I agree with the above posters. I started in medicine with several people coming out of doing their phd's and while they all felt behind they really didn't come off that way. Everybody is pretty much and idiot at the beginning of 3rd year. I remember being totally paralyzed when I was told to go just talk to my 1st third year pt even though I'd done a number of H&P's already. The beginning of 3rd year is scary to just about everyone. You can be great at doing H&P's but if you don't know how the hospital runs, how rounds work and whats expected of you (which is pretty much everyone at the beginning of 3rd year), you won't be effective. The learning curve in 3rd year is really steep and you'll catch up fast. When you get on the wards do your best to relax, if you have a sub-I pay attention to what they do and ask them questions as they can be a great resource, otherwise emulate your interns as best as you can.