resident1203
New Member
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- Jan 12, 2023
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Hi everyone. PGY1 psych here really struggling with residency.
I’ve always struggled with some subjects in school, particularly maths and sciences, and was always more humanities geared. I managed to get into medical school however, but in medical school I struggled with the firehose of information. I was able to learn and cram things in for tests and Osces and the like and pass, but I don’t really know how much I fully learned or stuck. I’ve had subjective issues with attention longstanding to say the least.
Throughout medical school I also struggled with a lot of imposter syndrome and unconfidence, in part, because it was so tough for information to stick in my head. This made me almost isolate from medical school peers, safe from few very close ones from medical school, but I did not have many study groups that I would be a part of, and took to doing things alone.
I entered into residency this past summer and I hit the ground running, really excited for my specialty. The first few blocks were on service and they went well because the expectations were on the floor and also because I had an attending who held my hand in the first block. The second block I felt I genuinely performed well/to my abilities and was proud of my work at that stage. The next two blocks similarly went well for different reasons until I hit CTU, at which point I realized that my medical knowledge was really lacking. I could handle relatively straightforward cases… but I saw that medical students knew more than I did, and in juggling all of my patients I saw how incredibly disorganized I was. I don’t even want to admit what I didn’t know because it’s so embarrassing. I didn’t want to come into the hospital some days for fear of not assessing a patient correctly, or making a mistake. When I returned to another psych-ish based rotation I found that I was unconfident on service during the day and on call. I realized that I only had 1 more block in psych until I was to become a senior, and was really down on myself about my performance (e.g. my impressions and plan were lacking and disorganized compared to what the senior wrote beneath mine, I was spacing out when patients were talking to me at times, still not sure of how to handle issues on the wards and would reach out to the seniors to get their thoughts, where my peers were not necessarily doing this; struggling to read patient charts and solidify information in my head).
I entered into a bit of burnout and depressed state around this point, and it was pretty bad. I would come home from work and just lie in bed when I got home, waiting to sleep and for the next day to begin. I would go into work hoping that things would be simple and nothing major would happen, lest I not know how to deal with it. There was passive, really bordering on active SI at one point (which was new for me), and that’s when I realized how bad it had gotten. All the things that once brought me such passion and joy and curiosity outside of medicine were consumed by these feelings of inadequacy and unconfidence - I basically forgot who I was… Recognizing all of this, I have been on leave from residency, but despite this time off I still feel in a hole and my nervous system still feels on full alert. I do have a psychiatrist/mental health care team which has been good.
In the past few months I noticed that I would struggle with confidence to sum up my patients fully on rounds (or even remember all their issues), even on simpler rotations. I feel like I have such knowledge deficits myself, I can’t even imagine teaching medical students! (Which will soon be a responsibility).
My question to the forum is: has anyone else (in any specialty) ever found themselves in a place like this? Has it ever gotten better over time? Seeking other stories and words of encouragement. I want to use this time on leave productively so that I return in a better headspace and with more resources and supports than before. And likewise, has anyone ever felt like this and decided to leave residency? Sometimes I honestly don’t see this getting better at all and I feel a sense of calm when I think about leaving clinical medicine. Has anyone felt like this and not been able to perform as a resident (and faced problems with this)?
I’ve been advised by some to seek out an evaluation for ADHD (which I have long suspected and will do), but unfortunately I have a comorbidity where prescribing stimulants is not super advisable.
I’ve always struggled with some subjects in school, particularly maths and sciences, and was always more humanities geared. I managed to get into medical school however, but in medical school I struggled with the firehose of information. I was able to learn and cram things in for tests and Osces and the like and pass, but I don’t really know how much I fully learned or stuck. I’ve had subjective issues with attention longstanding to say the least.
Throughout medical school I also struggled with a lot of imposter syndrome and unconfidence, in part, because it was so tough for information to stick in my head. This made me almost isolate from medical school peers, safe from few very close ones from medical school, but I did not have many study groups that I would be a part of, and took to doing things alone.
I entered into residency this past summer and I hit the ground running, really excited for my specialty. The first few blocks were on service and they went well because the expectations were on the floor and also because I had an attending who held my hand in the first block. The second block I felt I genuinely performed well/to my abilities and was proud of my work at that stage. The next two blocks similarly went well for different reasons until I hit CTU, at which point I realized that my medical knowledge was really lacking. I could handle relatively straightforward cases… but I saw that medical students knew more than I did, and in juggling all of my patients I saw how incredibly disorganized I was. I don’t even want to admit what I didn’t know because it’s so embarrassing. I didn’t want to come into the hospital some days for fear of not assessing a patient correctly, or making a mistake. When I returned to another psych-ish based rotation I found that I was unconfident on service during the day and on call. I realized that I only had 1 more block in psych until I was to become a senior, and was really down on myself about my performance (e.g. my impressions and plan were lacking and disorganized compared to what the senior wrote beneath mine, I was spacing out when patients were talking to me at times, still not sure of how to handle issues on the wards and would reach out to the seniors to get their thoughts, where my peers were not necessarily doing this; struggling to read patient charts and solidify information in my head).
I entered into a bit of burnout and depressed state around this point, and it was pretty bad. I would come home from work and just lie in bed when I got home, waiting to sleep and for the next day to begin. I would go into work hoping that things would be simple and nothing major would happen, lest I not know how to deal with it. There was passive, really bordering on active SI at one point (which was new for me), and that’s when I realized how bad it had gotten. All the things that once brought me such passion and joy and curiosity outside of medicine were consumed by these feelings of inadequacy and unconfidence - I basically forgot who I was… Recognizing all of this, I have been on leave from residency, but despite this time off I still feel in a hole and my nervous system still feels on full alert. I do have a psychiatrist/mental health care team which has been good.
In the past few months I noticed that I would struggle with confidence to sum up my patients fully on rounds (or even remember all their issues), even on simpler rotations. I feel like I have such knowledge deficits myself, I can’t even imagine teaching medical students! (Which will soon be a responsibility).
My question to the forum is: has anyone else (in any specialty) ever found themselves in a place like this? Has it ever gotten better over time? Seeking other stories and words of encouragement. I want to use this time on leave productively so that I return in a better headspace and with more resources and supports than before. And likewise, has anyone ever felt like this and decided to leave residency? Sometimes I honestly don’t see this getting better at all and I feel a sense of calm when I think about leaving clinical medicine. Has anyone felt like this and not been able to perform as a resident (and faced problems with this)?
I’ve been advised by some to seek out an evaluation for ADHD (which I have long suspected and will do), but unfortunately I have a comorbidity where prescribing stimulants is not super advisable.