Sunday, July 15, 2012

Hardest Month . . .


M3 year has flown by.  Sometimes I still can't believe I an M4 now and on my pediatrics sub-internship.  This is by far my most difficult month of med school yet, more so than even surgery.  I literally act as a functional intern on one of the pediatrics ward teams, except all my orders have to be verified by my senior resident.

There are rewarding moments.  There are moments and areas that I feel I shine at.  But all that is overshadowed by this constant anxious feeling that I'm not doing enough, or not doing things the right way, or not thinking fast enough.  It's terrifying.  Being the one responsible for a child's care in the hospital is daunting.  It's not that I don't basically know what to do, it's that I'm unable to instantly anticipate all possible (worst) outcomes and prepare for it.

I'm able to prioritize tasks fairly easily, to do what needs to be done, but I can't prioritize my thoughts as quickly when someone asks me a question or I'm asked to present a patient.  The information is there, but it's not organized the way I (later) type it up and it's unfiltered because I just ramble all the information - pertinent and non-pertinent.  I don't know why I'm getting flustered and blanking.

I'm now 2 weeks in to the rotation, about half-way done.  And I feel like I haven't significantly improved despite working my ass off.  Today was the worst day.  I showed up and was instantly handed 5 patients I didn't know, didn't have sufficient time to read through their chart, and on top of that I was the one admitting a new patient and had to do her whole work-up.  I was a mess and constantly second-guessing everything I said the whole day after that.  It took me way longer to catch up than it should.

Words can't express how defeated I feel right now.  How stupid I feel.  How slow I feel.  How not cut out for this I feel.  Maybe I should consider switching fields.  This was not how I expected to start M4 year, and definitely not how I expected this month to go.

8 comments:

madmanMD said...

i just realized you have a blog. i'll have to look back on your old posts and relive being a med student. the first few months of 4th year are tough. i wish i could give you some helpful advice, but really just try to do your best and be helpful and efficient.

you'll have your bad days but you sound like the kind of guy who will leave an overall good impression, which is the most important thing. also one thing you don't realize when you're a med student, is that residents/attendings have rather low expectations for students. so don't be too hard on yourself!

fan of casey said...

Aek -- you have to look at those bad days when you don't meet the standards you expect of yourself as learning lessons. when you have time to reflect (if you have time), think about what you can do better, how you can do better -- ask for help or advice if you need it. This is all part of your training -- because invariably you will make a mistake, it's part of being human. What's important is how you respond to adversity, persevere and get better.

naturgesetz said...

Could it be that what you're experiencing would be happening if you were sub-interning in some other specialty? IOW maybe it's not the pediatrics that's the problem, but the format of this month.

What's important is being able to handle what you face when you're an M.D. If it will be anything like this, then I think this will ultimately have the effect of preparing you for it. You'll develop your way of handling it as you become more accustomed to it.

kwakamole said...

I can't really give sound advice given that I'm just a third year myself, but I feel like everyone goes through the feelings you're going through now during rotations. I also don't think you would have been given all those responsibilities if your residents/attendings didn't think you were competent enough for them. It's only been 2 weeks since I've started third year (starting with peds) and I already feel overwhelmed but I also know that I have much to learn so I try to work everyday with that outlook. Anyways, good luck with the rest of your subI and fourth year!

Biki said...

Try to calm down and breathe. Im sure you are doing a good job, its just extremely overwhelming to be in complete charge of patients. I know you to well to believe that you are doing a poor job. Its nothing more than an over drive of stress at wanting to do a perfect job. Totally understandable. Just mentally take a step back and realize your not expected to be perfect, thats why you are still a student, and not a doc, yeah?

Yadhu Krishna said...

Hey.... please don't stress yourself so much...

The way people like you try to achieve perfection in everything you do is relieving.

When ever you feel stressed, just know that you are saving somebody's life. They are grateful to you for all the pain you take to let them live. You are doing God's job on Earth.

And do keep writing.

. said...

Hey Aek, I agree with fan of Casey...don't get discouraged. You're in this field because you want to be in it...don't let it get you down...ask for help...be the excellent person you are and hang in there...and do keep writing. That's important...realize you are human like everyone else. Doctors aren't any different than us with life.

Anonymous said...

Why were you handed 5 patients to present? That makes no sense. In all my rotations, I choose which patients I want to follow, and I usually pick up at most one per day. Near the end of my rotation I was carrying about 3-4 ICU patients.