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[tiramisu1]

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[operaman]

Sorry to hear you’re having a rough time out there. I’ll offer a few thoughts:

1) your peers don’t know squat either. Even the top medical students show up as interns on July 1st not knowing which way is up. I promise your peers are struggling to keep up too and will also be idiots on July 1st just like we all were.


2) beware the wisdom of crowds effect. Put enough peers in a room and it will seem that they all know more than you, and collectively they do. In truth, most probably have little tiny areas they’ve studied more recently or discussed on rounds the day before - add all that up and it will seem that everyone is smarter. If you split them all up into individuals, they’re a little more mortal. You will never be smarter than a room full of peers. The good news is that you don’t have to be.

3) one core issue is you need to learn how to study for shelf exams. Generally that means practice questions and it means a lot of them. My rule was to complete two full question banks per shelf. That would ensure I’d seen just about everything they could test me on. Get the shelf prep dialed in and you’ll feel better not being under the gun so much.

4) you don’t need to be the smartest doctor. Not only do you learn most stuff in residency, but you can tailor your practice later to whatever you like. And you have other docs to lean on. Even within my own specialty there are partners of mine who are better than me at certain things, so I just send those patients to them. I’m good at the niche of things I do well and they send those patients to me. There are plenty of practice options down the road where you can find a scope you’re comfortable with, and simply refer the rest to others.

5) find a good faculty mentor. You need someone in person who can help you. I often see students like this and it’s not usually a knowledge issue so much as a mindset and pattern recognition one. Usually they’re so focused on that last 10% of minutiae that they neglect the 90% of what’s pretty easy. If you’re failing shelves I suspect this may be part of your story too. Part of getting good at medicine is accepting that you will be wrong at least 10-20% of the time. Focus on getting that 80% of easier stuff. Learn the patterns that get you there most of the time and accept that occasionally the pattern will fail you. Figuring this out is best done in person, so if you can find a good faculty mentor it might be helpful. Ask around- your admin surely knows who some of these folks are and can connect you.

 

[Hollow Knight]

Have you considered being evaluated for ADHD/anxiety/depression? My mental heal slowed me down a lot in third year because I refused to acknowledge it/ didn’t have the self awareness. Talking to someone isn’t going to hurt you. Sometimes just working harder isn’t the answer.

Also, please keep in mind that a lot of the exams you take in med school have very little if anything to do with practicing medicine. It’s kind of amazing. People don’t expect interns to know hardly anything nowadays. The point I’m trying to make is that I’ve met many attendings and residents who scraped by the exams who are awesome doctors because being a doctor is not much like taking a multiple choice test. You need to pass and get out, but a higher class rank or step 2 does not correlate to clinical outcomes.

DM me if you want to talk mental health stuff or study strategies (I’m not a gunner.) but it sounds like you don’t believe in yourself. You got into medical school, you’re an incredibly smart and hardworking person. It’s probably a strategy or mental healthy thing more so than an ability thing.

 

[tiramisu1]

Thank you very much for the words of encouragement 🙏 I will keep these in mind.

 

[Drjc1977]

I have been dreading to go to rotations. I feel stuck. I'm not doing well in my performance. I have difficulty focusing and memorizing. I feel like I don't have motivation to improve. I do love rotations, I love seeing patients, I do have motivation to improve, but I'm not strong enough, and it just makes me want to give up. I am afraid of going out and socialize and interact with people. I will screw it up somehow, will make people think negatively about me, will make people think that I'm not a good person. I feel paralyzed. My mind would transport me elsewhere, I would imagine myself being somewhere else in the past that's more comforting and not in the present moment.

Problem #1: Lack of motivation. Multiple attempts to improve my study habits have failed. Problem #2: Feeling like I don't belong. I'm introverted and not good with socializing. I don't feel like I belong. I don't think I'm gonna be a good doctor working in a team-based environment. I think in groups I will be singled out at best and bullied at worse - and it would probably be my fault because of my personality and my incompetence. This makes me reevaluate whether I want to be a doctor or not.

The price is too big to pay to try to be good at it - as in, the price paid by the school for my training is just not worth it for someone who will end up being so incompetent like me (I have a scholarship too). I think people are disappointed and frustrated at me. Imagine taking double the time and effort and materials to train me, only for me to still be incompetent. I don't have any good excuse - I'm just simply don't have the natural caliber to do this. I love learning about diseases and I want to treat patients so much but I don’t think my patients, my colleagues or my superiors will trust me in the future.

I have failed multiple shelf exams, need to retake some of them, and now feeling discouraged for the upcoming shelf exams. Sometimes I feel "what for?"

I show up. I do show up, early, earlier than peers who do better than me. I do go for extra sessions. I do proactively take several actions to improve my performance. I tried hard in order to be able to say that I've tried. Still, I can't ever have the same knowledge as my peers. I would sit in a teaching session and my peers would be able to say things that I cannot. They would know little facts that I don't know. And the teachers told me straight up they can see that my knowledge is inferior than my peers. They don't know that I do show up early and do the extra work... maybe it'd be more embarrassing if they know. I know I'm doing something wrong compared to my peers, but I've tried and tried and nothing changes and I ran out of fumes.

I think I’m posting this not to ask “how to improve my study strategies” - that’s a separate issue. I guess the point of this post is the mindset aspect - how do I help myself when I don't even have the motivation? How do I keep going when my future as a doctor is so bleak?

The question is not “how do I regain my motivation?” - I know that my productivity ebbs and flows, and that it will regain itself at some point. That much is known. My question is when failure is so much more probable, so much more realistic... what do you even do? What will I do with my future? Do research instead? What realistically less demanding jobs that I can do after I finally able to scrape through and graduate from medical school? I know that I will be an incompetent doctor, I know my supervisors and colleagues will hate having me, I’m taking so much time and resources by being a slow turtle. What if it’s for the better good that I just don't attempt at all?

I would respectively suggest you consult a mental health professional. Of interest, I have not read one positive thing you have said about yourself. You may have an anxiety disorder, depression, or any one of a number of mental health issues. The way you think and respond could also be secondary to a systemic abnormality/illness. The fact you were accepted into medical school tells me you are smart enough to handle the information taught to you, but not strong enough to handle any social situation that puts you into the spotlight. If possible, you may want to consider a leave of absence to investigate why you feel/think the way you do. I do not know who you are but I consider you brave for coming forward with this and sharing with strangers. One last thought, do you really want to become a physician and have not accepted you really do not. I truly wish you well.

 

[tiramisu1]

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[deleted1192955]

I have been dreading to go to rotations. I feel stuck. I'm not doing well in my performance. I have difficulty focusing and memorizing. I feel like I don't have motivation to improve. I do love rotations, I love seeing patients, I do have motivation to improve, but I'm not strong enough, and it just makes me want to give up. I am afraid of going out and socialize and interact with people. I will screw it up somehow, will make people think negatively about me, will make people think that I'm not a good person. I feel paralyzed. My mind would transport me elsewhere, I would imagine myself being somewhere else in the past that's more comforting and not in the present moment.

Problem #1: Lack of motivation. Multiple attempts to improve my study habits have failed. Problem #2: Feeling like I don't belong. I'm introverted and not good with socializing. I don't feel like I belong. I don't think I'm gonna be a good doctor working in a team-based environment. I think in groups I will be singled out at best and bullied at worse - and it would probably be my fault because of my personality and my incompetence. This makes me reevaluate whether I want to be a doctor or not.

The price is too big to pay to try to be good at it - as in, the price paid by the school for my training is just not worth it for someone who will end up being so incompetent like me (I have a scholarship too). I think people are disappointed and frustrated at me. Imagine taking double the time and effort and materials to train me, only for me to still be incompetent. I don't have any good excuse - I'm just simply don't have the natural caliber to do this. I love learning about diseases and I want to treat patients so much but I don’t think my patients, my colleagues or my superiors will trust me in the future.

I have failed multiple shelf exams, need to retake some of them, and now feeling discouraged for the upcoming shelf exams. Sometimes I feel "what for?"

I show up. I do show up, early, earlier than peers who do better than me. I do go for extra sessions. I do proactively take several actions to improve my performance. I tried hard in order to be able to say that I've tried. Still, I can't ever have the same knowledge as my peers. I would sit in a teaching session and my peers would be able to say things that I cannot. They would know little facts that I don't know. And the teachers told me straight up they can see that my knowledge is inferior than my peers. They don't know that I do show up early and do the extra work... maybe it'd be more embarrassing if they know. I know I'm doing something wrong compared to my peers, but I've tried and tried and nothing changes and I ran out of fumes.

I think I’m posting this not to ask “how to improve my study strategies” - that’s a separate issue. I guess the point of this post is the mindset aspect - how do I help myself when I don't even have the motivation? How do I keep going when my future as a doctor is so bleak?

The question is not “how do I regain my motivation?” - I know that my productivity ebbs and flows, and that it will regain itself at some point. That much is known. My question is when failure is so much more probable, so much more realistic... what do you even do? What will I do with my future? Do research instead? What realistically less demanding jobs that I can do after I finally able to scrape through and graduate from medical school? I know that I will be an incompetent doctor, I know my supervisors and colleagues will hate having me, I’m taking so much time and resources by being a slow turtle. What if it’s for the better good that I just don't attempt at all?

I agree with some of the posts above. This sounds like you're asking for professional mental help.

What was your reason for "why medicine?" when you applied?
Do you feel like you would be happy working as a scientist?
Do you feel like the issue is more motivation or your happiness?

Are you able to pinpoint why you feel so discouraged and negative? It may be something as simple as your immediate environment--maybe you have roommates who are getting on your nerves and don't let you get quality studying in at home, or don't let you get a good night's sleep, etc. Maybe you study at coffee shops instead of at the library, and that is too distracting? As someone with ADD, I know that I have to do several things in order to help myself concentrate, e.g.:

1) Put in earplugs
2) Turn off my phones/devices
3) Set a timer

Do you think that it is more depression or motivation issues?

Not intended as medical advice but I'd suggest that you see a psychiatrist.

 

[Top Gun]

@Drjc1977 Thank you for your encouragement! I'm indeed taking a hard look at my career choice. Even being prompted by my school to reconsider... I'd like to at least graduate with a degree for sure, but I'm looking at a few other alternative career pathways in case I find that I'm not cut out to do clinical work.

When you say your school is prompting you to reconsider, do you mean they’re prompting you to reconsider becoming a physician? Or are they urging you to reconsider leaving med school, meaning they want you to stick it out?

 

[tiramisu1]

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[hommefatale]

Everyone has provided good insights, but just wanted to say I'm thinking of you & wishing you the best!

 

[Top Gun]

Thank you for coming by!

@purpledoc1 it a more depression/motivation issue, not my living environment. I have been doubting whether being a doctor is the right career for me. I have indeed been thinking about working more as a scientist/admin or otherwise a non patient-facing, less intense and less socially performative environment.

@Top Gun The former (well, they also want me to graduate of course - after all it's good for their stats if I do). The school wants me to reconsider doing my degree - not wanting to reveal much but I was accepted to a dual-degree program. I want to at least finish my degree, but at this rate, failing every shelf exam (except psychiatry) by 4-10% ...

​

You know, I was a bit like you as a med student. I didn’t fail shelf exams, but I was socially awkward and considered “weird” by other med students, residents, attendings, and nurses. People trash talked me behind my back even though I had never done anything to them. I was made to feel stupid whenever I had trouble mastering a procedure. I got berated by residents and attendings. When I asked an L&D nurse a question about something I was curious about, she passive aggressively told me, “If you don’t know by now, you’ve got a problem.” One or two attendings told me I should go into pathology as if that was the only specialty I was capable of doing, because they didn’t think I was capable of interacting with others. A SICU attending who frequently yelled at students during presentations told me I was below average and essentially that I had no potential to succeed. For a long time, because of this, I doubted myself and my own abilities.

Now fast forward to today. I’m a practicing nephrologist, double boarded in IM and nephrology, medical director of two outpatient dialysis units, and have a busy practice with a loyal following of patients and getting new referrals all the time. Many patients have complemented me on my bedside manner and have thanked me for explaining things and providing good care. I even scored above the mean when I did the ABIM recertification exam a few years back. And I have four and five star reviews on vitals.com and healthgrades.com. And I’ve even let some of those former classmates, residents, and attendings who picked on me and doubted me know about all of this. Including that SICU attending. I’ve also politely called them out on their behaviour toward me in the past. Basically, I gave all of them the finger in polite and civil terms.

Anyway, the point of this is not to brag, but to say only you can determine if this path is really right for you. No one else can. And if you’re committed and willing to work hard, you can overcome your obstacles and ultimately achieve whatever you want. Best of luck!

 

[Drjc1977]

You know, I was a bit like you as a med student. I didn’t fail shelf exams, but I was socially awkward and considered “weird” by other med students, residents, attendings, and nurses. People trash talked me behind my back even though I had never done anything to them. I was made to feel stupid whenever I had trouble mastering a procedure. I got berated by residents and attendings. When I asked an L&D nurse a question about something I was curious about, she passive aggressively told me, “If you don’t know by now, you’ve got a problem.” One or two attendings told me I should go into pathology as if that was the only specialty I was capable of doing, because they didn’t think I was capable of interacting with others. A SICU attending who frequently yelled at students during presentations told me I was below average and essentially that I had no potential to succeed. For a long time, because of this, I doubted myself and my own abilities.

Now fast forward to today. I’m a practicing nephrologist, double boarded in IM and nephrology, medical director of two outpatient dialysis units, and have a busy practice with a loyal following of patients and getting new referrals all the time. Many patients have complemented me on my bedside manner and have thanked me for explaining things and providing good care. I even scored above the mean when I did the ABIM recertification exam a few years back. And I have four and five star reviews on vitals.com and healthgrades.com. And I’ve even let some of those former classmates, residents, and attendings who picked on me and doubted me know about all of this. Including that SICU attending. I’ve also politely called them out on their behaviour toward me in the past. Basically, I gave all of them the finger in polite and civil terms.

Anyway, the point of this is not to brag, but to say only you can determine if this path is really right for you. No one else can. And if you’re committed and willing to work hard, you can overcome your obstacles and ultimately achieve whatever you want. Best of luck!

What Top Gun said!!

 

[EthylMethylMan]

Have you considered pathology? It’s not patient-facing, so it may be much easier for your personality type. Pretty sure it’s still not very competitive, so if you turn things around now, you could potentially still match.