Fork in the Road

[HopelessMS]

Hi SDNers,

Currently on LOA. I was burned out after 3rd year rotations and had difficulty with all aspects of being a 3rd year and med student in general.

Before final year starts, reservations about continuing and whether I will be able to match have started creeping into my thoughts. I have tried to ignore these thoughts because of the enormous amount of debt incurred financing med school, thoughts of disappointing self, family, friends, professors, etc. I still want to be a physician, but my ambitions thus far have written a check my abilities have proven to not be able to cash, i.e. I have struggled mightily with the academic side of medical school (in-class exams, shelf exams, Steps). Therefore, I have major imposter syndrome at this point.

I'll likely continue and finish since I have gone this far already. I just know that in 10 years time, I will be beating myself up if I did not finish. But it will be an emotional and mental struggle. I was hoping SDNers (interns, residents, attendings, anyone) who have been in similar shoes could share their stories about overcoming such thoughts and feelings and now bathe in the proverbial light at the end of the tunnel (if it exists at all, esp. with Rona not going away).

I won't be responding to any questions, just reading any posts for inspiration.

Thank you.

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[calivianya]

I thought third year royally sucked.

Yeah, it was nice being in the hospital and doing actual work... but by the time you're half-decent at a specialty and getting comfortable (i.e. week 4), it's time to be thrown into a new situation with totally different preceptors, patients, and diseases. If you're a perfectionist and like being good at things, which I'd say probably describes most of us, it's awful to be brand new again every four weeks. I had a lot of dread prior to starting every new rotation and never could sleep much the Sunday night before my first Monday just out of anxiety about how my first day was going to go, regardless of whether I thought I'd like the rotation or not.

The thing is that it does get better. I have found the experience to be pretty universal across my core site and multiple aways that fourth-year students are treated differently. You aren't grilled as hard about every single detail of everything you're thinking. A lot of attendings/residents seem to think you've grown a few brain cells during third year and treat you the same as they treat the residents. I've felt like a semi-competent adult during my fourth year, instead of like a kid reaching for a piece of candy across a table and getting her hand smacked. Maybe that's a terrible comparison but that's how I felt during a lot of my third year.

Also, expectations are lower in general. "Oh, you're a fourth year? Go home," is something I've heard a lot this year. People realize that you have interviews, and you're going through the residency match and it's stressful, so they're more likely to let you go home early and skate through the last of your rotations with minimal fuss. Your *personal* expectations are lower as well - because after early fourth year auditions are over, nobody's going to see your rotation grades, so forget about killing yourself for honors unless you just want to. The all-powerful pass becomes king, and that takes a ton of pressure and stress off on its own... and the funny part of that is you might honor the rotations anyway since you can actually sit back and enjoy yourself, and learn for the sake of learning, which is 100x more fun.

You should keep going. Remember that the vast, vast majority of people *do* match, and people match every year with red flags, course failures, etc. If you're not going for something super competitive and you apply broadly enough, odds are that you will match somewhere.

 

[Entadus]

So you finished your 3rd year? Excellent, you are so close. 4th year is generally much easier than 3rd year, so you're definitely through the worst of it.

Fears of not matching are probably somewhat exaggerated, but can still serve as powerful motivation to apply smartly (broadly).

 

[flapjack3d]

M3 sucked. Intern year has been better than any year of med school besides M1. Actually maybe even better than M1. I'm sure other's experience is different but my perspective on medicine and my own feeling of competence changed drastically between M3 and PGY1. And I had literally only 2 months of actual rotations in M4. Something just clicks a few months into intern year once you have real ownership of your patients, and you're not too worried about making good impressions on your attendings, and it feels awesome! I would highly suggest you finish and try to find any field your heart's in.
Edit: even during my residency interviews, i did not feel like i had any idea if i actually wanted to be a doc. didn't realize it until maybe september of intern year.

 

[Ganon]

I just want to say: everyone told me MS3 was soooooo much better, and it was easily my low point. I think for the people who's batteries are instantly recharged by working with patients, MS3 is a great time. I have been in healthcare for quite a while, though, so the stress of shelf exams, Step 2, and the pandemic made it a pretty miserable time honestly.

There have been times during 4th year that were truly, completely better. I'm feeling senioritis now, but it's nothing like how I felt a year ago.

I say gird your proverbial loins and give it a shot. You're so, so close.

Something that helped me was the thought that even if I don't match, having an MD degree is useful. I believe some college professors qualify for PSLF, and I know of some who have MDs who didn't do residency... The thought of being a college professor doesn't sound terrible, so we might as well finish strong, right?!

Now I plan on matching IM and have a cool career idea/hope for the future, so I'm trying to use that as motivation to keep it up, and you can too!

PM me if you think it would be helpful.

 

[TelemarketingEnigma]

I just want to say: everyone told me MS3 was soooooo much better, and it was easily my low point. I think for the people who's batteries are instantly recharged by working with patients, MS3 is a great time. I have been in healthcare for quite a while, though, so the stress of shelf exams, Step 2, and the pandemic made it a pretty miserable time honestly.

There have been times during 4th year that were truly, completely better. I'm feeling senioritis now, but it's nothing like how I felt a year ago.

Really really agree. I liked that MS3 felt more career relevant and I didn't feel like I was worried about failing things as much, but it was completely exhausting, especially with COVID changes. One of the really exhausting things is just the complete lack of control over your own schedule and life. 4th year has had some heavy senioritis but overall has been a million times better and i feel like i can enjoy medicine again in a way i couldn't during the 3rd year grind.

 

[calivianya]

Really really agree. I liked that MS3 felt more career relevant and I didn't feel like I was worried about failing things as much, but it was completely exhausting, especially with COVID changes. One of the really exhausting things is just the complete lack of control over your own schedule and life. 4th year has had some heavy senioritis but overall has been a million times better and i feel like i can enjoy medicine again in a way i couldn't during the 3rd year grind.

Popping back into to second the enjoying medicine again part.

I have my last day of an elective tomorrow, and honestly, this has to be the highlight of med school for me. Interviews are done, it's not somewhere I have on my list, and it's not in the specialty I'm applying to, so literally nothing matters as long as I pass... and I'm actually enjoying this rotation tremendously and I'm disappointed it ends tomorrow. Makes me think the rest of med school could actually be great if there weren't a million big sticks looming over your head that could hit you at any time.

 

[thepoopologist]

Honestly, the debt was what allowed me to summon the willpower to finish. There were other factors obviously, i.e. developing my skills, but the debt was the primary motivating force.

 

[Candidate2017]

This is normal. You should fear debt, disappointing yourself, and not knowing enough. The question is whether you are actually listening to those fears and taking positive steps, such as making good financial choices and studying. Also, imposter syndrome should never go away. Any physician who doesn't feel imposter syndrome is a threat to patients. There is a reason why we are legally required to continue studying as attendings.

There will be good days and bad days, good months and bad months. Make sure to make time for yourself outside of medicine (hobbies, friends, family), as well as surround yourself with friends in medicine who can share the good times and bad times with you. You will make a lot of difference in some patients' lives, you will make good money, you will make mistakes, you may even kill patients, you will be sued at some point. All these things are heavy and better borne with the help of friends.