Third year has brought so many new emotions, worries, and class dynamics.
The first two years of medical school are challenging for sure, but they are (usually) pass/fail and removed from the world of real patients and decisions about the future. They are care free in the scheme of things.
Third Year Changes
But things change once Step One comes along. That Step One score means a whole lot in the life of a future physician (which is a whole other can of worms.) The class is suddenly stratified even though no one really talks about their score. We talk in vague “I’m happy!” and “I’m disappointed” language. Some people start to make comments about dermatology and orthopedics while others let slip their fear about getting interviews. You can make a decent guess.
In clerkships we now worry about evaluations from our attending physicians and residents, and it can cause tension when everyone wants to do well. The third year clerkships function like apprenticeships; we learn on the job, putting the classroom memorization into context and getting a lot of things wrong along the way. We are lowest on the totem pole and feel worthless most of the time. How did I just spend two years studying and still know zero things about taking care of these patients? Does everyone else know more than me? Do I deserve to be here?
The occasional little wins are so crucial to maintain a positive psyche. That one right answer, a thank you from a patient, or searching through old charts to find something important can carry you for days.
It’s hard to stay focused on my own goals. It’s hard not to get caught up in scores and competition. It seems like everyone else wants to get the top of the top scores and publish all this research so they can match into competitive specialties, so shouldn’t I want that too?
My medical school colleagues are incredible. They are the most brilliant, insanely hard working, dedicated and passionate people I’ve ever met. They are pretty fun too! But we all want different things and came to medicine with different purposes. We all want to care for patients, but in vastly different ways. Yes, some have a passion for competitive things like orthopedic surgery, dermatology, or plastics. Some had the goal of getting at least a 240 (or better) on Step One. Some will do truly whatever it takes, sacrificing so much for their future career. Why do you think medical students have such high rates of depression and anxiety?
I came into medicine with a passion for preventative wellness and mental health. I want to develop relationships with my patients and treat the whole person. From the beginning, I’ve been drawn to less competitive specialties like family medicine, pediatrics, and psychiatry (even though I sometimes get embarrassed about the last one because there happens to be a stigma against mental illness and the physicians that treat them. And then I feel ashamed that I’m embarrassed because mental health is crazy important to me and why do I care what anyone else thinks? And isn’t that sort of the idea of this whole post anyway — stop caring what everyone else is doing?)
And though it doesn’t go along with the, “Do-whatever-it-takes-who-needs-sleep-anyway,” mantra that many med students follow, I definitely love that those specialties enjoy some of the nicer lifestyles. They may not make the most money by a long shot, but the hours are reasonable. My own health and happiness is important to me. I want to have the time to take care of myself so that I can be the best doctor for my patients. I want to be able to practice what I preach. Many of those really competitive, must-get-a-240 specialties wouldn’t allow me that.
So to those of you that can’t imagine being anything other than a surgeon or an ophthalmologist or anesthesiologist- go for it! Work hard, kick butt, and do the best you possibly can so you can follow your dream. We need those people! You are amazing!
But I’m going to stay focused on what’s important to me, and that’s okay too. I don’t have to want the same things as everyone else or follow the most intense, rigorous path. And it doesn’t mean I’ll be less of a doctor. I’m still going to work my butt off so I can take wonderful care of my future patients.
We need all types of doctors and all types of passions. But to be honest, I’m pretty darn happy that mine will allow me at least a little bit of sleep.