Awesome, nice to meet you and wish you the best. Do you have a journal?
You might be very familiar, but I write this for my own therapy and for those who don’t have an idea what the medical training process is like.
I think that the insecurity stems from the environment and the immense demands placed on us. You take some of the smartest, confident, compassionate people and throw them into a toxic system and training process and they become burned out, anxious, and depressed. Mental health is rampant in medicine, at least in the west, with many cases of suicide. On top of this, COVID happened during some of our toughest years which brought a lot of fear and isolation.
I go to a fairly “prestigious” institution and I come from a lower SES background. So in my case, I felt that I sort of didn’t fit in the first place as many of my peers come from wealth and ivy league backgrounds. It isn’t correct to compare yourself, but that’s just the nature of the medical training process when you are endlessly “competing” against the “best in the nation” to advance at every stage which requires its own exams, interviews, application process, fees from HS, college, med school, residency, jobs. Every step becomes more demanding. Suddenly, you feel very average when you are always surrounded by smart, driven, high achievers. It can be a toxic environment as you are graded and evaluated endlessly. One misstep or negative evaluation throughout several years can impact your ability to apply and interview for residency selection, another competitive and difficult training process. Without residency, your years are wasted and you are left with hundreds of thousands of debt. During clinicals, you rotate through each specialty, constantly adapting to new teams, people, patients, environments, witnessing serious disease, trauma, death, while still expected to go home and study to demonstrate your knowledge and pass difficult exams after long work hours. There are no breaks. As you finish an intense rotation and final exam every month, the following Monday you are thrown into an entirely new environment and field of knowledge and expected to perform, learn, finish assignments, H&Ps/notes, do research over and over and over again. We often have to forsake our friends, loved ones, hobbies, physical health to succeed. Med students are constantly bombarded with pressure to perform academically, socially, kiss ass to superiors, work on their CVs, burdened by hundreds of thousands of debt, treated like slaves and idiots at the bottom of the totem pole, and we have to eat up all the crap with a smile in the name of professionalism and service. I can work my hardest and do everything right to help my residents, but still be hit with an unfair or inaccurate evaluation at the end, subjective evaluations, by people who are stressed and burned out themselves. Because of our debts, we often don’t have the power to complain or make changes.
As it is, I have done better than expected in my evaluations and grades, etc. I have made incredible connections with mentors, students, patients. I think I have done a great job in balancing time with my loved ones and hobbies. I am confident that I will succeed to become a great doctor. Everyone has different capacities though and I have to say that it took blood, sweat, and tears for me as I always give it my all. It is just difficult because I don’t get a chance to decompress or take care of myself because the BS tasks and duties never end, resulting in anxiety and fatigue.
Will it be worth it and will I be happy in the end? I think it will be worth it when I am able to go out and work, have more control over my life/career, and actually connect to and serve my patients! It is hard to say if I would go through this again though and I am only about halfway through!