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Already exhausted with third year on an "easy" rotation
- Thread starter smh343
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I guess getting covid would give you 2 weeks off from clinic
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Only M2, but I’ve been through something similar in my old career , so I know how you feel I think . It’s a horrible feeling . Some things that I did that helped me personally that maybe you will find helpful as well:
1) I made a list of specific things I wanted to see snd experience during specific rotations , and followed that list . Some of those included learning how to talk to a psychotic pt, learn psych charting , and more. This way , instead of having “this sucks I can’t wait for this to finish” approach , I sort of shifted my focus to “I want to get the most out of it” mindset. It helped .
2) every evening I made a note of something Exciting and new that I wanted to do that coming weekend . Some of those things were little - like a specific icecream , or feeding birds , or whatever . Some things were bigger - a hike, for example . This way I had a lot of fun things to look forward to. The key was also to create new experiences- so I made sure that at least one or two things are something I’ve never done before .
3) I “rewarded” myself by eating my favorite food. For example , I would start thinking in the morning what I want to make for dinner , snd since I love food so much , I was excited. I would also try new recipes a few times a week (new exciting experiences here again).
4) I made a list of things that made me feel better, and make sure I do them in the morning - for example , I made sure I have time for coffee, I wear makeup (makes me feel more confident ), and I call mom in the morning when I walk my dog . This helped to start the day from the good note.
5) I would also slowly make a“fun things I’ll do when this is all over” list. This gave me a great opportunity to look forward to the finish line.
I hope this will help you .
Psych can be uniquely emotionally draining for people, it's definitely not just you. I wouldn't take this as a sign that third year is going to be rough all around or that you aren't right for clinical medicine.
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I get that for weeks at a time every once in a while. How much caffeine are you drinking?
Basically none, I'm hesitant to even try with how worked up I am!
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That's good. I'm typically on one-two Bangs per day in the pharmacy.
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Hey OP,
Sorry you're feeling this way. I'm smack in the middle of my third year rotations (my school does things in a funky way). I've done some heavy hitting rotations so far (surg, and at my school, neuro), as well as psych.
As others have said, some people find psych super draining and some don't. It's very different when you're on, say, EM and you can forget about your patients because you just saw them for 10 minutes and that was it. On psych, it can be harder to dissociate yourself. So hopefully other rotations will be a bit easier for you at baseline.
That said, the amount of work - and BS work - that we have to deal with is immense, and you're right that some clerkships have downright dreadful hours. I know that on surgery, I considered dropping out, and so did many of my friends. And that's the thing to remember: everyone else feels like this, too, even if they're trying to hide it. Third year is awful in pretty much every way: you're paying through the nose for the honor of getting yelled at by everyone from the patients to the nurses to the residents to the attendings; you have no control over your schedule; you can't focus on learning either to perform well on the wards or for the shelf; and you're exhausted all the time.
It sounds like you're doing some things right: you're getting your sleep, you're staying off the coffee, you're being reflective. What really helped me was being willing to say, "screw it, I'm going to [get drunk/see my friends/go on bad dates/watch netflix all day]." Take time for yourself, it's what keeps you human. At the end of the day, you have no real control over whether the attending likes you or if the resident only ever gives 2s on principle. You'll never know enough to feel good going into a shelf exam. Do your best and be willing to take a step back, even if you perform slightly less well - you'll still be a doctor.
And finally and most importantly, if you're really struggling and nothing is helping, DO seek out professional help. The med student suicide rate is too high, and clerkship year can destroy your soul.
I'm rooting for you.
Sorry you're feeling this way. I'm smack in the middle of my third year rotations (my school does things in a funky way). I've done some heavy hitting rotations so far (surg, and at my school, neuro), as well as psych.
As others have said, some people find psych super draining and some don't. It's very different when you're on, say, EM and you can forget about your patients because you just saw them for 10 minutes and that was it. On psych, it can be harder to dissociate yourself. So hopefully other rotations will be a bit easier for you at baseline.
That said, the amount of work - and BS work - that we have to deal with is immense, and you're right that some clerkships have downright dreadful hours. I know that on surgery, I considered dropping out, and so did many of my friends. And that's the thing to remember: everyone else feels like this, too, even if they're trying to hide it. Third year is awful in pretty much every way: you're paying through the nose for the honor of getting yelled at by everyone from the patients to the nurses to the residents to the attendings; you have no control over your schedule; you can't focus on learning either to perform well on the wards or for the shelf; and you're exhausted all the time.
It sounds like you're doing some things right: you're getting your sleep, you're staying off the coffee, you're being reflective. What really helped me was being willing to say, "screw it, I'm going to [get drunk/see my friends/go on bad dates/watch netflix all day]." Take time for yourself, it's what keeps you human. At the end of the day, you have no real control over whether the attending likes you or if the resident only ever gives 2s on principle. You'll never know enough to feel good going into a shelf exam. Do your best and be willing to take a step back, even if you perform slightly less well - you'll still be a doctor.
And finally and most importantly, if you're really struggling and nothing is helping, DO seek out professional help. The med student suicide rate is too high, and clerkship year can destroy your soul.
I'm rooting for you.
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Not to be harsh, but I would figure out whatever coping mechanisms you can now, whether that's friends or meditation or therapy or whatever works best for you. Much better to have that already established before you hit the even more intense 12-15 hours/day rotations like medicine, surgery, and OB.
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Why is your school making you do 4+ hours of didactics a day, papers, and assignments on top of clinical duties? Also why are residents texting a third year medical student about patients after you go home lol? I’d be burned out too. Ideally you should be focused on doing well on your rotation and that’s it. Not even research if you can get by without it.
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Because medical education is ****ing terrible.
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Every rotation is different and has stuff you gotta deal with/ that will drive you crazy. Honestly third year is just going through the motions and going the distance. Figure out something fun you like to do for an hour and do that when you get home.
In medical training (even when you become an attending), it gets tougher but you will just get better
In medical training (even when you become an attending), it gets tougher but you will just get better
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My psych rotation was, by far, the most draining and exhausting rotation and also, by far, the least number of hours. I didn't want to do anything that month. It made it super easy to cross it off the list.
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I guess Psych isn't for you.
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While you did receive some good advice above, I think we need more info to be able to guide you on what's going on.
1. How often do you have didactics? Is it every day? And is it 4 hours every day? Because that's crazy. Is didactics protected time, meaning you can't be paged/texted/called for any clinical duties during that time?
2. It sounds like you're on an inpatient unit. With inpatient, you really aren't "done" at 2. You may have finished seeing your patients, but you're still responsible for them until night shift comes in or unless someone is covering your patients. So if your residents are texting you during this time, that's fair.
3. If your residents are texting you after hours, I'd be searching for a why. Are your notes incomplete? Are you not documenting things (telling the patient you'll give them their cell phone, but not running it by your resident or documenting it?)? Are you forgetting to do things you were supposed to do?
4. Why are you studying a couple of hours every night for the shelf? Are you studying efficiently? That type of studying is not going to work on IM or surgery so you need to figure out a better way. Figure out how you learn and do that, but really a couple of hours every night for psych is overkill for the average med student.
Finally, third year is an adjustment especially if you've never worked before med school. School is easy. Working is hard and working in a hospital can be difficult, both physically and emotionally. You just have to figure out a routine. It's August. Give it til December. You'll become more efficient and be less exhausted, even on medicine.
1. How often do you have didactics? Is it every day? And is it 4 hours every day? Because that's crazy. Is didactics protected time, meaning you can't be paged/texted/called for any clinical duties during that time?
2. It sounds like you're on an inpatient unit. With inpatient, you really aren't "done" at 2. You may have finished seeing your patients, but you're still responsible for them until night shift comes in or unless someone is covering your patients. So if your residents are texting you during this time, that's fair.
3. If your residents are texting you after hours, I'd be searching for a why. Are your notes incomplete? Are you not documenting things (telling the patient you'll give them their cell phone, but not running it by your resident or documenting it?)? Are you forgetting to do things you were supposed to do?
4. Why are you studying a couple of hours every night for the shelf? Are you studying efficiently? That type of studying is not going to work on IM or surgery so you need to figure out a better way. Figure out how you learn and do that, but really a couple of hours every night for psych is overkill for the average med student.
Finally, third year is an adjustment especially if you've never worked before med school. School is easy. Working is hard and working in a hospital can be difficult, both physically and emotionally. You just have to figure out a routine. It's August. Give it til December. You'll become more efficient and be less exhausted, even on medicine.
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In addition to all the good advice above (there is def an adjustment period to M3, maybe psych isn't your thing, triage the really important stuff, do some self care, seek out professional advice if you're feeling depressed) I'd add:
-Make sure there's not something medical going on
Schedule a time to see your PCP asap and get some lab work done (FYI Dr's appts are a very legit reason to take a (half)day off for. This shouldn't be an issue for your school or site as long as you give them advance notice).
Check your Vit D and B12 levels. Get a mono spot and covid test to rule out infections that can exhaust you. Make sure there's nothing wonky in your lab values.
N=1 but when I went through my IM rotation and thought I was literally going to die because I was so exhausted (likely in my 3hr commute when I would doze off in traffic daily despite eating espresso beans like popcorn), I finally got in to see somebody when I realized I had pneumonia and came to find out that, in addition to the pneumonia, I had a raging case of mono and my vitamin levels had tanked. So what I thought was depression, which I had been trying to power through, was actually my body just shutting down. It took me months to get back to 100% with massive vitamin supplementation, eating better, and carving out extra time to sleep.
So when I hear somebody say they don't feel rested after their day off AND getting enough sleep, it rings those same alarm bells for me. Hopefully it's none of those things, and once you figure out how to balance your time and move on to a different rotation that fits you better, things will be easier, but imo it's definitely worth ruling out possible underlying issues if you're feeling that exhausted on a relatively chill rotation.
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Why do you feel like you have to convince psychotic patients to stay? Your job is to know the chart, get a SOAP, do a 2 minute presentation, and not get in the way:
John Doe, history of __, presents for __. Pt says, "Get out dumb student, Imma fart da WuFlu on you," and refuses to cooperate. Upon chart review he __. Vitals, imaging, EKG and labs are __. Mental status exam is __. Assessment is __ because __. Recommend __ for __.
Yes, the covid situation sucks. But med students bitch for patient contact and then bitch when they actually get patient contact. Can't have it both ways. Mask, face shield, gown, hand hygiene, and you're good to go, and hopefully you won't get a plaque at your school in remembrance of you.
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