I was a college sophomore at Binghamton University, and I had just walked into a research event at Quinnipiac University on a Sunday morning. I shepherded a research poster on Parkinson's Disease, a project I had worked on the prior summer. My partner, Sherry, and I set up shop on an easel in a weirdly lit gallery. I stretched, telling Sherry how excited yet nervous I was to present our project to a bunch of PhDs I’d never met before. Although in my head, I was really questioning what we were even doing there. We had some audacity, huh? We spent an entire summer giving twenty-two rats Parkinson’s Disease just to come here and present something we knew next to nothing about. I could’ve told you quite a bit about the symptoms of Parkinson's and about "L-DOPA induced dyskinesia," but not a single thing about the cerebellum or the pons. Couldn't even point to them. Regardless, we carried on, had lunch, and then filtered into a “Careers in Science and Medicine” panel. Inside this even more weirdly lit auditorium, a Russian-accented pharmacology professor from Quinnipiac’s School of Medicine sat on the far left of the table. I meagerly raised my hand to ask:
“What would you recommend a college student to start doing now to prepare for the rigors of medical school—or to just make that transition easier?”
The Russian-Pharm man almost jumped out of his seat and flailed his hands as if he was performing the YMCA dance in reverse. “Listen, and this goes for everyone in here. I want to make this clear: Medical school is EXTREMELY difficult—leaps and bounds more difficult than college. You will be studying all day long.....so difficult, so many hours, etc."
His bravado was impressive, but my question was unanswered. I told him that I understood that medical school was difficult, but I was interested if he could possibly talk about some skills a future med student should hone in on now in order to reap the benefits later on. Seconds later, as I received pretty much the same answer as before, I sat there disappointed and almost embarrassed that I seemingly couldn’t frame this question to make any more sense. A few years later, in my first year of medical school, it occurred to me that this general misunderstanding, this interaction, and this muteness surrounding what it means to be successful in medical school is something that still predominates in my life as I navigate a journey as weirdly lit as those rooms at Quinnipiac University.
If you ask any physician or med student about their first year of medical school, you will likely be met with sighs, glares into the distance, grimaces, and lofty phases, like “it was a grind” and “I wouldn’t want to do it again.” For most people, it’s a true slap in the face to go from easy-going gap years and fun summers to days filled with loading information, just to regurgitate it all out on the next exam.
When I first received that short white coat, I grinned with a tremendous amount of pride. After all those years of trying to be the perfect candidate to don the coat, there was finally a sense of clarity. A path. In between unexpected opera performances (yes, opera), the Dean talked about successful residency matches and promising student attrition rates. Professors who stood tall in long white coats spoke life and glory into our clinical dreams, with some mentions of the upcoming struggles we knew of but really didn't quite understand. We took an oath that actually meant something to all of us, and as I looked to my left and to my right, I saw students, just like me, in both awe and fear of what was to come.
And into the fire pit we went---drowning in anatomy labs, videos and PowerPoint lectures. Perhaps this was a perfect storm for a masochist, but it was an absolute nightmare for me. Each class had its own horrors. Anatomy would tease me with familiar terms only to karate-chop my brain with innervations and embryology. Histology hijacked the color wheel and weaponized it. Medical Biochemistry made undergrad Biochem look like a high school class, and Osteopathic Manipulative Medicine made simple words like "rotation" and "side-bending" sound foreign. We played it off cool in the lecture hall, but weekends were tough and early mornings on exam days were the worst.
Repetition. Repetition was the name of the game. Exams were on repeat---all 63 of them. Flowery language like "what an honor it is to be doing this" no longer motivated me. I was motivated by failure but not in a spirited entrepreneurial way. You see, being unprepared for exams made me feel physically ill. That's where this journey takes a dark turn, and a lot of people don't like to talk about it. In some forums on Reddit, I’ve encountered med students say that maybe it is best that the general public is ignorant about what we go through, suggesting that our “bottling up” of our true feelings maintains the aura that physicians are these miraculous lifesavers—fortified and unstoppable. But behind every physician (and I acknowledge that this may sound presumptuous coming from a rising second year student) was a medical student who questioned whether he/she was good enough.
I'm a big fan of the mantra "loose lips sink ships," which is understandably ironic as I dabble in journalistic endeavors like this blog (Have you subscribed? Hmmm..). Anyways, my school has its own forums where I can give feedback on specific elements of the curriculum and the overall experience; thus, it really doesn't help to share such items on here. However, after consulting with friends at other med schools and taking the time to understand the medical student community at large, I think an important piece of advice I can give is to "go against the grain when needed." This odd tidbit of advice comes into play in front of a backdrop of scholastic competition between medical schools. Just like colleges, medical schools are constantly competing against each other, from rankings to residency matches. And trust me, they don't spare the curriculum. Some schools have early clinical experience, others have flipped classrooms, pass/fail grading, traditional classrooms, research based learning, engineering-based learning, you name it. Around the country, medical schools are setting up a framework that they think works best for their students, but the thing is, the people making the curriculum are not the ones taking the tests for you. You have to adapt "the system" to your taste but need to do so at their pace, okay? That is the key, my friends.
Let's lighten up this party. I’m so happy to write and share with whoever reads this that although medical school often seems to be “the worst time of your life,” I often feel blessed to be able to go through this journey with an absolutely wonderful group of people who care about each other. Early on, I was able to gravitate towards a crowd that was seemingly so human and personable, whose smiles warmed up the frigid cadaver lab and contrasted greatly with my hours studying alone. In fact, I owe a lot to people who weren’t even in my class, such as my upperclassmen roommates who showed me what home-cooking and game nights can really do for a stressed out student.
To be honest, I never felt like I “found my people” to this extent in my life. High school was a mediocre experience socially for me, and in college I often felt isolated from the prominent Greek culture that I never took an interest in. I’ve also been around the block in a couple different work environments, like pharmacy, retail and EMS—of which many are filled with unfriendly and malignant cultures. So here’s my point: although being thrown into this fire pit called “medical school” is overwhelming albeit necessary for our professional development, I am so glad that I have done this for myself because the people that I have met are not only very special to me, but we have collectively built something inside our comradarie and social ties that matches just about everything I previously wanted out of my career, including job security, prestige, and an impact on my community. I cannot ignore that the rigors of my first year education actually helped elucidate these positive feelings from the sorer sentiments, and for that, I am grateful.
If it wasn't hammered on already, we can definitely liken the first year of medical school to a boot camp of sorts. A boot camp that pushes your abilities to think, memorize, manage your time, and to stay awake. That last one is a point that I struggled with immensely this past year. At face value, the hours of classes and nighttime studying are the main culprits, but the ones that really push you to your edge are the mistakes that you make consciously and subconsciously, such as waking up too early on the weekends and letting physical activity fall to the wayside.
Keep reason as a friend you talk to daily.
It can get so easy in this monotonous way of living to “keep calm and study on,” but if you feel like you’re being pushed to the edge, you ought to reason with yourself that your feelings of fatigue and anxiety are shared among people just like you. Why must you be the martyr who can't justify a 30 minute nap, a phone call to a loved one, or a walk around the block? Go ahead, be human. You can do this, but you could do it a lot better with some rest.
Ezra Guttmann is a medical student and blogger. Opinions on this blog are of his only. No medical advice.
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