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Thursday, November 29, 2018

Feeling the need to be perfect

I realized that I've been so stressed for the past couple of years (ever since I started 3rd year in May 2016) because I've always felt I had to be at 100% every minute of every day. It's led to me beating myself up every time I get a pimp question wrong, worrying about making awesome plans for all 20+ of my patients, and just generally thinking I suck at life and my job. It's exhausting and completely unsustainable.

I've developed this weird mindset that I have only one chance to make a good first impression and there's no coming back from it. Therefore if I screw up on the first day or don't do things to my very high satisfaction, I assume that all is lost and there's nothing I can do to change it.

It started with 3rd year when I changed services nearly every week and every day was the first day of work. It continued through away rotations during fourth year for that very same reason yet even higher stakes. Because of my scores, I knew I needed to be the best med student / rotator they had ever met and it all began with that dreaded first impression that I thought I couldn't change.

Surprisingly, this same feeling has continued during my prelim year. I had hoped that by being in one place for a whole year, that pressure would disappear because I had a whole year to make good impressions and I could allow myself one "bad" day once in a while. But for some reason, it's persisted.

Part of it is the shortened time frame for everything...one month on ortho in July, needing a letter of recommendation from my PD by August, and switching services and chiefs every month. I've felt the pressure to be perfect at every turn because it's a new group of people and again, the stakes are super high (probably the highest they've ever been). Everyone has to love me on the first day, otherwise I have failed. It's a warped way to think of things and obviously has to change, because it's done a number on my mental health.

The problem with this way of thinking is that I can never be good enough in my own eyes and therefore I'm destined to "fail" (by my standards). I'm at a strong general surgery program, so all the interns have their shit together, which makes it hard to stand out among the super stars. In the back of my mind, I always knew I couldn't be top dog of the 15 or so interns in my class, but that doesn't mean I didn't put the pressure on myself to try to be the best. Of course, I had to be awesome on Day 1 and whenever I slipped up (as in intern inevitably does), I would get very upset and mad at myself, and would just spiral into self-deprecation, which would make me even more upset and the cycle would persist.

I realize I can't continue this way for the rest of the year because I have been absolutely miserable and it has affected every part of my life. I have to accept that I will make mistakes and that it's okay to be wrong. I don't have to be perfect because that ship sailed long ago and my fate is probably sealed at this program already.

What I can do is continue to improve throughout the year. I can go back to the basics of checking all my boxes, following up on labs and consults, and being agreeable and affable. I can give myself a break whenever I mess up or don't do something perfectly. I can accept the fact that I am not perfect and should not expect to be the best intern this department has ever had, because that's simply not possible.

My new goal should be to impress my bosses with my improvement and growth throughout the year. I won't strive for perfection, but I will strive for being solid and strong, and on an upward trajectory. Although rank lists are due in only a couple of months, I still have 6.5 more months with this program and I'm sure if I do all those things, I can get a solid letter at the end of the year for the next application cycle.

I keep wanting to throw in the towel because the first impressions have already been made and I've had a rough couple of months. But another way to get good evaluations is to show how much I've improved and that I can turn things around, and that should be what I strive to do with all the time I still have left here.

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