🤣🤣🤣 this is the funniest thing i’ve ever read. not bcuz you’re dumb, but the way you wrote this. i think a lot more people feel this way more than you think.
“I look like 🤡 NOT 👨⚕️!!”
🤣🤣🤣 you’re hilarious man.
I’ll be real with you friend I didn’t read the post until just now, an error I make.
Most medstuds dump their knowledge between oct ms4 and July. This was restated again and again by attendings trying to assure me (second to last in my class) that my medical knowledge is good and to not worry so much about stuff that you will redrill again and again.
We’re humans and our memories take a long time to congeal into robust knowledge. It also takes reiterating it several times, in several emotional states. You’ll get there just like I will, it’s about the jog of the rest of your life, not the sprint you did in m1,2,3
Yep, I’m about to graduate as a medical doctor in 8 weeks and still feel this way EVERY DAY. A whole new generation of insecure doctors with imposter syndrome incoming and I’m here for it tbh.
Patients will be like: “I don’t know what causes this doc and that makes me anxious”. Doctors: “Same”
>Some areas of this brain might not be getting enough blood flow or something — don’t ask me how that happens — I don’t frickin know. AND DONT ASK ME WHAT ARTERY.
This is a good line.
My dumb ass remembered propofol as a beta bæocker throughout the entire post until you mentioned sleep and I was like "oh... yeah.. its for surgery, not cardio" 🤣
idk man, whenever people ask me if they’re really asleep with anesthesia, I usually just say “it’s more like your brain is on pause than really sleeping”
This sounds so stupid but could watching ninja nerd help with the physiology basics? Drawing it out? I don’t forget things if I draw them out and I’m very forgetful.
Looking up mnemonic devices?
I’m sorry you’re struggling. This has got to be tough. I would reach out to your schools office of academic affairs. It may be worth talking to a therapist- some schools have one on staff.
yup I have all the same feelings as OP but I cant honor anything except saying everyone saying Im "a pleasure to work with and fun to be around" which at this point I have no idea if they are just trying to be nice for my lack of knowledge.
and now time to shit my pants while I study for Step 2
For the first 6ish months of residency I always referred to myself as the personality hire. I was (am?) dumber than a box of rocks but at least I stayed chipper and was fun to work with. That alone helped me fake it and get decent evals until my medical knowledge somewhat caught up
lolol im an m3 but this is pretty much my MO with rotations. idk shit either OP. youre not alone. honestly even if i do know, my brain clears out everything when im pimped and i cant think
felt the same way as a MS3. now i’m a pgy-8 and everybody’s fav ICU attending because i remember what it was like to be lost and confused. just keep working hard. it does get a little better once you stay in one specialty in one hospital with one computer system… unless you end up wheee i am working cerner / epic / cprs across three hospitals but i digress
you’ll be fine kid, keep at it
Do you ever not think about something for quite literally twenty two years, and then find out that it's still locked in your brain, word for word, through a six-word reddit post?
https://www.youtube.com/watch?v=ygQ8mFo9cHY
Do not judge us too harshly. The internet was a simpler place in the early 2000's. Also this was the funniest shit in history to a 9 year old.
Nah this is every M3. Also with any physical exam skill I’m like “what do you mean I am supposed to be actually feeling/hearing something? you mean I don’t just pantomime the motion?”
looking back as an Attending, that is totally normal. i read all your questions and answered it off the top of my head correctly and getting to this point comes with time. getting all of it squared away will come with experience and you'll get a better sense of it as a Resident and Attending -i promise. before you know it, all that stuff will come to you like second nature.
Honestly the weed does not help lol. I noticed my memory starting to suffer when I was consuming. I don’t drink anymore, so it was my only way to relax.
Now I just have to raw dog this life and it kinda SUCKS haha
> Now I just have to raw dog this life and it kinda SUCKS haha
Never before has someone so accurately and succinctly articulated the way I feel about existence lmao 🥲
I do highly recommend Wellbutrin. Especially if you have anxiety and adhd (which nearly all med students have, let’s be honest). It might be helpful for some, but YMMV.
Because you learned it off a book or a video, something your brain spent years realizing wasn’t important cuz that’s how it learned for your SAT’s and high-school exams then never needed that info again.
You’ll learn and relearn so much as a resident, when you actually have to use this medication and see faces attached to symptoms and diagnoses. I know a nurse that went through little schooling but learned most of what she knows through experience. It’ll be the same with you, just have faith that you will get the material. And relax a little, your rant while hilarious, is giving me panic attack vibes.
You’re a good student, you’ll be a good doctor. Don’t regret your decision, you’ve come really far and deserve to see it through.
You learn on the job, and what you learn in school you may forget, but it still lays down a framework and a scaffold which you build on and prune depending on what you see
Sounds like you'd be an excellent specialist. I don't even remember the difference between thiamine and niacin anymore and I'm too old and rich to care.
Man, as an M4 who did average on exams and often got honors or near honors from attending evals… I don’t remember shit either
Every rotation I would forget what I learned on the last one. I legit don’t know what antibiotics to use and look it up every time. I was panicking for step 2 but was able to relearn everything. It all came back fast and I scored average which I’m fine with.
I again forgot a lot by the time my January EM subI came around. Again, I relearned what was needed and it came back faster this time. Residency will be the same and these cycles will be repeated again and again by all of us.
You are just at the beginning of this process, so you don’t know much and are getting your ass kicked day in and day out. It WILL get better but it takes time and repetition. That’s just how our brains work. Just hang in there and try to detach your self worth from your grades. That is something that will benefit you over your lifetime.
Have you explored the possibility that your difficulty with recall in a clinical setting is related to anxiety? I promise you you wouldn't have done well on every exam up until now if there was something wrong with your memory
but you wouldn't have done well on shelves if you really knew nothing
Stress is for sure a part why it's harder to answer stuff on rotations vs Multiple choice question
I had the same question as the above poster. Please go see a counselor and get evaluated. Anxiety is not necessarily a chicken or an egg scenario. It is a feed forward mechanistic cycle. You can have very normal nerves > they temporarily decrease your performance > then you get more nervous > suddenly you can't rest due to nerves or eat normally > then your performance drops even further > the normal transient nervousness everyone experiences becomes full fledged anxiety.
What you're describing is a long term, negative change in your feelings and behavior that is negatively impacting your life. It's time for some help. You deserve to be supported. I had the same issues in M1 and didn't think it was anxiety because I have always handled stress incredibly well and been a confident person. I've always been at ease with people and a social butterfly. A therapist and short term medication management helped me break the cycle and I am off medication after developing healthy coping mechanisms. You can have the same results and deserve to feel better. <3
As a sub I on an ICU rotation I was trying to get a letter from, a pt went into SVT in front of the resident and I. He asked me what I wanted to do and I just blanked.
Same situation as you, I knew the answers, had gone over it before, and this resident was a really good resident and teacher. He was even really nice to students! I had the wherewithal to tell him that my mind just blanked and I needed a minute or two to try to think, but it freaked me out in all the same ways you described. When that adrenaline hits, it is really hard sometimes. I made myself a laminated quick reference card (like the acls quick references) after talking to our ICU pharmacist about what was available in the ICU vs floor/hospital and kept that in my coat pocket with my other stuff until my 3rd year of residency when I realized I hadn't really looked at it since I was an intern or early second year running a team. I used it all-the-time until I got comfortable with the algorithm I built in my head. It took...maybe 30-40pts for it to be truly reflexively built in my brain.
Hang in there, And find ways to work through the imposter syndrome/fight or flight (or here, freeze) response. Remember, the first pulse to check at a code is yours.
anxiety or stress aren't always conscious and your performance can still be affected. it could also turn into a feedback loop. no solutions here just saying don't rule out anxiety on your own
Trust me - attending here - when I say you learn 99.9999% of what you need to know once you hit residency.
I don't even know what I actually learned in med school some days, lol. You'll be fine.
You know, whenever I have these thoughts I always think “I know dumb people who have passed med school and became doctors, why can’t I?” And that gives me hope. Clinical knowledge will come with time. As long as you know how to ACT like a doctor, you have the empathy and the right manners, you’re probably fine.
Enjoy what you’re doing, enjoy the journey and yes fake it till you make it
I felt this way all the way through M3 clerkships and well into the start of M4. The reality as I’ve come to understand it is that once you decide on a specialty and do it for more than a single 2 to 8 week block, you will pick up on pattern recognition, workflow, and algorithmic treatment processes within that specialty for >90% of the things you see on a daily basis.
I’m sure there’s an exception to this for some wildly specialized field in which patients have been worked up by 16 teams before you see them, but for the most part you will not be the first person on your residency team, in your hospital system, or among your specialty group who is treating a patient for whatever disease process and you will learn that through exposure in residency and maybe a little in M4 year if you focus your rotations on one or two areas of interest.
I felt fairly lost until about halfway through my last year (pgy-6). My program director offered me a job during pgy-5 and I just remember imagining myself doing his job in only one more year and change and being terrified. One day something clicked and suddenly I didn’t want my attendings around anymore. Am good doctor. You’ll be fine, put in the work and trust the process.
I could have literally written this post myself im crying 😭 I've never felt so seen! For what it's worth this post makes me feel happy that I'm not alone and neither are you🙂 also do you have ADHD? bc I have ADHD lol
You spelled amaurosis fugax correctly but idk what proporol is
But seriously, I think its helpful to do anki and keep it up even throughout your rotations
Nearly all of med students have or had these thoughts, it is totally normal, to give you some hope, just ask your peers the same questions you asked and you will find more than 70% struggle to find the correct answer.
Two things are totally normal in med school:
1-to forget what you have learnt and do rotations while you are preoccupied with thoughts like "how should i memorize these information" " how can i catch up and understand what these people are saying".
2- to wish that you are not a med student and curse every second and every person that influence you to attend medicine.
It is just the need for repeating, reviewing and using the learned info continuously. It is unrealistic to expect to perfectly and fully remember forever everything we learn, from every specialty and pathology etc.
So, i think remembering only works, at least for me, when I am actually using that knowledge daily. For example, when I did research in GI, i knew everything about the procedures, meds, even requirements for prescriptions of each drug and all the associated conditions, findings, physicals, and acceptably normal lab values... One year being out of that environment, almost everything is forgotten...
I think that people who know how to answer questions during rotations, just review it before their rotations, or that is the specialty they are really excited about.
ALSO, force yourself to go out of your comfort zone, little by little. It does not have to be constantly. Small daily challenges, increasing them as time goes by.
As someone who was (and probably still often is) in the same position in M4, dealing with complexity and ambiguity is not easy in the clinical setting no matter how well you score on STEP 2 or shelves. I frankly believe that the test-centered nature of medical school got worse during the pandemic when everyone was home and studying, and we need a return to learning for learning's sake. Not because von Gierke's disease is on STEP 1, but because someday a metabolic baby could arrive at your doorstep and you need to know how to rule it in/out.
Yes, you have attained a lot of knowledge for boards, but you are also presented answer choices, 4-5 of which are wrong. In the hospital, you could do hundreds of different things, and maybe 5 of them are right, and 1 of them is ideal (for each problem on the problem list – multiple by 5-10 and we have a decision party!)
I would love to recommend [this pre-print resource](https://oercollective.caul.edu.au/uncertainty-in-health-professions/chapter/chapter-1-general-introduction-to-healthcare-uncertainty/) It introduces and attempts to model tolerance of uncertainty for healthcare professionals, which exists from students all the way to attendings.
Understanding you are a busy student, I will offer a succinct-ish summary: becoming both familiar and comfortable with uncertainty of your own knowledge base and skills is the first step to figuring out what you don't know. Identifying what "stage" you are in a knowledge gap, and then asking clinical questions that fill the gap, is what makes a physician clinically and cognitively sound. Understandably, if you are like me, then you had no idea this was a whole process to consider, and thus you feel stuck in the anxious "what the hell should I do" spiral. This is fine.
For example: on rounds in the ICU recently, I was asked why my patient on high-flow nasal cannula (50%/50L) had poor tolerance of weaning despite good progress off the ventilator earlier this week. I was stumped – as a future pediatrician, this mixed bag of heart failure/COPD/hypoventilatory obesity/recovering pneumonia made ZERO sense to me, and I definitely felt a bit anxious and uncertain. (For the record: attendings can recognize this from a mile away; the bad ones the chastise, the meh ones acknowledge, and the GOOD ones embrace this as an optimal teaching moment).
My *next step* was to challenge both my assumptions and my knowledge base – do I *know* what is happening in this patient's lungs? I was asked to dive into common causes of respiratory failure and hypoxemia with oxygen support, and very fortunately the intern on our team helped me rule stuff out: anatomical shunt? We did a bubble study, which is negative. Hypoventilation from respiratory drive vs. obesity? He's *been* COPD/obese for years, it wouldn't explain the acute evolution of disease to put him in the ICU. Heart failure? This man is dry, we've diuresed him for a week and his lips are arid.
Then comes the light bulb moment: literal alveolar recruitment where oxygen diffusion happens. We haven't had a good picture of his lungs due to poor positioning w/ body habitus, and then heart failure really obscured the lung fields, cardiomegaly on top of this, and then after extubation we never had another CXR. So how the hell are his membranes perfusing right now? We don't know! Brilliantly, my attending already directed us towards an ultrasound where she actually detects signs of consolidation/infiltrates.
It is a physiologic shunt! I never would have guessed this on my own, but by challenging my assumptions of the patient's condition, re-reading (and reinforcing) what is (and is not) going on, I had 1. definitive evidence of what's going on and 2. a definitive plan to work with and test the hypothesis (attempt incentive spirometry, encourage movement/deep breathing, maybe a repeat CXR to ensure no evolving pathology). On a STEP 2 question, this would have been a bit easier to see, but in the real world, I had to turn some big cogs in my brain to see the bigger picture.
You (and nearly everyone else) are going through a very normal part of Medical Education that is certainly a part of the hidden curriculum: you are *supposed* to struggle diagnostically. It's the most important part of clinical cognition. Obviously patient care is the most essential point of all, but between an H&P and developing a plan, your **assessment** and **impression** will be the edge of your sword that cuts down disease. And you will keep honing that edge for what to cut (and what NOT to cut) through residency and beyond.
HAHAHAHA are you me??? I literally could've written this, M4, totally burnt out. For me the worst is probs antibiotics, I literally have NO idea what you even start people on for anything. Like did we learn this??????
Praying it's normal...............
Ok yeah me too thanks ok bye now
(you’re not alone in the feeling. the worst med school graduate is gonna be called doctor. worst case, you excuse yourself and do a quick lil googley goo on on daddy dynamed or something every now and then until you get it.)
bb have you thought about seeing a psychiatrist or a learning specialist? Are you sleeping? Are you getting all your vitamins and nutrients? I have ADHD and I can't spell out loud or sometimes recall the word I want on the spot. I can however write thing down fine, I have to put my headphones on whenever we're about to take a quiz or a test so hearing other people talk about it doesn't mix things up in my head
Not trying to diagnose you but have you ever been evaluated for ADHD? I have it and feel very much the same way with being able to remember facts for a short time really well and then purging them.
As my surgeon during the surgery rotation told me.
"Most thr things you learn in med school are doomed to be forgotten, what is important is the method of logic and thinking, treat the patient and not his/her symptoms; and remember above anything else, try to learn something new everyday, even if is not med related"
Medicine is just practice practice and practice and experience.
Also it is normal feeling overwhelmed, you are going to treat people, having their life on your hands, aint an easy job.
This mean that you CARE and that you are LEARNING.
Keep it up...im proud of you especially to give yourself the opportunity to be humble and humbled.
This actually has me laughing because I feel similar about boards in June. like I know that info is in there somewhere but uhhh no idea where😂😂😂😂😂
I cant wait to get to this feeling in 6 months
It’s so comforting to read how many people have had this exact monologue.
Current M4 anxiously waiting on the Match and I’ve been questioning if I made the biggest mistake of my life every day lol.
We got this!
I'm the opposite. Every attending I work with tells me I'm the best medical student they've ever had and writes spectacular comments, but I perform average to below average on my shelves
Are you inside my head or something? I’m about to start 4th year and I’m literally shitting myself cuz I have to do sub I and know things…. What are we going to do?
We all lack medical knowledge, that’s why we’re in medical school 👍🏼
As far as being awkward, might be worth seeing if you have social anxiety, which would also make it hard to process and learn during rotations. If it’s not social anxiety, just pick someone you know who people like (probably a man if you’re a man or a woman if you’re a woman etc) and try to imitate their behavior in social situations. Stand up straight and smile - if you seem comfortable, the other person will feel more comfortable too.
You can also practice making conversation with people who can’t escape lol. As a former barista, I think that’s a part of the service we provide. If there’s not a line, ask them what their favorite drink is or say you want to try something new and ask for recommendations (don’t forget to tip and compliment their drink making, that’ll get the convo flowing). Just try to make a little small talk with everyone who is being paid to stand there, grocery store, post office, front desk. The auxiliary medical staff are also great people to talk to, peep if they have pics of pets or kids on their desk, a new smart watch or water bottle. Introduce yourself and say you’re a med student. figure out stuff they like and try to talk about it in a positive or inquisitive way.
Also consider making your hobbies or interests known (sports team keychain, Pokémon decals, national park background on computer, coffee mug from your home state etc) so that people can start random conversations with you
You remembered all these medical words to type them. The general public doesn't know what those are.
It's imposter syndrome. Everyone gets a little of it. It will all come together. Especially if you pick a specialty you are interested in. No one remembers most of what they learned in med school.
If it makes you feel any better, from what I've gathered, passing exams and doing well on them feels like it's the most valuable thing in this field (unfortunately? or fortunately?). As long as you do that, match into residency, and keep on keeping on, you'll be a good doctor.
I'm on the other side of the coin. I do god awful on exams despite actually knowing a decent amount. I can answer a decent amount of pimp questions and recall things on the spot, but it translates to minimally passing and getting ugly test scores, so FeelsBadMan.
Bro The Feeling of Impostor Syndrome never Goes away. Medicine is a Marathon not a 100m Sprint. You Learn You Unlearn You Forget you Learn again and Repeat this Process countless no of Times. With Time things Fall into place. Even Consultants Feel this way you are not Alone
My friend, extreme chaos happens right before eternal clarity. Your brain was a brand new apartment and all the information is the furniture- it is being assembled and moved to the final spot.
You’re doing everything you should be doing- even going overboard to notice the little things like ST “elevations”.
>“STOP writing ST segment elevations on your notes — people are reading this.”
You’re one day away, and one small nugget of information away from the day you’ll be scanning EKGs visually and not calling it an ST elevation unless it’s at least 2 boxes high.
>There’s no way I’ll be a good doctor.
Good. Because the day you think you are a good doctor, you stop being one. Good doctors want to and hope to be good doctors.
Imho you sound burnt out and a wellness day to catch up on sleep will work wonders.
Your subjective perception of the situation is a lot less optimistic than reality, and I worry that you’d end up with clinical depression without healthier coping strategies.
You’re stronger than pimp question- the hierarchy sometimes puts power hungry people above you unfortunately, and you can’t let them win.
By failing to be good teachers, they’re still teaching you who you don’t want to turn into.
You’re neither the first nor the last person here who wondered if they had presenile dementia. Multiple studies have shown a significant (but temporary) drop in IQ test scores when subjects were experiencing psychological stress. Further, feeling down is a full time time for the brain and learning and memory suffer, aka “pseudodementia”. And you deserve to be the happiest and best version of you, and if you need help it’s okay because you owe yourself wellness. When was the last time you visited your favorite place around town, had a leisurely bath, or meditated on feel good thoughts? You’d find it understandable if somebody breaks up because there’s no spark left in a relationship, but your mind can’t “break up” with you and is screaming for mercy against being overworked.
I know you’re going to survive and thrive, you just need to step back for a moment and see how far you’ve come. Your post achieves ROSC at the end when you say
>And now, I’m too deep into this. SO DO NOT TELL ME TO QUIT NOW.
To put it more poetically, "I didn't come this far, just to come this far"
You got this. You’ll soon know it wasn’t a memorization contest after all, “Education is what remains when we have forgotten all that we have been taught”- the things you need to do to keep your patients alive- you’ll be doing it on autopilot a few years from now. You’ll probably misspell amaurosis fugax but with practice, it will be a reflex action to order a scan stat.
And just FYI, the person who said
>“STOP writing ST segment elevations on your notes — people are reading this.”
could’ve done a better job in the same amount of time.
AHA/ACCF/HRS Recommendations for the Standardization and Interpretation of the Electrocardiogram
1. For men 40 years of age and older, the threshold value for abnormal J-point elevation should be 0.2 mV (2 mm) in leads V2 and V3 and 0.1 mV (1 mm) in all other leads.
2. For men less than 40 years of age, the threshold values for abnormal J-point elevation in leads V2 and V3 should be 0.25 mV (2.5 mm).
3. For women, the threshold value for abnormal J-point elevation should be 0.15 mV (1.5 mm) in leads V2 and V3 and greater than 0.1 mV (1 mm) in all other leads.
4. For men and women, the threshold for abnormal J-point elevation in V3R and V4R should be 0.05 mV (0.5 mm), except for males less than 30 years of age, for whom 0.1 mV (1 mm) is more appropriate.
5. For men and women, the threshold value for abnormal J- point elevation in V7 through V9 should be 0.05 mV (0.5 mm).
6. For men and women of all ages, the threshold value for abnormal J-point depression should be −0.05 mV (−0.5 mm) in leads V2 and V3 and −0.1 mV (−1 mm) in all other leads.
I have a theory. What if the problem isn’t you, your knowledge, or your abilities? What if the problem here is doubt?
The all-too-common belief among attendings of ‘but pimping is how I teach!!’ and/or a general philosophy of shame-based learning does a great job of one thing: destroying our clinical confidence. Destroyed clinical confidence results in questioning yourself, your every move, your every thought, and puts us in a perpetual state of panic. Panic diverts cerebral blood flow away from our higher cortical centres (ie, cognition) and reverts us back to a ‘lizard brain,’ survival-first kind of thinking only. This is why we ‘can’t think straight’ when we panic. Our focus narrows. We don’t notice the details; we can’t. And, if you can’t think properly in panic, you sure as hell can’t learn well like that.
So, what happens? A vicious cycle of doubt —> panic —> impaired problem solving, impaired ability to recognize patterns and notice details —> impaired performance —> doubt is externally reinforced (ex via shame-based learning) —> escalation in panic, with the end result being continuous erosion of clinical confidence, a reputation as a ‘bad’ student or resident (which you internalize), and becoming a self-fulfilling prophecy of downward-spiral failure. Without clinical confidence, it doesn’t matter how much you know. It doesn’t matter how deep your knowledge is if you don’t trust yourself or constantly second guess yourself.
How do you get out of it? I was lucky to have the feedback that my knowledge was actually above my level x 1-2+ PGY years, but confidence was far behind expected for my level, -2 training years, which made me overall function -2. That feedback helped me understand what I wrote above, and make some strategies . To attendings, *clinical* confidence means faith in your own medical knowledge and decision making abilities. If you tell them your goal is to build your clinical confidence, they might help you do that. ‘Professional development’ reframes your success as a medical learner from being someone else’s problem and grounds it in practical reality. In my experience, it increases the engagement and sense of responsibility that attendings have over my learning and learner experience.
Wish I could write more. Gotta go to work. You can do this. I believe in you.
Repetition, practice, experience. You'll be amazed how much you learn and how your clinical abilities improve with time. This line of thinking is normal. Stay the course. If the anxiety is really impairing your day-to-day, I recommend seeing if you can talk to a therapist (a lot of med students can do free or very low-cost sessions through their campus health, especially if associated with counseling students).
Nice to know that I’m not the only one. There are times where I actually feel like a dumbass bc everyone in my group knows the answers to all the questions.
Hey man I’m sorry your feeling like this.
I wanted to offer some advice even though I’m not a doctor nor have I applied to medical school (yet). During my undergrad I was in a similar position, would ace my test but once I got into the clinic it was like I was brand new hadn’t ever heard of basic medications or procedures. I forgot everything including the last question they asked me.
Take a deep breath. Seriously. I’ve found that my lack of performance had nothing to do with not knowing the material but the expectation of me and how I’d be judged for my answer. I started to hate clinic and everything I was doing.
I had a break before I changed clinical sites. Finally a fresh start. What I found was to treat everyday like a fresh start. They may have hated me yesterday but today I’ll be better. Understand that you are learning (unfortunately like me the hard way.)
Try to control your emotions and whatever your feelings you have. YOU ARE NOT YOUR THOUGHTS. how you perceive yourself is not how others perceive you.
What I found is I was much harder on myself then other people. The constant beating myself up was a huge detriment to my performance. Be kind to yourself.
Try to remember that you don’t think the other students are 🤡s when they make mistakes or mess up. Why would they think that about you.
I'm an M1 with a shelf exam tomorrow, and I stg I almost cried because I forgot what vimentin was indicative of for immunihistochemical marking. We just learned it in like September but it's gone. I def feel like I'm gonna be a crappy doctor
I’ve been at attending a few years and I had a brain fart (luckily not with a patient) and forgot the word for a vasectomy today. I was looking straight at a ptygerium in a patients eye a couple of weeks ago and couldn’t remember the word even though I could describe exactly what it was (it wasn’t until I was putting it in my note 5 minutes later that I remembered). You’ll be fine.
Sounds like a bad case of imposter syndrome, its common mate. I promise you youre not dumb, youve passed the exams which means you can at least recall and understand the information short term.
How do you study? Is it a study method conducive to long term learning or do you cram? Do you keep up reviewing even after youve been evaluated on a certain topic? Keeping up with spaced repetition after the actual test is extremely important to actually know the stuff for life.
Also, you dont "need" to be able to answer everything. Most of the stuff you learn in school wont actually be used on a daily basis. Yes obviously its important to keep up in class, but from what ive heard youll figure out whats needed to remember long term based on what youll see most in whatever speciality you choose.
Also have you considered that stress and social anxiety could be causing you to do poorly when people ask you simple questions? I kinda get this too when im put on the spot or if im too stressed out. My mind goes absolutely blank and i feel so freaking stupid because i cant recall or explain simple things.
I came here today because I needed to stress post about my own clinical today (I’m on neuro) where I was asked to name calcium channel blockers. I COULDNT. NAME. ONE. Follow up redemption question I could name the different type but couldn’t tell you what was different about them. Literally so dumb and thank GOD for the locum PA who saved me from myself. Solidly feel like the biggest idiot ever so don’t worry you’re not alone. Dreading tomorrow and honestly don’t know how I’ll ever get all this down.
This is me everyday as I graduate this year. I write an exam and poof, everything is gone. The imposter syndrome hits hard. But these replies are comforting.
I feel like this post is half in jest, however a lot of us have felt somewhat similar. You don’t really know how to be a doctor until residency to be honest.
honestly tysm for writing this. just know reading this helped this anxiety adhd ridden ms3 feel not so alone in feeling like a complete idiot. i also dont know what propofol or any abx is
Its normal. Too much info. Gonna tell you a secret: that's why people become specialists. There are many videos where the most basic questions are asked to renamed doctors into an area - and they don't know the answer. Why? Because a cardiologist doesn't remember the basics of ortho; a psychiatrist would never remember things about vaccines, and so on. You got the idea.
What I do recommend to you is to focus on hands-on practice in order to get more experience. Experience is key to learning. You need to known how to diagnose, what to prescribe and that's it. There are some specialties where you just diagnose and refer patients to other doctors. There's no shame to revise content even during a consult. I would actually get worried if you're able to remember all that unuseful stuff.
Btw another nice trend are doctors who can't say if a certain name was a muscle or a dinosaur. Its so funny.
Cool post and relatable.
Im pretty sure i will have dementia by the age of 40.
Too much phone and pc made me not focus on any information i see in front of me.
Man lemme tell you about my rounds today; ER, 12 patients, managed to get myself stuck in basic gasometric interpretation in 2 of them, i dont know shit either bruv dw about it, my residents didnt either
Bro thanks for making this post. It really helps me feel less alone. I’m in dedicated for Step 1 rn and see a lot of posts, hear from classmates, or even attend sessions where people talk about being “bad” and only scoring average. Then I’m here barely staying afloat, not remembering basics as I do content review, and think if they are “bad” then what am I 💀
I say this in earnest, consult a psychologist; Nobody can think straight when they're overridden with emotions. Language is lateralized and you can't access it when the opposite hemisphere is overstimulated, memory retrieval too, is surprisingly state-dependent.
How will you recollect what you studied when in your mind, you are not perceiving clearly your surroundings? You are too busy accepting the harsh voices of self-criticism, you are not listening to them, you are too deep in your own mind to care for anything else. Who has given you these voices of self-criticism, in whose voice do you hear their whispers?
I've been in that mental space too, it sucks to be the last. But, I've gotten through it and I switched my life around. There can be a happy ending here too!
Focus on getting out of the fight-flight first, your mental health matters. It matters more than the degree, you will be a useless doctor if you actually overlook your own self-needs and now you need some time to fix your relationship to your own self. Doctors don't just pass medicine, we pass a general notion of well-being to our patients too, how else will they trust us? How will they trust someone who feels like this towards themselves, is this what you would teach your patients? Don't just do it for you, sit down and think about failure, honestly and earnestly, there's always a way to find your footing even if all else fails.
Don't belittle yourself just because you are emotional, everyone else just represses their emotional needs in order to exceed, apparently that's no longer a valid route for you. Deal with the self!
I don't think you're stupid, but it seems to me that you've made 'being stupid' your greatest fear so much that it immobilizes you and you are manifesting it outwardly. Why is being stupid bad? We've all been stupid! Anyone who says otherwise, they are lying through their teeth, stupidity is paving the way to progress, in fact.
Why is it so bad that you don't know a question? Why is it so bad to be alone? What does it mean to be a clown? Why hate it?
You're not a robot which remembers everything, you will naturally invest in what most appeals to you.
Take care of yourself and i'm sure you'll be a good doctor some day, if you don't believe it, then who will?
Learn as much as possible from hitting 'rock bottom', it's a lifetime opportunity and you can use your suffering to bond with people - as everyone is suffering. Not many people get to explore the emotional spectrum like that, it's absolutely worth it, makes life worth living if you get out of it. You're learning how to be 'human'.
The fact you're worried is actually good 💀. I'd be more concerned with the people not having this level of self-awareness or self-censure 😂. You understand the impact you'll have one day. I swear doubt is something purposely instilled in school as a protective measure, just so you start questioning more and proceeding more cautiously. It's actually a good mindset to have in this profession. It just sucks when it goes off the deep end, and now you're knee-deep in an existential crisis of self-doubt.
If anything, now you'll overcompensate by studying with the crippling wave of guilt, so a win is a win 💀
First, take a long, deep breath.
It sounds like you have the brains and capability, but you are simply tripping over yourself. You definitely have an underlying anxiety problem. That alone can make you "forget" everything and make you lose confidence in yourself. Highly recommend therapy, medication, meditation, or working out to feel more confident in yourself and your abilities. Fake it til you make it my friend (that's what everyone around you is doing).
Also, you don't have to know everything. No one does or can. Once you graduate (which you will), just focus on your specialty and forget everything else! Even if you want to go into FM, peds, or internal medicine, being in residency is vastly different from medical school because you live and breathe your field everyday for years. And you will learn more because you will have a higher sense of responsibility towards your patients to do so.
You're stressed and burnt out. But you can and will get through this.
Sincerely, someone in their first year of residency who has had this same exact internal monologue every day during third year.
The best way to learn is to write all that stuff down on the spot and review it when you get home. Don't worry if it makes you look like a nerd to be frantically scribbling notes during rounds. I promise no one cares.
Besides, if you need a cheat code for getting people to like you, showing them you are listening is it.
Honestly, this is the best tip I can give anyone for getting along with others, honoring rotations, making friends, whatever the situation is. If someone looks you in the eye and takes the time to tell you something personally, remember it no matter what. You can literally forget everything else and be fine, but if you forget something someone took extra time to teach you, good luck honoring a rotation or getting a good eval. If you don't remember whatever it is, it makes you look like you dgaf about that person or what they have to say, and people take that crap personally
I did 1000 cards daily for 9 months. Hated it. Switched it to just questions I missed. Still hated it.
Wasn't as helpful as just doing questions in that same time. Did better on exams anyways.
Do what floats your boat. My ADHD doesn't work with flash cards, simple as.
There are specific m3 decks and there's a mnemosyne deck that is a fraction of the size of anking for just First Aid things. The cards are straightforward, i like them
🤣🤣🤣 this is the funniest thing i’ve ever read. not bcuz you’re dumb, but the way you wrote this. i think a lot more people feel this way more than you think. “I look like 🤡 NOT 👨⚕️!!” 🤣🤣🤣 you’re hilarious man.
OP just described the internal monologue of 50+% of all MD/DO students.
They probably have a career writing thought provoking journals
I’m thoughtless.
Clearly your stream of consciousness is funny to some fam
Thank you. At least I have that going for me.
I’ll be real with you friend I didn’t read the post until just now, an error I make. Most medstuds dump their knowledge between oct ms4 and July. This was restated again and again by attendings trying to assure me (second to last in my class) that my medical knowledge is good and to not worry so much about stuff that you will redrill again and again. We’re humans and our memories take a long time to congeal into robust knowledge. It also takes reiterating it several times, in several emotional states. You’ll get there just like I will, it’s about the jog of the rest of your life, not the sprint you did in m1,2,3
Even this is hilarious 🤣 😂
Yep, I’m about to graduate as a medical doctor in 8 weeks and still feel this way EVERY DAY. A whole new generation of insecure doctors with imposter syndrome incoming and I’m here for it tbh. Patients will be like: “I don’t know what causes this doc and that makes me anxious”. Doctors: “Same”
>Some areas of this brain might not be getting enough blood flow or something — don’t ask me how that happens — I don’t frickin know. AND DONT ASK ME WHAT ARTERY. This is a good line.
OP should be a comedian
Am I a JOKE TO YOU?
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My dumb ass remembered propofol as a beta bæocker throughout the entire post until you mentioned sleep and I was like "oh... yeah.. its for surgery, not cardio" 🤣
Close tho, did you mean propranolol?
idk man, whenever people ask me if they’re really asleep with anesthesia, I usually just say “it’s more like your brain is on pause than really sleeping”
It didn't end well for MJ though.
I've never understood why MJ's quack was giving him propofol when precedex exists.
Lol
I was crying about this and sorted by new. I feel the same idk. Honor shelves but clinically dumb.. too tired to study at the end of the day. Ugh
Yeah, I can’t sit there and study after my rotation.
This sounds so stupid but could watching ninja nerd help with the physiology basics? Drawing it out? I don’t forget things if I draw them out and I’m very forgetful. Looking up mnemonic devices?
I’ve tried it all. I have concluded that I need H E L P.
I’m sorry you’re struggling. This has got to be tough. I would reach out to your schools office of academic affairs. It may be worth talking to a therapist- some schools have one on staff.
I wish I at least had the former. I can’t honor shit and I’m clinically incompetent 🙈 Hey at least I’ve been told that I’m fun to work with 🤷🏽♂️
yup I have all the same feelings as OP but I cant honor anything except saying everyone saying Im "a pleasure to work with and fun to be around" which at this point I have no idea if they are just trying to be nice for my lack of knowledge. and now time to shit my pants while I study for Step 2
For the first 6ish months of residency I always referred to myself as the personality hire. I was (am?) dumber than a box of rocks but at least I stayed chipper and was fun to work with. That alone helped me fake it and get decent evals until my medical knowledge somewhat caught up
lolol im an m3 but this is pretty much my MO with rotations. idk shit either OP. youre not alone. honestly even if i do know, my brain clears out everything when im pimped and i cant think
felt the same way as a MS3. now i’m a pgy-8 and everybody’s fav ICU attending because i remember what it was like to be lost and confused. just keep working hard. it does get a little better once you stay in one specialty in one hospital with one computer system… unless you end up wheee i am working cerner / epic / cprs across three hospitals but i digress you’ll be fine kid, keep at it
"yo mothafuckah weeee!" gonads and strife...
Do you ever not think about something for quite literally twenty two years, and then find out that it's still locked in your brain, word for word, through a six-word reddit post?
I was not a conscious being at that time. Is this a millenial reference?
Yup: https://youtu.be/vTN4RzXyFhc?si=AO93B1SCPelMSlxa
https://www.youtube.com/watch?v=ygQ8mFo9cHY Do not judge us too harshly. The internet was a simpler place in the early 2000's. Also this was the funniest shit in history to a 9 year old.
Well it's no worse than Skibbity Toilet
This happened to me with this exact song like 6 months ago lmao
Nah this is every M3. Also with any physical exam skill I’m like “what do you mean I am supposed to be actually feeling/hearing something? you mean I don’t just pantomime the motion?”
I was dumbstruck when my ED attending looked at me dumb struck when I didn't perform a rectal exam. Like "wait, I can do that now"
You can.. but do you really want to
THIS. why can i never see the TM in kids 🥲
looking back as an Attending, that is totally normal. i read all your questions and answered it off the top of my head correctly and getting to this point comes with time. getting all of it squared away will come with experience and you'll get a better sense of it as a Resident and Attending -i promise. before you know it, all that stuff will come to you like second nature.
You answered my questions from the top of your head. These questions have been asked millions of times — I can’t answer them. My mind is fked.
Same brotha. I’m 33 and worried about dementia because I can’t remember shit anymore haha
LOL everyday I debate whether I should go see neurology.
Then I remember the many mg of D9 I have consumed.
Honestly the weed does not help lol. I noticed my memory starting to suffer when I was consuming. I don’t drink anymore, so it was my only way to relax. Now I just have to raw dog this life and it kinda SUCKS haha
> Now I just have to raw dog this life and it kinda SUCKS haha Never before has someone so accurately and succinctly articulated the way I feel about existence lmao 🥲
I do highly recommend Wellbutrin. Especially if you have anxiety and adhd (which nearly all med students have, let’s be honest). It might be helpful for some, but YMMV.
Have you been evaluated for ADHD?
yes i have it
Are you medicated for it?
yes 😭
Because you learned it off a book or a video, something your brain spent years realizing wasn’t important cuz that’s how it learned for your SAT’s and high-school exams then never needed that info again. You’ll learn and relearn so much as a resident, when you actually have to use this medication and see faces attached to symptoms and diagnoses. I know a nurse that went through little schooling but learned most of what she knows through experience. It’ll be the same with you, just have faith that you will get the material. And relax a little, your rant while hilarious, is giving me panic attack vibes. You’re a good student, you’ll be a good doctor. Don’t regret your decision, you’ve come really far and deserve to see it through.
You learn on the job, and what you learn in school you may forget, but it still lays down a framework and a scaffold which you build on and prune depending on what you see
yeah but over time you will internalize the answers and -most importantly- why they are the answers
It’s burnout. You will be okay.
It gets better.
Sounds like you'd be an excellent specialist. I don't even remember the difference between thiamine and niacin anymore and I'm too old and rich to care.
Wait, do u suggest that u can be attending without memorizing all amino acid formulas?
Wait ... knowing that elastin is made up of high quantities of lysine, glycine, and proline is useless :o
Always has been
You sound like my spirit animal
Man, as an M4 who did average on exams and often got honors or near honors from attending evals… I don’t remember shit either Every rotation I would forget what I learned on the last one. I legit don’t know what antibiotics to use and look it up every time. I was panicking for step 2 but was able to relearn everything. It all came back fast and I scored average which I’m fine with. I again forgot a lot by the time my January EM subI came around. Again, I relearned what was needed and it came back faster this time. Residency will be the same and these cycles will be repeated again and again by all of us. You are just at the beginning of this process, so you don’t know much and are getting your ass kicked day in and day out. It WILL get better but it takes time and repetition. That’s just how our brains work. Just hang in there and try to detach your self worth from your grades. That is something that will benefit you over your lifetime.
Have you explored the possibility that your difficulty with recall in a clinical setting is related to anxiety? I promise you you wouldn't have done well on every exam up until now if there was something wrong with your memory
I don’t know anything > so I’m anxious NOT I’m anxious > so I don’t know anything
but you wouldn't have done well on shelves if you really knew nothing Stress is for sure a part why it's harder to answer stuff on rotations vs Multiple choice question
I had the same question as the above poster. Please go see a counselor and get evaluated. Anxiety is not necessarily a chicken or an egg scenario. It is a feed forward mechanistic cycle. You can have very normal nerves > they temporarily decrease your performance > then you get more nervous > suddenly you can't rest due to nerves or eat normally > then your performance drops even further > the normal transient nervousness everyone experiences becomes full fledged anxiety. What you're describing is a long term, negative change in your feelings and behavior that is negatively impacting your life. It's time for some help. You deserve to be supported. I had the same issues in M1 and didn't think it was anxiety because I have always handled stress incredibly well and been a confident person. I've always been at ease with people and a social butterfly. A therapist and short term medication management helped me break the cycle and I am off medication after developing healthy coping mechanisms. You can have the same results and deserve to feel better. <3
As a sub I on an ICU rotation I was trying to get a letter from, a pt went into SVT in front of the resident and I. He asked me what I wanted to do and I just blanked. Same situation as you, I knew the answers, had gone over it before, and this resident was a really good resident and teacher. He was even really nice to students! I had the wherewithal to tell him that my mind just blanked and I needed a minute or two to try to think, but it freaked me out in all the same ways you described. When that adrenaline hits, it is really hard sometimes. I made myself a laminated quick reference card (like the acls quick references) after talking to our ICU pharmacist about what was available in the ICU vs floor/hospital and kept that in my coat pocket with my other stuff until my 3rd year of residency when I realized I hadn't really looked at it since I was an intern or early second year running a team. I used it all-the-time until I got comfortable with the algorithm I built in my head. It took...maybe 30-40pts for it to be truly reflexively built in my brain. Hang in there, And find ways to work through the imposter syndrome/fight or flight (or here, freeze) response. Remember, the first pulse to check at a code is yours.
anxiety or stress aren't always conscious and your performance can still be affected. it could also turn into a feedback loop. no solutions here just saying don't rule out anxiety on your own
You're stressed as fk. You're a normal med student going through normal med student issues. As you gain experience it'll get better
Boss what you're suffering from is called imposter syndrome and it's totally normal.
Trust me - attending here - when I say you learn 99.9999% of what you need to know once you hit residency. I don't even know what I actually learned in med school some days, lol. You'll be fine.
They really bombard you with every single aspect of medical knowledge. Feels impossible to know everything :(
This gives me hope, I feel like a potato with match/residency looming around the corner lol
There are NPs who have 1/10th of your MS3 knowledge with 10 times the confidence. Just think.
The problem with the world is that the intelligent people are full of doubts, while the stupid ones are full of confidence. – Charles Bukowski
THIS
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You know, whenever I have these thoughts I always think “I know dumb people who have passed med school and became doctors, why can’t I?” And that gives me hope. Clinical knowledge will come with time. As long as you know how to ACT like a doctor, you have the empathy and the right manners, you’re probably fine. Enjoy what you’re doing, enjoy the journey and yes fake it till you make it
I felt this way all the way through M3 clerkships and well into the start of M4. The reality as I’ve come to understand it is that once you decide on a specialty and do it for more than a single 2 to 8 week block, you will pick up on pattern recognition, workflow, and algorithmic treatment processes within that specialty for >90% of the things you see on a daily basis. I’m sure there’s an exception to this for some wildly specialized field in which patients have been worked up by 16 teams before you see them, but for the most part you will not be the first person on your residency team, in your hospital system, or among your specialty group who is treating a patient for whatever disease process and you will learn that through exposure in residency and maybe a little in M4 year if you focus your rotations on one or two areas of interest.
I felt fairly lost until about halfway through my last year (pgy-6). My program director offered me a job during pgy-5 and I just remember imagining myself doing his job in only one more year and change and being terrified. One day something clicked and suddenly I didn’t want my attendings around anymore. Am good doctor. You’ll be fine, put in the work and trust the process.
This post is very relatable, even down to questioning the early onset dementia 😩😂
I could have literally written this post myself im crying 😭 I've never felt so seen! For what it's worth this post makes me feel happy that I'm not alone and neither are you🙂 also do you have ADHD? bc I have ADHD lol
i DOOO
LMAOOOOO. Damn.
You spelled amaurosis fugax correctly but idk what proporol is But seriously, I think its helpful to do anki and keep it up even throughout your rotations
I searched it up before I typed it out.
Nearly all of med students have or had these thoughts, it is totally normal, to give you some hope, just ask your peers the same questions you asked and you will find more than 70% struggle to find the correct answer. Two things are totally normal in med school: 1-to forget what you have learnt and do rotations while you are preoccupied with thoughts like "how should i memorize these information" " how can i catch up and understand what these people are saying". 2- to wish that you are not a med student and curse every second and every person that influence you to attend medicine.
It is just the need for repeating, reviewing and using the learned info continuously. It is unrealistic to expect to perfectly and fully remember forever everything we learn, from every specialty and pathology etc. So, i think remembering only works, at least for me, when I am actually using that knowledge daily. For example, when I did research in GI, i knew everything about the procedures, meds, even requirements for prescriptions of each drug and all the associated conditions, findings, physicals, and acceptably normal lab values... One year being out of that environment, almost everything is forgotten... I think that people who know how to answer questions during rotations, just review it before their rotations, or that is the specialty they are really excited about. ALSO, force yourself to go out of your comfort zone, little by little. It does not have to be constantly. Small daily challenges, increasing them as time goes by.
Are you me lmao? I still don't know what amlodipine does or is.
What the fuck is that
CCB but is it dihydro or non-dihydro
Hahaha this dude. Stay the course friend. Why dafuq you think we got CME for the old fogies in practice? ‘Cause they ‘member?
I had/ have the same issue even as a resident. You just keep pushing and learning things multiple time lol
Was wondering how you heard what goes on in my head daily… 😂
As someone who was (and probably still often is) in the same position in M4, dealing with complexity and ambiguity is not easy in the clinical setting no matter how well you score on STEP 2 or shelves. I frankly believe that the test-centered nature of medical school got worse during the pandemic when everyone was home and studying, and we need a return to learning for learning's sake. Not because von Gierke's disease is on STEP 1, but because someday a metabolic baby could arrive at your doorstep and you need to know how to rule it in/out. Yes, you have attained a lot of knowledge for boards, but you are also presented answer choices, 4-5 of which are wrong. In the hospital, you could do hundreds of different things, and maybe 5 of them are right, and 1 of them is ideal (for each problem on the problem list – multiple by 5-10 and we have a decision party!) I would love to recommend [this pre-print resource](https://oercollective.caul.edu.au/uncertainty-in-health-professions/chapter/chapter-1-general-introduction-to-healthcare-uncertainty/) It introduces and attempts to model tolerance of uncertainty for healthcare professionals, which exists from students all the way to attendings. Understanding you are a busy student, I will offer a succinct-ish summary: becoming both familiar and comfortable with uncertainty of your own knowledge base and skills is the first step to figuring out what you don't know. Identifying what "stage" you are in a knowledge gap, and then asking clinical questions that fill the gap, is what makes a physician clinically and cognitively sound. Understandably, if you are like me, then you had no idea this was a whole process to consider, and thus you feel stuck in the anxious "what the hell should I do" spiral. This is fine. For example: on rounds in the ICU recently, I was asked why my patient on high-flow nasal cannula (50%/50L) had poor tolerance of weaning despite good progress off the ventilator earlier this week. I was stumped – as a future pediatrician, this mixed bag of heart failure/COPD/hypoventilatory obesity/recovering pneumonia made ZERO sense to me, and I definitely felt a bit anxious and uncertain. (For the record: attendings can recognize this from a mile away; the bad ones the chastise, the meh ones acknowledge, and the GOOD ones embrace this as an optimal teaching moment). My *next step* was to challenge both my assumptions and my knowledge base – do I *know* what is happening in this patient's lungs? I was asked to dive into common causes of respiratory failure and hypoxemia with oxygen support, and very fortunately the intern on our team helped me rule stuff out: anatomical shunt? We did a bubble study, which is negative. Hypoventilation from respiratory drive vs. obesity? He's *been* COPD/obese for years, it wouldn't explain the acute evolution of disease to put him in the ICU. Heart failure? This man is dry, we've diuresed him for a week and his lips are arid. Then comes the light bulb moment: literal alveolar recruitment where oxygen diffusion happens. We haven't had a good picture of his lungs due to poor positioning w/ body habitus, and then heart failure really obscured the lung fields, cardiomegaly on top of this, and then after extubation we never had another CXR. So how the hell are his membranes perfusing right now? We don't know! Brilliantly, my attending already directed us towards an ultrasound where she actually detects signs of consolidation/infiltrates. It is a physiologic shunt! I never would have guessed this on my own, but by challenging my assumptions of the patient's condition, re-reading (and reinforcing) what is (and is not) going on, I had 1. definitive evidence of what's going on and 2. a definitive plan to work with and test the hypothesis (attempt incentive spirometry, encourage movement/deep breathing, maybe a repeat CXR to ensure no evolving pathology). On a STEP 2 question, this would have been a bit easier to see, but in the real world, I had to turn some big cogs in my brain to see the bigger picture. You (and nearly everyone else) are going through a very normal part of Medical Education that is certainly a part of the hidden curriculum: you are *supposed* to struggle diagnostically. It's the most important part of clinical cognition. Obviously patient care is the most essential point of all, but between an H&P and developing a plan, your **assessment** and **impression** will be the edge of your sword that cuts down disease. And you will keep honing that edge for what to cut (and what NOT to cut) through residency and beyond.
HAHAHAHA are you me??? I literally could've written this, M4, totally burnt out. For me the worst is probs antibiotics, I literally have NO idea what you even start people on for anything. Like did we learn this?????? Praying it's normal...............
The fact that you’re worried you don’t know enough proves you’ll be a great doctor. The worst ones think they know everything and don’t need help.
 Ok yeah me too thanks ok bye now (you’re not alone in the feeling. the worst med school graduate is gonna be called doctor. worst case, you excuse yourself and do a quick lil googley goo on on daddy dynamed or something every now and then until you get it.)
bb have you thought about seeing a psychiatrist or a learning specialist? Are you sleeping? Are you getting all your vitamins and nutrients? I have ADHD and I can't spell out loud or sometimes recall the word I want on the spot. I can however write thing down fine, I have to put my headphones on whenever we're about to take a quiz or a test so hearing other people talk about it doesn't mix things up in my head
Not trying to diagnose you but have you ever been evaluated for ADHD? I have it and feel very much the same way with being able to remember facts for a short time really well and then purging them.
I agree with the comment. ADHD person here. The struggle is real.
As my surgeon during the surgery rotation told me. "Most thr things you learn in med school are doomed to be forgotten, what is important is the method of logic and thinking, treat the patient and not his/her symptoms; and remember above anything else, try to learn something new everyday, even if is not med related" Medicine is just practice practice and practice and experience. Also it is normal feeling overwhelmed, you are going to treat people, having their life on your hands, aint an easy job. This mean that you CARE and that you are LEARNING. Keep it up...im proud of you especially to give yourself the opportunity to be humble and humbled.
This actually has me laughing because I feel similar about boards in June. like I know that info is in there somewhere but uhhh no idea where😂😂😂😂😂 I cant wait to get to this feeling in 6 months
It’s so comforting to read how many people have had this exact monologue. Current M4 anxiously waiting on the Match and I’ve been questioning if I made the biggest mistake of my life every day lol. We got this!
Great book called “Playing Doctor: Stumbling Through Medical School with Amnesia”. Your writing style even reminds me of his. Hang in there!!!
We are so cooked
Medical education and practice needs to change. It hasn't kept up with the times. Sad.
I'm the opposite. Every attending I work with tells me I'm the best medical student they've ever had and writes spectacular comments, but I perform average to below average on my shelves
I wanna be like this, mashallah. iA youll be a great doctor for your future patients
iA we both will ukhti :-)
In the same boat.
I would refer you to this resource: [https://imgur.com/a/npjRzip](https://imgur.com/a/npjRzip)
In residency you will get so many reps. So many. Again and again. And then again. Stuff starts to stick after that.
Have you ever been assessed for ADHD? Do you get enough sleep?
Are you inside my head or something? I’m about to start 4th year and I’m literally shitting myself cuz I have to do sub I and know things…. What are we going to do?
I’m this without the good test scores
Ive had to look up what BUN is like 10x this month. Still don’t even really know. Don’t even ask me about protein dipstick (???)
Are you me 😭??? Please, please, PLEASE let me know if you find a solution to this hellish problem. It's driving me insane
We all lack medical knowledge, that’s why we’re in medical school 👍🏼 As far as being awkward, might be worth seeing if you have social anxiety, which would also make it hard to process and learn during rotations. If it’s not social anxiety, just pick someone you know who people like (probably a man if you’re a man or a woman if you’re a woman etc) and try to imitate their behavior in social situations. Stand up straight and smile - if you seem comfortable, the other person will feel more comfortable too. You can also practice making conversation with people who can’t escape lol. As a former barista, I think that’s a part of the service we provide. If there’s not a line, ask them what their favorite drink is or say you want to try something new and ask for recommendations (don’t forget to tip and compliment their drink making, that’ll get the convo flowing). Just try to make a little small talk with everyone who is being paid to stand there, grocery store, post office, front desk. The auxiliary medical staff are also great people to talk to, peep if they have pics of pets or kids on their desk, a new smart watch or water bottle. Introduce yourself and say you’re a med student. figure out stuff they like and try to talk about it in a positive or inquisitive way. Also consider making your hobbies or interests known (sports team keychain, Pokémon decals, national park background on computer, coffee mug from your home state etc) so that people can start random conversations with you
*quickly googling amaurosis fugax* Neurology is my next rotation lmao
You remembered all these medical words to type them. The general public doesn't know what those are. It's imposter syndrome. Everyone gets a little of it. It will all come together. Especially if you pick a specialty you are interested in. No one remembers most of what they learned in med school.
If it makes you feel any better, from what I've gathered, passing exams and doing well on them feels like it's the most valuable thing in this field (unfortunately? or fortunately?). As long as you do that, match into residency, and keep on keeping on, you'll be a good doctor. I'm on the other side of the coin. I do god awful on exams despite actually knowing a decent amount. I can answer a decent amount of pimp questions and recall things on the spot, but it translates to minimally passing and getting ugly test scores, so FeelsBadMan.
When my patients come to see Dr Extremist, behind the scenes they are actually seeing Dr. Uptodate.
Would rather be a provider unsure of myself than one who thinks they know it all.
do you think you might have anxiety or depression? am getting that vibe and it might explain your memory problems.
Do you have ADHD lol
yes
Haha, htf you pass your exams what the secret. Clearly, you have a good memory for something.
Easy fix - get a small journal and write down whatever you get pimped on and what the answer is. Also prep for whatever rotation you have coming up.
We might be the same person but at least you are good at shelves
You're right. There's no way you'll be a good doctor. Because you're gonna be a GREAT doctor.
Bro The Feeling of Impostor Syndrome never Goes away. Medicine is a Marathon not a 100m Sprint. You Learn You Unlearn You Forget you Learn again and Repeat this Process countless no of Times. With Time things Fall into place. Even Consultants Feel this way you are not Alone
I’m in my final year and yeah…same lol.
My friend, extreme chaos happens right before eternal clarity. Your brain was a brand new apartment and all the information is the furniture- it is being assembled and moved to the final spot. You’re doing everything you should be doing- even going overboard to notice the little things like ST “elevations”. >“STOP writing ST segment elevations on your notes — people are reading this.” You’re one day away, and one small nugget of information away from the day you’ll be scanning EKGs visually and not calling it an ST elevation unless it’s at least 2 boxes high. >There’s no way I’ll be a good doctor. Good. Because the day you think you are a good doctor, you stop being one. Good doctors want to and hope to be good doctors. Imho you sound burnt out and a wellness day to catch up on sleep will work wonders. Your subjective perception of the situation is a lot less optimistic than reality, and I worry that you’d end up with clinical depression without healthier coping strategies. You’re stronger than pimp question- the hierarchy sometimes puts power hungry people above you unfortunately, and you can’t let them win. By failing to be good teachers, they’re still teaching you who you don’t want to turn into. You’re neither the first nor the last person here who wondered if they had presenile dementia. Multiple studies have shown a significant (but temporary) drop in IQ test scores when subjects were experiencing psychological stress. Further, feeling down is a full time time for the brain and learning and memory suffer, aka “pseudodementia”. And you deserve to be the happiest and best version of you, and if you need help it’s okay because you owe yourself wellness. When was the last time you visited your favorite place around town, had a leisurely bath, or meditated on feel good thoughts? You’d find it understandable if somebody breaks up because there’s no spark left in a relationship, but your mind can’t “break up” with you and is screaming for mercy against being overworked. I know you’re going to survive and thrive, you just need to step back for a moment and see how far you’ve come. Your post achieves ROSC at the end when you say >And now, I’m too deep into this. SO DO NOT TELL ME TO QUIT NOW. To put it more poetically, "I didn't come this far, just to come this far" You got this. You’ll soon know it wasn’t a memorization contest after all, “Education is what remains when we have forgotten all that we have been taught”- the things you need to do to keep your patients alive- you’ll be doing it on autopilot a few years from now. You’ll probably misspell amaurosis fugax but with practice, it will be a reflex action to order a scan stat.
And just FYI, the person who said >“STOP writing ST segment elevations on your notes — people are reading this.” could’ve done a better job in the same amount of time. AHA/ACCF/HRS Recommendations for the Standardization and Interpretation of the Electrocardiogram 1. For men 40 years of age and older, the threshold value for abnormal J-point elevation should be 0.2 mV (2 mm) in leads V2 and V3 and 0.1 mV (1 mm) in all other leads. 2. For men less than 40 years of age, the threshold values for abnormal J-point elevation in leads V2 and V3 should be 0.25 mV (2.5 mm). 3. For women, the threshold value for abnormal J-point elevation should be 0.15 mV (1.5 mm) in leads V2 and V3 and greater than 0.1 mV (1 mm) in all other leads. 4. For men and women, the threshold for abnormal J-point elevation in V3R and V4R should be 0.05 mV (0.5 mm), except for males less than 30 years of age, for whom 0.1 mV (1 mm) is more appropriate. 5. For men and women, the threshold value for abnormal J- point elevation in V7 through V9 should be 0.05 mV (0.5 mm). 6. For men and women of all ages, the threshold value for abnormal J-point depression should be −0.05 mV (−0.5 mm) in leads V2 and V3 and −0.1 mV (−1 mm) in all other leads.
I have a theory. What if the problem isn’t you, your knowledge, or your abilities? What if the problem here is doubt? The all-too-common belief among attendings of ‘but pimping is how I teach!!’ and/or a general philosophy of shame-based learning does a great job of one thing: destroying our clinical confidence. Destroyed clinical confidence results in questioning yourself, your every move, your every thought, and puts us in a perpetual state of panic. Panic diverts cerebral blood flow away from our higher cortical centres (ie, cognition) and reverts us back to a ‘lizard brain,’ survival-first kind of thinking only. This is why we ‘can’t think straight’ when we panic. Our focus narrows. We don’t notice the details; we can’t. And, if you can’t think properly in panic, you sure as hell can’t learn well like that. So, what happens? A vicious cycle of doubt —> panic —> impaired problem solving, impaired ability to recognize patterns and notice details —> impaired performance —> doubt is externally reinforced (ex via shame-based learning) —> escalation in panic, with the end result being continuous erosion of clinical confidence, a reputation as a ‘bad’ student or resident (which you internalize), and becoming a self-fulfilling prophecy of downward-spiral failure. Without clinical confidence, it doesn’t matter how much you know. It doesn’t matter how deep your knowledge is if you don’t trust yourself or constantly second guess yourself. How do you get out of it? I was lucky to have the feedback that my knowledge was actually above my level x 1-2+ PGY years, but confidence was far behind expected for my level, -2 training years, which made me overall function -2. That feedback helped me understand what I wrote above, and make some strategies . To attendings, *clinical* confidence means faith in your own medical knowledge and decision making abilities. If you tell them your goal is to build your clinical confidence, they might help you do that. ‘Professional development’ reframes your success as a medical learner from being someone else’s problem and grounds it in practical reality. In my experience, it increases the engagement and sense of responsibility that attendings have over my learning and learner experience. Wish I could write more. Gotta go to work. You can do this. I believe in you.
Time to go into pathology!
Repetition, practice, experience. You'll be amazed how much you learn and how your clinical abilities improve with time. This line of thinking is normal. Stay the course. If the anxiety is really impairing your day-to-day, I recommend seeing if you can talk to a therapist (a lot of med students can do free or very low-cost sessions through their campus health, especially if associated with counseling students).
Nice to know that I’m not the only one. There are times where I actually feel like a dumbass bc everyone in my group knows the answers to all the questions.
This is so hilarious 😂😂😂😭
Hey man I’m sorry your feeling like this. I wanted to offer some advice even though I’m not a doctor nor have I applied to medical school (yet). During my undergrad I was in a similar position, would ace my test but once I got into the clinic it was like I was brand new hadn’t ever heard of basic medications or procedures. I forgot everything including the last question they asked me. Take a deep breath. Seriously. I’ve found that my lack of performance had nothing to do with not knowing the material but the expectation of me and how I’d be judged for my answer. I started to hate clinic and everything I was doing. I had a break before I changed clinical sites. Finally a fresh start. What I found was to treat everyday like a fresh start. They may have hated me yesterday but today I’ll be better. Understand that you are learning (unfortunately like me the hard way.) Try to control your emotions and whatever your feelings you have. YOU ARE NOT YOUR THOUGHTS. how you perceive yourself is not how others perceive you. What I found is I was much harder on myself then other people. The constant beating myself up was a huge detriment to my performance. Be kind to yourself. Try to remember that you don’t think the other students are 🤡s when they make mistakes or mess up. Why would they think that about you.
I'm an M1 with a shelf exam tomorrow, and I stg I almost cried because I forgot what vimentin was indicative of for immunihistochemical marking. We just learned it in like September but it's gone. I def feel like I'm gonna be a crappy doctor
I’ve been at attending a few years and I had a brain fart (luckily not with a patient) and forgot the word for a vasectomy today. I was looking straight at a ptygerium in a patients eye a couple of weeks ago and couldn’t remember the word even though I could describe exactly what it was (it wasn’t until I was putting it in my note 5 minutes later that I remembered). You’ll be fine.
For real though, I think you might have ADHD. I would look into that, medication would be a game changer for you.
I do have ADHD. And I am on Adderall.
Sounds like a bad case of imposter syndrome, its common mate. I promise you youre not dumb, youve passed the exams which means you can at least recall and understand the information short term. How do you study? Is it a study method conducive to long term learning or do you cram? Do you keep up reviewing even after youve been evaluated on a certain topic? Keeping up with spaced repetition after the actual test is extremely important to actually know the stuff for life. Also, you dont "need" to be able to answer everything. Most of the stuff you learn in school wont actually be used on a daily basis. Yes obviously its important to keep up in class, but from what ive heard youll figure out whats needed to remember long term based on what youll see most in whatever speciality you choose. Also have you considered that stress and social anxiety could be causing you to do poorly when people ask you simple questions? I kinda get this too when im put on the spot or if im too stressed out. My mind goes absolutely blank and i feel so freaking stupid because i cant recall or explain simple things.
I came here today because I needed to stress post about my own clinical today (I’m on neuro) where I was asked to name calcium channel blockers. I COULDNT. NAME. ONE. Follow up redemption question I could name the different type but couldn’t tell you what was different about them. Literally so dumb and thank GOD for the locum PA who saved me from myself. Solidly feel like the biggest idiot ever so don’t worry you’re not alone. Dreading tomorrow and honestly don’t know how I’ll ever get all this down.
Bro I’m a fourth year and feel the same. Idk when it gets better bc I have no idea how I’m gonna actually be a doctor
Literally me
This is me everyday as I graduate this year. I write an exam and poof, everything is gone. The imposter syndrome hits hard. But these replies are comforting.
Don't worry OP, you've got the neuroses of 5 good doctors
“I look like 🤡 not 👨⚕️ “ I’m dying looool. Don’t worry. Once you get to your specialty it all meshes together.
Yo hang in there lol you got this. Remember the last rank graduate from Med school is still doctor and you’ll figure it out
this post has me cracking up. what if i become like this in med school omg
fuck man this is exactly how im feeling right now.
It’s working!
Youve 1:1 expressed how I constantly feel esp with being pimped and regressing to a shell of a person in the hospital
I feel like this post is half in jest, however a lot of us have felt somewhat similar. You don’t really know how to be a doctor until residency to be honest.
honestly tysm for writing this. just know reading this helped this anxiety adhd ridden ms3 feel not so alone in feeling like a complete idiot. i also dont know what propofol or any abx is
Its normal. Too much info. Gonna tell you a secret: that's why people become specialists. There are many videos where the most basic questions are asked to renamed doctors into an area - and they don't know the answer. Why? Because a cardiologist doesn't remember the basics of ortho; a psychiatrist would never remember things about vaccines, and so on. You got the idea. What I do recommend to you is to focus on hands-on practice in order to get more experience. Experience is key to learning. You need to known how to diagnose, what to prescribe and that's it. There are some specialties where you just diagnose and refer patients to other doctors. There's no shame to revise content even during a consult. I would actually get worried if you're able to remember all that unuseful stuff. Btw another nice trend are doctors who can't say if a certain name was a muscle or a dinosaur. Its so funny.
Cool post and relatable. Im pretty sure i will have dementia by the age of 40. Too much phone and pc made me not focus on any information i see in front of me.
Damn they just like me frfr
Man lemme tell you about my rounds today; ER, 12 patients, managed to get myself stuck in basic gasometric interpretation in 2 of them, i dont know shit either bruv dw about it, my residents didnt either
Bro thanks for making this post. It really helps me feel less alone. I’m in dedicated for Step 1 rn and see a lot of posts, hear from classmates, or even attend sessions where people talk about being “bad” and only scoring average. Then I’m here barely staying afloat, not remembering basics as I do content review, and think if they are “bad” then what am I 💀
I'm an M1 and actively forgeting everything from previous blocks. Was getting genuinely concerned, but I'm realizing it's normal.
This post describes me so well
I say this in earnest, consult a psychologist; Nobody can think straight when they're overridden with emotions. Language is lateralized and you can't access it when the opposite hemisphere is overstimulated, memory retrieval too, is surprisingly state-dependent. How will you recollect what you studied when in your mind, you are not perceiving clearly your surroundings? You are too busy accepting the harsh voices of self-criticism, you are not listening to them, you are too deep in your own mind to care for anything else. Who has given you these voices of self-criticism, in whose voice do you hear their whispers? I've been in that mental space too, it sucks to be the last. But, I've gotten through it and I switched my life around. There can be a happy ending here too! Focus on getting out of the fight-flight first, your mental health matters. It matters more than the degree, you will be a useless doctor if you actually overlook your own self-needs and now you need some time to fix your relationship to your own self. Doctors don't just pass medicine, we pass a general notion of well-being to our patients too, how else will they trust us? How will they trust someone who feels like this towards themselves, is this what you would teach your patients? Don't just do it for you, sit down and think about failure, honestly and earnestly, there's always a way to find your footing even if all else fails. Don't belittle yourself just because you are emotional, everyone else just represses their emotional needs in order to exceed, apparently that's no longer a valid route for you. Deal with the self! I don't think you're stupid, but it seems to me that you've made 'being stupid' your greatest fear so much that it immobilizes you and you are manifesting it outwardly. Why is being stupid bad? We've all been stupid! Anyone who says otherwise, they are lying through their teeth, stupidity is paving the way to progress, in fact. Why is it so bad that you don't know a question? Why is it so bad to be alone? What does it mean to be a clown? Why hate it? You're not a robot which remembers everything, you will naturally invest in what most appeals to you. Take care of yourself and i'm sure you'll be a good doctor some day, if you don't believe it, then who will? Learn as much as possible from hitting 'rock bottom', it's a lifetime opportunity and you can use your suffering to bond with people - as everyone is suffering. Not many people get to explore the emotional spectrum like that, it's absolutely worth it, makes life worth living if you get out of it. You're learning how to be 'human'.
How has your sleep been? Maybe you do have something underlying going on that may warrant a workup for potential memory issues
The fact you're worried is actually good 💀. I'd be more concerned with the people not having this level of self-awareness or self-censure 😂. You understand the impact you'll have one day. I swear doubt is something purposely instilled in school as a protective measure, just so you start questioning more and proceeding more cautiously. It's actually a good mindset to have in this profession. It just sucks when it goes off the deep end, and now you're knee-deep in an existential crisis of self-doubt. If anything, now you'll overcompensate by studying with the crippling wave of guilt, so a win is a win 💀
I believe in you, hang in there!
TL;DR, but good news- you'll be in good company haha
I think you just wrote alot of medical students daily intrusive thoughts 😭
r/usernamechecksout
we found the class clown of med school
I feel literally the same word for word, everything from the dementia to the something important is messed up in my head 😭
First, take a long, deep breath. It sounds like you have the brains and capability, but you are simply tripping over yourself. You definitely have an underlying anxiety problem. That alone can make you "forget" everything and make you lose confidence in yourself. Highly recommend therapy, medication, meditation, or working out to feel more confident in yourself and your abilities. Fake it til you make it my friend (that's what everyone around you is doing). Also, you don't have to know everything. No one does or can. Once you graduate (which you will), just focus on your specialty and forget everything else! Even if you want to go into FM, peds, or internal medicine, being in residency is vastly different from medical school because you live and breathe your field everyday for years. And you will learn more because you will have a higher sense of responsibility towards your patients to do so. You're stressed and burnt out. But you can and will get through this. Sincerely, someone in their first year of residency who has had this same exact internal monologue every day during third year.
The best way to learn is to write all that stuff down on the spot and review it when you get home. Don't worry if it makes you look like a nerd to be frantically scribbling notes during rounds. I promise no one cares. Besides, if you need a cheat code for getting people to like you, showing them you are listening is it. Honestly, this is the best tip I can give anyone for getting along with others, honoring rotations, making friends, whatever the situation is. If someone looks you in the eye and takes the time to tell you something personally, remember it no matter what. You can literally forget everything else and be fine, but if you forget something someone took extra time to teach you, good luck honoring a rotation or getting a good eval. If you don't remember whatever it is, it makes you look like you dgaf about that person or what they have to say, and people take that crap personally
Any M3 who feels clinically competent is a disaster waiting to happen.
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Qs > Anki. At least my experience. I fall asleep after 200 cards and usually never get it specifically correct.
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Nah. Anki isn't a panacea. Not everyone learns off seeing 1,000s of disembodied cards everyday.
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I did 1000 cards daily for 9 months. Hated it. Switched it to just questions I missed. Still hated it. Wasn't as helpful as just doing questions in that same time. Did better on exams anyways. Do what floats your boat. My ADHD doesn't work with flash cards, simple as.
Is it too late to do it now???
It's never too late
There are specific m3 decks and there's a mnemosyne deck that is a fraction of the size of anking for just First Aid things. The cards are straightforward, i like them
should’ve used anki 🤷♂️
🤷🤷🤷🤷🤷🤷🤷🤷🤷🤷
ah, I see you're a man of culture as well.
🥂
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