If you're going to take the philosophy of not caring much about grades, you have to accept that you're likely to do worse than those who do care about grades.
Honestly, I think the philosophy that "grades don't matter" is a bull****, lazy attitude promulgated as a defense mechanism by people who were beaten into submission and learned helplessness by egos that overreached their capabilities in the big pond of medical school. Medicine is a field of high responsibility, high social status and high social consciousness. The view that "oh, well, I got into med school so I don't have to work hard anymore. Despite being lazy, because I'm so smart and got into med school, I deserve the six figure salary, high social status, praise from my family, and privilege of caring for patients that comes with being a physician" is reprehensibly entitled.
Work your hardest and make sure whoever you love supports you. If you're in medicine and you're in a relationship with somebody who doesn't understand the importance of doing your best and working hard for your career, you're not with the right person. I have had really frank discussions with my girlfriend where I said that she and medicine are tied as my top priority. I think that's how it should be if you're in medicine. You've already invested a lot in this career and, besides that, soon there will be many people relying on you for their care.
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Perspective (grades & life)