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Tuesday, March 15, 2016

My first Step 1 nightmare

I'm in the throws of studying for Step 1, in that we're one week into our dedicated study period, and I had my first nightmare about this beast last night. This does not bode well for my mental health in the coming months.

You see, I blew off medical school for the past year and half and, as a result, there are glaring gaps in my knowledge base. Couple that with the fact that I need a good score to have any chance of matching into orthopedics (my current love), and I have a lot of stress on my hands right now.

At the end of our block curriculum, I knew that I had a lot of ground to make up, but in order to see just how much, I stupidly took a practice test last week. It was a disaster. It was so bad that I spent the rest of the afternoon scouring the internet for success stories of people who pulled up their score by upwards of 50 points. Yeah, not many of those out there. So I fell into a hopeless funk and resigned myself to sucking hard-core on the most important exam of medical school. Not surprisingly, the rest of the day was a wash.

I managed to pick myself up from that mini-depression mostly by talking to a bunch of friends who have been through this before. Some confirmed my fears that I wouldn't be able to bring up my score to where I need it to be. But others gave me hope since they were in similar situations as this and managed to pull off a miracle. I work best under fear, so I'm hoping this is the motivation I need to really buckle down and study my butt off for the next month or so.

Speaking of months, I had originally set aside 6 weeks for dedicated period, which is more than sufficient according to nearly everyone. But since half of the first week was taken up by orientation administrative things and it's now been confirmed that I know nothing, I'm most likely going to push my exam back by a week to get 6 actual weeks of studying instead of the 5-ish I currently have. I lose a week of vacation, which would've been spent in the jungles of Costa Rica with my dad, but I'm going to need those extra days even if it's only to help my psyche and not so much my score.

We have a school-administered practice exam this Friday, so I'll see how much I've improved in the two weeks since my last practice test and make a decision then. But seeing how my question bank averages are going, the answer is probably not that much.

Worst case scenario, I push back starting rotations by a month to buy myself even more time. I'm pretty sure it won't come to that, but I really like knowing worst-case scenario outcomes. It keeps the stress from overflowing into hopelessness and being too overwhelmed, which is when I truly shut down. Just enough stress, and I'm super productive. But once it boils over, I may as well call it quits.

In the meantime, I'll try to keep my exam-induced neuroses to a minimum on this blog. I hope I come out of this with some sort of success story. Fingers crossed.

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Note: I'll post more specifics about my practice exams and other scores once I'm finally done with this thing, much like I did my MCAT. I'm not so much ashamed of my practice score, but more in denial about how poorly I did. I prefer not to see the number in print again until I've hopefully managed to overcome it.

Friday, March 4, 2016

The time I almost quit medical school

A few months ago, I was done. I'd met with our dean of student affairs. I even floated the idea by my parents in a sarcastic manner to see how they would react (not well, even in a purely hypothetical situation). I was figuring out what I would do with a future that didn't involve medicine.

Partly because I couldn't imagine such a life and partly because I got some sleep and my hormones calmed down*, I stuck it out and here I am. But for about a week there, I was very close to throwing it all away.

I think it was mostly a grass-is-greener kind of thought-process, even though I like to think I've outgrown that kind of thinking. I had had an awesome summer of fun in the sun, family, and doing what I wanted to do when I wanted to do it. About a month into school, my brother threw a fantastic wedding, and then he did it again in the motherland for the rest of our family. My school and exam schedule allowed me to celebrate both of those awesome occasions, which made coming back to school in between all those festivities that much more painful.

The transition from such a high and doing all the things that truly make me happy (family, adventure, travel) to the low of things I really, really dislike (rote memorization of bullshit drugs whose names make no sense and will likely change by the time I hit the wards) was too much of a shock to my psyche. Add lack of sleep and some wacky hormones, and I was in for a perfect storm of self-pity.

There were also more legitimate reasons for why I thought medicine wasn't for me, which were much more alarming. The scariest thing was that they weren't new or original; they had just re-reared their ugly heads. I have had reservations about the medicine track ever since I seriously considered becoming a doctor freshman year of college. It's a big part of the reason why it took me nearly a decade after undergrad to bite the bullet and finally apply to medical school.**

The most disturbing was that there is nothing in medicine (including ortho) that I'm truly passionate about. This statement applies to most things in my life in that I have a wide variety of interests but nothing I truly live for. I like a little bit of everything, which is great for hobbies but not so great for the gauntlet that is medical training.

For example, over the summer, I spent a day in a rural clinic and we had a patient with really bad jaundice. Her urine was the color of maple syrup and her eyes were practically the color of my highlighter. The doctors gathered the med students around saying we'd probably never see jaundice this bad again. Everyone oohed and awwed in wonder. I couldn't care less. Funny urine. Big deal.

Maybe that simply meant that I'm not suited for primary care, which I've known for a while. Or that I was seriously burned out and needed a break from all things medicine. But in the depths of my umpteenth mid-life crisis, I kept coming back to that moment of near-revulsion and apathy which only fueled my confusion about what I was doing with my life.

What if after all this, I couldn't find something within this field that could make me happy, fulfilled, and make all this bullshit worthwhile? I wasn't looking for the highest of highs or to be the person that saves the world. I just wanted something more substantial with more concrete satisfaction than my previous job of staring at a computer screen and hoping my work would have some impact years down the line.

A year and a half into school, seemingly nothing had changed in that regard and I wasn't sure it ever would. That was the kicker. I could get through medical school and residency. Both are temporary. But if I couldn't find satisfaction in working with patients, which would be the bulk of my post-training professional life, why was I doing this at all?

For that week, I had one foot out the door. I would complain to anyone that would listen about how miserable I was and was only half-joking when I would say, "My tuition is paid through the New Year so I don't have to make a decision yet."

But, I realized I needed to stay within five minutes of meeting with my dean. Her simple suggestion to take a leave of absence to figure things out resulted in a visceral hell-no-I'm-not-doing-that reaction from me. It was pretty telling and made it clear to me that I needed to buck up, princess. Just as quickly as I had decided to quit, I was back on the med school train.

Unfortunately, threatening to quit school results in meetings with a lot of people trying to talk you out of it. So even though my dean had unknowingly succeeded in convincing me to stay during our first meeting, she also made an appointment for me to meet with Dr. D, one of our most popular and personable professors.

About a week later, I sat down with Dr. D and felt like an impostor in explaining my reasons for wanting to leave medicine, because I didn't really believe all of them anymore. But I kept up the charade to see what she would say. She essentially rehashed the same argument I gave myself when I finally decided to pursue this medicine business a few years ago.

There are so many opportunities within medicine, and patient care is only a fraction of what one can do as a doctor. If you get bored doing clinic, there's medical education, community outreach, pharmaceuticals, and Sanjay Gupta. The MD after the name opens up so many doors and puts you "on the other side of the table," as Dr. D put it. Sticking it out would have significant professional benefits and would be well worth it. She focused on my logical reservations about medicine and addressed them head-on. If I wasn't convinced to stay before speaking with Dr. D, I was definitely hooked when I was done with her.***

Months have passed since my near-quitting and although I'm now in a better place, all of my doubts about continuing with medicine have not completely disappeared. I still worry that I'm not going to fully enjoy being a physician, that I'll get bored and frustrated with my work, and that maybe something else would've been more suited towards my personality and what I want out of life.

But then I go to my preceptor and put a face to the patient whose EKG printout I just learned how to interpret. I go to grand rounds and learn the newest protocol for managing traumatic amputations. I scrub in on an ACL reconstruction and get to close a patient's wound.

When I take a step back and look at the whole picture, I realize I'm exactly where I need to be. It did take me years to finally decide on this path, but as a result, that decision was not made lightly. If I didn't give this a shot, I would regret it for the rest of my life. So even though this year has been rough, I don't regret it for a minute.

Times have been tough and will only get tougher. I'm sure this won't be the last time I'll want to quit, but I'm incredibly excited for what lies ahead.

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*I hate blaming stuff on being a girl, but sometimes it's so obviously the case that I can't ignore it. You'd think by now I could better control my emotions but sometimes they still get the best of me. At least I've learned to recognize when that is and can just wait for it to pass to get on with my normal, adult, rational self.

**I've wanted to be a doctor since I was in high school and worked as an EMT all throughout college. I matriculated in my late 20s. To say I have commitment issues is an understatement.

***Dr. D also pegged my personality within 10 minutes of our meeting. She is an incredible people-reader and it's no wonder she's a fantastic clinician.