Good Bye MedHopeful.com, Hello MedChatter.com!
So this is going to be my final post here at MedHopeful. From now on, I will be blogging (and doing a lot of other cool things) over at MedChatter.com.
MedHopeful was great for what it was – a place for me to log my progress through the admissions process and a place to freely write my ideas that I’m glad many of you found helpful. But I always knew we could do much more.
MedChatter.com is the culmination of many months of hard work with three other UofT medical students.
I’m still there, blogging, writing articles, making videos, and so on. But at MedChatter.com, there is room for you to get involved.
With a social network and online forum, in addition to numerous article/video resources, there’s now the opportunity for you to get engaged in connecting and discussing with others. Got a question? Ask it! Need to vent about how school went today? Blog about it!
It’s not about me just me anymore – it’s an opportunity for all of us to get involved.
I don’t think of it as MedHopeful dying – more like we’ve merged into something much cooler and much bigger.
So what are you waiting for?
Join MedChatter.com right now!
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Lunch with Alex
On Monday I had lunch with Alex Shipillo, a good friend of mine who is very smart, driven, and talented, and whom I always have good discussions with and learn a lot from. The funny thing about my friendship with Alex is that I had talked with him and formed a friendship before we had even met in person (no, it wasn’t E-harmony).
Alex and I both attended Shad Valley the same summer, but at different programs, but one of his best friends attended Shad Valley at McMaster with me. We found each other on Facebook, discovered we had a lot of common interests, and began chatting and sharing ideas.
Since the start of this year, Alex has been the President of Impact – Canada’s largest student-run entrepreneurship group. The funny thing is that it was I, a few years ago, who got Alex in contact with Kunal Gupta, the founder of Impact, after not really even knowing Kunal (I had just met him briefly the week before). But it seemed like a good person for Alex to contact. Funny how things turn out. (Or just my way of reminding Alex that he is in debt to my for life. Just kidding though, as Alex is talented enough to have gotten to where he is on his own, I’m sure).
At lunch, we started off by catching up with how each other was doing. I shared with him my progress with a project I was working on (and one you will all soon learn about).
But the biggest thing we talked about was basically about turning my life around and being more productive. I think I don’t come off that way, but I am super, super lazy and am very unproductive. Really, I am. I was very busy in high school and kept myself occupied with many cool things, but since undergrad, I have gotten very lazy. I think it’s partially due to my interests changing (and not finding things that really stimulate me) and partially due to my being way to lazy/burned out to take initiative. I also think it’s because I like instant satisfaction, and in the real world, you really got to put in the work and effort before you reap the rewards, and I struggle with that.
One key thing Alex talked to me about was developing better habits. He told me that if I could pick up a habit and perform it 21 days in a row, it would likely stick. So my plan is to pick up a new habit every 7 days, and hopefully after 21 days of performing each habit, it’ll stick. And I’ll slowly pile on new and improved habits that will become a part of my everyday life.
So the first habit I’ve decided to pick up is getting at least 7.5 hours of sleep every night. To be fair, I already broke this habit last night (in my defense, I was studying for my Determinants of Community Health Exam today). Hopefully I won’t break it again for a long time. Some future habits I’m thinking about picking up include a small bit of daily studying, daily workouts, regular productivity with my blogging, etc.
I feel really unproductive a lot of the time, and hopefully this will help.
Oh yeah, big changes coming – like I’ve been mentioning for a long time, but things are finally ready. MedHopeful is moving onto bigger and better things. More to come in my next post.
What’s up with premed altruism and nobility?
As I have mentioned many times before, I feel like our education system was developed with altruism and nobility at its core. I have seen it all the way from elementary school to undergraduate university (though obviously much less so at higher levels at education). While I think it’s nice that we’re taught to do “good” things, I think it is very problematic when this obsession with an ideal world clouds our ability to think rationally and critically. One of the most common examples I remember is being taught over and over again that “desiring money makes you a bad person”, etc. I don’t want to talk about money today because that’s a big topic I want to save for another day, but suffice to say, I think making simplistic statements like “desiring money makes you a bad person” is pretty ridiculous and dangerous, especially at a time when we should be helping young people to think instead of shoving ridiculous statements with no context down their throats. I’ll just stop here with the whole money thing and say that if you’re going to judge someone, judge them based on not just how they use money, but also realize that there is diversity in personal preference regarding luxury and even diversity in how that relates to our moral obligations to share with others.
I am not saying altruism is a bad thing. Being unselfish and serving others is something I highly respect and value, and is an important quality we all need to have at one point or another, particularly in the medical profession. It does become problematic, however, when you start taking it to the extreme and believing that only altruism is good and selfishness is bad in everything.
We all need to be selfish at some point, and anyone who denies ever being selfish needs a reality check. If you’re reading my blog right now (and I’m assuming because you want to and find enjoyment/value in it), I dare you to ask yourself whether this isn’t a selfish act considering that you could be out volunteering or cleaning up the park or something more altruistic. If you agree with me that we can’t be altruistic all the time (or that even if we could, it’s unhealthy), then let’s keep going forward. Clearly, there are times when altruism isn’t in our best interests and it has nothing to do with being a good or bad person – sometimes it’s just a choice.
Altruism can be good and all, but how altruistic we are and when we are is going to be situation dependent. Even doctors need to be selfish and take care of themselves – they need to go home, see their families, rest, etc. A stressed out, tired, unhappy doctor is not going to be good for his or her patients. Balance is important.
Premed Altruism
End of the 1st Semester of Medical School
I sit here typing this relaxed and in a pretty darn good mood. Although my first semester of medical school actually finished last Thursday, I’ve been too busy/lazy to actually sit down and write anything.
I think this is the first Christmas break in a while where I haven’t really felt any stress or guilt whatsoever, and I guess most, if any of the stress, I’ve had previously was due to school. Even if not stress, just things like worries or concerns. In high school I would have untouched homework over the break and feel guilty afterwards. In university, although I almost never had homework, there were concerns about courses, marks, etc. being geared towards medical school.
Now it’s a bit different since everything in medical school is pass/fail. You could argue that there are still thoughts/concerns over things like working towards desired residency programs, but since the beginning of university, my priorities/values have changed and I’ve slowly began to care less and less about things like this. Not saying that I haven’t thought strategically at all about things like residency (because I obviously have), but what I can do now is pretty limited, and I’m more concerned with doing what I want and finding a residency that fits me than trying to mould myself to fit a residency program.
Group Studying
I have to say that I felt more comfortable with this anatomy exam than the first one. This exam focused on the head, neck, back, and limbs. Before I go into how the exam went, I wanted to talk a bit about group studying because of something I experienced and came to realize.
About a week before my exam, I went into the anatomy lab with four friends to go over some anatomy with the dissected cadavers and prosections. As expected, I was the least prepared person there. However, that doesn’t mean that I would not be able to learn anything or contribute to the learning experience of the others – the problems were that there were too many people and we were not all at the same level of preparedness .
Unless everyone in a group study period (assuming this is an active, discussion based study period and not a quiet one) is near the same level of preparedness, this experience will not be useful/fruitful for everyone. The whole group is not going to completely slow down just for you (okay yah this could happen, but it’s not going to happen in a high stress environment, for example).
I think it might help to explain this with an example. Imagine I went to the anatomy lab with just one other person, and that person was much more knowledgeable than I am. I can’t teach her anything, but she can teach me a lot. Nevertheless, we both gain from the studying. I gain because I learn new things, and she gains by solidifying hew knowledge through explaining it to me.
But imagine then a third person comes along who is more knowledgeable than both of us. The second most knowledgeable person is going to focus her attention on learning from the new person, since that is more beneficial for her. The rest of the roles remain the same. The point being that unless everyone is on the same page, the group studying/discussion is not going to be beneficial for absolutely everyone. Just to clarify, when I say that it would not be beneficial for everyone, I mean optimally beneficial – that is, while it’s true that I am learning something while there in such an environment, there are better group situations where I would learn more.
So the following week, I decided to go to the anatomy lab with just one other person, and found the experience much more beneficial (though I must add i was more prepared). For the things he didn’t know, I was able to teach him, and vice versa. It’s also much easier to look over specimens and test yourself with fewer people around. It’s harder to test your knowledge when many other people are also going over the same specimen as you in front of you. There’s also the thought of not wanting to slow other people down, which is something that definitely impacted me before.
My Last Exam: Gross Anatomy 2
So anyways, back to the exam itself. There were 61 stations in total (with I think 5 or 6 rest stations somewhere in there). During my last exam, countless times I found myself in a situation where I would have to use my entire minute and a half to decide what to put down – I rarely had situations where I knew the answer right away and could relax for an entire minute.
This time, I started somewhere in the middle of the head and neck stations, and was happy to finally experience what I didn’t before. I guess I knew head and neck pretty well because I had an answer for everything and got most of them pretty quickly.
Unfortunately I wish I could say the same for the back and limbs. Well, I think back I was probably okay with, and I don’t remember too many questions about that. My confidence was sky high from head and neck, but started to die a bit when I ran into some trouble with limbs – that was some hard stuff, and I found myself again wishing I spent even more time studying in the anatomy lab. It did boost my spirits to finish my exam back in head and neck where I felt most comfortable.
I felt awful coming out of the exam last time and scraped by with a 74%, so I’m hoping that since I felt better, it’s a sign that I probably passed, but we’ll see.
A Plug, and My Break
I just have to make a plug for the best movie experience I’ve had in a while. You probably all know about it, but it’s so good, I’m going to plug it anyways:
If you haven’t seen Avatar yet, go see it. And if you see it, see it in 3D. The plot/acting/etc. isn’t amazing, but the visuals are stunning, especially in 3D. This movie is all about the experience, and it’s best experienced in 3D. My friends and I are considering going back to see it again in an IMAX theatre – it’s that good.
Christmas break has been great so far, and I’ve gotten to see a lot of people I don’t normally get to see. I’m not even counting down the days until school starts, it’s really not worth it – gotta just enjoy the moment.
Hope everyone has a great break – Merry Christmas! 
So I had my clinical skills exam today…
As I mentioned previously, one of the courses I take in medical school is the Arts and Science of Clinical Medicine (ASCM I) where we learn basic clinical skills. So far this year we learned to take patient history, vital signs (heart/respiratory rate and blood pressure), and some physical exams (precordial, peripheral vascular). Next semester we will learn more physical exams like neurological, abdomen, etc.
For this first ASCM exam, we were evaluated on taking patient history and vital signs. The basic outline of the exam was that you would work with either a standardized or real patient – take their history for up to 35 minutes, and then have the final 10 minutes for the vital signs. While this was going on, a physician would quietly evaluate us.
My scheduled exam time was 8:00 am. By 8:15 am I was the last student still sitting in the waiting room, waiting for my physician to come get me, worried that I was forgotten about or something.
Finally my physician comes out and says, “oh there you are, we didn’t know we had to come get you – we were waiting for you inside the room!” I chuckle in reply “Haha I was waiting for you too!”
So I walk into the room and the patient is already sitting at a chair – the physician asks me to take a seat across from the patient and begin the exam. I quickly grab some hand sanitizer and rub my hands together as I introduce myself to the patient. She has chest pain, and so I spend a few minutes asking her more about it. I then go on and ask her about her family history, past medical history, medications, allergies, habits, and social history.
I realize that this is going really quickly and she doesn’t have much information for me – it makes me start questioning whether I actually missed a question or something. Once or twice, I pause for a few seconds, trying to think if I asked everything. I’m pretty sure I did, but I’m a bit paranoid because it seemed to have gone by way too fast. I’m not too surprised though because my brother said his lasted only like 15 minutes, but of course, when you’re in the moment, it’s easy to over think stuff.
After having summarized her situation twice (lol, paranoid much?), I move on to the vital signs part of the exam. Heart rate: 64 beats/min. Respiratory rate: 16 breaths/min.
Just before I start the blood pressure measurements, oops, I remember: “Oh yeah, the heart rate was regular” lol. (this means the heart rate had a regular rhythm).
I put the blood pressure cuffs on the patient, no problem. I start by measuring her systolic blood pressure by palpation (i.e. palpating the radial artery in the wrist and determining the pressure in the cuff that it returns). I try it once, and realize as I release the pressure in the cuff that I’ve lost her pulse. No problem I guess, I apologize to the patient and tell her I need to do it again.
This time, as I pump up the cuff, I realize the cord is knotted. I try a few times and it’s still knots even after I unknot it.
“Sorry, this doesn’t usually happen” (honestly, it doesn’t, so it’s a bit frustrating that it happens during an exam).
“Don’t worry, it’s just a technical difficulty” says my doctor evaluator. I’m really happy at this point that I have a super nice evaluator.
I finally seem to have gotten the cord straight, and I go ahead and obtain her systolic blood pressure by palpation: 95 mmHg.
I then go on to use my stethoscope as well, placing it over the brachial artery in her arm, and listening for her systolic and diastolic blood pressures. This time everything goes well, no problems: 104/65 mmHg. Don’t know if that’s right, but there you go!
I thank the patient for her time, and the physician and I leave the room for a few more words. She asks me about my general observations of the patient, and I tell her that the patient looked comfortable and rested, but that she appeared a bit hesitant, maybe because she was seeing me from the first time or maybe from her concerns about her chest pain. I also note that she wasn’t in distress and she looked about her stated age, maybe slightly less.
The physician examiner tells me she doesn’t know if she’s supposed to give me my feedback right now, but she smiles at me and says, “but don’t worry, you did great!”
Which made me feel great because I figure if she’s going to say that, there’s no way she is going to fail me – that would be just way too cruel.
I wish I could take a nap, but I’m heading to the anatomy lab this afternoon (followed by a business meeting tonight), so I need to do some last minute studying of head and neck!
Have a good weekend everyone!
Roller Coaster of a Day
Okay not really much of a roller coaster, but definitely some ups and downs – sort of.
This morning I did my last anatomy dissection ever. We looked at the posterior part of the forearm and dorsal part of the hand (i.e. the back of the arm from the forearm to the fingers). Being able to see all of the muscles and their tendons, and essentially knowing how the arm and hand works mechanically was pretty cool.
It was cool until I cut myself with the scalpel being a bit reckless, but it was just a small cut at the tip of my finger. I’ll be okay, but can’t say it was fun.
After the anatomy lab, I went to pick up my Histology test from the office. I give the woman there my name, and as she hands me my test, she glances at my mark and goes: “Oh God…”
Errr – thanks? Haha. So yeah the morning was a bit meh you could say.
In the afternoon I went to Toronto Western Hospital to meet a doctor and researcher whose work I’m interested in. We chatted for a bit, and I’m optimistic about the possibility of doing some research with him next year. Hopefully that works out.
Tomorrow I have my end of semester clinical skills exam. We will spend 35 minutes taking a patient’s history, and then another 10 minutes measuring heart rate, respiratory rate, and blood pressure – all while be observed and evaluated by a physician. I’m told no one ever fails this exam, so I’m feeling pretty good about it except that I am first up at 8 am…
Alright, enough procrastinating. I need to study head and neck anatomy because I promised a friend that we’d review that stuff in the lab tomorrow (for our upcoming anatomy exam next Thursday) and I am pretty much a moron on anything anatomy-related at this point (as usual).
Wish me luck!
Clarification of My Last Post
So I got this nice email today…
Liu, Joshua Paul
You achieved the following scores on the STF exams:
Blood & Gross Anatomy average: 84.3%, Your mark: 74.7
Histology average: 85.0%, Your mark: 67.5
Embryology average: 76.49%, Your mark: 70
Boy, that Histology mark looks ugly. I will be super sad if I’m asked to do remediation for that. I’m not sure what happened – I wasn’t completely prepared, but I thought that part of the exam went okay. Guess you never really know…
Anyways, I wanted to sort of clarify my whole rant in my last post. Yes, admittedly, it was a rant.
Let’s be clear – my brother, Jerome, was in medical school here at UofT last year. So yes, I knew exactly what I was getting myself into – I knew that first year would be full of rote memorization, and that I was probably going to go insane. That being said, I didn’t really think about it. It’s one of those things where you’re like, “naw, I’ll just let future Josh deal with that problem”.
I do understand most of this knowledge is important and necessary for the development of my medical career – it’s just frustrating when it seems like the rewards that you reap from enduring the frustrating parts seem so far away. Constant memorization does not interest me, and my personality type is one where I get bored/frustrated when I can’t pursue something I’m deeply interested in and passionate about.
It also does worry me that I’m finding it hard to have the motivation to do anything but “just pass”. What does it all mean, and why am I doing it? It’s a good question, and I’m sure the answer will be complicated. I think it’s partly because of my dislike for memorization, that I naturally figure out the least I need to study to just pass.
So in short, yes, I get that I need to know this information – yes, I do need to just suck it up and get over it.
That being said, I do think developing critical thinking skills is one of those things that our education system constantly claims to do but doesn’t. They test them, but almost never help develop them, and if they do, it’s usually in pretty minute ways. What I mean by this is that exam questions often require critical thinking skills, but no one spends the time to help students (that are lacking them) develop those skills.
You don’t develop critical thinking skills by simply listening or learning the mechanics for tackling a common problem. You develop critical thinking skills by asking questions and trying to answer them. You develop critical thinking skills by discussing concepts with peers, challenging their ideas and having yours challenged, and together learning different ways to approach problems. That is, you learn how to think about the knowledge you’re taught.
All the time in school they say understanding is more important than memorization. I don’t think they take it far enough. More important than both understanding and memorization is knowing how to think about that knowledge.
I’m sure I’ve used this example before in another post, I want to bring it up again to clarify what I mean by this and why it’s so important.
Have you ever been stuck on a problem, so you go to a peer, tutor, or professor for help? They figure out the answer and explain it to you – and you understand how they got the answer perfectly. But, you still can’t do the next question on your own – why is that?
It’s clearly not a problem with understanding – you obviously understand the material well enough to understand solutions presented to you. The problem is that you don’t know how to think about the material yet – that is, you are struggling with the ability to think critically about the material on your own. This is what happens when you feel like you’ve studied the material and understand the answers to all the homework, and yet still seem to mess up on the exam.
I firmly believe that we need to invest the time and resources to help students learn how to think about the material they are being taught. It’s not enough that they “understand” the material, because understanding does not necessarily lead to critical thinking. We need to make that jump possible.
So This is What It’s Like to be “Below Average”
Looks like I started a trend with the very last exam I took at York. After doing below average in a course (Molecular Biology 2) for the first time ever in my life in my last year at York, I have begun the year by getting below average marks on my first two exams, as you all already know. Looks like I might be continuing this trend.
I took my third exam this past Monday – Histology, Embryology, and Ethics. The embryology answer key came out a few days ago, and unsurprisingly, I scored below average again. The class average was 75 and I got a 67 – yeah I guess the exam questions were pretty “challenging”. I say that in quotes because the type of challenge wasn’t something I particularly appreciated. It was challenging because some of the questions required knowledge of pretty minute details. If you know me well, you’ll know that I love concepts and hate rote memorization of random facts. That being said, maybe I will end up doing above average overall across all three sections, though I highly doubt it.
Does this bother me? A little bit, but not really. It only bothers me in the sense that some people might only correlate my intelligence or capability as a future physician with my grades.
It’s weird that we think this though, and when I say this, I mean the pure correlation between marks and intelligence. I remember growing up, whoever got the highest marks in class was considered the “smartest” or whatever. Forget for a second that we haven’t even defined what intelligence is, or if you believe in multiple intelligences, what type of intelligence school tests – even if we neglect these important discussions, it’s pretty clear that it takes more than “intelligence” to do well in school. I know people who I think are much smarter than I who I’m sure I got way better grades than in school.
Yes intelligence affects your marks, but so does work ethic, test-taking skills, and ability to perform under pressure (there are probably more, but these are the four that to my mind the fastest). Among all four, my work ethic is my weakest aspect. Unless I am very interested in something, I can’t find the drive to put in the work ethic to learn it. And if you are weak in one of these areas, it’s going to hurt your marks big time. For me in particular, the problems with having a poor work ethic when studying things I don’t want to becomes amplified in medical school because so much of it is based on effort. Knowledge requires time to learn, and in medical school (at least here at UofT), knowledge is constantly being thrown at you. I can’t reason my way out of knowing the concentration of sperm cells in semen (my very first exam question required this knowledge, and of course, I never expected I would actually need to memorize that number – yes you could argue that anything taught is “fair game”, but you can easily write an unreasonable exam using all knowledge taught).
What saddens me is that it’s almost as if things still haven’t changed yet. One of the things that discouraged me about my undergraduate education was that there was so much emphasis on knowledge and next to nothing on developing thought processes, which as you know, I think is far more important in the grand scheme of things. We assume those thought processes will develop on their own, despite the fact that they are much more difficult to develop than simply accumulating knowledge, which simply requires reading a textbook (yes learning material from a textbook requires the ability to understand, but wait, that comes from thought process!).
I’m not saying knowledge isn’t important, because it is important. But knowledge becomes meaningless when we don’t know how to think about that knowledge, how to manipulate it to come to a solution to solve problems – and not just a solution, but to be able to develop the best solution. I feel like we grow up learning how to identify the best answer on a multiple choice test, but are never told that maybe the best answer isn’t listed on there.
Then again, you could just tell me to forget all this, suck it up, and memorize the damn textbook. I’ve got my last anatomy exam in less than two weeks, and there are loads to know (the head is pretty complicated as you can imagine…). But hey, I think I enjoy whining more.
Best of luck to everyone with their fall exams!
I Passed!
I’m sure people are going to say “oh Josh, of course you passed!”, but the reality is that I barely passed. I got a 72% – you needed 70% to pass, and the class average was 82%. I could easily have been on the bad side of variance and failed. Oh, and oops, scored below average again.
But that’s fine – I’m just ecstatic that I passed and don’t have to remediate or worry about something nasty going on my academic transcript.
Going to go out and celebrate – thanks again for everyone’s support!
I Think I Failed but Maybe it was Exactly What I Needed
The morning of Monday, November 9th, I gave up for the first time ever while studying for an exam. When I say give up, I mean that I knew I wasn’t completely ready for the exam, but was unable to stay up stay up all night long to make sure I was as close to ready as possible. It was 1:30 am and I was tired and my brain hurt from all the studying the past few days. So I just gave up and rolled into bed.
I walked into the Anatomy / Hematology exam at 8:30 am that morning already knowing that I was going to fail this exam a reasonable proportion of the time. My guess at the time was that I was probably about 75%+ to fail. Some people might say that I walked in with a defeated attitude, but trust me, that is not like me at all. I like to think I am pretty honest with myself about reasonable expectations, and my assessment was that my reasonable expectation was a fail. Unfortunately, my assessment was close to spot on.
The Hematology section was actually pretty good for me. There were 15 multiple choice questions, and I found them pretty easy, so I’m not worried about that. What I am worried about is my performance on the Anatomy portion of the exam.
The exam format was a bell-ringer, and it was my first time doing one. For those of you who have never done a bell-ringer exam before, the way it works is that the exam is made up of a bunch of stations (in my case, 60), and each station has something like a prosection (professional dissection of a cadaver, e.g. a heart)), diagram/photograph (e.g. a cross-section of the abdomen), radio-imaging (e.g. X-rays), or stand-alone questions. You get 1.5 minutes to look at the specimen/image at the station, and then there are about two questions on your sheet that you need to answer about it.
The vast majority of the questions were “Identify this” or “Identify that”. Which basically meant that the most and best preparation for the Anatomy component of the exam was spending time in the anatomy lab looking at our dissected cadavers as well as diagrams from the text books, and being able to name things. For someone who did not take the anatomy labs that seriously and didn’t even spend much time in the lab leading up to the exam, you can imagine how screwed I felt as I went from station and station and not being able to identify things right away (remember, you only have 1.5 minutes, and trust me, that goes by super fast).
Long story short, I knew I was screwed for the Anatomy portion within the first 10 minutes of doing it. My approach to the exam was just plain bad (poor work ethic, combined with not focusing on the right thing). I’m predicting a good mark on Hematology, and something like a 40% on the Anatomy portion of the exam. I heard that the Hematology and Anatomy sections might be grouped together for one mark, and so I’m hoping that happens and it saves me in some way.
If not, and if I do fail the Anatomy section, I’m not sure what will happen. 70% is a pass, and 60-70% is remediation – what happens if I get below 60%? Good question, if you know the answer, let me know =).
How do I feel? Feel pretty stupid, for one. A bit worried about what the consequences might be too. Questions like “if I fail, does this go on my transcript? Will this screw me over long term?”. We ask ourselves a gazillion questions whenever we screw up, despite the fact that what we should only worry about is the future, since we can’t change the past. Whether I failed or not, at this point, is kind of irrelevant in terms of what I can do about it. All I can do is damage control now, learn from my missteps, and make sure I don’t screw up in the future.
I’ll be honest, my thoughts were much more jumbled and messed up at the time. While I was struggling to study Anatomy the week before (and by struggling, I mostly mean struggling up the will to open my notes), I started questioning whether I should even be here. Why wasn’t I more motivated to study like my peers? Is that a function of my poor work ethic, or an underlying lack of interest in medicine? Was my poor exam performance subconscious self-sabotage to get me out of here?
I’m still trying to figure all these things out.