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Navigating Setbacks in Medical School

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Setbacks in Medicine – Interview with Dr. S

 

We have all encountered setbacks on our medical journey. As driven individuals, it is sometimes easier to focus on our perceived failures than celebrate our successes. We think back to disappointing grades, negative clinical evaluations, or poor interview performances. We already knew that this was a risk when we decided to embark on this academic journey. However, what is more valuable is learning how to cope with these setbacks. In order to provide aid to our future LMSA doctors, we interviewed a recently matched LMSA doctor that went through setbacks during his journey and what he learned from his process. 

 

Interviewer: Could you please share with us when you first started experiencing struggle in medical school?

 

Dr. S: Hahaha, the struggles really started before medical school– grades, extracurriculars, essays, interviews. When I went to medical school, I had to move to another city and navigate the transition away from my friends and family. The first struggle I encountered was very personal– transitioning my identity as a Latino to a new, different space.  Back home, I lived in a community where the majority of people were Latino; I had a super strong sense of community. When I moved, I saw that there were much fewer Latino people. I already knew this, because I had researched the demographic of the city ahead of time, however I didn’t realize how lonely it could be. Our class also had a lower number of Latino students. I made lots of friends, but I was of course still very homesick and missed aspects of my culture being represented around me. I was also very motivated to help patients in the Latino community moving forward, so I was nervous about not being able to develop that aspect of myself. 

 

Interviewer: How did you cope with struggles regarding your transition as a Latina/o/x person to a new city that did not have a large Latina/o/x community?

 

Dr. S: I knew that this was going to be a big challenge for me emotionally so I started looking for resources. I joined our LMSA chapter pretty early on, which was a huge help. I had initially been concerned that joining clubs early might distract me from making sure that I could keep up with my medical school classes. However, being able to hang out with friends from my community made me feel supported during emotionally difficult moments. We had similar frustrations, some shared goals, and the same desire for home cooking– so we had a great support group. I also joined a community organization that was founded to help the growing Latina/o/x population in the city. Since our Latina/o/x community was relatively newly immigrated to the city, there were not a lot of resources to support them so I felt that I could really give back by volunteering with the newly established organizations. 

 

Interviewer: Could you please share with us if you had any academic struggles?

 

Dr. S: Of course! I was never great at Anki cards, but I found that visuals worked for me– Sketchy and diagrams. I had a couple of tests that I did not pass during the pre-clinical years that shook me. I tried to make a better study plan moving forward to make sure that I would study a little bit each day even when I was exhausted; it is important to avoid cramming in medicine since everything builds on itself. You want to build the big picture and then delve into the details and have a good structure that you are always adding to. You have to be strategic about how you build your information. I used to get lost in specific questions for hours, but you don’t always have time for that. I also found that I focused better in coffee shops and if I took a small break every 1-2 hours. You just have to find what works for you. When you start building good habits, then everything will start to feel easier. This is something that I definitely developed over my 4 years of medical school.

Around 2 years into medical school, I had a really difficult time when I scored poorly on Step 1. I had attempted to keep doing club activities and research during my dedicated time and I was spending way too much time reviewing my UWorld question and getting very micro-focused on specific details. The days before the exam, I did not feel confident but I wanted to keep up with my friends and I knew that I had put in some time, though maybe not the most efficiently. When I got my results back, I was crushed. It really shook me and it was hard not to take those emotions into everything else that was happening at that time– clinical rotations. It was hard not to feel imposter syndrome and like I was far behind my classmates. 

 

Interviewer: How did you cope with these emotions of having missed a mark that you had set for yourself?

 

Dr. S:  Mental health is so, so important. I struggled trying to separate my identity from my Step 1 scores. But I knew that ultimately that I would have to do that in order to move forward from that setback in a healthy way. I spoke with family and my partner a lot– it can be really challenging to talk through those emotions. I used my school’s counseling services and their education advisor, which I really appreciated. I developed those coping methods that I mentioned earlier: trying to build a general framework before filling in details, trying to use visuals/Sketchy, setting a small number of questions to do every day during clerkships (10-20 questions on busy days; 40 questions on early dismissals; 40-80 on weekends) to try to get through my question bank, and working at coffee shops here and there when I felt that I needed a change in scenery. 

When it came to take Step 2, I let all my research mentors and clubs know that I was not going to be available for a month. I was very intentional about keeping up my pace in UWorld; it was my main resource. On the days I was tired, I tried to study with someone else present to keep me accountable. I would try to explain concepts to my partner to get practice on those questions that I was not as sure about. All of these baby steps really made a huge difference and I scored 30 points higher on my Step 2! During residency interviews, I think only one person asked me about this and they were very kind and understanding– they know that everyone experiences setbacks and I think what they really want to see is positive growth and a courage to meet these challenges. I ended up getting into my first choice!

 

Interviewer: What is the biggest piece of advice that you would give to other medical students going through this journey?

 

Dr. S: We have all gone through so much. We have all struggled and persevered to get to where we are now. The grades and benchmarks that have been set along the way are very arbitrary. There are so many people that I see around me (medical students, residents, physicians) who I respect deeply who have gone through experiences that have shaken their confidence and have taken a serious mental toll. Every time I hear about these things, I am surprised and I want to tell them how much I respect them and how those setbacks did not change how confident and impressed I am by their clinical brilliance and compassion towards patients. Everyone has setbacks; medicine is full of micro-traumas– in pre-clinical years and clinical years. Being a kind person and trying your best to move forward in a positive way is the only thing that matters; just focus on small steps. Celebrate yourself. Celebrate your wins. Don’t dwell on your setbacks. Don’t dwell on negative interactions with others. The grades don’t define you– your years of dedication and perseverance and positive interactions with others define you. The hospital staff that you know for a few days doesn’t define you– your family and friends who have known you your whole life can help you refocus yourself and if you are happy with where your current life choices. If you take one step in front of the other, you will have a positive impact on everyone’s lives around you and you will have succeeded and reached a spot that is just right for you– a space that is built around you and the great things that you have to offer.

 

Interviewer: Thank you so much, Dr. S! 

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Jose Arriola Villafuerte

Committee Member

Sidney Kimmel Medical College at Thomas Jefferson University

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