When to Call it Quits (Need Unbiased Opinions)

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What should I do?

  • Take leave of absence and remediate M1 and M2 coursework

  • Leave school indefinitely and search alternative career paths

  • Finish the MD and go a non-clinical route

  • Give up on an academic medicine research career and match into a non-competitive community program

  • Don't give up on original medical career - push through and do whatever it takes to get there


Results are only viewable after voting.

2MDorNot2MD

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Hey SDN community,

So I came here to ask for advice from some third party, unbiased sources. I am a third year medical student at a top 20 medical school and I am considering throwing in the towel because it seems as though my desired career (academic medicine clinician/researcher) is basically out the door at this point.

The story: M1 started off rough, but I began to kind of get a hold of things around 2 months in, then there was a severe medical issue that happened with one of my family members that required me to leave school for a couple of weeks. From that point on I was playing catch up. I had to retake some missed exams, so I was behind in general which resulted in me failing exams in nearly each subject block and constantly having to make up exams. The family situation plus the deterioration of my personal relationship at the time led to a bit of a spiral. Fortunately, my institution does pass/fail the first two years so as long as I managed to pass I was still able to skate by and advance. In retrospect, I should have spent more time summer after M1 reviewing M1 subjects that I really never completely had a full grasp on, but I did not - I did research (actually won an award for it lol). Then M2 came and was rough because of my lack of fundamental knowledge developed during M1. Still, I continued to skate by but always scored among the lowest in my class on any given exam.

Finally, step time came and I had a breakdown. I couldn't even come close to a passing level on the NBME practice exams (was scoring below the 0th percentile). I became obsessed with thinking that either I had somehow become a miserable test taker (despite scoring above the 90th percentile on MCAT), I didn't learn the information well enough, or I just wasn't smart enough to do this. It got into my head and I spiraled. The decision was made to postpone step1 til after third year hoping that the clinical context would help put the M1 and M2 material in perspective.

Now M3 has been rough as well. I've managed to pass all the shelfs I've taken (had to retake 1), but other things have gotten in the way of getting the best possible grades. Nervous breakdown on a standardized patient exam, nerves getting in the way of the shelf exams, resident with a vendetta against me, etc. Things just keep getting in the way and my transcript after 4 clerkships is garbage: 3 passes and a high pass, including a pass in my desired field.

At this point, I'm really considering waving the white flag on medicine. Maybe it just wasn't meant to be. I think I can still manage to pass my clerkships and get the MD but I am looking at going the consulting route; going and getting an MPH or MPP and doing policy work and research; maybe getting an MSW and doing social work, or trying to get a job teaching high school or college.

I guess I'm just looking for any guidance at this point. The few friends who know my situation keep telling me to brush myself off and keep going but it really seems for not. I don't see a pathway to what I wanted to do in medicine currently (I want to do policy and public health research with an international perspective so there are only a few institutions in the country with substantial footholds to do this in a residency program). Family is supportive of whatever I want to do but they don't know anything about medicine (I'm first gen) so their opinions are often steeped in misunderstanding my reality. I can say that my institution has been really supportive and they understand the situation well. I think if I wanted to I could take a leave of absence but IDK what good that would do at this point. I could go back and try to remediate some classes and stuff but I can't retake these clerkships. I do still have step1 up in the air but even if I magically pulled off a great score, I don't know if that would make up for a pass on the clerkship in the field I want.

I'm just genuinely lost as to what I should do moving forward.

Please feel free to be as harsh and realistic as you desire in any responses. I appreciate people keeping it real with me.

TL;DR: Drop out? Take leave of absence? Finish and go non-clinical route? Give up on desired career in medicine and just match into anything possible?
 
What is your desired field? So you are passing everything at least and are considering dropping out because one field which you haven't mentioned could possibly be unattainable? Is there any different path you could take to result in the same goal? Seems like a drastic conclusion for what could be a minor problem.
 
What is your desired field? So you are passing everything at least and are considering dropping out because one field which you haven't mentioned could possibly be unattainable? Is there any different path you could take to result in the same goal? Seems like a drastic conclusion for what could be a minor problem.

Hey! Thanks for replying - I appreciate it! Sorry about the vagueness, I just am weary of putting too many specific details about myself online.

As far as the field goes - it certainly isn't the most competitive, but it's more the career I want that is difficult to be successful in. My goal has always been to be in academic medicine doing global health research and policy work (in addition to clinical work and teaching). I recognize there are multiple different fields I could do this in, but the reality is that there aren't that many institutions where I could realize this goal. There are maybe a dozen universities that have legitimate researchers and clinicians doing this kind of work. Granted, almost every university has maybe 1 or 2 people doing this kind of work, but an actual established infrastructure for doing this type of work really doesn't exist at many places. This infrastructure is the only real way to establish the kind of track record you need to win very limited grants later on in your career.

Could I match somewhere in a field that may some day allow me to do this work? Sure - probably. But it would be a long uphill climb to get there coming from a non-established or high pedigree program - which is an unfortunate truth. I'm already in my 30s and don't want to be 45 before I finally am at my desired career.

Hope that makes more sense?
 
Does your school not have resources such as counseling to help you with these issues? (We're willing, but I don't know to what extent you've worked with them already). I definitely don't think you should give up on medicine at this point. You've gone through some stuff recently, but you've proven that you can handle the curriculum of medicine when you focus on it. Do you really only have a singular field you'd be interested in doing? What happens when you go through m3-4 and find other fields that you think are cool too? I think you have so much potential and throwing in the towel because of some hardships seems ridiculous. There are so many more things you can do and you should consider opening your mind a little bit even if your original goals aren't realistically attainable (I'm not saying they're not, but it could be more difficult).

Re-evaluate what you think is important in what you want out of a career and see if there is more than one way to attain that goal. Be flexible and don't drop out now. I'm sure once things start going more smoothly, you're going to be a rockstar.
 
Does your school not have resources such as counseling to help you with these issues? (We're willing, but I don't know to what extent you've worked with them already). I definitely don't think you should give up on medicine at this point. You've gone through some stuff recently, but you've proven that you can handle the curriculum of medicine when you focus on it. Do you really only have a singular field you'd be interested in doing? What happens when you go through m3-4 and find other fields that you think are cool too? I think you have so much potential and throwing in the towel because of some hardships seems ridiculous. There are so many more things you can do and you should consider opening your mind a little bit even if your original goals aren't realistically attainable (I'm not saying they're not, but it could be more difficult).

Re-evaluate what you think is important in what you want out of a career and see if there is more than one way to attain that goal. Be flexible and don't drop out now. I'm sure once things start going more smoothly, you're going to be a rockstar.

Hey thanks for responding, kelminak!

So yes my school has been great about resources, that is part of what is so frustrating about my continuing lack of success. I was linked up to the school counselling center where I got both a psychiatrist and a therapist; additionally I was set up with an academic skills counselor who works with me on study guides and things of that nature. That's probably part of the reason I've been able to at least pass everything so far, even if it is at the bottom of my class.

Also, in regards to other ways to attain the career I want, I feel like an MPH or MPP would potentially get me half way there in regards to my research wants but I would not have the ability to forge clinical relationships with patients or teach in a clinical capacity, which is the other half of the career I want.
 
Hey! Thanks for replying - I appreciate it! Sorry about the vagueness, I just am weary of putting too many specific details about myself online.

As far as the field goes - it certainly isn't the most competitive, but it's more the career I want that is difficult to be successful in. My goal has always been to be in academic medicine doing global health research and policy work (in addition to clinical work and teaching). I recognize there are multiple different fields I could do this in, but the reality is that there aren't that many institutions where I could realize this goal. There are maybe a dozen universities that have legitimate researchers and clinicians doing this kind of work. Granted, almost every university has maybe 1 or 2 people doing this kind of work, but an actual established infrastructure for doing this type of work really doesn't exist at many places. This infrastructure is the only real way to establish the kind of track record you need to win very limited grants later on in your career.

Could I match somewhere in a field that may some day allow me to do this work? Sure - probably. But it would be a long uphill climb to get there coming from a non-established or high pedigree program - which is an unfortunate truth. I'm already in my 30s and don't want to be 45 before I finally am at my desired career.

Hope that makes more sense?

Not really. You really think that it's competitive environment to get into these fields as a physician? Do you have any particular evidence to support this? Also, what is your debt level? An MPH or MPP alone is unlikely to get you a salary that will efficiently handle medical school debt.
 
Not really. You really think that it's competitive environment to get into these fields as a physician? Do you have any particular evidence to support this? Also, what is your debt level? An MPH or MPP alone is unlikely to get you a salary that will efficiently handle medical school debt.

I think OP means that being successful in that field is difficult because of grant limitations, etc (correct me if I'm wrong OP). He's not wrong that the vast majority of funding for international research projects go to a relatively small number of schools. I know at my school there are very few people in the medical school running around with these types of grants (some exist in the public policy, law, and business schools though).

OP - trust your gut, but don't give up because the road gets rough. You chose to be with patients for a reason at some point in time. Try to remember that reason.
 
Not really. You really think that it's competitive environment to get into these fields as a physician? Do you have any particular evidence to support this? Also, what is your debt level? An MPH or MPP alone is unlikely to get you a salary that will efficiently handle medical school debt.

Yes, like ChemEngMD said - it's a competitive environment to get into global health work because funding is very limited and is taken up by a few big players at big name institutions. Places like Hopkins, Brigham, UCSF, UWashington, etc eat up a lot of the funding for global health stuff and if you come from one of those programs your chance of getting funding is definitely way better. Global Health Policy funding is especially limited - most of the money for global health is still in ID, specifically HIV.

In regards to debt, I just crossed over the 6 figure mark this year. I think my final amount of debt will be around $150k.

Thanks for all of the comments guys!
 
I would take a leave of absence and then tell yourself that all you have to do is finish your degree. That will alleviate a ton of the anxiety and stress which sounds like it is the only thing holding you back. Once you've given yourself some time, I'm sure you'll be surprised with how much progress you'll make. It sounds like you've been through a lot and giving yourself a break might be what you need. When I was in grad school, my fiancé left and then my apartment flooded and I had to live in temporary housing. I was a wreck and just needed a few months to pull myself together so I took a leave then came back to finish strong.
 
Honestly your reasons for wanting to quit are stupid. If you really think being a social worker or in consulting is better than doing non-academic/non-global health medicine then ya maybe you should just quit
 
Your school let you stay on rotations without doing Step/Level 1?

Yes in fact I'm not the first at my school to do it. And you may or may not know this but multiple top tier institutions do their clinical rotations before taking either step (Penn for sure, I think Baylor, and I think Duke). It's most definitely not a requirement for third year at a lot of places.
 
Honestly your reasons for wanting to quit are stupid. If you really think being a social worker or in consulting is better than doing non-academic/non-global health medicine then ya maybe you should just quit

Haha harsh, man, but I appreciate the honesty. I don't think I'm the first person to get into medicine for a specific reason and become disillusioned when not able to achieve it. In fact there are sadly a couple of suicides per year of medical students and trainees who were having difficulty reaching their desired goals.

I'm not saying you're wrong because maybe if I wouldn't be happy as any type of physician then maybe medicine legitimately was never really for me. IDK but I know I worked hard to get to this point and it would be a major let down to be in medicine and not be doing what I came to it for.
 
What experience do you have in global health? Lots of people interested in it have unrealistic fantasies.

Hi DrBowtie! Thanks for responding! So my global health experience is not massive but I have spent 2 summers doing work abroad (1 clinical and 1 research) and I have had a lot of mentors in the global health sector. So I've seen their jobs and lifestyles. I think I have a relatively realistic grasp on the concept, which is why I recognize the need to go some place with a strong global health infrastructure for residency. It definitely is not the easiest lifestyle by any means and it is certainly not as glamorous as people believe it to be, but it's where my heart has been for some time now.
 
Very sorry to hear of your woes, OP. This is yet another data point as to how med school can break even a healthy student.

I strongly recommend a LOA. Something is very broken and you need time to fix it.

I'm surprised that you didn't take LOA in M1.


Hey SDN community,

So I came here to ask for advice from some third party, unbiased sources. I am a third year medical student at a top 20 medical school and I am considering throwing in the towel because it seems as though my desired career (academic medicine clinician/researcher) is basically out the door at this point.

The story: M1 started off rough, but I began to kind of get a hold of things around 2 months in, then there was a severe medical issue that happened with one of my family members that required me to leave school for a couple of weeks. From that point on I was playing catch up. I had to retake some missed exams, so I was behind in general which resulted in me failing exams in nearly each subject block and constantly having to make up exams. The family situation plus the deterioration of my personal relationship at the time led to a bit of a spiral. Fortunately, my institution does pass/fail the first two years so as long as I managed to pass I was still able to skate by and advance. In retrospect, I should have spent more time summer after M1 reviewing M1 subjects that I really never completely had a full grasp on, but I did not - I did research (actually won an award for it lol). Then M2 came and was rough because of my lack of fundamental knowledge developed during M1. Still, I continued to skate by but always scored among the lowest in my class on any given exam.

Finally, step time came and I had a breakdown. I couldn't even come close to a passing level on the NBME practice exams (was scoring below the 0th percentile). I became obsessed with thinking that either I had somehow become a miserable test taker (despite scoring above the 90th percentile on MCAT), I didn't learn the information well enough, or I just wasn't smart enough to do this. It got into my head and I spiraled. The decision was made to postpone step1 til after third year hoping that the clinical context would help put the M1 and M2 material in perspective.

Now M3 has been rough as well. I've managed to pass all the shelfs I've taken (had to retake 1), but other things have gotten in the way of getting the best possible grades. Nervous breakdown on a standardized patient exam, nerves getting in the way of the shelf exams, resident with a vendetta against me, etc. Things just keep getting in the way and my transcript after 4 clerkships is garbage: 3 passes and a high pass, including a pass in my desired field.

At this point, I'm really considering waving the white flag on medicine. Maybe it just wasn't meant to be. I think I can still manage to pass my clerkships and get the MD but I am looking at going the consulting route; going and getting an MPH or MPP and doing policy work and research; maybe getting an MSW and doing social work, or trying to get a job teaching high school or college.

I guess I'm just looking for any guidance at this point. The few friends who know my situation keep telling me to brush myself off and keep going but it really seems for not. I don't see a pathway to what I wanted to do in medicine currently (I want to do policy and public health research with an international perspective so there are only a few institutions in the country with substantial footholds to do this in a residency program). Family is supportive of whatever I want to do but they don't know anything about medicine (I'm first gen) so their opinions are often steeped in misunderstanding my reality. I can say that my institution has been really supportive and they understand the situation well. I think if I wanted to I could take a leave of absence but IDK what good that would do at this point. I could go back and try to remediate some classes and stuff but I can't retake these clerkships. I do still have step1 up in the air but even if I magically pulled off a great score, I don't know if that would make up for a pass on the clerkship in the field I want.

I'm just genuinely lost as to what I should do moving forward.

Please feel free to be as harsh and realistic as you desire in any responses. I appreciate people keeping it real with me.

TL;DR: Drop out? Take leave of absence? Finish and go non-clinical route? Give up on desired career in medicine and just match into anything possible?
 
Agreeing with the wise gentleman above - something is definitely wrong and you need to fix it. I'm having a hard time reconciling how you can pass shelf exams yet score in the 0th percentile for Step 1 practice exams. You clearly had a rough start to medical school but are managing to pass your exams now. I know you are guarding your identity, but the whole story just doesn't hold together. There are only a few things that can cause a story like yours, and all of them call for some serious work with a mental health professional. Everything else is a non-starter until this is worked out and addressed and doing so is really beyond the scope of what a forum like this can do.

If you are unable or unwilling to pursue serious professional help and do whatever is required, then I would strongly argue in favor of finding another path. Any other path. To be honest, you aren't even to the hard part of training yet. Medicine will make minced meat of anyone without the support structure and coping skills to handle the stress, the sleep deprivation, the high stakes, and the scrutiny. What's worse, there is a tipping point where enough slip ups and mistakes start to bring both further scrutiny and cost you the benefit of the doubt. It's the point where any mistake (and yes you will make mistakes) goes from eliciting a "gee, he must have been having a really off day or something else must have happened because that's not like him" to garnering a "well that just figures." Try going to work every day under THAT kind of stress and scrutiny! Your past experience makes it highly likely you'd face something like that at some point along the way, and even if you didn't, my gut tells me you would THINK you were facing it.

Perhaps this is where I see the next biggest disconnect (behind the clear need for help) - your perceptions of your situation are not aligned with reality. You had a rough M1 year but survived, you passed M2 with the lowest scores in the class at a top medical school. You have passed all your clerkships thusfar. Really the only wildcard is the outstanding Step 1. There is nothing from a purely academic standpoint that would prevent you from moving forward in your career. Your words betray the fact that you have absolutely no idea what it takes over the long term to build the career you want because you have spent your life thusfar only in school (perhaps the biggest giveaway was following your story of poor responses to high stress situations with the idea of doing consulting work instead). I'm old enough to have had friends go through the Big Law/I-banking/Consulting "up or out" meat grinder and seen what it can do to people -- I wouldn't look to such things as a refuge.

My 0.02 in a nutshell:
1) LOA
2) Find professional help and address your underlying issue(s)
3) Start re-aligning your expectations
4) Go back and finish school
5) Take your underlying issues and strengths/weaknesses into account when choosing your specialty or other career. These are arguably more important than what interests you. Do NOT make the mistake of doing what you love above all else; focus on what you're actually good at.
6) Pick a residency based on what you can finish and do well in, not based on what institution has more global health funding in your area.
 
Haha harsh, man, but I appreciate the honesty. I don't think I'm the first person to get into medicine for a specific reason and become disillusioned when not able to achieve it. In fact there are sadly a couple of suicides per year of medical students and trainees who were having difficulty reaching their desired goals.

I'm not saying you're wrong because maybe if I wouldn't be happy as any type of physician then maybe medicine legitimately was never really for me. IDK but I know I worked hard to get to this point and it would be a major let down to be in medicine and not be doing what I came to it for.

If you'd rather do whatever random crap you mentioned than any medicine outside the oddly specific niche you've concocted then yes I think medicine is not for you.
 
OP, what makes you think you need to go to the perfect residency program in order to make this dream a reality? There are multiple specialties that offer non-ACGME fellowships in global health (most are probably going to be in EM or FM). I would strongly doubt these fellowships are super competitive given that they don't give you any specific new clinical skills or boost in pay, so you don't have to have gone to the top residency program in the country to match into one. If you do well in that fellowship and get great publications, it could help you get a job at that institution. Alternatives would be do a part-time MPH that you finance with the earnings from your medical career. You don't even have to be in academia to work in global health. There are many organizations like Seed Global Health and Health Volunteers Overseas that allow you to contribute without making it a full-time career. I can't tell you every one of these options will work perfectly because, well, I haven't done them, but all seem to me like better options than throwing away your medical training and starting from scratch.
 
Obviously other people have commented on how you definitely need to seek out help and figure out why you're scoring so low. Something doesn't make sense in the picture, and only someone that can counsel you in person can help you figure out what that is.

However, I think that one of the biggest issues (with regards to your question) is that you've created a really specific and thus stressful idea of what your future has to be. Would you still want to be a doctor if you couldn't do academic medicine? What about if you didn't do global health research, but went abroad 1-3 months a year? What if you worked full time with an NGO that allowed you to work/research abroad? You're going to need to work to imagine a variety of possible futures for yourself, otherwise the stress is going to keep you trapped in the cycle that you find yourself in. Maybe you really would only be happy doing this one little niche area only at specific institutions, and if that's true than maybe you should just give up. However, would you be happier doing whatever work you could do with your prior degree, rather than finishing school (at least) and (hopefully) finishing some kind of residency? Again, maybe that's true, but you need to think back to why you went to medical school in the first place, address your problems in a serious and focused way, and only if the opportunities available to you outside medicine would make you happier than what you currently have before you should you consider leaving. A leave of absence to give you time to focus on your mental health may be in order. I know plenty of excellent doctors who went through serious hardships during medical school or residency and are very happy where they are now, having gotten through it and to the other side. You absolutely can do this, but it's going to take some serious soul-searching and it may take some time away so that you can address what's really going on. You should absolutely be re-evaluated by a different learning specialist and psychiatrist, as that seems like the most straightforward reason for what's going on.

I've worked in global health as well, and don't let yourself get trapped into the belief that there's only one path forward. You could do any specialty and carve out a niche for yourself both doing work abroad and doing research. Sure, it may be significantly more difficult doing so at some institutions, but if that's what you love then don't let the barriers in your way stop you.
 
Wow thanks for all of the responses, everybody! Especially from those of you further along this path than I that are able to provide some perspective.

I plan to take everything you've said to heart in the coming days and weeks and reach out to my current academic and mental health support team to determine the best move forward. I do think that there is a fog of mental health issues that is clouding my perspective on this matter and it needs to be worked out.

Thank you all again.
 
To me this is obvious, but you are worrying about your grades WAY TOO MUCH. After you finish residency/fellowship, NOBODY will care about what your grades were during medical school. Yes, academia is a competitive environment. However, your ability to land a desirable academic position will be about what you bring to the table in terms of fellowship training, research, teaching, experiences, etc., and not your step scores and grades. If you are genuinely interested in global health work, you will be highly in demand, regardless of the prestige of the institution where you trained, as few physicians tend to truly dedicate time and effort to this field. If you don't want to pursue academia, who cares about your medical school grades, you will be just fine!

If you've spent much time in the hospital around doctors you will see that they come from medical schools across the world and all sorts of different residency/fellowship programs. You can absolutely still be highly successful with your career in medicine and land the job YOU want.
 
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Hey SDN community,

So I came here to ask for advice from some third party, unbiased sources. I am a third year medical student at a top 20 medical school and I am considering throwing in the towel because it seems as though my desired career (academic medicine clinician/researcher) is basically out the door at this point.

The story: M1 started off rough, but I began to kind of get a hold of things around 2 months in, then there was a severe medical issue that happened with one of my family members that required me to leave school for a couple of weeks. From that point on I was playing catch up. I had to retake some missed exams, so I was behind in general which resulted in me failing exams in nearly each subject block and constantly having to make up exams. The family situation plus the deterioration of my personal relationship at the time led to a bit of a spiral. Fortunately, my institution does pass/fail the first two years so as long as I managed to pass I was still able to skate by and advance. In retrospect, I should have spent more time summer after M1 reviewing M1 subjects that I really never completely had a full grasp on, but I did not - I did research (actually won an award for it lol). Then M2 came and was rough because of my lack of fundamental knowledge developed during M1. Still, I continued to skate by but always scored among the lowest in my class on any given exam.

Finally, step time came and I had a breakdown. I couldn't even come close to a passing level on the NBME practice exams (was scoring below the 0th percentile). I became obsessed with thinking that either I had somehow become a miserable test taker (despite scoring above the 90th percentile on MCAT), I didn't learn the information well enough, or I just wasn't smart enough to do this. It got into my head and I spiraled. The decision was made to postpone step1 til after third year hoping that the clinical context would help put the M1 and M2 material in perspective.

Now M3 has been rough as well. I've managed to pass all the shelfs I've taken (had to retake 1), but other things have gotten in the way of getting the best possible grades. Nervous breakdown on a standardized patient exam, nerves getting in the way of the shelf exams, resident with a vendetta against me, etc. Things just keep getting in the way and my transcript after 4 clerkships is garbage: 3 passes and a high pass, including a pass in my desired field.

At this point, I'm really considering waving the white flag on medicine. Maybe it just wasn't meant to be. I think I can still manage to pass my clerkships and get the MD but I am looking at going the consulting route; going and getting an MPH or MPP and doing policy work and research; maybe getting an MSW and doing social work, or trying to get a job teaching high school or college.

I guess I'm just looking for any guidance at this point. The few friends who know my situation keep telling me to brush myself off and keep going but it really seems for not. I don't see a pathway to what I wanted to do in medicine currently (I want to do policy and public health research with an international perspective so there are only a few institutions in the country with substantial footholds to do this in a residency program). Family is supportive of whatever I want to do but they don't know anything about medicine (I'm first gen) so their opinions are often steeped in misunderstanding my reality. I can say that my institution has been really supportive and they understand the situation well. I think if I wanted to I could take a leave of absence but IDK what good that would do at this point. I could go back and try to remediate some classes and stuff but I can't retake these clerkships. I do still have step1 up in the air but even if I magically pulled off a great score, I don't know if that would make up for a pass on the clerkship in the field I want.

I'm just genuinely lost as to what I should do moving forward.

Please feel free to be as harsh and realistic as you desire in any responses. I appreciate people keeping it real with me.

TL;DR: Drop out? Take leave of absence? Finish and go non-clinical route? Give up on desired career in medicine and just match into anything possible?

Wtf, everything is fine. Just keep going. You'll match, be successful, and there will be ways down the road to achieve your goals if you stay persistent.

Like Step Up says, you've probably seen many admirable physicians in the hospital. I've been competitive all my life but now I'm like if I could just grow up and be just like one of these people, I'd be happy with my life. You are blowing this way or of proportion. Keep trying to honor but you'll be fine regardless. Also, I don't get how you're such a prestige-freak yet you feel like you'd be happy dropping out of medical school and getting an MSW?

Sent from my iPhone using SDN mobile
 
If you're already midway through 3rd year, just finish off the MD with some easy rotations. Better to have the degree than nothing at all. Then just move on with your life with whatever you want.
 
Can you do a LOA and get your MPH at the same time? That way you wouldn't have to explain an absence, it would fit in nicely with your goals and could still give you enough time/space from medicine for a mental break. I know 'multiple top tier institutions' have build in or work-around MD-MPH programs that can sometimes tailor very nicely with a year gap between clinical or pre-clinical years.
 
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