depressed. However, it will pass. The clinical years were absolutely fantastic! Certainly not a cakewalk, especially in my school, but I was actually doing some "doctoring" and I really enjoyed it. Do take the opportunity to explore psychiatry. These days they're coming out with some fantastic treatments, and I do believe that field is going places.

 

[WanderingMan]

Why not finish the semester and then take a research year or something. Buys you some time.

Sorry things aren't working out.

These are my thoughts as one possible option, except perhaps doing a masters in public policy or in health policy during that "year off". Thanks for your input.

 

[SteinUmStein]

I can only speak from my own experiences as someone wrapping up M2 year and starting Step 1 studying - it sucks. It really does. And I'm not sure taking time off is going to improve your outlook, situation, or your intuition on whether medicine is right for you. Honestly it wouldn't take that much to push me into your type of situation and the best advice I could give to alternative universe me is to just keeping going despite it all. Press on to M3 year and see how you like clinical medicine, which is much closer to what your actual career will look like. M1/M2 years and boards studying will be a distant memory... at least that's what I tell myself. Best of luck.

 

[WanderingMan]

I do not think that I am currently suffering from depression, although I can easily see the current situation leading to its development.

You think that a leave of absence would be a mistake? Why is that?

Thanks for your reply.

The vicious cycle: depression --> problems in school --> depression --> problems in school (or substitute whatever you care about if not school)

I have disappointed everyone who ever believed in me to the extent that I can look no one in the eye. No self-confidence at all. This just creates more problems, and on and on I go, spiraling downwards. Don't make the mistakes I did. Stay in school or you could end up hating yourself like me.

 

[asmith1121]

I hated med school...except for physio and pharm, it seemed like mindless memorizing and constantly feeling bad about yourself bc you can't remember some line in robbins. I use to think...I could do p chem...why the eff is this so difficult? I was always the best at match/chem/physics and yet managed to bomb anatomy. Why do I suck so much? I felt like I would never be good enough, it was a vicious cycle of scraping by and feeling bad about myself. Then finally it clicked at some point. I promise there is way more critical thinking and analyzing third year. You'll feel way better...at least hold off until you've passed step 2, then do whatever you want. There are a lot more people than you think that are feeling exactly what you're feeling. Hang in there!

 

[WanderingMan]

Thanks for taking the time to reply and share some insight.

Was studying in the clinical years more satisfying in that you could easily relate it to the patients under your care, or was it something else? Was it the memorization and material itself, rather than the hours of studying required, that left you feeling burnt out during your second year?

To be quite honest, it sounds very typical of second year. I certainly felt horrible and burnt out at that stage. A good friend of mine was very depressed. However, it will pass. The clinical years were absolutely fantastic! Certainly not a cakewalk, especially in my school, but I was actually doing some "doctoring" and I really enjoyed it. Do take the opportunity to explore psychiatry. These days they're coming out with some fantastic treatments, and I do believe that field is going places.

 

[TexasPhysician]

Everyone hates the first couple years of medical school. Third year is a little better. 4th year is fun. Residency is awesome. I love my psychiatry residency - absolutely worth it.

 

[drizzt3117]

Thanks for taking the time to reply and share some insight.

Was studying in the clinical years more satisfying in that you could easily relate it to the patients under your care, or was it something else? Was it the memorization and material itself, rather than the hours of studying required, that left you feeling burnt out during your second year?

You don't have to study as much during m3 as you do during 1/2 and what you read is much more medically relevant.

 

[Cdg02001]

I certainly don't know how bad you're currently feeling, but rest assured that I felt the same way at the same point in my education as you. I "phoned it in" the entire first two years of medical school and had the same feelings of guilt and shame associated with it as you, as well as concern that things would not get better.

Boy was I wrong. I remember during August of my third year I was working on a Saturday (I had been working 6 day weeks the entire summer) and I was exhausted. It was 4PM, I was writing up a pt note, and I suddenly realized that I hadn't had lunch yet -- a normal occurrence in medicine, but my first time. Not only had I not felt hungry yet, I had been so busy I didn't know I had blown through lunch. In my previous career (also PhD track in wet labs) I would be so bored I'd regularly schedule breaks practically every hour to get a coffee and net surf, but in this case I had been so busy I don't think I'd been to the bathroom yet that day.

A huge wave of emotion swept over me, and I almost broke down in tears at the nursing station. It was positive emotion -- I felt like someone who had lived my whole life with ADHD and had just gotten his first dose of ritalin. I was working hard, enjoying it, and doing something that mattered. Since that day I've never looked back. The more intense the clerkship, the more I enjoyed it. It also transformed my performance -- I went through a "just squeak by" student in 1st and 2nd year to almost entirely honors in my clinical years. This was because studying no longer felt like a chore, but more a duty, and because at a certain it no longer feels like rote memorization.

Without knowing more about you, my advice would be to hang in there. The first two years of medical school are not what being a doctor is about, but you're just a few months away from experiencing it firsthand. Then you'll know if you really are a doctor. Ever since my clinical years in medical school, I have woken up every day knowing I'm in the greatest profession in the world. I could not imagine doing anything else with my time. Make this decision after third year.

 

[JS1980]

While not the exact same situation, I found myself in kind of a similar one suring my second year and felt compelled to chime in.

I hit a point similar to the one you're at somewhere early on in second year. It just got to a point where I just couldn't get myself to sit down every day after class and memorize a ton of minutiae. I ended up phoning it in for most of the year, something I had never done throughout my entire educational career. Like you, I had had depression in the past, but it never got to the point where it affected my school work or job performance. However, this was kind of different - that whole year really had me questioning whether I had chosen the right field and whether or not I could even do this.

Long story short, I ended up taking a year off after second year (did a research fellowship) and it was the BEST decision I could have made. The time off allowed me to separate myself from, at that point, the negative school environment and really evaluate what I wanted out of my career.

After coming back, I was re-energized and things have been a lot better because of it. Others may say things get better during 3rd and 4th year, but you know yourself best. I know that it would have been a HUGE mistake to just continue with 3rd and 4th year because I would have just been going through the motions at that point. You need to do what is best for you.

 

[SteinUmStein]

I certainly don't know how bad you're currently feeling, but rest assured that I felt the same way at the same point in my education as you. I "phoned it in" the entire first two years of medical school and had the same feelings of guilt and shame associated with it as you, as well as concern that things would not get better.

Boy was I wrong. I remember during August of my third year I was working on a Saturday (I had been working 6 day weeks the entire summer) and I was exhausted. It was 4PM, I was writing up a pt note, and I suddenly realized that I hadn't had lunch yet -- a normal occurrence in medicine, but my first time. Not only had I not felt hungry yet, I had been so busy I didn't know I had blown through lunch. In my previous career (also PhD track in wet labs) I would be so bored I'd regularly schedule breaks practically every hour to get a coffee and net surf, but in this case I had been so busy I don't think I'd been to the bathroom yet that day.

A huge wave of emotion swept over me, and I almost broke down in tears at the nursing station. It was positive emotion -- I felt like someone who had lived my whole life with ADHD and had just gotten his first dose of ritalin. I was working hard, enjoying it, and doing something that mattered. Since that day I've never looked back. The more intense the clerkship, the more I enjoyed it. It also transformed my performance -- I went through a "just squeak by" student in 1st and 2nd year to almost entirely honors in my clinical years. This was because studying no longer felt like a chore, but more a duty, and because at a certain it no longer feels like rote memorization.

Without knowing more about you, my advice would be to hang in there. The first two years of medical school are not what being a doctor is about, but you're just a few months away from experiencing it firsthand. Then you'll know if you really are a doctor. Ever since my clinical years in medical school, I have woken up every day knowing I'm in the greatest profession in the world. I could not imagine doing anything else with my time. Make this decision after third year.

👍 👍 This is why I would avoid taking time off unless there is something you specifically want to do before starting M3 year. You don't have the information you need to make a decision of whether a career in medicine is right for you, but you will in a few months if you stick it out. There's always gap year options between M3 and M4 year if you need time to think about your M3 experiences, etc.

 

[FSU2013]

Stick it out, at least to the end of M2, then take Step 1. Don't close any doors.

You made a calculated, informed decision to pursue medicine in a sober mind. Don't make a knee jerk decision that will undo all of your work to date.

I got my bachelor's in physic, got an 'A' (actually an A-) in quantum mechanics - I know excatly what you are talking about - I was in the exact same situation as you are last year. Med school is exceedingly intellectually challenging, but not because it requires and extremely high IQ, but because it requires an extreme intellectual determination (and tolerance of BS). I'm now in my third year - things get better. You start to see patients and actually help people. It's a different world. Second year is filled with a boat load of memorization and it's entirely focused on how people die......it's soul crushing.

90+% of med students feel how you feel. No one likes second year. Everyone hides it. Since med school is so hypercompetitive, people are afraid to show any weakness, but it's there.

If medicine isn't for you and you really think that you are making the right decision, then do it, but it makes sense to at least finish the year and take your boards. Take some time off and think about it long and hard, you don't want to regret it for the rest of your life.

Best of luck.

 

[asmith1121]

I certainly don't know how bad you're currently feeling, but rest assured that I felt the same way at the same point in my education as you. I "phoned it in" the entire first two years of medical school and had the same feelings of guilt and shame associated with it as you, as well as concern that things would not get better.

Boy was I wrong. I remember during August of my third year I was working on a Saturday (I had been working 6 day weeks the entire summer) and I was exhausted. It was 4PM, I was writing up a pt note, and I suddenly realized that I hadn't had lunch yet -- a normal occurrence in medicine, but my first time. Not only had I not felt hungry yet, I had been so busy I didn't know I had blown through lunch. In my previous career (also PhD track in wet labs) I would be so bored I'd regularly schedule breaks practically every hour to get a coffee and net surf, but in this case I had been so busy I don't think I'd been to the bathroom yet that day.

A huge wave of emotion swept over me, and I almost broke down in tears at the nursing station. It was positive emotion -- I felt like someone who had lived my whole life with ADHD and had just gotten his first dose of ritalin. I was working hard, enjoying it, and doing something that mattered. Since that day I've never looked back. The more intense the clerkship, the more I enjoyed it. It also transformed my performance -- I went through a "just squeak by" student in 1st and 2nd year to almost entirely honors in my clinical years. This was because studying no longer felt like a chore, but more a duty, and because at a certain it no longer feels like rote memorization.

Without knowing more about you, my advice would be to hang in there. The first two years of medical school are not what being a doctor is about, but you're just a few months away from experiencing it firsthand. Then you'll know if you really are a doctor. Ever since my clinical years in medical school, I have woken up every day knowing I'm in the greatest profession in the world. I could not imagine doing anything else with my time. Make this decision after third year.

This is so true....during third year...I studied bc I wanted to know...for the patients, it was no longer about me. It was no longer about memorizing. I also went from scraping by...to honoring and killing step 2, bc that's really when you start to put the pieces together. It's not just memorizing for some test you don't care about...it's about wanting to know everything you can to solve a problem...for a patient. No better way to spend your day.

 

[Rendar5]

It sounds like you're interested in psychiatry or neuropsych. There is very little teaching of this in most places during the first 2 years of med school. What you need to do is get some help to get through this year and the step1. And then schedule your psych rotation extremely early on in your 3rd year. If after that you're still apathetic about medicine and it isn't depression talking, quit. and get an MPH.

 

[MrCheetah]

I am coming up to the 3/4 mark of my second year, and frankly I feel as if the past year and a bit has been me "phoning it in" 8 or 9 days out of 10. I hate myself for doing this, because it isn't fair to anybody--not to the future patients, not to the other students, not to our instructors and support staff, not to my family and friends, and not to myself. All passion seems gone from my pursuit of medicine about 95% of the time, whether it is lectures, labs, case based learning (CBL) sessions, or clinical skills sessions (my school has a CBL and systems-based curriculum). I kept thinking that it was a bad unit, or I was experiencing a bit of depression, or I was being lazy, or...I don't know what else. None of these explanations hold water after more than a year. I have never consistently felt this way before, not even in the worst period of grad school when I was suffering from very bad depression (suicidal, barely able to get out of bed, crying at my desk), and it seemed like my projects were going nowhere. I still thought it was important to show up to the lab and give it my best.

I have begun to seriously reflect on my personality, strengths and weaknesses, and passions. My passions are how the mind works, politics and policy, and teaching. I also still have an interest in chemistry and the physical sciences (but I think pursuing a PhD would be the wrong thing to do--I left with a masters degree after deciding against this). None of these subjects, outside of the two week block of psychiatry and some aspects of immunology and (integrated) pharmacology, ever come up in any sustained way during the first two years of medical school. A 1 year masters in public policy is starting to look very attractive as a springboard to an alternative career that I actually care about.

I came into medical school, in my mid to late 20s (after a change from a PhD career track in chemistry and some additional preparation), with what I believed were the right reasons--a mix of motives including intellectual curiosity about a challenging field, making a difference in the lives of people, a passion for psychiatry, and a well-paying and secure profession. What I thought was a mature, robust, and realistic mix of motives. My interest in psychiatry was reinforced through a small research project in the area last summer: my favorite part of that job by far was talking to the psych. patients in interviews. I have been told that I have great analytical and critical thinking skills, as well as a nice bedside manner. But I hate, hate, hate the mountains of memorization--the brachial plexus isn't harder than quantum mechanics or advanced organic chemistry (easier, if anything), but it is soul crushingly boring.

I have heard from some people that clerkship and beyond, despite their significant challenges and stresses, are far more satisfying than the preclinical years. Others have said that preclinical students don't realize how easy they have it and that "you ain't seen nothing yet". It seems to depend on the person, the school, and the chosen specialty, from what I can piece together. Is clerkship still mostly memorizing mind numbing information in between scrambling to learn how to navigate the hospital's records, professional hierarchies, doing "real" histories and exams, and doing the occasional procedure? Is 95% of medicine shoveling tedium into your mind, mixed with a robotic application of probability algorithms?

I realize that neither life, nor especially medical school, is all puppy dogs and rainbows for 99.9% of people, but at what point does it go beyond "sucking it up" to unnecessary self-punishment, as well as the wrong career path? What if I stick with this, survive, and then emerge from it in my mid to late 30s still hating my life? I refuse to believe that all jobs/life in the "real world" must make a person miserable.

I have been speaking with a psychiatrist, a counselor, my school's director of student affairs, and will be speaking to the assistant dean in the near future on this subject. In the meantime, any constructive and mature input would be appreciated.

Do you have much cash in the bank? If its just a little doom and gloom I'd say continue and see what third year brings. Being 3/4 of the way through 2nd year, I think you're probably a little too far invested to make a career swap here. However, if its getting bad why not take a year off and do something radical to totally refresh your mind and perspective on things, like travel around the world?

 

[Chakrabs]

Thanks for taking the time to reply and share some insight.

Was studying in the clinical years more satisfying in that you could easily relate it to the patients under your care, or was it something else? Was it the memorization and material itself, rather than the hours of studying required, that left you feeling burnt out during your second year?

It was all of the above that left me burnt out. I hate just sitting around with a book and trying to pound minutia into my head just so I can regurgitate it out. Especially since much of the information isnt really applicable to day to day patient care. Obviously there's plenty of that to study in 3rd yr as well, but there's a lot more stuff thats applicable to what you're actually seeing and doing on the wards. Also for me, there was just something to going into work and coming back after a long, hard day that made me feel more like a working-man. I just felt much more adult, and as if it mattered more. Its very hard to explain, but I can tell you, it was a huge improvement over 2nd year, and my grades certainly reflected it!

 

[WanderingMan]

A big thank you to everyone for their advice. At this point I will try to muster through the rest of this year and decide during the summer whether a leave of absence would be warranted.

 

[brianmartin]

I feel exactly the same as you do. The problem is that as I learn more about myself, the less and less interested I am in the details and logistics of the stuff I can't see--chemicals, hormones, transmitters. I'm discovering that I am a person who deals better with things I can see and touch, and that I'm much more comfortable with the forest than the trees. And for me, medicine is all trees and no forest.

 

[phospho]

A big thank you to everyone for their advice. At this point I will try to muster through the rest of this year and decide during the summer whether a leave of absence would be warranted.

I don't usually post anymore, just because it's been so busy. But I couldn't help but read through this thread. PLEASE read Cdg02001's post over again. I can't begin to tell you how much 2nd year sucks. You're at the same point with the same mentality with the same attitude I was in a year ago. Not only me actually, but so many others.

Right now is LITERALLY the worst time to self-reflect, and reconsider your decision. You're at the very lowest and most miserable time in all of medical school (and your life in general). You need to focus on getting through second year and getting your boards over with. I realize that during this path that led to medical school (I am also a nontrad), a lot of people have told us it doesn't get worse, or "just put up with it for a little more", or "hang in there, because next year is going to be worth it", etc... I promise you that this time it's for real - it really does get better. I'm only a third year, but not one resident or physician has ever told me otherwise. The only third years who have told me that third year sucks compared to second year (as you mentioned) are quite literally socially ******ed, are miserable people in general, or their motives (for their advice to you) are questionable. I'm obviously generalizing here, but I'm sure you catch my drift.

Nothing in undergrad or during the first 2 years of medical school was even close to the great experience that third year has been. The crazy thing is that every medical student truly knows this. In my humble opinion, if anyone who has gone through third year tells you to reconsider your career options, or that maybe you really do need to take some time off, they've forgotten what it's like to be at the same exact point in time of medical school where not only are you burned out from the non-stop roller coaster of 2nd year, but everyone around you seems like they are only warming up as they get ready to start studying for boards.

As I am sure you can tell from my post, last year around this time was probably the lowest points of my life. As I've gone through 3rd year, it's been very helpful to hear medical students talk about their time during second year. These stories are only now starting to come out. Talk about PTSD dude. I wish they talked about it that much when I was going through it. The system expects us to be perfect, so you won't see bitching or crying around you. That makes it infinitely harder when you start thinking that you may be the only one going through this. I assure you that you are not. As I mentioned, reading Cdg02001's reply to you might be worth your time. At this time last year, I would've printed it out and taped it on the wall right beside my computer screen.

Sorry for the long post. I hope it helps! Best of luck to you!