Transitions of a first year medical student

by Kristine Casal

The moment you get accepted to medical school, you never really think about how everything is going to be different. You figure everything’s going to stay the way they are, with the exception of the inevitable long and laborious hours of studying day and night. You don’t think about how much time you won’t have (because you had the weekends, right?) or friends you might lose along the way.

I know I didn’t. In fact, I was so convinced that I could do it all: go to class from 8am-12pm then be in the anatomy lab from 1pm-5pm, eat dinner, then study until my eyeballs went numb or I pass out in my cubicle at the library. I would wake up the next day and do same thing all over again. I assured my parents that I do TRY to remember to eat in between classes or studying, that I TRY to not drink too much coffee. I tried to keep my relationship steady, because I didn’t want to be part of the infamous “turkey drop” statistic. Plus I tried to maintain the tight bond I had with friends I considered family and then have some type of social life.  Try, try, try. I had no idea how long I was going to make it work, it lasted for a little while but then it got too exhausting. Something had to give, and in my case a lot did.

Shortly before the second term, my relationship ended because I didn’t want to make any time or effort. We rarely saw each other and I became too self-involved, I wanted all my time to myself. Soon after, I realized that I was also burning bridges with my best friends. Not intentionally mind you, I’ve made attempts to work it out but the damage was done and we’ve already drifted so far apart. I was never around nor did I really care about being there. They wanted my time but that’s exactly what I didn’t have enough of. My priorities changed gradually throughout this first year, and it quickly dawned on me that I wasn’t the same.  I typically like to make everyone around me happy, that’s just the kind of person I’ve always been—but in reality that wasn’t doable anymore. Being in medical school is a full-time (unpaid) job, and I am investing on my career and future here, so sacrifices had to be made. I just didn’t expect it to be at this magnitude.

The thing is, I’m going to be saving lives one day so I want to be damn good at it. I’ve worked so hard to get here and if I have to give up certain things to live my dream then so be it, cheesy as that may sound. This seemingly challenging and endless journey has brought me new experiences, relationships and friendships with a few amazing people that will become my future colleagues.

As a medical student, you have to adapt to survive. No one likes change, but you have to compartmentalize and prioritize accordingly more so now than ever, in order to focus on what’s important and preserve your sanity. There will be days that you want to give up and wonder how you’re going to get through it all. You might lose some friends, who may or may not come around. No matter how frustrating, you have to accept that you can’t force everyone to understand. You have to learn to let go and move on. You’ll always have your family’s support; don’t you want to continue to make them proud?

Life is going to throw a ton of curve balls along the way but just remember to take it one day at a time. Learn how to be selfish, and actually be okay with it. For me, this was a hard pill to swallow. But then remind yourself that you’re entire life will be dedicated to helping others; this IS the perfect time to put yourself first.

I did. How else would I have, almost (finals are still looming) survived my first year?

Kristine Casal is a medical student.

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  • Megan

    I’d love to ask you a few questions and get your advice about some medical school related things. Great article!

    • Kristine

      Hey Megan!
      I would love to give some advice! I’ll try to give some helpful ones as much as I can, you can email me anytime!

      • Connie

        I’ve just read this too and I admire you! Whenever I need advice may I ask you some questions too?

  • txmed

    I remember thinking the importance of the first years of medical school. Don’t take the following wrong, certainly the pre-clinical years lay the basis for everything, but looking back on it from residency the stress I placed on myself trying to succeed those first two years was an overburden.

    The transition into the first year of medical school is quite a tsunami. But just bear it that most of your truly relevant education is still to come.

    • Fam Med Doc

      I agree. Although foundational, of the four years of med school & 4 yrs of residency & a fellowship, year 1 & 2 were the least important. I stressed out way too much in those years. Needlessly.

      As a matter of fact, residency is what’s important & where you become a doctor. I remember a number of self-important, unhelpful, even abusive faculty at my med school. So made med school more difficult than it needed to be. To all the med students sweating it out, this is my advice:
      IGNORE all the negativity the school throws your way. As long as you are not being threatened of being kicked out of med school for bad grades, the grades are meaningless. You WILL graduate. You will be a COMPETENT physician. If a faculty member is throwing you crap, just smile, say nothing, grit your teeth & know it will be over soon. Screw them.

      I wish I wudda known that bit of advice in med school. I would have been less anxious, more self-confident, & happier. I’m 8 yrs out of all the schooling/training & I understand that now.

      Good luck my friends.

  • Dr Sam Girgis

    Thank you Kristine. Your post reminded me of my first year of medical school. It was very hectic and difficult, but very well worth it. You will have to continue to prioritize goals, friends, relationships, and other things in your life. The strain on your time will continue, and you may think that it could not possibly get any worst. Well, it will… in residency, your time will become an even greater commodity.

    Dr Sam Girgis

  • thunderroad

    How much discretionary time do you have during your first year? I am only a premed now, but I am already feeling strain on my relationships. I’m hoping that my family can adjust to making do with frequent small chunks of time. What tools do you use to manage your time?

    • Kristine

      I think the curriculum varies depending on the institution, but for my school my first semester barely left us anytime during the day to study because we had classes during the morning then lab until 5. So most studying happened after dinner until the wee hours. Second semester wasn’t as bad, the problem was that we had a test every two weeks so you pretty much had to study as much as you can with the copious amount of material given in such a short period of time. This last semester was the easiest, mainly because we’re going through systems probably the least demanding as far as understanding concepts so I slacked a little bit more than I did in the past. (Slacking means taking a half a day off, but being way behind the next day!). The weekends were reserved for reviewing all that weeks material in preparation for another wave of new ones.

      My family was the most understanding in my situation. I brought my parents to orientation and my school had a program for them where they saw our everyday schedule, what to expect, how to be supportive and I guess it really did help them be a but more understanding me not being around so often. My mom even offers to come see me to clean my apartment or do my laundry but it would be absurd for me to accept being that I am 25 years old. I do come see them when I have a little cushion time usually after an exam where taking a day off won’t throw my schedule off.

      As far as friends/significant others, it depends. Most of my friends do understand without me even explaining a thing, but the ones I was closest with really didn’t get it. Our falling out resulted because of my absence and it’s something I’m truly upset about but it brought me more negative than positive to the point where it started affecting my attitude and overall mood at school, and so I made the decision that I need to let go because it wasn’t benefiting me at all.

      I didn’t use tools per se, but I did try a planner or google calendar but that really stressed me out more. I love lists so I like piling things on thinking I could easily strike them out.. not so much when you don’t have that much hour in the day. To keep up with “real life events” I use my Iphone’s calendar for reminders but when it comes to school I use A LOT of post its! I usually come in to school 7am and plan my day make a short, attainable list for the day. I try not to pressure myself on what to get done in hopes to be more efficient and less eager to just get it done. Then again, you can modify everything to your own needs, it’s a matter of just figuring out what works for you.

  • Dylan Mann

    Now I can’t wait to start med school next month :)

  • MD

    Agree with above. Medical school sets the foundation for residency training. The first two years of medical school are by far the least important in terms of becoming a competent doctor. Residency and fellowship training is where you will truly learn your specialty and become a competent physician. The learning however never ends, even when you are an attending.

  • solo fp

    The first two years are simply there to provide some info for the step 1 USMLE. Many of the profs acted like royalty and had their own little kingdoms with no real clinical experience. Many of them were quite abusive and treated students worse than their lab rats. The doctor preparation starts in the 3rd and 4th years to become a doc, and I found my community rotations had the best docs and teachers. Residency is what really prepares you to be come a practicing physician. I will never forget the grunt work and poor treatment I received in med school on a couple of rotations despite many hours of hard work. Residency was even harder work but much more rewarding. Much of med school is simply a right of passage with the real medicine coming after med school.

  • J P

    This article left me unsettled in that the point of becoming a physician is to work WITH people, but in the process we have to sacrifice BEING with people. It’s ironic. Though I agree with this article that sacrifices need to be made, unfortunately I cannot see someone just give up friendships/relationships. Social life is a PART of the process and a PART of the vocation of being a doctor. Yes, there will be a significant reduction in time spent with friends, even over the phone or other media, but to sacrifice relationships you’ve been pouring into for 5 years, 10 years…that’s ridiculous. There is a disconnect with trying to become the “perfect” doctor while in the process throwing others out the window. Though undergrad general education compares little to medical school, I had noticed making too many sacrifices with my friends to pursue my “dream.” As a result my grades and sanity suffered despite studying more, and then I realized I made my ambitions my life. No matter how passionate you are about your work, friends and family count for more than we think. There is always time for friends and family. Always.

    • Kristine

      I totally agree with you as well, every situation obviously varies. But in my situation, my friends penalized me for “replacing” them with school. I made the time and effort when I could without having to give up a substantial amount of time for my studies. I couldn’t give them the demands that they wanted. I wished that they were more understanding with my situation, but our arguments grew to be more trivial and juvenile, which was why I made the executive decision to let go. As far as my relationship, I just realized that we had different goals and that I needed someone who was more driven as I am about not just work but life in general. It’s part of growing up as an adult I believe, you just learn based on your experiences. Actually, this year has made my family and I much closer than before and I’ve been so thankful for their unyielding support. Again, a lot has made it work for them, without exactly losing their sanity and I’m glad it did, but not so much in my case. It’s been a trying year that’s for sure.

  • I.

    People that are going to enter to MedSchool just has to realize how hard it would be and this post says a big part of it. Not to mention the so many many times that I changed my rutine and way of study and still had the same results. Pretty frustrating but time wasn’t enough. About the relationships, im still with my fiancee bc he already went to grad school and he already knew how much time to study i needed (otherwise i think we had couldnt make it)… But here i am, just ended my first year a week ago. It is not impossible and im proud to say that now im a MS 2. Greetings from Puerto Rico!!

    • Kristine

      4 more days and 3 exams are keeping me from being an MS 2!! happy vacationing you definitely deserve it :)

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