Medical school is like a tennis match—a series of short sprints and challenges that, when put together, tell a larger story. Unlike tennis, however, everyone can win. Being “successful” in med school has multiple meanings—from caring for your rural hometown, working with your institution to implement a racism in medicine curriculum, and matching into orthopedic surgery. No matter how you define “success,” there will be bumps and potholes along the path. I learned the following tips either through receiving advice or living through a challenging situation. I’m hopeful they can help you squeeze more positivity out of your journey.
1. Prepare for “catastrophe.”
I made an appointment with our school psychologist during the second week of medical school. After struggling a bit with the MCAT, I needed a structured outlet to work through issues that would inevitably arise. This early relationship proved to be one of the best decisions I ever made. The psychologist was always willing to run through a study schedule or work together to quell some spiraling drama related to my personal life.
Almost any event during medical school can feel like a catastrophe. Your stomach will drop when you “fail” a clinical skills session. Does this mean I’m not cut out to be a physician? The answer is always “No.” But a strong relationship with your psychologist and experiences working through “catastrophe” prepare you for times when something slightly bigger goes wrong.
For me, a slightly bigger event came the night before Step 2 CS (good riddance). I was nervous but finally fell asleep at 1:30 a.m. The hotel fire alarm blared ninety minutes later, sending guests scurrying into the hallways. It was a false alarm, but the effects were real. I sat—wide awake—thinking about how unlucky I was and never fell back asleep. Luckily, I had enough experience with “catastrophes” and strategizing with the school psychologist that I could press forward. At 6:00 a.m., I gave myself a pep talk, drank a big coffee, and prepared to push through a day of awkward small talk, power outages, and unrealistic clinical encounters.
The experience taught me more than just to prepare early for “catastrophe.” It also taught me that what we think is catastrophe in medical school normally ends up being just fine. Reflecting on these experiences confirms one of my favorite quotes: “If something seems horrible, it’s probably just bad. And if something seems amazing, it’s probably just good.” Notable exceptions to this phrase include personal or family health emergencies, but it’s a nice idea to keep in mind.
2. Be flexible—find your learning style.
During M1 year, most classmates used Anki, so I tried it. This program uses flashcards and spaced repetition to quiz students on facts from prepared “decks.” I used it for one week and learned very little. And I realized what I often disliked about lectures was a lack of structure, a problem that Anki did not remedy. So, I decided to type notes and organize lectures in hierarchical structures to allow me to pull out facts about gram stains or microvilli. To be clear, thousands of students swear by Anki, but it didn’t work for me, so I found something else. In essence, be flexible in study habits.
During clinical years, being flexible is different. Instead of studying as your full-time job, you’re enrolled in a master’s level course load in sociology (i.e., learning to interact with nurses, staff, and physicians) while also studying for shelf exams every 6-8 weeks. It’s completely different, so you must adapt. There are several modes of learning. Here are a few I liked:
Books. Pick one book per clerkship and read as much as possible. The Case Files series for pediatrics, family medicine, and OB/GYN are superb. For surgery, try the small book by Pestana (if you want to be a surgeon, add in De Virgilio). For psych, stick to First Aid Psych and for internal medicine, I liked Step Up to Medicine.
Podcasts. I listened to an episode during each drive for rotations with a commute, making the trip more productive and less painful. (Full disclosure, I am a producer on The Cribsiders. Still worth a listen.)
Videos. I watched videos during each clerkship. They create a change of pace, but just watch the ones that you need.
UWorld. This is the big one. Everyone does and should do it. Instead of studying in timed blocks of 40 like during preclinical years, consider blocks of 10 on “tutor mode” in-between clinical requirements (i.e., surgeries). Do not try to do every question in a section! The point of diminishing returns comes far before you finish them all, and the makers of UWorld continually add questions to improve the product. This means the total number is arbitrary so go to sleep and don’t ruminate about your 200 unused surgery questions.
3. Count these years as part of your career.
After my second test in medical school, I called my brother in a rage. I had just studied Trendelenburg gait and had even answered a question in front of our in-person class about it! (For those reading this post in 2022, an “in-person class” was a gathering of people from the same academic year into a large room to hear a lecture.) But I still missed the question on the test. I was furious! His response was simple: “You’re going to be taking tests the rest of your life, so don’t worry too much about any single question. Just learn.”
From the start of medical school, students talk about “getting through this block” or “finishing school to start residency” or “enduring residency to start fellowship.” Try to resist this attitude. If you’re always waiting for the next step, you’ll be 40 by the time you can “enjoy” anything. If you miss a question about something you “know” then you didn’t know it well enough! And that’s not a bad thing. After all, if we knew everything, we wouldn’t need school. Focusing on learning instead of a specific grade on a test frees you to consider medical school as part of your career.
4. Take Step 1 seriously.
Step 1 changing to pass/fail is a good thing. (I was more a proponent of a “three-tiered” system, but I have zero power, and no one asked me.) However, one thing I worry about with the pass/fail change is that it might allow students to study sparingly. To be clear, students were in unhealthy physical and emotional places when Step 1 was scored. But studying hard for the test is extremely useful to prepare for third year. “Hard” means 6 to 8 hours per day for 4 to 6 weeks.
Tracing back confidence in third year, a lot of it was due to connections across organ systems from Step 1 studying. This was particularly true for complex, multi-system conditions like cirrhosis and lupus. Finally, Step 1 is bad but not completely bad. Pre-clinical lecturers will proclaim that Step 1 is completely irrelevant to “real medicine,” but that’s not true. The test includes questions about shock, antibiotics, and electrolytes. Critical care providers talk about alpha and beta receptors every day! Sure, around 20% of questions are horrible and esoteric—it’s a bad test but not nearly irrelevant.
5. Ask for help.
Some topic(s) will not sit right with you in medical school. For example, I didn’t understand the anatomy of the skull. So, I asked a TA to meet me in the lab for a 30-minute session. She peppered me with questions that I got wrong at the beginning and at least partly right by the end. Switching back and forth between public and private schools since elementary school, one aspect is consistent: If you ask for help, usually someone is ready and willing. This is applicable to any level of education. Just ask. And if you aren’t satisfied with the answer or want another opinion, ask someone else.
6. Help your institution.
Throughout medical school, you will receive thousands of emails from your institution. Most will rot in your inbox. Occasionally, however, you should consider reading some of these emails and volunteering to help, perhaps during a light rotation.
Why? First, a change of pace from sitting in the library is refreshing. Helping carry boxes of food for a local drive may be exactly the reset you need. Also, you accumulate points with your institution by helping. Professors talk and it’s helpful to be in good graces when you inevitably run late to a clerkship meeting.
Finally, medical school puts a lot of work into your education, so it makes sense to help them on occasion. You will assuredly come across students who have the viewpoint that “The school works for us.” But really, it’s more mutualistic—you get a lot out of the deal also. Whether it be an MD, DO, MBBS, PA, or NP, the institution provides a degree that will make you immediately respected, drive up earning potential, and give you access to meaningful work for life.
Edward W. Corty is an internal medicine-pediatrics resident.
Image credit: Shutterstock.com
