Hanna Renaldi's Blog: What to Expect During Medical School

What to expect during medical school

You’re about to embark on four years of learning, working, socializing, and then learning and working some more. The best way to prepare for the long road ahead is to know what to expect. This post will walk you through the various avenues of medical school education, from reviewing what and how you’ll learn to making time for your own health and personal growth.

Curriculum Styles You May Encounter in Medical School

When you initially researched medical schools, you probably noticed that each school emphasizes different styles of teaching – and that some schools offer more than one approach. Here are some of the different curriculum styles you may find:

• Traditional-based: In this style of teaching, you learn about healthy normal anatomy and physiology the first year, then abnormal and disease processes the second year.

• Systems-based: In a systems-based method, you learn about each organ system, e.g., neurological, musculoskeletal, cardiovascular, and study both the normal and abnormal aspects at the same time. Then you move onto the next organ system.

• Problem-based: In this more recent approach, students are given patient cases and learn about both normal and abnormal aspects of human health in the context of an entire patient. For one patient, there may be a combination of organ systems involved, so you will study about the effects they have on one another. Some feel this is more relevant and practical to learn, while others feel there is a risk of becoming overwhelmed or missing some vital information.

The good news is many schools use a blend of all these methods, and almost all schools use problem-based learning at some point during the four years. Whichever style your school emphasizes, they should monitor students’ abilities to retain and use their knowledge in a practical (e.g., case-based) situation.

Learning Opportunities at Your Medical School

Some schools have mandatory lectures, while others make only their small group classes and labs mandatory. If you tend to tune out and fall asleep during lectures, you may decide to spend some of this time studying.

You may be a visual or tactile learner, in which case labs and hands-on situations work better for you. However, if you learn by listening, make every effort to attend lectures. Professors want their students to do well, so they often drop little hints as to what will be on exams. Plus, you will get a chance to ask clarifying questions and to find out what other students are asking. Often, another student poses a question that is the same as yours, which reassures you that you are not alone in your confusion.

Whether studying in groups or alone, keep your own learning style in mind. If you don’t know what your learning style is yet, this is a great time to figure it out.

Note-Taking and Sharing Services Available at Your Medical School

Some med schools organize a note-taking service, where students take turns creating detailed notes for each lecture and then share them with everyone else. The benefit of this is you can relax in a lecture where you are not the assigned note taker and listen to the information, knowing it will all be written down when you need it later. If you are sick or need to miss a lecture for some reason, you won’t miss out on the information entirely.

The drawback is you could miss something, especially if the note taker was not on the ball. At some schools, professors send their notes out before lectures, so students can read directly from the lecture notes while they listen. This may tempt you to skip class, although you may miss out on questions asked by other students (and more importantly, the answers).

In medical school, it is often up to you to decide how best to spend your time. Some days, you may benefit more from being in class than others.

How You’ll Interact with Patients During Medical School

You will start by learning how to take a complete patient history and review of systems, and eventually progress into the physical exam. The first few times spent interacting with patients can be a little scary, so many schools ease you into this by having you interview actors posing as patients. Other schools depend on experienced patients who enjoy working with students.

Many patients enjoy teaching students and take great pride in contributing to your education. Their goal is to help make better doctors (which they do). Let them show you how to make things more comfortable, and you will both come away feeling a positive connection.

Who You’ll Learn from While in Medical School

You will learn a variety of approaches to patient care, from attendings, residents, nurses, technicians, and of course, from the patients themselves. In the end, you will pick and choose which styles, techniques, and approaches work best for you.

Your approach will often vary depending on the patients and their temperament and situation. Experiment with different methods to find your unique bedside manner.

Personal Growth in Medical School

On a personal level, in addition to developing your bedside manner, you will develop meaningful friendships with classmates.

Medical school is not simply the time you spend in class, but an immersion into the medical culture. Your classmates become your tribe as you share inside jokes and trivia that only they can understand. You will probably find yourself talking about medicine all the time, even while eating (imagine cadaver talk), and your family and friends outside of medical school might not understand the all-encompassing nature of your studies.

If someone close to you becomes frustrated with your inability to spend time with them, try to set aside time for a phone call or meal and be sure to ask about their life. If you have a partner who is not in medicine, you will need to take extra steps to ensure that they feel a part of your world. Introduce them to your med school classmates, bring them to social activities, and stop talking about medicine when you are together.

On the other hand, many doctor-doctor marriages have their origins in medical school. For some, this is an ideal situation, as your partner will inherently understand what you are going through and why you need so much time to study. For others, it’s too much of a good thing. Either way, if a relationship is to flourish during medical school, you will need to put effort and time into it, and remember to make it a priority.

Taking Care of Your Health During Med School

Med students tend to imagine they see every disease state in themselves while they are studying it. So, while you should never ignore symptoms, if you think you are dying from a rare condition, do a reality check. If you are still convinced that something is wrong, don’t hesitate to visit student health. They are used to med students showing up with a range of med school-induced symptoms and do their best to educate and reassure you if that is all that is needed.

On the other hand, medical students are human and experience all the same diseases that our patients suffer from. While cancer, diabetes, and other serious conditions can occur, more students suffer from anxiety, depression, and stress-induced conditions. Be sure to take care of yourself, so that you can care safely for others.

Deciding on a Specialty

It’s time to do some serious introspection and think hard about who you are, what your passions are, what your skills are, and where you see yourself in the future. Ask yourself the following questions:

• Do you see yourself in Primary Care? If so, will it be Pediatrics, Family Medicine, Internal Medicine, or Ob-Gyn?

• Do you imagine subspecializing in an area of Internal Medicine, such as Neurology, Cardiology, Gastroenterology (and dozens more)?

• Do you like doing procedures? If so, do you want a medical specialty that does a lot of procedures? Or a pure surgical specialty? If so, which one? Or maybe you would like a procedure-based specialty like interventional radiology or interventional cardiology?

Then there are the fields of Anesthesia, Dermatology, ER, Radiology, Ophthalmology, Pathology, and Psychiatry to think about (and all the subspecialties available under these). There are even combo-residencies (Internal Medicine-Pediatrics, and Family Medicine-Psychiatry). If you look hard enough, you will find residencies or fellowships in preventive medicine, rehab medicine, occupational medicine, pain medicine, and other lesser known areas. See the AAMC website for a complete list.

So how do you choose? The first thing to consider is what clerkships you enjoyed most and whether you liked them because of the people you worked with, or because of the work itself. This can be hard to tease apart, as an energetic and fun-loving chief resident can make anyone think they will enjoy surgery while a grumpy or overbearing attending can take the fun out any rotation.

If you are seriously considering a specialty, be sure to do a fourth-year rotation and really get to know the lifestyle. Stay overnight in the hospital with the residents to see how much time they spend with patients and how much sleep they get. Can you see yourself doing this job day in and day out? Do the residents seem happy? Is this a lifestyle you can live with in the long-run?

Year by Year: What to Expect Throughout Med School

Each year of medical school is different, complete with different challenges and expectations.

First Year

This year gives you a deeper understanding into the intricacies and of human health and disease. Many schools do the gross anatomy cadaver dissection this year. You may take courses in genetics, microbiology, histology, microanatomy, pathology, and physiology. Most medical schools give first-year students an opportunity to see patients and learn the basics of the physical exam and medical history.

Many students find the first year to be intensely challenging, while others feel it is a repetition of what they learned in undergrad. For most, it is a rollercoaster of information and non-stop experiences. Kind of like being a toddler and having the freedom to explore your world for the first time, you may switch between feeling excited and scared.

Summer Break

This is widely touted as “the last summer.” Some students use the time to travel and experience global medicine, while others explore their interest in research. Many medical schools create opportunities for clinical exposures, so you can use this time to look into specialties you have an interest in. Be sure to also use this some of this time to recover from the intensity of school and to relax and catch up with friends and family.

Second Year

At most schools, you will continue to deepen your basic science training in the second year, with an emphasis on the relevance to clinical conditions. You will also develop your clinical skills and get more patient exposure. In some schools, you may find yourself in the hospital; however, there will still be a considerable amount of classroom and lab time. You may learn more about pharmacology, immunology, and/or neuroscience.

Year two is capped off with the USMLE Step 1 exam, which assesses your understanding of how the basic sciences apply to human health. Most schools integrate USMLE prep into their second-year coursework and give extra time for studying.

Third Year

The third year consists of the following:

• Hospital rounds: This year you will find yourself on the hospital wards seeing patients and working with a team of residents and attendings. You may even have some actual responsibilities, although these will probably be minor. You start to become an integral part of the team, but nobody expects you to save lives yet. In fact, the best part of medical school is always having someone above you to make sure your patient is safe. While schools love their med students, you will often be the last one to understand a joke on rounds, and that’s okay. The ability to laugh at yourself will go a long way to keeping your stress at bay.

• Core clerkships: The typical third-year clinical clerkships include Internal Medicine, Family Practice, Surgery, Neurology, Ob-Gyn, Pediatrics, and Psychiatry. Some schools also have mandatory rotations in Radiology, ER, and ICU. You may even have an opportunity to do more specialized electives. If you are considering a specific specialty, try to get exposed to it as early in your training as possible. This will give you the time you need to be sure it is right for you.

• Patients: Hospitals affiliated with medical schools often attract patients from other communities with more complex and rare diseases. You may see things that doctors in private practice don’t get to diagnose or treat often.

• MD/PhD students: This is the year when most MD/PhD students find themselves separated from their classmates and delving into research. They may get to do some clinical rotations during this time, with the goal being to not forget everything learned in the first two years.

Optional Year

Some schools offer a “gap year” between the third and fourth years of medical school for students to accomplish an in-depth research study, participate in global medicine trips, or undertake independent study. In general, you need to be in good academic standing and have a solid plan for what you plan to accomplish during this time. Check with individual schools as to whether they offer this year and the deadline to apply.

Fourth Year

Here’s what you can expect during your fourth year of medical school:

• Month-long electives: Depending on your school, this year may include a combination of specialty clerkships, sub-internships, research/independent study, and time off for interviews. Some schools continue to have required coursework though the fourth year, while others leave the program entirely up to you. Your main goal should be to decide which specialty you plan to pursue, and to set the stage for acceptance to residency.

• Clerkships: As a fourth-year student, you will be heads and tails above the third years who are just starting their clinical work. Your residents and interns will likely give you more responsibility, and with that comes sought after privileges. You may get to assist in surgery, admit patients, or participate in procedures. You may finally feel like a real doctor, even if it’s only for a few minutes each day. Use this time to get to know your attendings and earn letters of recommendation for residency.

• USMLE Step 2: Sometime during this year, you will probably study for and take the USMLE Step 2. This exam focuses on the clinical applications of basic sciences and understanding of disease states. Together with Step 1, it is the main tool that residencies use for comparing applicants from different schools. If you are hoping for a competitive training program, take Step 2 preparation seriously. Some medical schools provide tutoring for this exam, but there are also online resources available.

• Visiting sub-internships: Sometimes considered a month-long interview, visiting sub-internships give programs an extended time to see what you are like. However, they also give you a chance to see another hospital from the inside and find out if you like their style of training. Are their M+Ms (mortality and morbidity conferences) high pressured or laid back? Do the residents get plenty of hands-on procedures or do fellows do more cases? Is there a focus on research or primary care training? And perhaps the most important, do the residents seem confident, well-prepared, and reasonable happy?

• Research: Med students often use elective time in their fourth year to complete, write up, and submit their research findings for publication.

• Residency applications: Now is the time to apply to residency programs. It’s like your med school application all over again, only with a specialty in mind.

• Time off for interviews and other interests: October through December is prime time for scheduling your residency interviews. Be sure to spend enough time at each program to get to know the residents and their teaching style. Most medical students choose lighter electives during these months, to allow for the extensive travel.

How an Admissions Consultant Can Help You Get into Medical School

We’ve covered a lot in this post – and it’s exciting and maybe a little scary to think about the unfolding of the next four years. But before you start planning your schedules and emotionally preparing for patient care, you need to overcome the first hurdle: getting into medical school.

The acceptance rate for many med schools is under 10%, with an overall acceptance rate for all U.S. MD and DO programs of well under 50%. To beat your competition and get accepted into medical school, you need to make sure your application is strategic, compelling, and thoughtful.

And an Accepted admissions consultant can help dramatically.

When you work one-on-one with an experienced medical school admissions consultant, one with decades of experience guiding applicants just like you to acceptance at top medical schools, you position yourself for success. You learn how to identify your competitive advantage, and use it to get accepted. Explore our Medical School Admissions Consulting services, choose the best med programs to apply to, and then confidently submit a stellar app that will get you ACCEPTED!

Suzi Schweikert is a former UCSD School of Medicine adcom member who has mentored students in healthcare programs for over 20 years. She has a BA in English Lit from UCLA, an MD from UCSD, and an MPH from SDSU. Want Suzi to help you get Accepted? Click here to get in touch!