I've always been (unfortunately) always been the weird fish in the small pond whether in special ed / ESL in elementary school, in the youth shelter or on the ambulance, and I'm sure my being neurodivergent is not helping. I am enthusiastic about many topics (even anatomy, which I managed to survive) and now we've moved on to my favorite pet topics ... medical biochemistry, and I'm finding the level of learning is broader, but at a more superficial level compared to the PhD Biochemistry coursework (which had heavily clinical correlations) when I was an MS student holding toe to toe with PhD students and passing their exams.

I'm trying my best to make friends instead of unintentionally making adversaries but I'm finding I'm really clashing with my classmates over differences in background.

The biggest difference is in socioeconomic background and transportation (I take public transit, my classmates have cars. I am saving up for a car despite driving ambulances as a job for years. Probably won't be able to afford a car until second year, but definitely by rotations. Difference in SES background is playing a bigger factor in school than I anticipated. Most of my classmates simply can't relate to poverty, and I'm guessing my classmates who are also poor do a better job of hiding their SES compared to me. I live in the big city but my school is in the suburbs, and I take the train from the city. I'm frustrated that my classmates and student organizations that plan events do not accommodate the logistical needs of impoverished students. Even as we are trained on how to care for poor patients in theory, it is painfully obvious that most of my classmates do not know the daily struggles and lifelong impact of poverty. When I mention personal struggles and experiences being on Medicaid (for discussing a patient scenario that literally involves socioeconomic determinants of health), the whole discussion group goes crickets. It's really frustrating.

There are some other exacerbating factors. I've been usually good at hiding my autism spectrum disorder (as a woman), so I thought, but I guess now that we are in biochemistry land it is difficult to suppress not wanting to go into detail about topics we covered in my past research-focused MS program. I know most of my classmates are only interested in research for the purposes of applying to competitive residencies. They only want to focus on topics covered on the next exam, whereas I am not worried about the next exam because anatomy is over (finally) the biochemistry we are covering right now is rather superficial compared to the PhD-qualifying exams in biochemistry I passed (I hedged my bets and would likely have become a PhD student in biochemistry had I not gotten into medical school - I had several offers from different PIs.) I did not apply MD/PhD but I am trying to get into my school's MD/PhD program at the end of second year. This has made it seem to my classmates that I am not easy to work with or do not deserve help, when in fact, I am just extra enthusiastic about a subset of advanced topics I've studied and researched for years while I am still struggling with so many other aspects of being a student, including navigating specialties and mentors, juggling living expenses and supporting my partner at home.

The students who are parents and who would relate to struggling with living expenses think it's weird I do not have children at my age. (I am a nontrad student so I'm about 5-8 years older than most). My partner and I are both queer and we want to start a family, but naturally Medicaid does not cover fertility support for queer couples. I do not know anyone in my school who knows the struggles of poverty, and no one in my support system (majority low SES) can relate to the struggle of studying medicine.

I feel so incredibly isolated and alone. I have broad interdisciplinary interests, want to advance the state of the art of medicine through research, and I also want to care for patients. I may be undecided on my specialty, but I honestly wouldn't know what to do were I not in medicine. I'm not fitting in school and I don't think I fit anywhere else.