I’m a failing medical student
Tags: Failure, Pain, Medical School, Perfectionism, Struggle

My name is Adrienne, and I am a struggling med student. I am currently working on finishing my third year. By that, I mean that I’ve failed three rotations in my third year (but passed two of them on the second try so far). I’m currently waiting to hear from the Committee on Student Promotions whether I can repeat that third rotation, if I have to repeat all third-year rotations, or if dismissal from medical school is on the table.

I feel a lot of shame and embarrassment for how much I’ve struggled. Even my dean said that while struggles are normal in medical school, a student shouldn’t be struggling this much, and there is something going on that I have to figure out.

I decided to write this because I want to be open about my struggles. I value anonymity, but I want to use my real name because it makes me feel more vulnerable and nervous. I’m scared to hit the “Publish” button, but I will. I want to practice vulnerability (à la Brené Brown). I’m afraid of how residency programs will view me if they read this. But I think working on my personal development is ultimately more important than falling back into the comfort of doing what I do so well: hiding and worrying about how the abstract “Others” might view me.

I want to help create a culture in medical school where it feels more acceptable to struggle or fail. Med students often hear that we are meant to make mistakes in order to grow personally and professionally. We are also held to high achievement standards, and sometimes it feels like to fail is bad.

So, I think that people don’t talk about it, or they do it in hushed voices with shame hanging over their heads.

I don’t want to feel shame for being a normal human being. Maybe it’s not typical for a student to struggle this much in medical school. But I still feel like a normal person.

When I was growing up, I did well in school and was praised for getting good grades and being smart. I still do get good grades in areas that I am interested in and passionate about, and I believe I’m smart. I wish I could understand why I’m unable to translate that into areas I am less passionate about but still interested in.

I also have a fear of being wrong or failing. To become less fearful and accepting of messing up, I want to talk about times when I did poorly in school:

I failed my renal/liver block exam. I did well enough on the next exam to average a pass between the two blocks and move on.

I scored 209 on step 1 (a low score on the first of three licensing exams to become a physician).

I got a conditional pass for my 8-week-long internal medicine (IM) clerkship due to concerns about my ability to take a history, do a physical exam, and present the patient on rounds. During IM, I had multiple tearful talks for many hours with attending and administrative physicians and my chief resident (my tears, not theirs). After a 4-week-long remediation in which I threw myself in with passion and devoted nearly every moment to improving in IM, I did not pass. Now I am awaiting the decision of the Committee on Student Promotions about next steps (retake IM, retake all of my third year rotations, or dismissal from medical school).

I got a conditional pass for my 6-week pediatrics clerkship due to failing the shelf exam. I retook and failed the shelf exam a second time. I retook the entire clerkship and passed after I figured out a study method that worked for me (flash cards).

On my emergency medicine clerkship, I had a talk with the clerkship director about concerns about my clinical performance, namely being able present patients and come up with a thorough differential diagnosis. I ultimately passed this rotation.

I had a meeting with the family medicine clerkship director due to concerns about my presentations and ability to come up with a differenial diagnosis. I ultimately passed this rotation.

I have been meeting with a therapist through my school since June 2020. I’ve learned that my personal issues include perfectionism and a fear of being wrong; fear of rejection; fear of pain; not wanting to feel my emotions; and disordered eating and body image issues (which I absorbed from my parents and society).

I have a few good med school friends who have been extremely supportive and helpful to me. Sometimes I feel like I don’t deserve their support and love and wonder why these people who do well in school are friends with and want to help someone like me.

I am figuring this out.

In the meantime, I want to talk openly about failure and be my true self, which includes someone who has struggled and failed a lot. I want the medical school culture to change and to feel safer or more accepting of ourselves, even as it requires all of us to fit a certain mold to make it through. Maybe I can help others feel less alone.