Step 1 coming up....feel like giving up

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Half Moon

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Hey guys....so I'm a second year student getting ready to take Step 1 in about a month. Just looking for any advice or a different perspective. The past two years of med school have been really difficult for me. I had a lot of personal events occur during the summer before M1 that changed me a lot and I even considered deferring my start, but in the end decided that maybe starting something new would be a good distraction. This turned out to be a huge mistake and I became extremely depressed over the course of the year in a way that I never thought was possible. Couldn't go to class, would stay in bed til past noon most days, eating barely anything. I would manage to study a couple hours each day and cram for tests at the last minute and somehow managed to scrape by and just barely pass mostly due to having a pretty good science foundation prior to med school. The worst was that I hid this from everyone. I had never been a depressed person before and hate showing weakness. I lied to my friends and family about how I was doing, but I slowly began isolating myself from everyone. It wasn't until the last couple months of M1 that things became unbearable and I finally told my family how I was feeling. At this point, I was on the phone crying with my mom every night, not sleeping, unable to eat or study. During exams, it was a struggle to even focus on what I was reading and block out everything else that consumed me. I still put a smile on whenever I was forced to be at school and I don't think anyone would have ever guessed what was going on behind closed doors.

I finally ended up failing our last two blocks and had to remediate over the summer. I came home for the couple weeks before the remediation exams and that's when I really fell apart. My parents had me start seeing a psychiatrist and therapist and I started taking anti-depressants. Going back to school for remediation was torture. I remember breaking down crying as soon as I got back to my apartment and remembered all the miserable nights I had spent there the past year feeling so hopeless and alone. I was ready to give up then but my parents insisted that I keep trying and not throw my future away and even offered to help pay for school as an incentive. Somehow I managed to pass remediation and spent the rest of the summer in therapy and taking my meds in the hopes that second year would be better.

M2 hasn't been much better...I've continued my therapy with doctors near school, but I feel like this hasn't helped me much. My family seems to think anti-depressants are magic pills and accuse me of not taking them because they don't understand how I can still be in so much pain. I still find it incredibly difficult to focus and motivate myself and I've become even more isolated and alone. Even though I've managed to make it through classes, I don't think I will be able to pull this off on the boards. I was supposed to start my dedicated studying a week ago but instead have just been laying around my apartment crying and drinking. I feel like I'm at the point where I can't keep living like this and want to give up but I don't know what I would do besides sitting at home, which would probably make me feel worse. I wanted to be a doctor all of my life and worked so hard to get here and once wanted this so badly. I know I will regret it one day if I give up now and I feel like if I take a leave of absence, I won't come back. And it sucks because I know I could have done so much better.

Should I just try to push through and take Step 1 as scheduled? I've made it this far...but feel completely unprepared at this point. Or should I take a leave and try to study for it again in a few months? Or just give up completely because this field is too stressful and will cause me to relapse in the future? I really do want my life to get better and despite everything that has happened, I still feel hope that things have to get better one day, even though I know I have to put in the work to get there.

Thanks so much if you read all of that and for any advice you can offer.

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I would look into what happened before M1 year in that summer. I think you need psychotherapy more than pills. (not medical advice). I have no license to do such a thing.

Also, I would ask the school for help. They have programs in place or at least mine does. The worst thing you can do is fail Step 1 at this point. I would seek help and get better and then prepare for Step 1. This will delay going into the clinics and hospital but you are in no shape to see and help patients. You need to take care of yourself first and foremost.

God speed.
 
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I think you've already answered your own question. Definitely talk with your advisors and psychiatrist but it sounds like you might benefit from a year off to regroup and really deal with your conditions. Step 1 aside, 3rd year is a lot more stressful for most people than M1/M2. I think if I were in your shoes, I would take a practice NBME exam and see where I stood. If it looks like you're safe to pass, go ahead and take it; if not, don't. My thought is that after a year off you may have a harder time remembering all the Step 1 minutiae, so pass it now if you can. If you are in danger of failing based on a couple of practice exams, then nothing to lose really by delaying.

Many people take time off during med school for various reasons. Taking care of yourself is what's most important right now, whatever that may mean to you. If you take a year off and decide not to come back, then you've saved yourself more years of misery and a lot of student loan debt. If you do come back, you'll be doing so with a fresh outlook and with a new group of people.

Whatever you do, make sure you are in constant contact with your deans office and office of student affairs or whatever official channel your school has. Tell them your story and seek advice from people who are there to help you. It is MUCH easier to get people on your side if you do things proactively.
 
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I don't have anything really to add other than I'm in a very similar situation to yours. As you can already tell by my being on this forum instead of studying, I really need to get my ass in gear as well. Godspeed to both of us lol
 
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Sorry to hear your problems. You are absolutely no way in any shape to take step 1. In my opinion medicine for you isn't a priority right now, your health is.

Take a couple of months off. Come back stronger and more prepared. Don't push yourself and set yourself up for failure and even more depression.

I wish you all the best
 
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I have nothing really to add except for support. I hope you hang in there and that things take a turn for the better.
 
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OP, I just want to offer my support. I also agree that you need to take care of yourself first & foremost. That is most important. I hope things work out well for you. Just hang in there. I'm pulling for you.
 
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Thank you all so much for all of your kind words and support. It really means a lot to me, especially because I feel like I can't talk about any of this with my friends or classmates.


I would look into what happened before M1 year in that summer. I think you need psychotherapy more than pills. (not medical advice). I have no license to do such a thing.

Also, I would ask the school for help. They have programs in place or at least mine does. The worst thing you can do is fail Step 1 at this point. I would seek help and get better and then prepare for Step 1. This will delay going into the clinics and hospital but you are in no shape to see and help patients. You need to take care of yourself first and foremost.

God speed.

I agree that psychotherapy is really important for me to stick with right now. I've had a hard time finding a therapist that I feel comfortable with and have tried quite a few to try and find a good match. For some strange reason, I've found that I feel much more open and comfortable talking to male therapists even though I am a female. Don't know if others have had similar experiences. The first psychiatrist that I saw during the summer after first year was the only one who I felt like I could completely trust and open up to, but I go to school in another state and haven't been able to find that connection again. But perhaps I'm looking for the wrong traits in my doctors and maybe someone with more experience in psych could share their thoughts.
 
you'll be doing so with a fresh outlook and with a new group of people.
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I would defer for a year as you get things back together. Don't take step 1 because if you do poorly, that will mess up your chances for residency and there are no second chances. Good luck, I've been depressed at times although not as severe as you. Medical school can be a lonely journey, even if you're with friends.
 
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Thank you all so much for all of your kind words and support. It really means a lot to me, especially because I feel like I can't talk about any of this with my friends or classmates.




I agree that psychotherapy is really important for me to stick with right now. I've had a hard time finding a therapist that I feel comfortable with and have tried quite a few to try and find a good match. For some strange reason, I've found that I feel much more open and comfortable talking to male therapists even though I am a female. Don't know if others have had similar experiences. The first psychiatrist that I saw during the summer after first year was the only one who I felt like I could completely trust and open up to, but I go to school in another state and haven't been able to find that connection again. But perhaps I'm looking for the wrong traits in my doctors and maybe someone with more experience in psych could share their thoughts.

May I suggest a Psychologist? Again, I have no degree so this is not medical advice. They are on average better at psychotherapy than a Psychiatrist. You may benefit from finding help from several sources. Maybe look for a support group too. It always helps when you feel you are not alone. We are social creatures by nature. Hence, why we look for the approval and want to be accepted by others despite what some say. Most often these folks are using their antisocial or saying I do not like others attitudes as a coping mechanism. And in some cases there are those that are truly antisocial and not quite right. Hence, they need more than psychotherapy. And most end up in a correctional facility.
 
May I suggest a Psychologist? Again, I have no degree so this is not medical advice. They are on average better at psychotherapy than a Psychiatrist.
So Psychiatrists are not a more evolved psychologist a la Frasier Crane? I'm so confused.
 
So Psychiatrists are not a more evolved psychologist a la Frasier Crane? I'm so confused.

In general, they are not as good in psychotherapy. They deal more with the medically ill Psy patients that need meds. Hence, why I am looking for a program that spends good time on psychotherapy.
 
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take LOA and wait for the Step 1 until you feel you're ready. Don't want to take it not ready and fail couple times.
 
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but only up to 6 times
Count the number of times he put the word, "try",

If at at first you don't succeed (1)
try, try, try, try, try again. (5)
5+1 = 6
 
Best of luck, Half Moon. Medical school and things related can really push one to his/her breaking point. I'm not exception either. Wish you all the best.
 
but only up to 6 times

Count the number of times he put the word, "try",

If at at first you don't succeed (1)
try, try, try, try, try again. (5)
5+1 = 6

Wasn't he just making reference to the "USMLE 6 attempt" thread, not necessarily to the number of 'trys' in the sentence?

I thought it was funny.
 
Wasn't he just making reference to the "USMLE 6 attempt" thread, not necessarily to the number of 'trys' in the sentence?

I thought it was funny.
I thought it was funny too. Yes, GuyWhoDoesStiff was making reference to the USMLE 6 times attempt thread. Just realized Psai was also facetiously referencing it. :laugh:
 
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Wasn't he just making reference to the "USMLE 6 attempt" thread, not necessarily to the number of 'trys' in the sentence?

I thought it was funny.

I have faith that GWDS specifically put 'try' in his link exactly 5 times on purpose.
 
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