Wayfaring MD

Well here we are again at the end of the school year, and the TOADS’ inboxes are flooded with “oh crap, I got a C” questions once more. 

Since we are all tired of answering these questions, I’ve decided to make the ultimate guide for bad grade advice. So here goes. 

So you got a bad grade. Bad for you may be a B+ or C-. Frankly, the number doesn’t matter to me. What matters is your first step. You can:

A) Have a panic attack because your mind automatically jumps to seeing you living in a cardboard box with $500K in student loan debt because hey, with that grade there’s no way you can ever be a doctor and if you can’t be a doctor you might as well give up on all your dreams, right? (Proceed to Chapter 1, entitled “Calm Yo Tits”).

B) Tell yourself the grade is ok because dangit, regardless of grades you are getting into med school because it’s your destiny (Proceed to Chapter 2, entitled “Reality Check”). 

C) Beat yourself up about the grade for 5 minutes and then enjoy your summer, after which you will start the semester fresh and ready to study harder (Proceed to chapter 3, entitled “Good Thing You’re Not a Gunner”).

D) Ask yourself “what would WayfaringMD/Cranquis/TNQD/md-admissions do in this situation?” (Proceed to chapter 4, entitled “The Not-So Omniscient Blogger”)

E) Immediately sign up to retake every class you’ve ever taken. (Proceed to Chapter 5, entitled “I owe the Government my Left Kidney”)

F) Blame the grade on your semester of depression / your crappy roommate / your home stressors / whatever (Chapter 6, “Blame it On Milli Vanilli”)

Chapter 1: Calm Yo Tits

Seriously, calm thyself. One bad grade is not the end of the world. Everybody struggles at something. Maybe you’re bad at that subject. Maybe you had other reasons for screwing up. Doesn’t matter. Hakuna Matata. You gotta put your behind in your past. Yep, you’ll have to work harder to bring up your GPA next semester, and you may even need to retake a class, but one bad grade or one bad semester doesn’t have to end it. Geez, if everyone gave up after one failure, we wouldn’t have most of the cool stuff we have today, like vaccines and Viagra and iPhones and sriracha flavored chips. Part of being a doctor is using your mistakes and shortcomings to motivate you to do better. 

Chapter 2: Reality Check

Sure, one bad grade is usually not a big deal. (See Chapter 1). But a pattern is different. Everyone thinks they are special enough to be the kid who got into med school with a 3.2 GPA and a 22 MCAT because of their outstanding extracurriculars and shining personality. Our mamas tell us we’re special and we can always achieve our dreams. Well let’s just get real for a moment. If you’re continually struggling to get through undergrad and are making “minimally acceptable” grades, then you might not be able to handle the pace of medical school. 

Chapter 3: Good Thing You’re Not a Gunner

Way to be, you anti-gunner, you! You know that your life is not over. You understand that you are not defined by the letters on your transcript or by the ones after your name. Hey, why don’t you go on vacation? Get a job. Volunteer. Change the world a little. Don’t sit in the library and agonize over every missed test question. Hey, if your next class builds on the one you bombed, maybe you should do some reading over the summer and brush up on the concepts you’re rusty on. But don’t get crazy. Just try harder the next time around. Change your study habits and methods. Get a tutor. Give up Facebook (or heaven forbid, Tumblr!) for a few weeks. Find a study group. Better grades are possible. 

Chapter 4: The Not-So-Omniscient Blogger

See now, that’s where you went wrong. Because as cool as we are, the TOADS do not know you, your school, or your individual situation. But you know who does? Your school’s pre-med advisor. Or your upperclassman mentor. Or your favorite professor. Or your academic advisor. These people already know your issues (or at least know you better than we gray-faces do). They understand the requirements at the schools you are interested in. When you ask us whether you should retake a class or change your major or whatever, we’re going on generalizations when we answer you. We can’t give you a tailored, personalized response like the advisors who know you can. So next time, read this post and then go ask them. 

Chapter 5: I Owe The Government My Left Kidney

Retaking classes can be good or bad. What matters is why you are retaking the class. If you did poorly in a class that you will need to really understand before proceeding forward, then by all means, you should probably retake it so you don’t bomb the next one too. But if you’re retaking based solely on the GPA numbers game, I think it’s kind of silly. Also, retaking 1, maybe 2 classes is ok, but if you’re getting into more than that, well… see Chapter 2. 

Chapter 6: Blame it On Milli Vanilli

Life can be hard. I know this. And difficult life circumstances can certainly lead to problematic grades. But this should not be the theme of your personal statement. Don’t go through 4 years of college with terrible grades and then ask an admission committee to look past them because you had some hard times in your life. Sure, it makes for a great story, but how do they know if you can handle the huge emotional/financial/intellectual challenge that is medical school? Instead, take some time off if you need to. Put school on hold, get your life together, and start fresh. Show the AdComs that you were strong enough to not only get through the hard times, but to thrive on the other side. 

Hang on! Just a week or so left! Congrats to everyone who is graduating and becoming real live doctors and to those who are about to start medical school! You are in for a big adventure, that’s for sure.

And for us few who have already graduated, happy hump day. Get back to work. Have a beverage tonight with your fellow medblrs.

Dr. C: How can you know the difference between depression and burnout in residency?

JB: By how you act when you’re on vacation. 

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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I hope everyone matches where they were hoping for. Just remember, go into today with

Hopefully today will be the 

and won’t end up like this

And gunners, when people ask you where you matched, don’t be all lame like

 And don’t brag either. 

Just

And for everyone else, hold on to your hats, because 

How can I make myself care enough about my undergrad classes (chem, ochem, physics, bio, etc.) to do well in them so that I get into medical school? Right now I’m having trouble getting motivated enough to study them. –amputatedwings

Motivation is a hard thing to find. You can’t just create it out of thin air. It’s something you have to continually work on to be able to keep it.

Before I get into how to grow and maintain motivation, let me strike down some misconceptions. 

•      “I hate this biochemistry stuff, but when I get into studying things I’m interested in in medical school, it will get easier.” 
   When I got to medical school, though, the motivation was no easier to find than in undergrad. I couldn’t go off of pure curiosity, because curiosity wasn’t enough to make me excited about the function of the alpha subunit on the cholera toxin molecule (which I learned in my first week of medical school). It wasn’t interesting to me. There’s TONS of stuff in medicine that is boring to me. Case in point: eyeballs. Gluconeogenesis. Toenail fungus. Biostatistics. Rhinoviruses. I could go at this all day. The point is though, if you hate pre-med, you very well may hate medical school. Figure out what you really love and do that. 
• 
•  ”My future patients/sick grandma/history of childhood illness will motivate me.” Heh, not so much. I love my patients, and I love patient care, but it was definitely not on my mind at midnight while learning the bleeping histologic appearance of the terminal ileum or about the 500 different foramina and fossae of the skull (both tidbits of knowledge which I have yet to use in my clinical work, btdubbs). 
•  ”My significant other / mommy / puppy will keep me going.” Son, yo mama doesn’t have a CLUE what med school is like, unless she’s a doctor, and in that case she will probably have even less sympathy for your butt. I had friends with extremely supportive families and significant others, but at the end of the day, many times they’d be calling other med students saying, “I’m ready to quit. I’m putting in an application at Starbucks.” 
• 

Ok, so where do we get motivation from?

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In a few months I’ll be choosing a specialty to start my residency and I have doubts between choosing Psychiatry or Family Practice; I like both. Any advice? -entropycomeseasy

When I first started med school, my dean told me “if you like a little bit of everything and you don’t hate psych, you should be a family doctor.” She’s totally right. We see tons of psychiatry in family medicine. And I really enjoy the FM-type psych stuff. I like treating depression and anxiety and cognitive disorders. I am not a big fan of treating acute psychotic breaks and such. Which is why I’m a family doctor and not a psychiatrist.

But if you like it all, why not do both? There are combined Family Medicine-Psych residencies out there. They’re rare, but they do exist. I think in the next few years there may be an expansion in primary care-psych programs, especially considering the shortages of each these days. There was an article about these programs on KevinMD recently. 

If you want to choose one or the other, consider the following:

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Attending: He needs to have a big bowel movement and then he can go home.

Resident: If I have one, can I go home?

Hi, what makes students who get into top medical schools different from other candidates? I can’t seem to find any student profiles on the web. Thanks <3

Let me start with sort of an obvious statement: Students who apply to (and go to) top medical schools want to be in a top medical school. Think about this: there are TONS of super smart people out there who specifically chose NOT to go to a top school. They make this choice for a myriad of reasons, including geographic preference, cost, family obligations, specialty interests, and research preferences (or lack thereof…some schools require research, others do not). So a degree from somewhere other than Pitt or Hopkins doesn’t mean they aren’t brilliant.

But students who go to top schools often go to those schools for the prestige of it all. They know that school will look good on residency and fellowship applications, and they know they will have a solid education there. But remember, one does not have to go to a top school to get a top education. What you learn is mostly up to you.

Also, know what a “top medical school” is for YOU. Just because it’s the best doesn’t mean it’s the best for you. For example, I could have applied to the top school in my state, which is ranked in the top 25 for research and top 20 US medical schools overall. However, their rankings in primary care education are much lower, and considering my interests, it wouldn’t have been the best place for me to go.

Back to the question. I’m guessing it really was more about how to get into a top school, so let’s go there. If you wanna go to a commonly recognized top school, you need:

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Attending: Did you go home last night and learn Spanish so you can communicate with your patient?

Intern: No sir. 

Attending: Lazy intern…

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.