5 essential aspects of medical school that you wouldn’t expect

Interview season is winding down and budding physicians everywhere are clutching tightly to their hard-fought medical school acceptance letters. I thought now would be an opportune time to reflect on what I wish I had known before starting medical school.

Let’s boil it down to five essential aspects of medical school that you wouldn’t expect or are of such crucial importance you should be reminded of them.

1. You will have time for a life. Please, this is medical school. You will have no time for a life. Your time will be dedicated to weeding through intricate theories on the latest medical advances. I was actually picturing this upon matriculation to medical school. Luckily I was wrong! Yes, medical school is hard and it is time-consuming (devouring?) but you will have time to do the things you love. It is all about time management. Determine what activities are most important to you and make time for them. You will perform better in the long run.

2. Ignore the gunners. People will give you different definitions when asked to define a gunner. I define them as people who are willing to throw their peers under the bus if they think it will help themselves succeed. The truth is the majority of these people are misguided and likely have some form of personality disorder at baseline. Ignore them. Let the gunners gun. It is not worth your energy to compare yourself to them. Let their verbal diarrhea run in one ear and out the other (how’s that for a visual?). Here’s what you can do. Worry about you! Your job is to do what you have to do to succeed.

3. You will make sacrifices. Medical school is expensive not only monetarily but also emotionally.  It can be extremely difficult to see your friends from undergraduate living it up while you are spending the majority of your time with your nose to the books. You will miss out on some events that are extremely important to you. If medical school is anything it is a lesson in delayed gratification. I don’t mean to sound bitter (I’m not!) I just want to express that this is a very real phenomenon. You have been forewarned!

4. You probably won’t be at the top of your class or get a 270 on the USMLE. I know, I know. You breezed through high school and excelled in undergraduate. Why would medical school be any different? You will rock this too gosh darn-it! Be realistic. Look around the room. All those people you see are thinking the same thing. If you find yourself somewhere in the lower half of the class do not get discouraged! Be realistic and remember…

5. Your classmates will be amazing people … and you are amazing too! I am constantly humbled by all the extraordinary things my colleagues have done. Advanced research, volunteering, fundraising, these are the ingredients of a successful medical school applicant. Guess what? You are part of this elite group. Don’t ever forget you deserve to be there too!

Regardless of what I tell you and what you read, you will always feel unprepared on your first day. Don’t be afraid, dive in head first. I thoroughly enjoyed 95% of medical school and you will too with the right attitude.

“Survivor, DO” is a physician who blogs at Surviving Gray’s.

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  • adh1729

    You may have time for a life; or you may get into your chosen specialty. You might not be able to have both.

    • http://www.facebook.com/survivor.do Survivor DO

      Adh, I respectfully disagree. Medical school, and life in general, is about time management. You MUST make time to do the things you love. Take a good hard look at your schedule, if there is truly no time to do something that relaxes you and/or gives you enjoyment then I suggest you DROP something that doesn’t. If you don’t you are going to become burned out and miserable which is NOT conducive to future success.

      • adh1729

        I agree that burn out is bad for a person; I have lived it. I went to med school in the 90s. I don’t agree with our system of medical education at all; I think it is destructive to health and to life. I would never advise my children to do what I did. Nevertheless, my point still stands: if you tell the average med student to memorize the telephone book, be top 10% and get a step one USMLE > 240, they will have to make tremendous sacrifices. I did. (And then, as an MS4, I decided that I wasn’t even interested in the competitive specialty.)

        • acid rain

          What’s an MS4?

          • adh1729

            4th year medical student

        • http://www.facebook.com/survivor.do Survivor DO

          ADH, I agree with you that our medical education system is flawed. I would be interested to hear your suggestions on how we can fix it.

          • adh1729

            I doubt that my suggestions would fly in 21st century America (government and allies wouldn’t allow it), but here goes:
            1. First and foremost, bring back the apprentice system with a vengeance. Start a highly-structured residency at age 18-20. Before you drop dead from shock, let me explain that the neophyte would have extreme supervision for as long as needed, and might work 50-60 hours a week max (with no homework after hours) and might work for no pay for years. Combine med school/residency. Minimize premed. I am a surgeon; what in the heck do I care regarding Grignard reagents or SN1 vs SN2? Does Emile Durkheim matter anymore? Let each specialty decide what premed and med school elements are needed in their “residency”. If the individual student wants a traditional liberal arts degree first, great. If not, fine. Don’t force people to “learn” subjects when they never interested in the first place; such “learning” is likely transitory.
            2. Minimize memorization. Of course it is needed, but why not figure out a system where most of the knowledge is learned on the job, from seeing case after case? That type of knowledge is likely to last for decades, unlike the stupid cramming for O Chem/Biochem that lasts a week at best.

          • http://www.facebook.com/survivor.do Survivor DO

            Thanks for your well thought out response. I agree with most of what you wrote. Not saying that any of this will ever happen but in a purely hypothetical world I think we should shorten basic medical education to a year or so, everyone needs SOME ground to stand on. Coming straight out of high school without any great emphasis in physiology/anatomy I think it would be tough to catch up. After this take on some form of apprenticeship similar to what you describe. The major issue I see with this is that students would have to decide on their specialty too early- I have run across many 3rd/4th year med students that still don’t know what they want to do. Perhaps the training needs to be more general at first and allow the student to specialize their curriculum as they see fit. Regardless, I agree that there are WAY too many years of classroom study before we even get into the hospital. I would say 75% of my “training” before entering the hospital as a 3rd year was useless. We need to cut out this fluff to save both money and time.

          • adh1729

            We agree about nearly everything. BTW, I assume that you are a DO; I did not mean to insult you with my phrase “well trained MD”, I hope you understand. I have actually served as a preceptor for a couple of DO med students.
            One of my biggest beefs is, the change in a person after a grueling decade-and-a-half such as premed/med/residency/boards. Some of it is necessary maturation and hardening, and some of it is burnout, cynicism, depersonalization, apathy. Endless hours in the classroom, endless drill and memorization, destroy the energy, imagination, and creativity of youth. (In my own case, I was homeschooled; classroom didn’t start for me in a major way until age 18. Burnout and apathy caught up to me eventually anyway, especially with those 100+ hour weeks in surgical residency.) A person just goes into survival mode, sinks lower on the Maslow hierarchy, and I don’t know that the process is ever entirely reversible.

          • adh1729

            (continued) 3. Cut out the tests, shelf exams, board exams, etc. Instead, integrate lecture and testing and let them occur on the job during work hours, for a couple of hours here and there. Create tutorials with lecture/quiz/review quiz. Bring back quiz questions from 1 week, 1 month, 1 year, 3 years. When the student demonstrates retention by getting the question correct enough times, retire that question and bring in new ones.
            4. Have an instructor + 2-3 students deliver medical care to the indigent and only to the indigent. If physicians are caring for the indigent for the first 10 years of their careers (starting age 18 or so), we should be able to shut down Medicaid right there.
            5. Transfer stable indigent patients to the teaching hospitals, or the teaching division of the hospital/ER. Get the students plenty of experience.

          • adh1729

            I have given a long answer; start with #1 below.

            (continued) 6. Shut down 100 medical schools and let there be instead a few medical schools sprawled out over the country with numerous little branch divisions. Eliminate expensive architecture, buildings, administrators, etc and actually concentrate on your finished product, a well-trained MD. Concentrate on the individuals doing the teaching; make sure they have time to teach, that they are doing it to the best of their ability. Pay them well, to teach. For those (hopefully more rare) situations where classroom lecturing is needed, choose only the best lecturers and beam their lectures across the country to thousands of students, at their own pace and place.
            7. If students want other knowledge (ancient Babylonian history, pottery, ballet) they should be able to learn that on their own time. I don’t see the point of forcing Dickens novels down the throat of someone who lacks interest.
            8. I think high school is time enough to learn to write, to learn to read the constitution and basic American and world history and civics. I don’t think your average physicians need to learn calculus, and if you force them, they will never remember dy/dx and the MacLaurin expansion of sin(x) a decade later to save anyone’s life.
            9. Allow persons to switch residency tracks (but if they go from family med to pathology and can’t earn their keep for a couple of years, guess what, they can work for free.)

  • AP

    Thank you. I really needed to hear this. I need time with my wife, and I’m glad it’s not like we are imagining it to be now.

    • http://www.facebook.com/survivor.do Survivor DO

      AP- Don’t get me wrong, it IS hard and even in my short career I have seen a number of marriages strained and some broken but if you make sure to make your relationship a priority you should be able to get through it! Good luck!

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