Boards Post Traumatic Stress Disorder. It is real

Many people probably think I'm just making excuses for the way I feel about test taking these days, and no one wants to hear me talk about failing the boards one more time. But the fact of the matter is, it has permanently and horribly affected my life. I can't just get over it, like people seem to think I can. And in talking to other students who have also failed the boards, it seems to be a pretty common theme.
We have been through a traumatic event. We may not have been in 'Nam, or in Iraq. We may not have been brutality beaten or held hostage (at least, not literally). We may not have been in a natural disaster and almost lost our lives. We may not have been in a plane crash or been witness to a murder. But in our own way, we have suffered a trauma that isn't likely to leave our minds any time soon.
The boards are built up to be the end all be all of tests. Nothing in life matters quite as much as your board scores. They determine your entire future, your ability to get a good residency, fellowship, attending position. You will forever be judged on your board scores. And maybe none of htat is really true, but by the beginning of second year that is for sure what you think. You spend all of your time studying, worrying, stressing, crying, and then studying some more. the atmosphere during boards prep time is the worst time you'll ever have in your life (at least, I have to hope that is the worst experience I will ever have). And then the dreaded day comes when your scores come in, and you find out you failed.
The world really does feel like it is ending. You see all your hopes and dreams for the future fade off into the distance. All of a sudden all you can see is this failure, it defines you, it has ruined you, it means everything to you. And no one who hasn't failed the boards can truly understand what that means. They think they can, and they can be supportive of you, but when you've failed teh boards, you have lost a piece of your life. It is a dark, dark day. It shouldn't matter as much as it does, but sadly it does.
A friend of mine who also failed the boards said she went through the five stages of grief, and it is totally true. It is just like any other tragic moemnt in a person's life, except that it shouldn't matter so much. So when I tell people that I have PTSD from it, they laugh and tell me to cut it out. But they don't understand that I do wake up in the middle of the night freaking out about having failed. I do dwell on it and what it means for my future. I dread being denied residencies beause of this failure. I feel like it completely defines me. And the worst part is, it has taken all of my limited test taking confidence and killed it.
So now, when it is test time, I fall into a horrible depression. I can't get out of bed. I snap at everyone. I worry about failing. I can't focus long enough to study. I dont want to study. I'd rather stare off into space than get out my book. I start to cry, my stomach ties up in knots, and all I can think about is how I failed the boards and will never again be able to take a test. I try to tell myself that I will pass the rest of these tests, that if I study hard enough I'll be fine, that this time around I'll be prepared for whatever test is coming, but the week before the test the same thing happens: I realize I haven't spent enough time studying. I start to stress about how I shold be studying more. I try to study but become distracted by anything and everything. I feel a deep sense of dispair, and worst off, I don't care about anything. I'm so busy being stressed and anxious and depressed about the test that I have no energy left to study. So I stay in bed all day. I watch television. I stare at the ceiling. I take naps. I write blogs. I do not study. I do nto do anything productive. Because I tell myself I don't have time to go to the gym because I have to study, or I don't have time to clean or cook because I have to study, but then when I go to study, I just can't do it. And for some reason I never say I can't lie in bed all day because I have to study.
Then test time comes around and it is basically a self fulfilling prophecy. I don't do well on the tests, because I can't get myself to study. I have lucked out thus far and not failed another test, but maybe it is just a matter of time. Will I ever be able to get over this? Is it something that can even be fixed? I have to hope that eventually I will get over this and be able to study again, because the test taking is not anywhere near over. That all being said, I should probably go back to studying for my test next week...

Another example of how I am not a good medical student

I haven't blogged in awhile because I've been so busy with third year, which for all of you struggling first and second years out there, third year is awesome. I'm finally starting to feel a purpose towards this crazy life I chose, and am reminded of why I wanted to do this in the first place. Third year has given me hope that I did not make a mistake and that I do, in fact, want to be a doctor, and that I am, in fact, fully capable of being a good physician. Not to toot my own horn or anything but I am an excellent communicator, patients and other staff love me, and I'm a hard worker, so eventually I am going to be a good doctor, as soon as I figure out all this medical stuff. And I'm starting to see that that will come in it's own time. It was great when a doctor told me that the purpose of third year is not to learn everything about medicine, but to learn how to learn and how to practice as a doctor. The learning everything comes slowly over time. That is nice to know.
So, that's the good news about third year. I've figured out a couple of secrets to help me get through the rest of the year. Unfortunately, all of these secrets make me feel like a horrible slacker, and makes me worried about my future in medicine if already I'm finding all these shortcuts for life. However, I have also decided that when I want something, I'm willing to work hard for it, and I don't see the point in busting my ass for something that isn't going to make a huge impact in my life.
For example: I have pretty much decided that I'm either going to do internal medicine or pediatrics. Unless my neurology rotation is just the greatest thing since sliced bread, I don't really think any of the other stuff holds any interest for me. That has lead to me checking out completely in my rotations, which is bad. I am currently in my OB rotation, and I've realized that OB is just not for me. So I'm not going to go into it. However, if I were a good medical student like all the others, I'd still work my ass off for an amazing grade or whatnot. I am not like the other students. I have realized that I am not going to honor or high pass this rotation, and if I just do well enough, I am going to pass. So, instead of working my ass off to just pass, I've decided to just pass. That means showing up on time, being nice to my patients, doing my work, leaving, and studying for the test. It does not involve getting to work early, trying to overly impress people, and going above and beyond. Is that bad?
I think it is a little bad, because now my attendings can tell I have no interest in OB, and they probably think I'm a horrible medical student, and that really isn't good. But on the other hand, it is helping me stay sane in this crazy world. Saving up my energy for my rotations that are going to count for my future. Right? I sure hope so. Otherwise I'm just a bad student, and does that translate into being a bad doctor? I sure hope not.
The things I've done, that I'm pretty sure no other medical student has done in the history of medical school. Okay probably not that big a deal, but still:
1) I take naps. Why not? You know the saying "eat when you have a chance to eat, sit when you have a chance to sit, pee when you have a chance to pee?" I take that a step further and nap when I get a chance to nap. There is a call room for students on this rotation, and sometimes I have absolutely nothing to do, and I can't stand the thought of studying anymore, so I take a little nap. Apparently that is horrifying to some of my classmates. I think it is just good thinking.
2) I leave when I have a chance to leave. I am not one of those "are you sure?Maybe I should stick around," types of students. If the attending says there is nothing going on and I have the option of just sitting around waiting for something to maybe happen or leaving now, I'm going to leave. And if there has been nothing going on for hours, I'm going to ask if I can leave. It's just one of those things. So yes, I've left the hospital on a weekday at noon before, because someone said I could. And at 430 I've asked if I can go home to study or whatever if I haven't done anything since noon. And I don't think that is going to affect my evaluation enough for me to really worry about it.
3) Rotations where high pass is determined by a test grade automatically means I'm just going to pass. Therefore, I am not going to put too much effort into it. I cannot do well on tests. I have anxiety, I don't study enough, I have no self esteem. It's just a thing I've gotten used to. So while I believe if I study hard I can pass the test, I know that for most of these rotations I am not going to do that well. So what does it matter if I pass with a 70.1 or a 89.9? It doesn't, especially since all they see is pass. So I'm not going to kill myself to turn in stellar work for our busy work that we are given. I'm not going to try and be the best student ever. I'm going to do what it takes to get through, learn what I can in the meantime, and try to hold on to my sanity.
4) I plan things during rotation time so I can get out of rotations. Especially in the ones I'm not passionate about. Sure, I'll come have a meeting on campus at 3pm! That works just perfectly, that gets me out of clinic for awhile. It's for school right? Oh I have a doctor's appointment...oh yeah...hmmm...dont' feel bad about it. Granted, I don't do this every day, but I probably do it more often than I should.
5) I am devious. Recently I have started playing attendings against each other. Not really in the horrible way that sounds. More in the "oh Dr. so and so said I should work with them today..." and then turning around and being like "oh I need to get back to work with the other doctor" and then leaving. Or hiding out to study. They don't seem to notice. It's pretty awesome. Or going to preceptor in the morning, coming home and napping before going back to my rotation. Yep, that is me.
Hopefully none of my attendings will ever read this blog, or I will be busted big time. But honestly, I don't think any of this is going to have a negative effect on my ability to treat patients, because when I'm with a patient I give my best, I give them everything. I'm passionate to work with people, I want to help them as best as I can, I like to be there for them and be the one to take care of them. I just don't put up with a lot of bullshit, and I can't pretend to be something I'm not. Which is a gunner. So, yeah, maybe that makes me a bad student, but I don't hear my patients complaining. Maybe it's because I leave before I can hear them. hmmmm....