some counseling needed for a first year

[hihihi]

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I'm a long-time reader (about 2-3 years), but a first time poster. This site has truly helped me into my first year of medical school. Thank you to everyone that puts serious posts out here for people like me. I truly appreciate it.

I just started my first year, and I don't know what to think about it. I have a hard time getting started studying every night. My classmates are really competitive, and I feel like a slacker everytime I go to class. I am not at a top-notch school, but my classmates are people that would be willing to turn their life over to medicine. I am not going to do that. I feel like medicine is a job, not a life. Am I wrong to think this? Also, I am going to be competing against these people for residency positions. Am I at a disadvantage because I don't live, breathe, and eat medicine?

Does anyone feel the same way as me? I am glad to have the oppurtunity to study medicine, but I don't want to be ONLY known as a great doctor...I want to be known as a GREAT husband, a GREAT dad (sooner or later), and a GREAT guy.

Is this attitude of mine a bad one? I am not shooting for #1 in the class...I am not shooting for top 10% of my class. I want to be in the top half to top third of the class.

I like the "laid back type" of specialties, such as Radiology and Anesthesiology. I truly don't think that I will be happy anywhere else. Is my attitude going to hurt my chances of getting into any program?

I know this is a choppy message, but these are the thoughts that have been going through my head. Anyone in the same boat as me please reply. I hope I'm not alone out here.

Thanks for all the help.

 

[paean]

Anxiety is really common when starting a new experience. Many of us are in a similar position, because no matter how you slice it, the people surrounding us are the brightest and most dedicated group we have ever been immersed in. If you are used to comparing yourself to a group to see if what you are doing is good and on target, you may find yourself not getting the reassurance or ego boost that happened in undergrad.

I'd strongly suggest that you talk to someone in your student affairs office (or if you have one, the person or department responsible for student well-being) about how you are feeling. They probably will have the best idea of what it is like for entering students, and advice on how to make the transition. They can also tell you about opportunities for ongoing counseling, if you feel that you could use the support.

One last comment. Why are you aiming for the top 1/2 or 1/3 of your class? We're all used to aiming for the top, but now you are in a group of overachievers. If you don't feel that medicine is all there is to life, how about letting go the goal of being on the top, and enjoy a more balanced life while in school?

Let us know how it works out over the next few weeks.

 

[hihihi]

Thanks for the reply...and the good advice. The main reason I am kinda worried about my "non-gunner" attitude is that I am going to be competing against the so-called "gunners" of my class for residency positions. Is it possible that I will be pushed into a residency (even if I don't like it) because I have no other choice...due to my class rank. I know a lot about the residency match process, so I know that you don't list programs that you don't like. But...Let's just say that after my third year, I decide that I either want to be a radiologist or an anesthesiologist...nothing else even interests me. What will be my chances of getting into ANY program that I list on my match list??

Keep the ideas coming...I love and need advice

 

[mycin1600]

Radiology is a very competitive residency. I suggest you become a gunner, FAST!

 

[Jalby]

Originally posted by mycin1600
Radiology is a very competitive residency. I suggest you become a gunner, FAST!

I think top half or top third should do it. (assuming boards, too). But it definately isn't a residency that you can fall into.

 

[PimplePopperMD]

Originally posted by hihihi

I feel like medicine is a job, not a life. Am I wrong to think this? Also, I am going to be competing against these people for residency positions. Am I at a disadvantage because I don't live, breathe, and eat medicine?

Is this attitude of mine a bad one? I am not shooting for #1 in the class...I am not shooting for top 10% of my class. I want to be in the top half to top third of the class.

Fact is, like it or not, medicine IS more than just a job. You're feeling it now. It takes more dedication than a "job"... Later on, after residency in a field (like pathology, perhaps), you can see it as a job. Not now!

Having said that, the first two years aren't terribly important for residency. Just pass. The important stuff happens when you take boards... that's really important! And third year clerkships are really important as well.

I agree with the poster who said that you shouldn't worry about where you are in the class... just pass the first two years, and then work really hard for boards and third year clerkships if you're going into a competitive specialty.

 

[scully]

hihihi-

I agree with pimplepopper, that the first two years don't matter terribly much. I know plenty of people who have decided on radiology late in 3rd year/early 4th, and did fine. They did not start worrying on day 1, did not become gunners, but enjoyed their experiences and their lives.

It does seem like there are two types of med students (at least at my school) -- those that are gunners, who only associate with other med students, and who live med school. The others have kept their old friends, hang out with spouses/families, and don't let medschool dominate their lives. The top students are from both groups. So don't feel like you can't be a good husband, person, etc... It is possible to treat medical school like a job (granted, an extremely demanding one!) and still have a good, well-rounded life. You just have to be disciplined, and keep your priorities straight!

PS- Radiologists are laid back folks -- no gunners allowed!

 

[anamarylee]

hihihi
I know exactly what you mean. I fee like an underachiever whenever I'm in class or gross lab and everyone else knows every little piece of trivia and I don't. I have a VERY hard time sitting down to study every day. I've never had to do it before except right before an exam or to do a paper or something related. It's so hard getting organized and just understanding all of it. I wouldn't say my class is full of "gunners" but it's certanly not filled with people I'd like to hang out with, bring to my home, have a meal with. I've been going through a major "down" period, just feeling depressed and overwhelmed. A class of 115, only one student has approached me to see if I'm ok. It's dishartening when people around you only care about themselves. But I think about my clinical skills class experience and get some encouraging thoughts in my head, and that helps me settle down, because I really want to do this. I just wish people around me were nicer, not gunners.

 

[mikegoal]

wait a few weeks you will see there are people that are exactly like u in your class

 

[hihihi]

All of your advice is GREAT...It's good to know that I am not the only one out there feeling like this. Now, I want to ask y'all about the residency match. If I am die hard radiology and anesthesiology during my 4th year (or any two specialties, for that matter)....and assuming that I am right about the average for board scores and grades compared to my classmates....what are the chances of me getting in to ANY residency that I put on my list? Surely, there have been people in the past in a situation similar to mine. I have read all the time on this message board about great programs vs. not-so-great programs. Right now (even as a first year) I feel like if I can get into any program on my list, I would be grateful. Right now I feel like I wouldn't care what kind of program I get into...as long as it is in the SPECIALTY that I want. Hell, I really don't even know what the difference in a good program and a bad program is! Keep the advice coming...this is great.

 

[DuneHog]

Originally posted by scully
hihihi-

PS- Radiologists are laid back folks -- no gunners allowed!

Dream on. Certainly radiology has a laid back atmosphere once you get there, but at my school it seems like a least half of the people going into rads are total gunners. This will continue to be true as long as the job prospects, reimbursement and hours for radiologists continue to be as fantastic as they are now. Like it or not, all residencies, radiology programs included, screen for interviews using board scores, AOA etc (things gunners strive for and often achieve). And no interviews=no match.

For the original poster:

My advice would be to do the best you can. Learn as much as you can and be dedicated to doing what's best for the patient. You can still do this and have a life outside of medicine, but medicine requires dedication - regardless of specialty. No one wants a radiologist who gives a crappy differential because they didn't study in medical school or learn how to give a good differential in residency. And no one wants a radiologist who is not available after 4pm because they are too interested in "having a life." Honestly, if you are so concerned about lifestyle you should really reconsider your career choice. It is really hard to be a good doctor (even a radiologist or anesthesiologist) without being dedicated. That said, there is nothing wrong with seeking some balance. Just realize that part of being a doctor means making some sacrifices for patient care. If you or a family member were ill, you would want your doctors (including your radiologist or anesthesiologist) to go the extra mile for you, and you would not want any of your doctors thinking about your care as "just a job".

Also, as far as anesthesiology and radiology go, both of these specialties require a solid understanding of the concepts taught in the first two years of medical school. Radiology requires knowing about the pathophysiology of virtually every medical specialty, without the benefit of seeing multiple patients with disease processes to help register it in your memory. Anesthesiologists practice the physiology taught in the first two years every day. Sometimes the monotony of the classroom years of medical school may get you down. But try to remember that some of this stuff will be important later on. You will certainly have a chance to learn it again, but it is important to establish a good foundation.

Sorry for the tirade. Sometimes I just get frustrated hearing people in ther 1st and 2nd year of medical school come off sounding so self-centered and so concerned with lifestyle. It seems like lifestyle has become such a focus for so many medical students, however I bet that none of this was discussed with the admissions committee.

 

[PimplePopperMD]

Originally posted by DuneHog

Sorry for the tirade. Sometimes I just get frustrated hearing people in ther 1st and 2nd year of medical school come off sounding so self-centered and so concerned with lifestyle. It seems like lifestyle has become such a focus for so many medical students, however I bet that none of this was discussed with the admissions committee.

Some things aren't discussed at interview settings, but are certainly thought about. Why shouldn't medical students be concerned about lifestyle, income, etc? Wanting a life outside of medicine is "self centered"? It most CERTAINLY is! And we should all strive for a certain amount of that.

Likewise, I get sick and tired of some medical students (and a very few residents) who lash out at folks for being concerned about future income, future lifestyle, when making decisions about CAREER. Look -- one must be happy in life in order to be a good doc. That means that some people (ie me) would not lead a satisfied existence as a general surgeon, regardless of interest in the field.

My take -- when deciding on a career, take your interest into account, but only the foolhardy don't take their personality into account... you must fit your own style, your own values, into your career choice; if you can't, then you will burn out (or be bored, alternatively) later.

 

[scully]

DuneHog-

I agree with many of your points. However, you make it sound like wanting to spend time with family/significant other is a bad thing. I think you will find that medical students with someone significant in their lives are concerned about having time to make their relationships work. There is no reason why this can't be more important to them than school or work and it does not make them self-centered. Most doctors have families and do not compromise patient care.

I think that you probably have a different concept of "having a life" than others here have expressed. I know that as a premed and 1st year I was constantly told that medical school and residency would be nothing but life in the hospital. I have found out that this is an exaggeration, and if you manage your time well, you do have time to spend with others, exercise, and do a few non-medical things while still being a very good student doctor. Perhaps you are referring to people who want easy specialties because they want to goof off or not work hard. I don't think that this is what hihihi was saying. There is a difference between someone who wants bankers' hours so they can go golf at 4pm (you are right -- these should not go into medicine) and those who want to get home by 8pm to see their wife and kids.

As far as radiology goes... the people in my school at least who are going for rads are smart, very sharp, motivated people, but I wouldn't call any of them gunners. They are all very friendly, very helpful, and well-rounded. They work hard, but they also do volunteer work, go to class functions and parties, etc... This is not my idea of a gunner. (We do have gunners, but they are mostly surgery and derm types who are always looking for an edge.) I talked to the head of the program at my school two days ago, and she said that the person mattered much more than the numbers, and regardless of board scores, an annoying gunner was not going to get a residency there. That is not to say that you don't have to perform well to get your foot in the door, but you don't have to be a gunner to perform well enough.

 

[hihihi]

The reply from DuneHog is the type of reply that I thought I would get from starting this thread. In fact...that type of reply is what brings out my pessimistic view of my life in medicine. Oh well, one bad (not really bad...just kind of a downer) reply out of ten is a lot better than I expected.

I will be one of those type of students who pick a specialty almost entirely on lifestyle. No...not the money aspect, but the stress-level and the hours/on-call time/vacation aspect. I don't care if I have a true interest in a particular type of specialty...I would start to hate it if it turned into my whole life and it took away from some of the things I like to do with my friends/family. It happens to a lot of physicians...and they end up being miserable. The purpose of all of this for me is to prevent it in the beginning instead of turning 40 years old (with a not-so-great family, high stress levels, and total job burnout) and finally realizing that I made a mistake in my specialty choice.

I like to work hard, when I know I am going to get rewarded with it. Then, when I get rewarded with it...it makes me work even harder. It's a cycle with me. But, I guess that I am so early into medical education, that I just am scared that I will invest all of this time and not find the medical career path that fits me.

Thanks again for all the responses..even the "bad ones"..HAHA!

 

[DuneHog]

I've obviously touched some nerves. I suppose my words were a little sharper than I meant them to be.

I guess I felt like the general tone of the responses was a little skewed and I felt I should take the other side. I am married and interested in having my time for spouse, kids and hobbies just like everyone else. I agree that wanting be happy and have a life outside of medicine does not make you self centered. The best doctors are the ones who are able to balance all of these things while still being dedicated to taking care of patients.

The main point that I wanted to convey is that it is worth considering whether medicine is right for you. Regardless of what specialty you are in you will be expected to put patients first by society and by your colleagues. And sometimes this means making sacrifices. Sure everyone needs to have balance, and certainly everyone should consider all factors, including lifestyle, in their specialty choice.

Sorry hihihi, my intention wasn't to beat you down for having concerns about lifestyle. It is just that I think that a lot of doctors who are unhappy at 40 didn't choose the wrong medical specialty. They chose the wrong field altogether and would be better off doing something non-medical.

Don't get discouraged by feeling a little overwhelmed at the start of the first year. Everyone does. And people that have posted responses have been appropriatly supportive. But also remember that the time demands of medicine don't get any less after the first year, and it's easier to get out now than it is once you are a resident with a ton of loans.

Regarding radiology, I wasn't trying to imply that you needed to be a gunner to get into radiology. But there are definitely gunners in radiology residency. Scully, it sounds like you are lucky to have such a likeable group of co-applicants at your school. But I assure you, it isn't like that everywhere.

Pimplepopper - I'm not sure why you are so intent on picking a fight with me. Here is a quote from a post of yours from a previous thread:

This is not a job to make money. It honestly isn't. It's something to which we need to dedicate ourselves.

There are two sides to every coin. I was just trying to give some balance to this thread by taking a point of view that you are obviously familiar with.

 

[MDgonnabe]

hihihi,

[Wow, it's been a while since I've posted here! My, things have changed. 🙂 ]

Anyways, I just wanted to say that I definitely empathize with everything you've been saying. I'm going to a nonranked, non-gunner school and despite that I still totally feel like an idiot. And even though I feel like an idiot (or perhaps because of it) I can't bring myself to crack open the books, either. I feel overwhelmed and am worried that even if I try I somehow won't make it. What makes this even worse is that every second I take to enjoy my life I feel guilty. Sleep makes me feel guilty. I don't feel like a human being anymore I feel like a medbot or something. I thought people were exaggerating when they said that you'd study a lot as a med student, but apparently they weren't. Don't get me wrong! I enjoy learning as much as the next med student. And I didn't go out socializing my every waking moment as an undergrad. (In fact, by most people's standards I didn't have much of a social life at all and I was fine with it.) I enjoyed things like working out, music, reading and being with my few, close friends now and then just to hang out. Now, starting my first year of med school, I feel as though I've lost what little I had of a social life and it's really depressing me. Like hihihi, I don't have tremendously high expectations. I was a laid back psych major as an undergrad and I'd love to do psychiatry or maybe even family medicine someday. I'm hearing that psych is getting a little harder to get into (though apparently each area goes through cycles of popularity from year to year). But the bottom line is that any field that I will want to go into will require me to be in touch with my humanity in some form or another. I need to be able to relate to my patients in many more ways than just as a medical encyclopedia. And with the way medical school is panning out right now I'm afraid I'll somehow lose touch with my ability to relate to anything other than books and tests. Any thoughts?

 

[ckent]

Hey MD,
Good to see you posting again. Don't worry too much about 1st yr, everyone gets overwhelmed at first but ~90% of the class will get into their groove and become much more relaxed a few months into school. Don't try to schedule all of your time for studying, taking breaks and sleeping is just as important as studying. Think of sleeping and taking breaks as time well spent by making you more efficient during the times when you are studying. Even though med school might seem overwhelming now, at the end of this year you will look back and wonder what you got so worked up for in the beginning of the year. It just takes time. My recommendation would be to remember the things that you used to do for fun and continue doing them during med school. My thing was easy, because I really like watching TV, so irrespective of whether I had to test coming up, I would always schedule it so that I could take that half an hour or hour to watch my favorite programs on TV. Exercise is also important, you can't sit in a chair all day and expect to keep healthy, so it's always nice to get up and walk around every 2 hrs or so as a break. To be honest, I really do miss my first 2 yrs of med school. It gets fun once you get the hang of it, you learn when you need to study and when you can take breaks. Since classes usually ended at 12 pm, I used to take an hour or so for lunch, then another hour to surf the web and post on SDN before I really got into my studying. Some days I just wouldn't feel like getting out of bed and I would miss class and it wasn't a big deal or anything. Don't think about it in terms of passing or failing, just think about it in terms of trying your best and seeing what happens. You will pass. Remember that ~97% of students graduate, and those 3% that don't usually have other, non-academic factors that prevent them from following through. And psychiatry is an easy program to match into, but don't let that deter you from studying hard because you really can't know now what you want to do. Also, the harder you study now, the easier it will be to pass the boards. Good luck!

 

[Neurogirl]

As a second yr neurology resident, I have "been there, done that" and know exactly what you're going through. I want to be encouraging, but at the same time, I think a dose of reality is in order. You need to realize that the competitive specialties are competitive for a reason. If you want a lifetime of great money and even better hours, you have to pay the price. That means good grades, good board scores and good LORs (which you get by being a great 3rd yr). Having gone through the process, I can tell you that grades in the first two years DO matter. They matter because 1) they affect your class rank, and 2) the people who did the best on the boards were USUALLY the same people who had good grades to begin with. If you don't learn the material over a two year period what makes you think you can just cram and do well on the boards? I think telling someone to "just worry about passing", then telling them to "do well on the boards" is being a little unrealistic. Are there a few people who are able to pull this off? Sure, but for the majority of people, it just doesn't work out that way.

Now, before anyone starts calling me a gunner, let me just say that I was not. In fact, I was kind of a slacker and I totally understand your feelings about studying. As a third and fourth yr, I got mostly honors, but my grades in the first two years and my board scores weren't great. Fortunately for me, I became interested in a specialty that wasn't competitive and I was able to get a great residency. That brings up another point. You may find that you hate radiology. Believe me when I tell you that you don't want to spend most of your waking hours in a field you hate...no matter how good the hours and money are. Try to keep an open mind until you've had a chance to experience lots of different specialties. Also, remember that no matter what field you go into, you can have a life outside of medicine. Of course, some specialties are more demanding than others, but most, at least most non-surgical fields, allow one to have plenty of free time. And try to keep things in perspective. All doctors make good money. Even FPs make more money that the vast majority of people. You'll make a very good living no matter what you do.

Also, you're just going to have to accept the fact that no matter how you slice it, medicine has never been and will never be, "just a job". No matter what field you go into (even radiologists take call), there will be sacrifices. Your collegues (and society as a whole) will expect you to be available when needed. If you don't appeciate that concept, just think about how you'd feel if you or a loved one needed medical attention but the doctor said, "sorry, but I'm off the clock...your problems will just have to wait until the morning". Everytime I start to feel tired, or put upon, or envious of my friends with "jobs", I try to remember how priviledged I am to be able to practice medicine. I have been given the opportunity to help people (in ways no one else can) and sometimes even save lives. Even with the bad hours and stress (remember, I'm just a resident...things will get better), it is a great honor and I feel incredibly lucky. Now I'm not saying that I don't enjoy my free time. I work hard, but I also play hard! You must have balance. Otherwise you'd quickly burn out.

Finally, just because you're doubting your choice now, doesn't mean you made a mistake choosing medicine. I am completely devoted to my profession and LOVE being a physician, however, I HATED the first two years of med school. I constantly felt overwhelmed and concerned that I'd made the wrong decision. Then I made it to the third yr and suddenly everything made sense again. So hang in there! I remember an old joke...There's only one thing worse than being a med student. NOT being a med student! Think back to when you were applying to school and try to appreciate the humor! Good Luck!

Neurogirl DO, MPH (pgy-2 )

 

[hihihi]

Thanks everyone for the advice and for your thoughts on my approach to medical school and a career in medicine.

I am slowly but surely coming to grips with my approach to life in general. I have always been the type of person that put a lot of pressure on myself...yet I always wanted to be laid back. This self-pressure has probably stemmed from outside pressure in that I never wanted to let anyone (parents, friends, family) down or disappoint anyone. That is a lot of pressure to put on one's self...that is what I am coming to find out.

This all probably has a little bit to do with why I have high blood pressure, and I get irritable a little easier than most. All in all, I want a relaxing lifestyle, where my life will not pass me by. I want to be able to enjoy the small things in life. Medicine is a life that makes this point of view very hard. You study hard in undergrad to get good grades.....You study hard for the MCAT to have a good shot at med school.....You stress about a great med school interview.....Then you get in to med school.....But, wait.....Now I have to study even harder to separate myself from even smarter people, so that I can get into a good residency.....You study hard for the USMLE's.......You work your a$$ off during rotations.....Then you get into that residency you wanted....But, wait....Now I have to work even harder to get that great job at the place you want to live......So, you get that job.....But, wait.....Now I have to work even harder to make a lot of money because I want to reward myself for working so hard....etc....etc...etc...

This reminds me of that quote that I love....."Happiness is a journey...not a Destination"

That is why I am taking this approach of "medicine is not my life". But, in the back of my mind, I am wanting to get into a lifestyle residency. I am beginning to find out that these two ideas are somewhat incompatible. Maybe there is a great balance out there for me, but I will just have to wait my turn, to find out what specialty is for me.

Any further comments are appreciated. Thanks again.