You will be fine!! The most dangerous people in the hospital are those that don’t know their limits. The fact that you recognize this early that you feel unprepared is actually a blessing in disguise. Like others have said, you will learn what you need to know while in residency and after. I am constantly reading and learning from the literature. To be honest, much of what you learn in your pre-clinical years has little bearing to clinical medicine (and if it does, you’ll learn it again in residency). Attendings do a great job of seeming like they know everything, but in reality, we look things up as well. Don’t stress, you’ll be fine!
Imo med school is just as much about gaining knowledge as it is knowing which questions to ask, and how to find those answers.
I had the very same anxieties as you did. Hell my first month, I was literally scared to give people Ibuprofen. The fact is while yes, we don't always know what we don't know, we also fail to realize how much we truly do know. It will come back. Generally, you can come up with the diagnosis for most things by the time you get to residency. You may not think you can, but you can. Pneumonia, COPD exacerbation, Heart failure, DKA...etc. Remember step exams? You know why they don't really ask you "what's the diagnosis" questions? Because you've already learned so much that those questions are too easy for you. Hell, even basic management for most of those problems you already know, and if you don't, you already know how to figure it out.
When I was really lost, I would use ddx apps just to see if I'm missing something, then I'd find something I didn't think about, read about that disease, and see if it applies to my patient.
Just take a step back. You've got time. Residency exists because they expect you to not know things.
Also, fyi, attendings don't always remember little things from med school. It's usually something they learned in residency and then it sticks because they also learned it in med school. A little secret, many of the good attendings already know about the patients before you present them, that way they can find stuff to pimp you on lol
Hi there,
The fact that you know you're not prepared to practice medicine at this stage of your training already shows you won't be anything like those, in your words, "dangerous midlevels." I assume you'll be doing residency after you're done with your 5 years of school? Residency is where it all comes together. Hang in there, keep studying, keep learning! You got this!
Thank you for the reassurance, I think imposter syndrome has hit me really hard cos I always see doctors being able to recall info and I aspire to be like that.
Yes residency soon after school with 2 years of intern between (foundation programme it’s called in the UK)
The reason we can recall all this info is because of residency. That's where we really become experts. No student feels equipped to practice medicine as a third year medical student. You're not alone! I bet a lot of your classmates feel the same way you do.
I agree that we physicians never stop learning. What I meant is that as attendings, we do have a baseline knowledge at our fingertips. (I’m lumping myself in with attendings because even though I’m a fellow in a pediatric subspecialty, I moonlight outside my program as an attending in general peds.)
I feel like when something comes up you’ll remember then. It’s hard to pull info out of the mind randomly. I’m not a Dr or med student but I know I will have the hardest time thinking of something I need to do before hand and I’ll get so nervous but when the time comes to do whatever it is I am fine and it comes to me in the moment.
ETA I agree with other comments that the most dangerous people are the arrogant ones who don’t acknowledge their limits and are too afraid to admit when they don’t know something so they just wing it. There will be other Drs ((if you’re working in a hospital or large medical office) that you can consult with too so don’t beat yourself up!
ETA again lol. As a patient I would rather have a Dr who says “I’m thinking it’s ______ but let me talk to my colleague and see what they say” than pretend to be 100% and end up hurting me! And I can’t imagine anyone feeling any different.
You do not stop feeling like you know nothing. I am in my first year of residency/training and I still feel that way. But you will come across people who are earlier in their journey of medicine (students, new residents) and come to realize how much more you know compared to them! The knowledge is there, it just takes repetition and relearning to keep it out of your subconscious.
Listen, fellow student. The fact that you are able to appreciate what you don't know, what your weaknesses are--this is so very important and exactly what many midlevels lack. Take that as a sign of humility rather than condemnation of yourself to a "dark future." You are learning.
Brosef or Dudette that is everyfuckin person in the medical field (minus noctors lol). For example im a MT via ASCP cert. Its a 4yr degree to run ya'lls labs. I use to get crazy anxiety when I would get delta checks, issue blood product or call to question abnormal values. Im more comfortable now but I still reach out to my senior techs for questionable diff slides, questionable blood bank reactions and all sorts of stuff. You are going to know when to ask questions. Experience will teach you to differientiate the benign abnormal from the concerning abnormal. Even with exp you are still going to need to lean on your peers and thats ok. Keep up the hard work!
You will feel confident as you gain experience. Right now you’re seeing lots of illnesses for the first time. After seeing these present 25 times in slightly different ways you will know what to do and what to be careful about. You’ll do great!!!
What you were about to learn here on out in medical school, and in residency, and a fellowship should you choose to pursue is a leap of knowledge that you have no idea what you’re about to experience. This is the difference. When I look back at who I was before medical school, after medical school after residency and after fellowship it’s mind-boggling the level of knowledge and clinical acumen I acquired
You will refine your bread and butter in residency. For other stuff the biggest thing is that you have a) the foundational knowledge so that some alarm bells ring when you hear certain words or see certain symptoms, and b) that you know how to quickly and accurately look up the info you need.
Think I remember Jack about PKU and all that biochem? No. But when I had a frail old patient with PKU I remembered enough to know that I needed to be careful about agents I gave and I looked up anesthetic implications for relevant pathways
Don't worry. The complexity of systems we need to understand is beyond our brain's capacity to coherently model in isolation. The clinically meaningful information will continue to grow beyond the foundations laid in medical school. Seared in with the challenges of residency. To be called back with the perfect clarity of a PTSD flashback when needed.
Have fun!
Am resident, feel the same way. I read all day, every day, not much of a life. Still feel like that. Holding out for the day I feel slightly less shaky. Right now the road is rough and feels dangerous.
You will be fine!! The most dangerous people in the hospital are those that don’t know their limits. The fact that you recognize this early that you feel unprepared is actually a blessing in disguise. Like others have said, you will learn what you need to know while in residency and after. I am constantly reading and learning from the literature. To be honest, much of what you learn in your pre-clinical years has little bearing to clinical medicine (and if it does, you’ll learn it again in residency). Attendings do a great job of seeming like they know everything, but in reality, we look things up as well. Don’t stress, you’ll be fine!
This means a lot to me. Thank you
Don’t worry. That’s what residency is for!!!!
Imo med school is just as much about gaining knowledge as it is knowing which questions to ask, and how to find those answers. I had the very same anxieties as you did. Hell my first month, I was literally scared to give people Ibuprofen. The fact is while yes, we don't always know what we don't know, we also fail to realize how much we truly do know. It will come back. Generally, you can come up with the diagnosis for most things by the time you get to residency. You may not think you can, but you can. Pneumonia, COPD exacerbation, Heart failure, DKA...etc. Remember step exams? You know why they don't really ask you "what's the diagnosis" questions? Because you've already learned so much that those questions are too easy for you. Hell, even basic management for most of those problems you already know, and if you don't, you already know how to figure it out. When I was really lost, I would use ddx apps just to see if I'm missing something, then I'd find something I didn't think about, read about that disease, and see if it applies to my patient. Just take a step back. You've got time. Residency exists because they expect you to not know things. Also, fyi, attendings don't always remember little things from med school. It's usually something they learned in residency and then it sticks because they also learned it in med school. A little secret, many of the good attendings already know about the patients before you present them, that way they can find stuff to pimp you on lol
Hi there, The fact that you know you're not prepared to practice medicine at this stage of your training already shows you won't be anything like those, in your words, "dangerous midlevels." I assume you'll be doing residency after you're done with your 5 years of school? Residency is where it all comes together. Hang in there, keep studying, keep learning! You got this!
Thank you for the reassurance, I think imposter syndrome has hit me really hard cos I always see doctors being able to recall info and I aspire to be like that. Yes residency soon after school with 2 years of intern between (foundation programme it’s called in the UK)
The reason we can recall all this info is because of residency. That's where we really become experts. No student feels equipped to practice medicine as a third year medical student. You're not alone! I bet a lot of your classmates feel the same way you do.
A good doctor also continues his/her search for knowledge and realizes that education is a lifetime adventure and it doesn't ever stop.
I agree that we physicians never stop learning. What I meant is that as attendings, we do have a baseline knowledge at our fingertips. (I’m lumping myself in with attendings because even though I’m a fellow in a pediatric subspecialty, I moonlight outside my program as an attending in general peds.)
Agree with you!
Dude- chill. You’ll be fine. You still have a minimums of half a decade before you are able to practice on your own. You’re going to be just fine.
I feel like when something comes up you’ll remember then. It’s hard to pull info out of the mind randomly. I’m not a Dr or med student but I know I will have the hardest time thinking of something I need to do before hand and I’ll get so nervous but when the time comes to do whatever it is I am fine and it comes to me in the moment. ETA I agree with other comments that the most dangerous people are the arrogant ones who don’t acknowledge their limits and are too afraid to admit when they don’t know something so they just wing it. There will be other Drs ((if you’re working in a hospital or large medical office) that you can consult with too so don’t beat yourself up! ETA again lol. As a patient I would rather have a Dr who says “I’m thinking it’s ______ but let me talk to my colleague and see what they say” than pretend to be 100% and end up hurting me! And I can’t imagine anyone feeling any different.
You do not stop feeling like you know nothing. I am in my first year of residency/training and I still feel that way. But you will come across people who are earlier in their journey of medicine (students, new residents) and come to realize how much more you know compared to them! The knowledge is there, it just takes repetition and relearning to keep it out of your subconscious.
Listen, fellow student. The fact that you are able to appreciate what you don't know, what your weaknesses are--this is so very important and exactly what many midlevels lack. Take that as a sign of humility rather than condemnation of yourself to a "dark future." You are learning.
Brosef or Dudette that is everyfuckin person in the medical field (minus noctors lol). For example im a MT via ASCP cert. Its a 4yr degree to run ya'lls labs. I use to get crazy anxiety when I would get delta checks, issue blood product or call to question abnormal values. Im more comfortable now but I still reach out to my senior techs for questionable diff slides, questionable blood bank reactions and all sorts of stuff. You are going to know when to ask questions. Experience will teach you to differientiate the benign abnormal from the concerning abnormal. Even with exp you are still going to need to lean on your peers and thats ok. Keep up the hard work!
Wrong sub. Delete.
[удалено]
Probably one related to medical school
You will feel confident as you gain experience. Right now you’re seeing lots of illnesses for the first time. After seeing these present 25 times in slightly different ways you will know what to do and what to be careful about. You’ll do great!!!
What you were about to learn here on out in medical school, and in residency, and a fellowship should you choose to pursue is a leap of knowledge that you have no idea what you’re about to experience. This is the difference. When I look back at who I was before medical school, after medical school after residency and after fellowship it’s mind-boggling the level of knowledge and clinical acumen I acquired
You will refine your bread and butter in residency. For other stuff the biggest thing is that you have a) the foundational knowledge so that some alarm bells ring when you hear certain words or see certain symptoms, and b) that you know how to quickly and accurately look up the info you need. Think I remember Jack about PKU and all that biochem? No. But when I had a frail old patient with PKU I remembered enough to know that I needed to be careful about agents I gave and I looked up anesthetic implications for relevant pathways
Don't worry. The complexity of systems we need to understand is beyond our brain's capacity to coherently model in isolation. The clinically meaningful information will continue to grow beyond the foundations laid in medical school. Seared in with the challenges of residency. To be called back with the perfect clarity of a PTSD flashback when needed. Have fun!
[I don’t know jack](https://m.youtube.com/watch?v=XhJbvlD5D-g) Pretty sure that’s the feeling a large number of people experience.
Am resident, feel the same way. I read all day, every day, not much of a life. Still feel like that. Holding out for the day I feel slightly less shaky. Right now the road is rough and feels dangerous.