As we near the end of the current four week rotation period, I’m realizing that we are nearing the end of the fifth month of M3 year. We are no longer early M3s, no longer the fresh-faced members of our inpatient teams, and no longer blissfully unaware of how far behind we set our preceptors in outpatient clinics. We’ve learned that being “on service” means working on a medical team in an inpatient setting, that getting someone “teed-up” means ordering all the necessary labs and imaging for the next step in treatment, and that asking whether there is “anything else that needs to be done” means that you’re ready to go home. I’ve also learned, and I can only speak for myself here, although based on lots of different conversations, I think it’s safe to say that I’m not alone, that I still don’t have any real sense of how I’m doing or what’s coming next. Over the course of a single day I can count both instances where I felt competent, well-prepared, and like I’d learned a lot on my previous rotations and those where I felt like I might as well have been some random person off the street for all I was demonstrating any medical knowledge in my presentations. As we start to get back feedback and grades (I say start because we’ve only really completed two whole rotations so far, and it takes 5-6 weeks to get grades) I’m also realizing that I’m probably somewhere in the middle of my class, and that by definition all but two of us are in the middle somewhere. There are things I’ve done well on, things I wish I done better on, and things I hardly remember doing (note that most things that occurred before about 5am fall into this category). I’m finding relative grading (that is, grades that compare you to classmates) a disconcerting change from PhD-land where everyone can be a superstar. I’m trying to move forward though, learning as much as I can along the way, and not letting the little hiccups get me down.