To delay or to add a year after 3rd year? advice?

[KrauseXian]

I apologize ahead of time, this will be a bit of a mess (which is why I haven't figured this out and need advice.)

I finished 1st and 2nd year at a US allopathic school. Those years were pass/fail, I never failed anything but every single unit was a huge struggle to get through all the material. I studied all of my spring breaks, every weekend, nights, labour days, everyday, always. It was barely enough time for me to pass each exam. I passed STEP on my first try and got a 206 but also felt extremely rushed and only finished 10% of Uworld. I'm passing, but I also don't feel like I'm able to keep up. 3rd year started 18 hours after I finished my STEP exam and I started on general surgery, getting up at 4am, feeling like a zombie after those intense months of studying now to get pimped on anatomy that I know I don't know, and I'd love to go study before surgery clerkship started. I don't have enough energy after 14 hours of work when I get home to open a book and study (I'm an older student), so I've studied almost nothing this year, and I'm massively behind on concurrent school homework assignments. I am burnt out and feeling intellectually underprepared for 3rd year.

There are 48 weeks of full day clerkships this year, with 3 weeks reserved for taking shelf exams after each clerkship, and 1 for Christmas. I don't know enough about match, away rotations, or residency program, but from what I understand, as soon as that's over I need to start applying to away rotations to interview, rank programs, then try and match all while doing my 4th year clerkships? Here are my main problems.

1. I'm exhausted and can't focus well after the past year of tests, then STEP, with no break, so I'm worried about my clerkship performance being dismal.
2. I have no idea what residency I'm interested in yet (IM, Peds, Med/Peds, Family, Radiology, Pathology?). I only know I don't like lysosomal storage diseases. Shouldn't I do my all my 4th year clerkships and electives before starting to apply to programs?
3. When I know what residency I want, I'd like to do a few 4 week away rotations at programs that I want to apply to, but I don't know what that is yet.
4. I'd love to do an international rotation, but there's little time for that.
5. I'd love to have a month or two off to study for STEP 2 and actually finish Uworld.
6. I'd love to study for my shelf exams at some point.


So what should I do?
1. Take a break now and completely mess up my school schedule for 4th year, leaving me no time for away rotations and interviews?
2. Add a full year to medical school and take a month break now, then finish 3rd year, do my 4th year required clerkships and electives, and then use the extra year to make up the month I'd miss now, and for away rotations (2-3 months), STEP 2 studying (1-2 months), international rotations (1 month), interviews (1-2 month), moving to a new city, ect.
3. Do nothing and just stay on track, feel rushed and underprepared, get whatever I get on STEP 2 without studying much, apply to places before I know what I want to do, and start residency feeling exhausted.
4. Other?


I have a meeting on Monday with my school and I don't know which of these I want to say is my preference. And all of these are "options."

Thanks for reading all of this! And thank you for your advice!

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[ACSurgeon]

At least part of your problem is effeciency. Getting through 10% of uworld despite busting your hump tells me you didn't prioritize correctly. Doing on block of uworld per day would have gotten you much further than 10%.

As for what you should do: take a year off. Realize that this will hurt your application to residency but not as much as a failed rotation or step exam. During your year off you have to figure out how to be more efficient, get some rest, and try to do something worthwhile to help residency application (ie research).

Finally, a middle ground option would be to get through third year, take a year off, and then come back as a fourth year. This has a few advantages:
- it give you time to set something up to do during your year off
- this allows you to study for step 2 since you've done all your rotations.

 

[Ceusina]

Starting on surgery as a brand new MS3 is really, really tough (and especially tough since you had so little time between Step 1 and starting your first clerkship). You're rightfully burnt out. It's hard to think clearly when all you desperately want is a little time off to "regroup." I understand that feeling. I started MS3 two days after I took Step 1. It sucked. A lot. But, things will get easier. Just focus on surviving surgery. Use your weekends to get some studying in. As the year progresses, you'll figure out how to survive rotations. You'll figure out how to best study for shelf exams. Not every rotation will be as grueling as surgery (psych and family med come to mind...). You'll figure out what you like best after rotating through all of the core specialties. You don't start applying to residencies until the fall of your 4th year, after you've completed all your core rotations. You apply to away/audition rotations during the spring of 3rd year... by that point, you should have narrowed down what you like most to 1 or 2 specialties.

Just focus on each day as it comes. Now is not the time to worry excessively about what speciality you like most and how tired you'll be when you start residency. You have plenty of time to figure out your speciality and you'll have time to relax before starting residency (by choosing some "easy" 4th year rotations and after graduation).

Don't go off schedule. It'll only make your life even more difficult. Do everything you can to stay on track. It's tough, I know. But you really don't want to have to explain your time off to residency program directors (especially when you don't have a great reason, other than feeling burnt out... aka no family emergencies, health issues, etc.).

Other medical students (all) have felt burnt out and stressed. They survived and you will too. Things will get better as you progress through 3rd year!

Good luck!

 

[J ROD]

I say suck it up. We have all been there.

 

[hmockingbird]

Starting on surgery as a brand new MS3 is really, really tough (and especially tough since you had so little time between Step 1 and starting your first clerkship). You're rightfully burnt out. It's hard to think clearly when all you desperately want is a little time off to "regroup." I understand that feeling. I started MS3 two days after I took Step 1. It sucked. A lot. But, things will get easier. Just focus on surviving surgery. Use your weekends to get some studying in. As the year progresses, you'll figure out how to survive rotations. You'll figure out how to best study for shelf exams. Not every rotation will be as grueling as surgery (psych and family med come to mind...). You'll figure out what you like best after rotating through all of the core specialties. You don't start applying to residencies until the fall of your 4th year, after you've completed all your core rotations. You apply to away/audition rotations during the spring of 3rd year... by that point, you should have narrowed down what you like most to 1 or 2 specialties.

Just focus on each day as it comes. Now is not the time to worry excessively about what speciality you like most and how tired you'll be when you start residency. You have plenty of time to figure out your speciality and you'll have time to relax before starting residency (by choosing some "easy" 4th year rotations and after graduation).

Don't go off schedule. It'll only make your life even more difficult. Do everything you can to stay on track. It's tough, I know. But you really don't want to have to explain your time off to residency program directors (especially when you don't have a great reason, other than feeling burnt out... aka no family emergencies, health issues, etc.).

Other medical students (all) have felt burnt out and stressed. They survived and you will too. Things will get better as you progress through 3rd year!

Good luck!

This.

Also, you can arrange an international rotation 4th year.

My school lets you pick your schedule for 4th year. So you could have a month to study for Step 2 if you wanted and many people in my class did that.

 

[KrauseXian]

Thanks for the advice everyone! I really appreciate it!