Dear third-year medical student:

It’s hard to believe as I am writing this, that I am in my last rotation of third year. This year has been amazing and has gone by so quickly. There is no way to predict or to prepare for what your third year will have in store, but if it is anything like mine, it will be full of ups and downs. Moments that you will cherish for the rest of your life and a few that you will wish you could forget.

You will laugh, with your colleagues, with your residents,  with your patients and when you accidentally drink your attending’s coffee. He won’t even hold it against you; he may even laugh with you as you spit it out because it has too much Splenda in it.

You will cry. Maybe during your surgery rotation. Maybe alone in the hospital bathroom. But it will be OK. You will survive that day and the rest of the rotation and appreciate what you learned at that moment when all you want to do is go home and crawl into bed, but you wash your face and scrub back in.

You will lose your patients. Maybe on pediatrics, where death feels unfair and cruel. You may visit the “butterfly room” alone afterward and try to imagine what that mother is thinking. Say one last goodbye to that three year old who never had a fair chance and then go try to teach the six year old down the hall how to swallow pills using Tic Tacs and Halloween stickers with googly eyes.

You will make mistakes. You will overlook important labs or miss huge and obvious physical exam findings. You will always forget to ask something that in retrospect seems like the most obvious question in the world. But you will get better. Every single day you will improve, and you will realize that someone pointing out your mistakes is a necessary step in developing into a competent and qualified physician.

You will change some one’s life. You will talk to patients more than anyone on the team. You will inevitably explain something they never understood. You will ask a question that no one had taken the time to ask before, and you will unlock a history they have never felt comfortable sharing. As medical students, we have the opportunity to know our patients on a deeper level than anyone else on our team. We have the time to spend talking to them. When we are residents with twenty patients to see and 10 minutes to spend with each, we will not get to hear the stories of pain, of healing, of suffering and of happiness and we will miss them.

You will fall asleep. On rounds, in the ER, in your car in the parking lot, standing up during a kidney transplant at 2:00 a.m., and even occasionally in your own bed.  You will never feel more awake though, than in the moment you open your eyes just in time to watch the surgical clamps removed and blood flow through that same transplanted kidney, saving a 23 year old’s life.

You will learn more than you ever imagined possible even when you do not realize you are learning. You are surrounded by incredible, caring, and compassionate people every day. Your residents, your attendings,  your fellow students, the nurses, techs and secretaries and most of all, your patients, will teach you about life, death, hard work, and also a little medicine.

You will grow as a person and begin to see your own potential. You will realize that the “C” on your transcript from first year really does not matter (seriously), and that you are meant to be here. Even if you failed a pathology test or two, you are still capable of becoming a great doctor.

I hope your third year is every bit as happy, sad, energizing, exhausting, confusing, simple, rewarding, and beautiful as mine has been.

Lauren Gambill is a pediatric chief resident.  She can be reached on Twitter @renkate.

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