As a 3rd year medical student, life and work can be demoralizing. You are a perfectionist by nature; you dare not succumb to failure. To you, failure could mean the inability to stick a vein, not being able to spit out the criteria and numbers for different stages of sepsis, or simply being … average.
It’s hard to admit, that I’m simply mediocre now. I’m no longer the magna cum laude student, rockstar laboratory extraordinaire, artistic organic chemist on paper, or master calculus calculator. I can excel on the hospital floors, writing the perfectly organized (and legible) SOAP progress notes and spending quality time talking to the patients, taking their histories, and doing a very thorough physical exam. I can attain the perfect clinical grades and positive evaluations, on Surgery, Ob/Gyn, Pediatrics, Psychiatry, and Medicine. And you know what pops my blissful bubble and leave me deflated like a breathless balloon? That’s right, the dreaded shelf exam. At Stony Brook, your final course grade practically depends on the final shelf exam. Each rotation is very variable. In Ob/Gyn, the shelf exam is worth 10%, versus in Surgery, it’s a whopping 30% and the main determinant. Heck worse, in Pediatrics, which I totally should have attained an Honors, the shelf exam is not even factored in; it’s a mere qualifier! That means, no matter what your final tally is, if you don’t reach a certain percentile, say 50th percentile, you absolutely cannot get a High Pass! And these shelf exams are long, stupid, and arbitrary, where you are compared to the whole nation of medical students taking the exam. Many times, I learned more about patient presentations and management on the floors, and not from these stupid shelf exams. If you are a good subject test taker, the odds of doing well are in your favor.
For me, I suck at taking tests. I’m at a clear disadvantage already. With each rotation, I go in with enthusiasm and determination; I come out slumped and slugged. I cannot say I’m satisfied with my mediocre passes, because I know I could’ve achieved high passes and honors.
I did make one simply, yet playful promise to myself: the first clerkship you get Honors is the field of your destiny.
Guess what? It finally happened today! Interestingly, the two fields I’ve been debating between happened to be the ones where I’ve attained the highest grades this year. Both happen to be my elective clerkships, where, surprise, you don’t have shelf exams and heavily based on clinical experience!!
So destiny has spoken … ANESTHESIA it will be! I did 2-weeks in January, and absolutely loved it. I was very much involved in patient care, took initiative to do procedures and ask questions, and worked hard to study the basics of anesthesia. Even after my 2 weeks, I was still attending the Wednesday morning Grand Rounds (I was not there simply for the morning coffee and muffins). It is a specialized field with a set knowledge of physiology and pharmacology you apply to patients of all kinds, from young to old, sick and healthy. You learn to take care of sick cardiac patients, see through the delivery of healthy babies and care of the mother, manage pain, and much more. With so much diversity in patients and cases and opportunities to jump into emergencies, you become the master artist of resuscitation. That’s what I realized I loved. It feels mighty exhilarating to finally see the light at the end of the tunnel, the light that you can reach your potential and succeed, personally and academically.
Here’s a snippet of my clinical evaluations, which has also helped boost my self-confidence that I am making the right decision for myself, and not anyone else:
“Connie was enthusiastic and eager to learn about anesthesia. She was a bright student. She had excellent interpersonal skills. She was engaging, inquisitive, and personable. She was always behaved in a professional manner. She was well prepared. She was successful to perform careful endotracheal intubation in the operating room. She also successfully mask ventilated patients in the OR , and place ivs. in the OR as well as oral airways, nasal airways, LMA, spinals and epidurals. She also particpated in the pre-procedural time out. She was a great team member-always helping out and was attentive to her patient. she showed great enthusiasm in procedures and “hands on” patient care. she was actively engaged in discussions of relevant clinical topics.”
My mother has always been tough on me. She wants me to enter a field where I can accumulate the moolah. She wants me to do hematology/oncology. Never has she supported me. She’s been good at poking a needle into my blissful bubble and making me feel inadequate and terrible. She’s good at pointing out my mistakes and saying, “See, you have a terrible memory… you can’t be a good doctor, let alone an anesthesiologist.” It hurts when I don’t have her support and confidence and she doesn’t listen to my interests. Publishing compliments and gloating over my first Honors are not to boost my ego or show off; it’s to prove to my mother and myself, that I am capable of realizing and following my dreams. I can be good with procedures because I’m not clumsy all the time. I can be good with patients because I like to talk and comfort people. I can be successful because I believe in myself.