Wayfaring MD

I am a senior in high school and I want to become a doctor, but medical school seems… Tiresome and depressing. I feel like once I get there I’ll be so isolated and alone that I will give up. How does one handle that? It just seems so daunting to me. But medicine is my passion and I don’t want to give it up! -scienceofthes0ul

Well friend, you have judged medical school correctly…sort of. It absolutely can be tiresome and depressing, and it is at times (and residency moreso). But the cool thing is that when you’re tired and depressed, most of your friends are probably feeling the same thing. 

That doesn’t sound very comforting, but it kind of is. You will be surrounded by people who are just as miserable as you are, and they can empathize with you and you can use each other to get through. It’s funny, I spent less time with my friends in med school than I did with friends in undergrad, but I was much closer to my med school friends, and I think it’s because of this miserable dynamic. 

Take my best good friend, for example. We somehow managed to get every 3rd year rotation together, which was a godsend. She kept me sane, for real. And during our 4th year when we parted ways for much of the year, we still called each other almost daily to share crazy patient stories, catch up, and commiserate. 

But just in case you’re not lucky enough to find a best good friend in med school, here are some tips to avoid isolation, depression, and burnout. 

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Hey fourth years, how great has fourth year been for you? Amazing right? I told you it would be. Like all good things, fourth year must come to an end, and the beginning of that end is, of course, RANK LISTS. Rank lists are due February 20 (and if you didn’t already know this, you need to step up your game yo), and I’m sure you guys are all freaking out about them a little bit. 

A close friend of mine e-mailed me recently about her rank list decision making, and she said, 

I have been expecting to have a “big moment” of sorts where the lights come down from heaven and God says “this is where you are supposed to go.”

We all hope for that feeling. That moment when it’s all clear.

So far, that hasn’t happened for her, and I imagine it hasn’t happened for many of you. I had my own little rank list crisis last year (btw, I matched my first ranked program, but I won’t tell which of those two it was), so I totally understand the frustration and the worries and fears associated with making this list that will determine the course of your next 3-7 years. 

So here’s a little advice to consider in your decision making:

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Just remember, no matter how tough school and life get, it could always get worse. 

For example, you could have neurogenic bladder and have to catheterize yourself… and also have Parkinson’s.  

Hi, I’m a second year medical student, I finished an exam today and I did well, but I came back still feeling stressed, thinking how I’ve got a long way to go, it scares me, and I live with someone who is so competitive, it makes me so tensed:( help - victorianavina

Ok, repeat after me, victorianavina:

Hakuna. Matata. Hakuna. Matata. 

In all seriousness though, the test is over.

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Hey Doc! So I just took my pharm final today and I know I failed it and failed the class as well because I haven’t been doing well. Have you ever failed a class in med school? How did you deal with it? I feel so incompetent. I just need someone to tell me HOW TO STUDY and LEARN/RETAIN the material. I’m not stupid right? It will get better right? Am I going to kill my patients or be jobless.. I also feel like I forgot my anatomy and biochem…what am I doing in med school!? –Anon

The short answer to “has WayfaringMD ever failed a class” is yes. My school was weird and our subjects were taught longitudinally throughout the year rather than in semester blocks, so you were required to pass each subject for the year overall. If you failed, you had to remediate the subject. I ended up failing 2 subjects by a narrow margin and had to remediate them before I could take Step 1. 

How to deal with failing? Hakuna matata. The fail is already done. You can’t change it, so don’t get down about it or stress over it. Just focus on doing better on your second time around. Change your study habits and techniques. Try something different, because clearly what you did before wasn’t working. However, don’t fall into the trap of spending ALL your time on your “bad” subjects and neglecting your “good” subjects, because you will find your overall grades dropping. Just because you didn’t fully grasp pharmacology on your first go-round doesn’t mean you won’t get it eventually. Remember, medicine is a lifelong learning process. Keep working at it, and one by one the concepts will come to you. 

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Hi! I know you’re super busy, but I have a question that I didn’t see answered in your FAQs. My friend recently started med school and he’s quite down. He says he’s behind in everything, unsure of himself and of his friends. What can I say to comfort him? What would you have wanted someone to say to you if/when you felt like that? Thanks! :) - mindsandbrains

I think the biggest thing to remember is that EVERY medical student, resident, or doctor feels this way at some point in their career (Even me, remember?). Many of them won’t admit it, so we end up with lonely, depressed, stressed out med students who don’t realize that there are literally dozens of people around them feeling the same way.

For me, knowing that even my mentors felt insecure some days made me feel loads better. 

But here are a few ways you can encourage your friend:

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Can you give me tips on dealing with depression? I’m a second year med student (on a international university, so is second year of six) who really loves medicine, especially surgery, but feels that does not have what it takes to be successful, to be a good doctor. I’m constantly thinking, “I’m not good enough, not that smart, I don’t have the abilities…” :S (can you please answer this on anon?)

I once told my mentor (and imo the best freaking doctor in the history of ever) that I didn’t feel like I was smart enough to be a doctor. This was like late in my fourth year of medical school, so I should have felt more confident, right?

Her (very wise) response? 

“I wake up every day and think I’m not smart enough for this job. That’s what keeps me reading and learning.”

The point is, none of us feel good enough, smart enough, compassionate enough, competent enough, etc, at least at some point in time, if not all the time. The people who claim they do have everything under control are the ones most in danger of hurting someone because of their arrogance. Shoot, I have the “I’m not smart enough to be a doctor” thoughts at least weekly, and I’m already a doctor. 

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aseaofshells replied to your post: Even WayfaringMD has bad days

My problem is centered around comparing myself to others. If anyone is better in any way than me I immediately feel inadequate and want to give up completely. I just break.

So what if someone is better than you at something? I’m pretty sure you’re better than them at something else. Use those feelings to motivate you to do better. And hey, even if you’re never the best, try to get satisfaction out of the fact that you’re doing your best.

I used to be extremely competitive in high school, and once I figured out how to work hard for myself and for my own satisfaction rather than to try to outdo someone else, I was much happier and much more confident in my own abilities. 

So chin up, and stop comparing yourself to other people!

Last week I wrote about finding purpose in life, and I mentioned that I am human and that I do have bad days occasionally, and I promised to elaborate later. Well now it’s later and here I am elaborating. 

Let me start by saying

.

Everyone is insecure about something. We compare ourselves to other people and put ourselves down. We all handle this insecurity in different ways. Some people go with the “fake it till you make it” system, while others become perfectionists or gunners to try to overcome their insecurities. Then there are those who cave under the weight of their fears and become anxiety-ridden messes, and those who repress and hold in all those emotions until they suddenly run out uncontrollably like overflow diarrhea in a fecal impaction (that’s right, I went there with the poop metaphor). 

So which type am I? According to my closest friends and my counselor, I’m the poop type. But I’m learning to be more regular (pun intended) about showing my emotions/frustration/insecurities. 

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Patient’s parent: So how long have you been a doctor?

Me: umm…three months… 

Me (in my head): Please don’t request another doctor just because I look young!

Parent: That’s cool. I just graduated dental school. You’re doing a great job so far. 

Me (in my head): 

How do you stay optimistic, lively and happy despite all the problems and negativity around? How do you turn negativity to positivity? I guess this really boils down to … how do you find your sense of purpose?  - follower who requested to say anonymous

First off, let’s get one thing straight: WayfaringMD has bad days too (more on that in a post to come). What you see of me on this blog is just a small part of who I am. 

Now, about your questions. The “sense of purpose” question is the easiest one for me to answer. My purpose comes from Jesus Christ (hear that noise? That’s the sound of 100 followers clicking unfollow). My purpose is to bring him glory, simple as that. I love helping people, but if I tried to do this job just to please people (or myself), I’d go crazy. I would never feel adequate, and I would feel like a total failure when I tried my hardest and people didn’t appreciate me. This is a big reason why doctors burn out. They try to get their worth from paychecks, smiling patients, or accolades, but it’s never enough.

But Jesus is different. I get my worth from him. He chose to love me when I was unlovable. If I’m following his will for my life, I know he’s pleased, regardless of how inadequate I feel or if other people don’t appreciate me. When I forget this fact, the negativity and feelings of inadequacy come creeping in. 

So there you have it. I wish I had a formula or a Joel Osteen-type 10 step program to outline to help you find your purpose, anon, but I don’t. My only answer is Jesus. 

Hi. I’m really struggling with studying for USMLE Step 1. I know all the generic advice. I basically have zero fun or moral support, and lots of pressure. Correction - there are a few random people who I have never met in my life - either through gtalk/forums… but that hasn’t helped me in any way whatsoever. I hope this isnt inappropriate or out of place in any way. To avoid rambling that could be off-putting, can you give any suggestions to peak motivation and focus? I think I’m losing it. -doctumbl

First, on the pressures of med school life: having internet buddies is great (I have plenty, for sure), but they are no substitute for good, supportive, in-the-flesh friends. Are there any fellow classmates / upperclassmen / professors you can vent to? (If not, you can always Skype me @ WayfaringMD). 

On motivation and focus: the best thing for me was to set short term goals. Find something fun and stress releasing you want to do every day during your step 1 study. It can be exercise, sports, tumbling, going to the movies, going out to dinner, etc. Set a goal of X amount of material (reasonable amounts, of course) you need to cover before you can go do that fun thing. You’re stressed out, of course, and you really want to go have fun, so that will motivate you to stick to your studies and get your work done. 

If a goal for the end of the day is not enough, set even shorter goals. For example:

- I’m going to get through 20 pages of First Aid by lunch and then I’m going to make the best grilled cheese sandwich ever made and eat it outside

- I’m going to do 100 World questions and then call my best buddy (make sure you schedule phone dates if your friend is also studying!)

- Just 5 more pages and I’ll have a 5 minute dance party

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