Third year, thinking about quitting

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NeuroRu

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I'll try to keep this a brief as possible.

TLDR: Been in school forever. Done mediocre in med school. Third year, burned out, not happy. Thinking about quitting. Have a few back up plans. Any advice appreciated.

I've been in school for 11 years. Started out pre-med, got derailed into the research world, wasn't happy with that, decided to go to med school (pre burned out). Started med school with high hopes, but these were immediately crushed when I failed anatomy. I was going to do a research track but wound up having to drop this because I remediated anatomy the summer I would have done the majority of my experiments. Also was in the midst of a divorce and to complicate things further I have bipolar disorder, so that is a permanent confounder.

Second year rolls around and at this point I'm just happy to pass everything. I did enjoy some of the clinical stuff we did but I was even more burned out by the time Step 1 happened. Didn't have enough time to study and passed with a lackluster 203. So there goes any real hope of doing more competitive specialties. Feeling pretty bitter at this point.

By the time third year started (1 week after Step 1!), I was thinking, okay, maybe this is finally my chance to shine! But as many of you probably know, third year is a total crapshoot and there is almost no correlation between effort and outcome. This frustrated me. I was considering psych and put more effort into this rotation than anything previously. Did well enough on the shelf to high pass but I worked with a miserable attending who found it physically painful to give any positive feedback. So, I'm completely jaded and cynical and sick of all the bull****.

Now I am taking this block off to do some soul searching. There has been barely anything positive about my med school experience. I hate the hours (not a morning person), I hate the lack of time to take care of oneself, I hate the culture of medicine (hierarchy, having to be PC all the time, etc). I have mixed feelings about patient care, sometimes I enjoy it, sometimes I don't. I did enjoy my neuro and ED rotations, but I don't want to go into a residency just to face the same stress and environment that I've not dealt with well in med school. I haven't performed well, I'm constantly having to adjust my psych meds and I'm 100k in debt again. And so I'm seriously thinking about exiting with the last shred of dignity I have.

I have a master's in chemistry and was doing well in a PhD program in chemistry prior to med school. I could get a job in industry, or return to finish my PhD, but I really don't know what I want out of life. I'm wondering if anyone has any advice for me, such as what kinds of things I should think about with quitting, if things are better at all in residency, if I do decide to proceed, how I should deal with my mediocre performance. Any thoughts on any of this would be appreciated.
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Finish your degree. The grass is always greener, and being a doctor is a really good gig. Many students share your frustrations with what you mentioned above.

It sounds like you're interested in psych which is a growing field that is in high demand for good physicians. Try to focus on the positives aspects of what's ahead instead of what happened first year, on step one, and in past rotations. You're in a better place than you're giving yourself credit for.
 
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it sucks to be the position you are in, but if I would push forward. most of us have had feelings of self doubt and or fleeting thoughts of quitting though our medical training. Medical school is tough ... there is no other way to describe it. residency is tough too... but in its own way and it sounds like you are interested in psychiatry so you would be in a field that you will enjoy.

IMO, 3rd year grades arent as random as medical students seem to think. helpfulness is a large component of the clinical grade. at least for me, the people who I tend to grade higher arent necessarily the ones that are the smartest, but the ones who are available and seem willing to help out
 
finish the degree and then opt for a non med job after
 
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You made it to third year and you're contemplating quitting? I can't even...
 
I would get a consulting job with your md.
 
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Yeah I would at least finish. I won't say that you should do a short residency like IM or FM, but yeah definitely finish as it'll help you in the long run and you've made it this far. 4th year is pretty easy, especially if you aren't planning to do the match. Just set up a bunch of electives and start the job hunting process.

And no things aren't better in residency. The same problems you discuss in regards to med school are magnified. Even less time for yourself (generally speak, there are some cushy FM programs out there) and you start all over at the bottom of the barrel your intern year. So unless you definitely want to practice clinical medicine I would not do a residency. Good luck in your decision.
 
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Try talking to someone else in psych. It sounds like the you got stuck with a crappy attending. Just speaking with an awesome one could give you a lot more enthusiasm for the field. You could also consider path or rads where you won't have much patient interaction or stress. There's other things you can do with an MD, too, or so I've heard. Maybe try to talk to someone at your school about those options? I know how frustrating third year (and all of med school) can be, but you're so close! Only 18.5 months until us third yeas are MDs!
 
I cringe to think what my posts during 3rd year would look like if I wasn't on a hiatus from SDN.

3rd year isn't medicine. 3rd year isn't even real life. 3rd year is a glorified hazing ritual. F*** any med school administrator who argues otherwise.
 
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NeuroRu said:
I was considering psych and put more effort into this rotation than anything previously.
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NeuroRu said:
I hate the hours (not a morning person), I hate the lack of time to take care of oneself, I hate the culture of medicine (hierarchy, having to be PC all the time, etc).
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From what I've seen and what I've heard, I don't think any of these exist in psych. Not even really in residency.

If you're interested in psych, it seems like a really great gig. Easy hours, great compensation for the hours you work, and the people who go in to psych tend to be pretty cool people. Remember that the grass is always greener on the other side. 3rd year is temporary and not reflective of what your life will look like in the near future.

If I had any interest in psych I would go into it in a heartbeat.
 
Agree with the above.

Finish the MD and at least do an internship.

You're almost 3/4 done plus 4th year is a lot better than the first 3 years.

Find a job at a rural clinic or urgent care and pay off your loans.
Then you can just work part time and find something you love (teaching, research, consulting, etc...)
 
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HelpPleaseMD said:
it sucks to be the position you are in, but if I would push forward. most of us have had feelings of self doubt and or fleeting thoughts of quitting though our medical training. Medical school is tough ... there is no other way to describe it. residency is tough too... but in its own way and it sounds like you are interested in psychiatry so you would be in a field that you will enjoy.

IMO, 3rd year grades arent as random as medical students seem to think. helpfulness is a large component of the clinical grade. at least for me, the people who I tend to grade higher arent necessarily the ones that are the smartest, but the ones who are available and seem willing to help out
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I dunno, I think resident grades are usually pretty fair and consistent because residents are acutely aware of the medical education process. But attending grades are completely random. I've had attending evaluations say I'm "unsatisfactory and borderline failing" while other attendings in the same rotation write evals that say I am "outstanding and a credit to the team."
 
OP, here's the thing- work sucks. It just does. If you leave medicine, you'll go on to another job and realize it sucks too. And then you'll go to the next one- spoiler, that one's also going to suck. So you can keep going from ****ty job to ****ty job for the rest of your life, or you can take the ****ty job that lets you make a difference and gives you a decent income to boot. Or you could just give up and quit now I guess, only to realize that everything sucks everywhere and you at least could have had a half-decent sucky job rather than wasting piles of money and time for nothing.
 
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Trousseau said:
I dunno, I think resident grades are usually pretty fair and consistent because residents are acutely aware of the medical education process. But attending grades are completely random. I've had attending evaluations say I'm "unsatisfactory and borderline failing" while other attendings in the same rotation write evals that say I am "outstanding and a credit to the team."
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all i can say is wtf? I never experienced anything that random. that really sucks if it came out of nowhere and you thought u were doing well. I made it a point to ask for feedback as a med student at least half way in. Some attendings are for lack of a nicer term ******* and rather comment at the end of evals rather than give feedback for improvement
 
HelpPleaseMD said:
IMO, 3rd year grades arent as random as medical students seem to think. helpfulness is a large component of the clinical grade. at least for me, the people who I tend to grade higher arent necessarily the ones that are the smartest, but the ones who are available and seem willing to help out
Click to expand...

At my school your grade counts for nothing and might as well be a picture from a coloring book.
 
HelpPleaseMD said:
lol. hey you gotta play the game.
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Not saying it's a good thing. On most services we spend way more time with the residents than the attendings, but their evals don't count.
 
Did you take out student loans? How do you plan on paying that back if you did? Might as well finish your degree, its kind of late to back out at this point.
 
at is in your control:
1) Get the Bipolar under control (this includes depression)
2) Stop focusing on what you have done, focus on what you can do
3) Forget about other people in medicine - people in medicine suck

To do:
1) Get the Bipolar under control (this includes depression)
2) Either go Family or Psych for the match
3) Get the divorce figured out (if it is not already)
Give the other person whatever they want to get this finalized. Do not worry about being alone/finding another person. If you want to have a quality life, you will need to take time "off from relationships" to find yourself before you can get back towards finding another partner. You will never be alone - you have family.
4) Finish 3rd year
3rd year is the worst year of medical school for quality of life
5) Take 4th year to figure yourself out and regain what you lost during medical school
4th year is nothing like 3rd year - you have plenty of time off, especially if you are going Family/Psych for the match

Other Options:
1) Finish medical school, do not go to residency but go finish that PhD (if you can do this) then go work in industry with a MD/PhD in chemistry. You will have plenty of solid 6 figure job offers.
 
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bd290 said:
At my school your grade counts for nothing and might as well be a picture from a coloring book.
Click to expand...

Mine was the opposite. The shelf was basically a tiny irrelevant fraction of your clinical grades. We did this because our dean of education would insist that a study* showed that clinical evals were the single best predictor of eventual resident performance.

*of course she was the study's first author, but if you bring that up, she'd get pissed off.
 
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Don't quit. Try to get a LOA if at all possible and take the time needed to refresh yourself. Have to agree with MadJack that you'll likely find yourself bumping to the next career, only to find it's no picnic. You mentioned you were in a PHD program in chemistry...now in med school...there's nothing wrong in figuring yourself out, but there does come a point where you just stop moving around.

Rejuvenate and get fresh perspective, then jump back in.
 
WingedOx said:
Mine was the opposite. The shelf was basically a tiny irrelevant fraction of your clinical grades. We did this because our dean of education would insist that a study* showed that clinical evals were the single best predictor of eventual resident performance.

*of course she was the study's first author, but if you bring that up, she'd get pissed off.
Click to expand...

Sounds nice. Ours were split pretty evenly between attending evals and shelfs. Resident evals meant nothing.
 
HelpPleaseMD said:
IMO, 3rd year grades arent as random as medical students seem to think. helpfulness is a large component of the clinical grade. at least for me, the people who I tend to grade higher arent necessarily the ones that are the smartest, but the ones who are available and seem willing to help out
Click to expand...

ugh, sorry to be contrarian but this is the type of attitude about medical students that has always rubbed me the wrong way.

I'm not doing a whole lot with students at the moment, but when I was a resident, the purpose of the students wasn't for them to be "helpful" to me (I had my own job to do whether I have students there or not), it was for them to acquire and demonstrate knowledge and skills.

I can only speak to Psychiatry, but what I need to see for a good grade are things like, "can you competently document a mental status evaluation?", " can you demonstrate to me that you understand how we come up with a working diagnosis for a patient without getting overly concrete?" "can you understand how we triage and dispo a patient during an evaluation?", and "can you appreciate how biological, psychological, and social elements are present in creating the patient's current condition?" These are the types of things that every physician needs to know regardless of what specialty they go into. If they want to stay late, make phone calls, etc. that's all well and good, but it's not what a student is paying 40k per year to do.

Sadly I had a girl on one of my rotations a couple years ago who was smart, hard-working, a generally nice person to be around, but when it came to mental status evals, she just...wasn't...getting...it. She really worked harder than her peers, but she really gave off the impression that she'd be a future PG2 internal med resident who'd be missing delirium and calling it mania. I appreciated the effort but I just couldn't give her anything close to honors.

Overall though I'd much rather have a student with who quietly got his/her **** done and went home than one who stayed late and made a show of it. Ability to do the latter is what makes a good medical student I suppose, but it's the former that makes a good resident.
 
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WingedOx said:
ugh, sorry to be contrarian but this is the type of attitude about medical students that has always rubbed me the wrong way.

I'm not doing a whole lot with students at the moment, but when I was a resident, the purpose of the students wasn't for them to be "helpful" to me (I had my own job to do whether I have students there or not), it was for them to acquire and demonstrate knowledge and skills.

I can only speak to Psychiatry, but what I need to see for a good grade are things like, "can you competently document a mental status evaluation?", " can you demonstrate to me that you understand how we come up with a working diagnosis for a patient without getting overly concrete?" "can you understand how we triage and dispo a patient during an evaluation?", and "can you appreciate how biological, psychological, and social elements are present in creating the patient's current condition?" These are the types of things that every physician needs to know regardless of what specialty they go into. If they want to stay late, make phone calls, etc. that's all well and good, but it's not what a student is paying 40k per year to do.

Sadly I had a girl on one of my rotations a couple years ago who was smart, hard-working, a generally nice person to be around, but when it came to mental status evals, she just...wasn't...getting...it. She really worked harder than her peers, but she really gave off the impression that she'd be a future PG2 internal med resident who'd be missing delirium and calling it mania. I appreciated the effort but I just couldn't give her anything close to honors.

Overall though I'd much rather have a student with who quietly got his/her **** done and went home than one who stayed late and made a show of it. Ability to do the latter is what makes a good medical student I suppose, but it's the former that makes a good resident.
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Is this a big deal though? I mean, can't people consult you guys for that? I know of ortho residents who consult internal medicine for SBP in the 140's and the pt are already on a antihypertensive.
 
WingedOx said:
the purpose of the students wasn't for them to be "helpful" to me (I had my own job to do whether I have students there or not), it was for them to acquire and demonstrate knowledge and skills.

I can only speak to Psychiatry, but what I need to see for a good grade are things like, "can you competently document a mental status evaluation?", " can you demonstrate to me that you understand how we come up with a working diagnosis for a patient without getting overly concrete?" "can you understand how we triage and dispo a patient during an evaluation?", and "can you appreciate how biological, psychological, and social elements are present in creating the patient's current condition?" These are the types of things that every physician needs to know regardless of what specialty they go into. If they want to stay late, make phone calls, etc. that's all well and good, but it's not what a student is paying 40k per year to do.

Overall though I'd much rather have a student with who quietly got his/her **** done and went home than one who stayed late and made a show of it. Ability to do the latter is what makes a good medical student I suppose, but it's the former that makes a good resident.
Click to expand...

2672021.jpg
 
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DaTruMD said:
Is this a big deal though? I mean, can't people consult you guys for that? I know of ortho residents who consult internal medicine for SBP in the 140's and the pt are already on a antihypertensive.
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I mean you could, and that's why we're here to help. I'm not going to say I never consulted FM with a "this dude has an untreated a1c of 10, please help"

But a medicine/surgical resident should have a somewhat sharp eye for delirium because usually "change in mental status = bad news"

I'm also a bit of a stickler about that particular issue because while I think the IM residents where I trained were good, they had some attendings that were flat out awful at understanding what was going on in their patients' mental statuses and would get pissy when we wouldn't let them turf their unstable delirious guy onto psych. On more than a few occasions that sh-tty behavior would trickle down to otherwise good residents.
 
WingedOx said:
ugh, sorry to be contrarian but this is the type of attitude about medical students that has always rubbed me the wrong way.

I'm not doing a whole lot with students at the moment, but when I was a resident, the purpose of the students wasn't for them to be "helpful" to me (I had my own job to do whether I have students there or not), it was for them to acquire and demonstrate knowledge and skills.

I can only speak to Psychiatry, but what I need to see for a good grade are things like, "can you competently document a mental status evaluation?", " can you demonstrate to me that you understand how we come up with a working diagnosis for a patient without getting overly concrete?" "can you understand how we triage and dispo a patient during an evaluation?", and "can you appreciate how biological, psychological, and social elements are present in creating the patient's current condition?" These are the types of things that every physician needs to know regardless of what specialty they go into. If they want to stay late, make phone calls, etc. that's all well and good, but it's not what a student is paying 40k per year to do.

Sadly I had a girl on one of my rotations a couple years ago who was smart, hard-working, a generally nice person to be around, but when it came to mental status evals, she just...wasn't...getting...it. She really worked harder than her peers, but she really gave off the impression that she'd be a future PG2 internal med resident who'd be missing delirium and calling it mania. I appreciated the effort but I just couldn't give her anything close to honors.

Overall though I'd much rather have a student with who quietly got his/her **** done and went home than one who stayed late and made a show of it. Ability to do the latter is what makes a good medical student I suppose, but it's the former that makes a good resident.
Click to expand...

the question was what helped a student get better 3rd year grades and what i said applies to most residents. I def would rather grade a student who helps with social work/follow up on lab work higher than someone who presents and afterwards runs off to study for his/her shelf all day long. imo students are not "too good" or paid too much to be part of the team. calling sw for their 1 patient isnt the end of the world. 9/10 most residents will give the more helpful student a better grade, but then again, i am not in psych and i suspect the culture is a bit differnt
 
WingedOx said:
I mean you could, and that's why we're here to help. I'm not going to say I never consulted FM with a "this dude has an untreated a1c of 10, please help"

But a medicine/surgical resident should have a somewhat sharp eye for delirium because usually "change in mental status = bad news"

I'm also a bit of a stickler about that particular issue because while I think the IM residents where I trained were good, they had some attendings that were flat out awful at understanding what was going on in their patients' mental statuses and would get pissy when we wouldn't let them turf their unstable delirious guy onto psych. On more than a few occasions that sh-tty behavior would trickle down to otherwise good residents.
Click to expand...

i dunno i'd order stat intubate and put on precedex/propofol gtt and call psych for AMS/agitation.
 
HelpPleaseMD said:
i suspect the culture is a bit differnt
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Eh, not really, but as I said I'm pretty contrarian about med student evaluations. The fact that I have the male version of "resting bitch face" never really helped me as a 3rd year, so I'm perpetually bitter about subjective evals.
 
WingedOx said:
I cringe to think what my posts during 3rd year would look like if I wasn't on a hiatus from SDN.

3rd year isn't medicine. 3rd year isn't even real life. 3rd year is a glorified hazing ritual. F*** any med school administrator who argues otherwise.
Click to expand...
Can you elaborate on this?
 
NeuroRu said:
I'll try to keep this a brief as possible.

TLDR: Been in school forever. Done mediocre in med school. Third year, burned out, not happy. Thinking about quitting. Have a few back up plans. Any advice appreciated.
Click to expand...

Finish. You're too close to finishing to quit. I did not enjoy my 3rd year of medical school. I am enjoying being a 3rd year resident however. I will tell you, this side of the fence is much much better and you should wait it out and see for yourself. The world opens up. You are not at the bottom of the hierarchy. There is some autonomy. Nurses will listen to you. Other docs for the most part (there is always an dingus) will treat you decently. You can look at a job listing for 230k or much higher and say to yourself, that can be mine in X years.
 
alpinism said:
Agree with the above.

Finish the MD and at least do an internship.

You're almost 3/4 done plus 4th year is a lot better than the first 3 years.

Find a job at a rural clinic or urgent care and pay off your loans.
Then you can just work part time and find something you love (teaching, research, consulting, etc...)
Click to expand...

:thumbup: I have a friend that is doing extremely well with 1 year post grad training... 180k/year and 25k/year loan repayment at a rural location.

OP should definitely finish and do 1 year post grad training so he/she can be eligible for a license in most states...
 
One of my friends quit in 4th year! I thought it was extremely foolish, however he was going through some family related issues and questioning his commitment to medicine, the hours, lifestyle, etc. Everyone tried to convince him to stay and just finish, but his mind was made up. Now he owns his own business near the small town where he grew up and while I'm sure he works hard and makes less than most physicians, he seems content. So maybe it was the right move for him.
 
asdf123g said:
I just read it. Does 4th year get better? Or is one just so used to the crappiness and or they know "the light at the end of the tunnel" is almost there?
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4th year is infinitely better. By far the best year of med school.

1) you're much less clueless and can actually contribute to patient care
2) most of the year is spent doing enjoyable electives and audition rotations
3) no more small group sessions, weekly quizzes, or reflection papers
4) you don't have to study for shelf exams at the end of rotations
5) grades don't matter anymore once you submit residency applications
6) the hours are much better and you actually get time off to spend with friends and family


Plus yeah, you also start to see the "light at the end of the tunnel."
 
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alpinism said:
Almost 10 years later and this is still a perfect description of 3rd year.
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Ironically I hadn't read it until a couple weeks ago when someone posted it in a "where is Panda Bear?" thread.

It was so eerily accurate to my own experience that I started getting ideas of reference that PB was living inside my head. :wideyed:
 
WingedOx said:
Ironically I hadn't read it until a couple weeks ago when someone posted it in a "where is Panda Bear?" thread.

It was so eerily accurate to my own experience that I started getting ideas of reference that PB was living inside my head. :wideyed:
Click to expand...


I agree. Perfect description of surgery rotation. Wonder if PB is still around here as someone else?
 
Mad Jack said:
OP, here's the thing- work sucks. It just does. If you leave medicine, you'll go on to another job and realize it sucks too. And then you'll go to the next one- spoiler, that one's also going to suck. So you can keep going from ****ty job to ****ty job for the rest of your life, or you can take the ****ty job that lets you make a difference and gives you a decent income to boot. Or you could just give up and quit now I guess, only to realize that everything sucks everywhere and you at least could have had a half-decent sucky job rather than wasting piles of money and time for nothing.
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I dropped out in MS1 and went back to my old ****ty manual labor job. It miserable but it's a lot less miserable than med school was. I can only imagine how much worse it gets in 3rd/4th year, or residency.
 
circulus vitios said:
I dropped out in MS1 and went back to my old ****ty manual labor job. It miserable but it's a lot less miserable than med school was. I can only imagine how much worse it gets in 3rd/4th year, or residency.
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4th year is nice. I don't have to go in early, I leave when I want, I don't care about people's opinions of me, only study the things I want to study. Then I have people telling me to come to their places, where I get a nice dinner and lunch before talking to some people. No complaints.
 
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circulus vitios said:
I dropped out in MS1 and went back to my old ****ty manual labor job. It miserable but it's a lot less miserable than med school was. I can only imagine how much worse it gets in 3rd/4th year, or residency.
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According to some MS4, 3rd and 4th year at my school is a breeze except for surgery/IM rotations...
 
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W19 said:
According to some MS4, 3rd and 4th year at my school is a breeze except for surgery/IM rotations...
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The work load is easier though things like waiting for match day and having no idea what time zone you're going to be living in a few months from now because of a decision that's completely out of your hands isn't fun.
 
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