It’s not a sprint, it’s a marathon.

You often hear this analogy about the medical training process, but, having run a few marathons myself, I think it’s particularly apt. I’m working my way through my fourth and final year of residency now, and I can attest that running marathons was one of the better things that prepared me mentally for the challenges of med school and beyond.

26.2 miles is no trivial thing. Getting ready for a marathon takes dedication and tons of time. Your typical regimen lasts about 18 weeks, during which you run about five days a week. As you ramp up towards race day, you will spend one of your weekend days running up to 20 miles at a time, an endeavor that itself takes three hours or so, depending on your pace.

In medicine, like in marathon training, you set a goal, and you work your tail off to achieve it. We all face limiting factors and variables: There’s natural talent and work ethic and personal obligations that may affect your ability to put in extra time. Some people are happy just to finish a marathon. Others hope to break the 4-hour mark. Still, others shoot for an even more impressive time to qualify for the Boston Marathon.

Marathon training completely recalibrated what I thought my body could endure and achieve. Before signing up to run one, the farthest I’d ever run at a time was about five or six miles and, after that, I thought I was thoroughly exhausted. Training for a marathon you find out you can go those five or six miles and then you can just keep going. And going. One step at a time, one foot in front of the other. Turns out, you didn’t even know what exhausted was!

That happens in med school too. The volume of information that you must absorb and retain in your first two years is legendary — the proverbial drinking from the fire hose — but you can’t really appreciate it until you’re in it. I studied exponentially more than I ever had previously or ever would’ve believed possible. Additionally, until med school, I didn’t know I could stay up on my feet all night and then, running on fumes, make a PowerPoint presentation to a room full of people the next morning.

Then comes residency, which, like the second half of a marathon, is an even tougher test of physical and mental endurance. In my previous career in journalism, I had worked plenty of long days, night shifts, weekends and holidays, but medical residency is in a class by itself. We’re talking about a job where regulations were recently instituted to limit work to 80-hours-a-week. Eighty hours is twice what most working people consider a full time job.

And then there’s “The Wall.” Anyone who’s run a few marathons likely has hit it, usually after about 18 miles, when you feel yourself truly reaching complete exhaustion. Maybe you slow to a walk, as I did in the 25th mile of one race as the sun beat down on a wickedly unshaded stretch of road. But still, you keep those feet moving, one foot in front of the other.

It’s likely to happen in medical training too, maybe after a month of night float, maybe after failing an important test.

But when the finish line is finally in sight, you experience a blur of emotion, a combination of relief, pride, and elation. Maybe you find an extra kick of energy to sprint to the end. Maybe you are content to just walk it home.

You glance at the time as you cross the line. Maybe you nailed the goal you were shooting for. Maybe you even surpassed it. Congrats!

Or perhaps you were not at your best that day. You caught a cold just before the big day. Instead of dashing, you were dragging. Maybe on race day, it’s crushingly hot or pouring rain. But still, you just completed a marathon. Look at the big picture. 26.2 miles! Congrats!

It’s no surprise that many in the medical field also are actual marathon runners. Two other residents in my relatively small program have completed marathons too. Doctors tend to be driven, goal-oriented people who like a challenge — and marathons are, you might say, epic.

The very idea was inspired by the legend of an ancient Greek messenger, Pheidippides, who raced from Marathon to Athens to deliver news of an important Greek victory over invading Persians in 490 BC. After making the announcement, Pheidippides collapsed and died from exhaustion. The distance he ran — about 40 kilometers — inspired the official length of the first organized marathon race at the 1896 Olympics in Athens.

More than a century later, the feat of running 26.2 miles is no longer unique to Olympians. From 2000 to 2009, the total number of marathon finishers in the United States increased from 299,018 in 2000 to 473,354 in 2009, according to an epidemiological study published in The American Journal of Sports Medicine. It’s still impressive, but I’ll bet you know some people who’ve run marathons too, if you haven’t run one yourself.

Ironically, after eight years of medical training, my marathon-running days likely are over. There have been too many long days with no time to work out, when the only exercise I got was walking up and down the hospital stairs. I’ve got kids these days too, and my knees aren’t what they once were after undergoing surgeries for two medial meniscus tears.

I’m still running my marathon of medical training, though. But I’m getting closer to that finish line too, one step at a time.

John Biemer, a former reporter, is a pathology resident.

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