This post is dedicated to the many 3rd year students whom I have had the privilege to teach over the past 35 years.  They continue to inspire me to help them become great physicians.  They care.

The third year of medical school is wonderful, but it is a year of great change.  Those readers who are physicians will completely understand, and I will try to explain to the non-physicians.

During the third year, medical students spend much time with patients.  They become part of the health care team.  They interview and examine patients.  They hear the stories.  They see the consequences of disease.  They see self-destructive behaviors.

During the third year, you meet patients from every walk of life – walks of life that you never really understood.  You meet drug addicts, hard-core alcoholics, lung disease patients who still smoke, the profoundly mentally ill.  You also help care for the unfortunate patients who have a horrible disease or become victims of horrendous trauma.

You see the joy of life in the delivery room.  You see critically ill patients recover to a normal life.  You see death.

One must mature during that year, just because of these experiences.  During the third year you confront mortality and morbidity.  You experience the trust patients give you when you clearly care about them.  Most patients show third year students respect and treat them as they treat physicians.  The patients will tell you everything and trust that you will do everything you can to help them.

During that year the student collects stories.  As we often say, you cannot create these stories, they are just too fantastic.  Some of the stories are funny; some of the stories are cruel.  Medical students, residents and practicing physicians do engage in black humor – telling inappropriate stories about patients.  They do this to relieve the psychological strain of our work.

The 3rd year students quickly learns to share medical stories primarily with other students, residents or attending physicians.  A story that is interesting or funny to a medical student may sound ghastly to a non-medical peer.

Thus, these students go through another maturation process.  As physicians we rarely share our stories expect with other physicians.  No one else can really understand.  We cannot explain the context, yet other physicians understand immediately.

I love teaching 3rd year students.  I love watching them mature from nervous beginning students to confident 4th year students.  I love watching them go on to residency and become great physicians.

It all starts in the greatest year of school that any of us experience – the 3rd year of medical school.

Robert Centor is an internal medicine physician who blogs at DB’s Medical Rants.

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