Depressed 3rd Year

[mentallyspentmedstudent]

I'm basically on this forum looking for validation because tbh I haven't been able to get any on my clinical rotations. I am depressed. I am anxious. I wait for one rotation to be over so I can move on to the next. That being said I've made it this far so I do what is expected of me. At times, I actually really enjoy what I do. The reason I'm verbal vomiting today is I'm fresh off the heels of a feedback session with a CTU staff I worked with for the past two weeks. He told me I'm "standoffish" and "detatched" at times. I've been told I'm shy and to speak up more often but these adjectives are new. I'm finding it hard to accept the feedback given the fact that I show up and try my best (which is probably not the best given my mental shitstorm). The only reason I can think of why I'm being perceived this way is because I'm so effing scared of sucking all the time that I'd rather not look like I'm too invested or some bullshit...or maybe I just suck. 

To add to it all, I'm constantly comparing myself to the other med student on my team who's interested in IM as a career. They get rave reviews and even got a LOR from the same staff who disliked my demeanour. Anyways, all in all, add to my misery or add to the sob story. Or don't. Big heavy sigh....

[Lactic Folly]

I'm sorry to hear. That is not constructive feedback, and likely reflects the staff person's filter. It's tough when clinical evaluations are so subjective yet seem to carry so much weight. As in other aspects of life, not everyone you meet is going to "click". Just take the actionable feedback that you can (concrete actions like speaking more often), and discard the value judgments.

Many of my colleagues (all fine clinicians and people) have a horror story (or stories) of preceptors who seemed to dislike them from the start. Just like jr high/high school, it does get better once you find the environment where you can thrive.

[Sardaukar]

As someone who is in 4th year and Clerkship still going and almost over, I can relate to some of the things you've mentioned. Firstly, there were also times were I felt i was just waiting for one rotation to end and the next to begin. An endless torrent of evaluations, judgement, trying to impress and being "on" all the time. Add in CTU which is essentially all of that but now you feel you are competing against other medical students and being DIRECTLY judged against another and the stress and anxiety about how you do becomes all consuming.

What I learnt is that we are our biggest critics, we see our faults more clearly and we fixate on them all too easily. At least for me, the biggest stressor on my well being wasn't my staff, other medical students, or the workload - it was me, I was fixating, ruminating and focused too much on the feedback. 

I'm not saying that this is you by any stretch, but Its hard to get feedback like this and during clerkship you will receive feedback that is not so great and honestly, not constructive. Find the teaching point (if any) and move on, you've made it this far, you are competent, you are working hard. As for the shy bit, I've had friends receive that feedback - its not because they suck, but its because the preceptor wants to know more about you and your knowledge. We all fear sucking but remember - you are a LEARNER, we are LEARNERS and even when we graduate as residents we are learners and as staff physicians we are life long learners - this is your moment to ask question and inquire. If you get feedback that "you should know this" - fine, go read up on that topic and the next day thank your preceptor and tell them you learnt a lot about that topic. Most preceptors will respond to your questions and like that you take an interest in their specialty. 

The expectations of you in 3rd year are not as high as you perceive - perceived interest, attitude, and just being chill and fun to work with matter most. Keep your head up, you are doing great, give it your best and somedays it wont be your best and thats fine because again, we are learners. 

I guarantee how you feel about comparing to your peers/stressors/staff feedback are felt by many medical students and you are not alone.  

With that said, if you are feeling signs of clinical depression, seek counselling through your school and friends as they can help you through this and give you an opportunity to speak out loud with someone else.

Don't hesitate to PM me if you have any questions.

[ellorie]

As a PGY5 I have to say that clerkship was probably one of the crappiest parts of my medical training.  You’re moving all the time, you don’t really belong, you’re on the bottom of the ladder and shit rolls downhill, you basically have to always be trying to not just be competent but actually impress people who have power over you and are sometimes frankly malignant, all the while studying for exams and getting very little sleep. 

I have to say it does get better. Even as I’m up to my eyeballs in the Royal College I have to say I honestly hate it less than clerkship. 
 

I think it’s really important to have support. I hope you’re talking to people you can trust about how you feel and that you’ll consider reaching out for professional help if you need it. If you are in fact becoming clinically depressed, rather than having a very normal low period, as much as the temptation is to deny it and hope it goes away, you want to get it before it gets you into actual trouble. 

[bearded frog]

If you're depressed an anxious see a health care provider ASAP. (One not affiliated with your school if you're the tin foil hat type). You're doing yourself a disservice by not being at your full potential on a relatively critical time of your career by not working on addressing your mental  health. Take a leave if need be.

[mentallyspentmedstudent]

37 minutes ago, bearded frog said:

If you're depressed an anxious see a health care provider ASAP. (One not affiliated with your school if you're the tin foil hat type). You're doing yourself a disservice by not being at your full potential on a relatively critical time of your career by not working on addressing your mental  health. Take a leave if need be.

I have already taken a 1 year leave. This is how I'm feeling afterwards lol 

 

[mentallyspentmedstudent]

21 hours ago, Lactic Folly said:

I'm sorry to hear. That is not constructive feedback, and likely reflects the staff person's filter. It's tough when clinical evaluations are so subjective yet seem to carry so much weight. As in other aspects of life, not everyone you meet is going to "click". Just take the actionable feedback that you can (concrete actions like speaking more often), and discard the value judgments.

Many of my colleagues (all fine clinicians and people) have a horror story (or stories) of preceptors who seemed to dislike them from the start. Just like jr high/high school, it does get better once you find the environment where you can thrive.

Thanks. I guess I'm whining a bit but I did think I improved over the course of my time working with him. It just takes me a while to open up to new people and feel comfortable with what I'm doing. In fact, compared to my previous social anxiety in performance situations, I thought my calm and level voice was a leap forward. I'm just finding it hard not to get dejected and feel like my fate is written in stone. 

 

[mentallyspentmedstudent]

11 hours ago, ellorie said:

As a PGY5 I have to say that clerkship was probably one of the crappiest parts of my medical training.  You’re moving all the time, you don’t really belong, you’re on the bottom of the ladder and shit rolls downhill, you basically have to always be trying to not just be competent but actually impress people who have power over you and are sometimes frankly malignant, all the while studying for exams and getting very little sleep. 

I have to say it does get better. Even as I’m up to my eyeballs in the Royal College I have to say I honestly hate it less than clerkship. 
 

I think it’s really important to have support. I hope you’re talking to people you can trust about how you feel and that you’ll consider reaching out for professional help if you need it. If you are in fact becoming clinically depressed, rather than having a very normal low period, as much as the temptation is to deny it and hope it goes away, you want to get it before it gets you into actual trouble. 

Yeah third year sucks. I try talking to my family about these concerns but they have a poor understanding of both mental illness and medical training. I don't have too many friends because I took a year off from school and am now with a new cohort of students. That being said, I am quite social and open around my peers about these concerns but have learned to keep certain insecurities/rants to myself given how most other students conduct themselves. It genuinely seems like I'm the only riddled with so much insecurity at times. I think the absence of positive reinforcement in my life recently is keeping me in the dumps. Like I'm trying my hardest but it seems to be the bare minimum expected of people in my rank which obviously does not warrant accolades. 

I also found it funny how the attending was surprised when I told him I actually learned a lot about medicine on CTU. Simply because I have a gazillion nasty self-depracating thoughts racing through my head all the time doesn't mean I'm not making an effort to read up on things and fill in my knowledge gaps. 

Okay, I'm self imposing a time out now. I'm tired and rambling. Thank you for your input, ellorie. 

[Intrepid86]

As far as negative interactions with Attendings goes, being called standoffish and detached is actually pretty tame, compared to what it could have been.

[Leon]

Clerkship was by far the most stressful time for me as I suspect it is for most of us. When comparing myself to others I think those with a lower self esteem are more prone to suffer from performance related anxiety and I was definitely one of those people. I also found my personality was such that I did extremely well on certain rotations and average on others. I almost failed one and the feedback I got was that I'm so passive I'm effectively part of the wall during a clinical encounter. That was nice to hear hah. This was so crushing the feedback session is vividly burned into my memory. 

I was really disheartened at the time but now, in pgy3, looking back I've come to realize that not all feedback is divine judgement on your actual abilities. Different staff have very different lenses both between and within specialties and you have to learn to be humble enough to accept constructive feedback that helps you learn while also being aware that perhaps not all feedback is necessarily accurate and not be too disheartened by some negative comments. This is difficult to do as there exists the inherent tendency to be somewhat narcissistic and just reject perceived negative feedback so it's a fine line. Hope this is helpful. 

 

[sangria]

I'm sorry that it's been hard. There is good kind of feedback, and then there is the bad kind. You will see plenty of both. Let yourself feel those emotions - for me, they were feeling exposed, embarrassed, defeated etc , but then regroup and decide if there is an ounce of truth to what they said and take it as an opportunity to learn. That's the whole point - you want to get better. Nobody can take that away from you. You have the power to decide how to react.

Also remember that feeling so you know what not to do when you are giving feedback one day. Be constructive and specific. Perceived character flaws are neither. 

[gumballs]

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