Sunday, July 24, 2011

The Great Disappointment

Up front, I should say that it is very difficult for a medical student to discuss their short comings.  Most of us are Type A by nature, and not eager to show weakness.  With that being said, I will share my most recent disappointment with the hope you will not judge too harshly.  For the past eight weeks,  I have been enjoying my Family Medicine rotation.  It was the one rotation that I've looked forward to nearly all year.  I had a wonderful time working with my community preceptors and KU attendings in clinic.  The first seven weeks of the rotation reinforced my opinion on how wonderful seeing patients in the clinic can be.  I enjoyed the patients I met and loved the ambulatory setting.  You can solve problems for 25 patients and it is all in a day’s work. 
I worked hard and tried to learn as much as possible in preparation for my upcoming sub-internship in Family Medicine.  I took notes, read up on new topics, and did everything I could to show initiative.  Unfortunately, I hit a speed bump during week eight.  During the final week we had several tests that would be used to help determine my grade. We had a clinical skills assessment which I thought went fairly well.  I did a presentation from my underserved clinic experience which also went fine. But when I took the NBME shelf exam, I quickly realized I had not adequately prepared. My study plan was not adequate.  I assumed that since I had done well on the Pediatric and Internal Medicine exams, I would do fine on Family Medicine.  I used a case study book, but the content didn’t have enough depth.  I was not prepared for the test.
After the test I went home nearly in tears, telling my husband Matt that I bombed the shelf and my future career was in jeopardy.  He doesn’t put much stock in this complaint any more since I have a habit of feeling this way after every shelf and they inevitably work out fine.  But I told him that “No really. This time I really, really mean it!” Adding insult to injury, on the last day of the clerkship, we took a departmental exam on which I did absolutely, positively horribly.
On the last day of the clerkship I had to meet with three of my KU attendings, all of which I respect and one I consider my mentor.  I was embarrassed to sit down with them after they had sung my praises for seven weeks.  I didn't feel like I was able to finish strong and now they knew.  I learned at the meeting that even the clinical skills exam didn't go nearly as well as I had thought.  My department exam score was above the average, but still embarrassing to me.  My shelf score won't be released for another few weeks. Despite my performance on the exams, my attendings gave me kind words of encouragement.  I felt a little better afterward, but I am still kicking myself over potentially blowing a superior grade on the most important rotation of my third year.  We will see what the shelf score does for my grade.  I’m trying to stay hopeful.  For now I have learned my lesson.  I will never again assume I know enough.  The enticing thing about medicine is that there is always something more to be learned. 

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