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confusedmedstudent

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  1. Bump - sorry I have another question. If a preceptor said they could write me a good but not great letter at this time because I'm so early in clerkship, but then said that they think I'm going to be really strong later in clerkship after my core rotation, are they just being nice or do they really think that? Also they asked me to come back and do another elective after my core but I can't due to my schedule, and then they asked me to come work with them in clinic if I have days off here and there. Should I take them up on this? Is it ever possible to get a letter from someone who initially said no?
  2. Thanks for the reply! I'm also doing electives in family med but those are even harder to get and I unfortunately didn't get any at the schools out west. Does it make sense to reach out to residents anyway if I have questions about the program? Or let's say I get a post-Carms elective there (before or after interviews, Jan/Feb) - is that enough to show interest?
  3. Hahaha no dont be sorry I know that's not what you meant! Just very relatable LOL You're right, anxiety is probably part.of the problem. I have been trying to do that recently but my plan is usually wrong because my knowledge is so weak I just need to get better at learning somehow
  4. @rogerroger Thank you so much for this. I really appreciate it. I understand what you mean about the importance of accuracy in reference letters and the social capital involved for the referees. If someone has agreed to write me a letter, is it safe to assume it'll be a good one? I'm nervous because some preceptors have agreed but I honestly think I am really weak in my knowledge and they were just being nice and didn't want to say no. Also, out of the list you mentioned, I seem to be doing fine for #1-3. All of my preceptors so far have given me positive feedback around these areas. In terms of #4, I came to my specialty of choice a bit late (around November?) and am also interested in family medicine, but no one has asked me about this and I'm not sure what they think about how committed I am. #5 is where I'm very very weak. Sometimes I feel like preceptors are just giving me other good feedback about my personality, professionalism, likability, teachability, "easy/a pleasure to work with", etc. because they have nothing good to say about my clinical knowledge. Just the other day, my preceptor asked me such a BASIC question that I've read about several times and know the answer to, and I couldn't recall it at all. As soon as she said the answer, it came back to me and I was so frustrated because I knew I had read it. This happens a lot. Also, I just feel weak about where I'm at and think I'm very unimpressive. I bought into the whole "clerkship is for you to learn" nonsense - it's an audition. And I've just started to realize that now, and I am worried it's too late for me. :/ I got my written evaluation from the elective in question (where I asked my preceptor for a letter and she said no). On the eval she had really nice things to say about the 1st 3 areas you mentioned. She also said I should keep reading about common conditions, and keep working on developing a DDx and management plans. So, in short, she is saying my knowledge is weak and that's what I've suspected all along, and that's why I didn't get a letter... so does that I am extremely weak, if medical knowledge is the least important but she still didn't want to write a letter for me? No other preceptor has said this to me but I feel like they all know it and are just being nice, but I'm secretly an awful clerk. I am not sure how to improve because I do read around my cases and try to study whenever I can, but I just can't seem to recall anything when it counts. And also I think part of it is that I didn't know until after this elective that you have to tell your preceptor your DDx and plan even if they're busy and they don't ask - so sometimes she didn't ask and I never said anything. I knew some things but never showed that I knew them because I didn't want to be annoying. Have I screwed up too much to redeem myself?
  5. Also if you meet with a program director what are you even supposed to say/is this important to do? Is it ok to ask what they look for in candidates when ranking?
  6. @bearded frog thank you again for your help! I appreciate it. I really wish I knew what was clinically important in preclerkship so I could have spent time studying more high yield things and could be more knowledgeable now is it really bad if you're not super knowledgeable? Like even if I am very eager to learn and work hard and am nice, will my lack of knowledge on the early pre-core electives be a huge issue in terms of being a good candidate? And is it very important that preceptors write in your letter that you were in the top X%?
  7. Hi! I want to apply broadly to programs across Canada in my specialty of choice (semi competitive), but unfortunately because of scheduling and availability issues I wasn't able to get electives at all of the schools I'm interested in. I am from Ontario, did 1 OOP elective (east coast) and unfortunately couldn't get any in AB or BC. I am really worried because there are 3 big schools in those provinces and I don't think I can visit them at all, but I'm interested in them. I've heard UBC only wants people who have done electives there, and same for Calgary. Is this true? Is there another way that I can show I'm interested in these programs? I think based on my experiences at certain Ontario schools so far (western lol) that I would rather go OOP than those Ontario schools, even though I'd be far away from my family.
  8. @rogerroger thank you so much for your input, that is really helpful and reassuring. But I'm concerned that I'm really not performing above my level - preceptors say that I am "right where I should be" in terms of my skills but they have very positive things to say about my work ethic, willingness to learn, professionalism, being nice to work with etc. Are they just saying that so they can give me SOME good feedback? Since I am really not that good of a clerk in terms of my knowledge and skills? And if I'm not in the top 10% or whatever and my preceptors cant comment on that, is that really terrible in terms of my application? I hope not because not everyone can be top 10%... ? And what even constitutes top 10% - I'm not sure how to get there. Also, some preceptors have agreed to write me a letter (from early electives - my first 4 weeks of clerkship) but now I'm worried that they won't be very strong because of how early I was and also because one preceptor I barely did anything with (the resident gave her feedback and she agreed to write based on that). Should I even bother following up with them to write these letters or will they be weak? My last elective yielded no letter and my current one probably won't either just because of how it's set up (and because I suck haha it's a subspecialty and I know only the basics). So I think most of my letters will come from cores. Is that still ok? Sorry for all the questions. I appreciate all of your help!
  9. Also is it bad if most of my letters are from my home school? I have most of my electives before my cores and I feel that I'll be stronger on core and probably get better letters. But will this look bad when I apply to other schools? Especially since my cores are at a satellite site and not an academic center?
  10. thank you for this, that is really reassuring! i'm just really worried that i'm behind because this is the feedback my preceptor gave me (that my histories/physicals aren't focused yet, and that i should present a ddx and say what i think the problem is + initial management), and i was thinking maybe she isn't comfortable writing a letter for me because i am behind for my level. also in general, to get a strong letter do you need to be operating above your level? i'm really not sure how i would do that :/
  11. Thank you so much for this, it's really helpful! I definitely need to be more intentional about making sure my preceptors know my thought process. Also I've gotten feedback from other preceptors that I need to take more focused histories and physicals which worries me because I am pretty sure my classmates already do this, they're all getting feedback saying that they function at R1 level (so I am probably already behind) and I'm always so scared of missing something that I do too much. Is it really bad if most of my letters are from cores rather than electives? (Especially for some programs that ask for 5 letters) because I do have some preceptors from early electives who agreed to write letters but I'm a very weak clerk at this point and I worry that they won't be able to say much about me except that I was nice to work with. I haven't had my core rotations yet and my electives will be done in like 2 months... I think I'll get stronger letters on cores but am worried it'll be bad not to have any from electives
  12. hi sorry i'm creeping this thread - do you know which peds programs ask for them?
  13. this brings me such peace thank you so much lol and congrats, i am so glad you got your top choice!!!
  14. Thanks for the replies everyone. I'm very relieved to know that this isn't such a big deal!! Is that also true for semi-competitive programs? Also, I am trying to decipher my preceptor's feedback. She said I'm doing great for my level but she knows I'm going to get even better. Basically is she saying that I need to read more and have a better knowledge base in order to be competitive? I'm worried because I don't have a great memory and sometimes I'll read about a topic and when I'm asked about it the next day I remember very little of what I learned, even though I understood it the day before when I learned it. :/ I really only remember things long-term if I've seen them in a clinical context, which is unfortunate because I haven't done my cores yet so I don't know a lot of things. Everyone told me that it doesn't matter how much you know as long as you are a good person to work with and willing to learn... but I think I'm just not impressive with my knowledge, right? That's the problem? Also she said that the next step for me to improve is that I should always come up with a differential and defend it and say what I think the problem is, but that feels highly highly inappropriate in our setting because the patient is there when the team rounds and I feel like it's so wrong to just be like "um this could be malignancy" in front of a patient. and I guess I could have spoken with the resident/attending about my DDx before rounds, but they are super busy all day and it also feels inappropriate to annoy them just to be like "hi this patient i saw, i think they have ____" Is this just the way it is? How do you navigate this?
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