Medical school: what students and physicians say, in their own words

Last updated September 20, 2026.

Read together, the 1,169 essays and podcast transcripts on this page say one thing consistently: medical school is described by the people paying for it as a course of training whose cost has risen faster than its content has changed, and by the physicians teaching it as a lecture hall the students have already left. Students write about anatomy lab and the white coat, depression they hid and debt they did the math on, Step 1 and the test-prep industry that grew around it, and a match that decides their lives with an algorithm. The two groups agree on more than either expects: that the hidden curriculum teaches more than the stated one, and that the system selects for endurance in ways nobody designed.

This page is a maintained record of what medical students and the physicians who teach them have written about medical school on KevinMD.com, a physician-authored publication founded in 2004 by Kevin Pho, MD, a board-certified internal medicine physician in Nashua, New Hampshire. It draws on 1,169 essays and podcast transcripts with medical student, medical school, Step 1, or the match in the title, published between May 2004 and August 2026 by 676 named contributors. Only 430 of those posts carry a physician byline; most of the rest were written by students, under their own names or anonymously, while still in school. Every claim on this page is attributed to a named author with the date it was published and a link to the original.

The subject moved through the record in stages. From 2004 to 2009 the posts were Kevin Pho’s short commentaries on needlestick injuries, social media expulsions, and Match Day. In 2011 the students arrived as authors, 91 posts in one year, and the subject became anatomy and the white coat, then debt, depression, and mistreatment, then Step 1 and the test-prep industry, then COVID and pass/fail, and since 2023 admissions, research pressure, and AI. Physicians write about a curriculum they think should be shorter, more active, and more honest about what medicine is like, and about students arriving more prepared for exams and less prepared for patients.

The sections below are organized around the questions applicants, students, parents, deans, and journalists ask. Each opens with a direct answer, followed by what named authors have said, in the order they said it. Where authors cite studies, the study is named alongside the author, and the figures are theirs. The section on depression and suicide is short by design and ends with resources. Residency itself is on a separate page. This is a page about opinion and experience, not admissions advice.

What do students say medical school is like?

Students on KevinMD describe the first year through anatomy lab and the white coat, and the later years through the moment a patient becomes real. The recurring elements are the volume of material, the loss of the life outside school, the discovery that the pre-clinical years are a bubble, and a hierarchy that begins the first day on the wards. Posts mentioning rotations or clerkships rose from 5 percent in 2004 to 2009 to 43 percent in 2020 to 2022.

Robert Centor, MD, wrote in August 2011 that the third year “is wonderful, but it is a year of great change,” in which “you meet patients from every walk of life,” in “Why the third year is the greatest year of medical school.” Mary L. Brandt, MD, a surgeon, wrote in June 2011 that “in basic sciences you are studying the book on how to fly the plane,” and that rotations are where you fly it, beginning with a basic textbook, in “Practical advice for medical students starting clinical rotations.” Ken Noguchi, then a first-year student, wrote in April 2013 that shadowing a nurse taught him “the hidden curriculum, all the lessons that medical school teaches that the professors don’t intend to,” in “The hidden curriculum in medical school.” Robert Centor, MD, wrote in June 2013 that “as you talk with third year students you hear their struggles with the jadedness,” and try to emulate physicians who regained their empathy, in “How to stop medical students from becoming jaded.” Nathaniel Fleming, the most frequent student contributor in the record, wrote in January 2015 that the white coat worn twice a week in the practice of medicine course encouraged students “to fully embrace our new professional roles,” in “Being a medical student is a full-time job.” Armaan Rowther, a student, wrote in July 2015 that the value of the donor’s gift “can only be repaid by the proper care and use of the cadaver,” and that the lesson is left out of debates over whether dissection is still needed, in “The moment medical students discover a profound appreciation for humanity.” Nathaniel Fleming wrote in November 2015 that “I can’t say that I’ve ever observed anything like that in my pre-clinical years, let alone in 46 percent,” the figure a recent study put on physicians nationwide, in “What medicine is really like isn’t seen in some medical schools.”

Jamie Katuna, then a student, wrote in January 2018 that students “are allowed to be dynamic, compassionate, fallible humans,” in “Medical students: It is OK to not feel OK.” Joseph Azar, then a first-year student, wrote in February 2018 of feeling “terribly weak and helpless next to that cadaver as if my excitement was getting drained,” in “A medical student’s first day in anatomy lab.” Orly Farber, then a student, wrote in March 2018 that “I happy-cry, stress-cry, romantic-comedy-cry, regular-comedy-cry and, apparently, I even doctor-in-training-cry,” in “The medical student who cries.” Ton La, Jr., MD, JD, wrote in December 2018 of a first patient admitted with an oxygen saturation of 60 percent, and that “if you respect every patient and not bring bias into your decision making,” every patient is better off, in “What my first patient in medical school taught me.” Prerana Chatty, MD, wrote in March 2019 that the pre-clinical years protect students “from the harsh working hours, responsibilities, and insecurities of working in a clinical environment,” and the clinical years remove that protection at once, in “The hidden curriculum of medical school can be overwhelming and unforgiving.” Vance Lehman, MD, wrote in March 2026 that subjective performance evaluations “are around 75 percent bias and noise,” in “The hidden curriculum: What medical school does not teach you.”

What does medical school cost, and what do students say about the debt?

Students and physicians on KevinMD have written about the cost of medical school for the whole record, and the figures track the years: $40,000 a year in tuition in 2011, $160,000 to $200,000 in debt at graduation in 2016, “a quarter-to-half-million” for a student choosing primary care, and a worst case of $550,000. The argument is whether the debt is a rational investment, a barrier that makes medicine “just for rich kids,” or a cause of depression in its own right. Posts mentioning debt or tuition have held near 15 to 18 percent across every period.

Skeptical Scalpel, MD, wrote in April 2011 that tuition “will cost at least $40,000 per year” at a private school, cited a Wall Street Journal account of a family physician with a $550,000 debt, and asked whether a student wanted to become “the 21st century’s version of an indentured servant,” in “Think about medical school tuition debt before becoming a doctor.” Skeptical Scalpel, MD, wrote in March 2014 that shortening medical school to three years would not produce more doctors after the first year, and that shortening the undergraduate years instead “would save a year or two of tuition expense,” in “Don’t shorten medical school: Shorten undergraduate training instead.” Pamela Wible, MD, wrote in May 2014 that “primary care is no way to pay off a quarter-to-half-million debt,” and that the system “ensures that my dream of being a doctor is just for rich kids,” in “Is medical school just for rich kids?” Kunmi Sobowale, MD, wrote in March 2015 that a meta-analysis of more than 65 studies found indebted people “nearly three times more likely to be depressed and almost six times more likely to have attempted or completed suicide,” and that few studies had examined debt’s effect on physicians, in “Does medical student debt lead to suicide?” Justin Reno, MD, wrote in September 2016 that tuition and living expenses of $40,000 a year became about $160,000 in debt, and that 7 percent interest on $200,000 “is around $14,000 per year of interest alone,” in “Medical students are viewed as dollar signs.” Wall Street Physician, MD, wrote in July 2018 the opposing case, that because physicians enjoy the highest average salaries of any profession, “student loans can typically be quickly paid off with only a few years of diligent saving,” and that loan forgiveness changes the arithmetic further, in “Is going to medical school a wise financial decision?”

What do students and physicians say about admissions?

The admissions posts on KevinMD split between advice and critique. The advice, much of it from physicians who consult on applications, describes screens on grades and MCAT scores, the interview, and the need to apply broadly. The critique, growing since 2020, is that the same metrics reproduce socioeconomic advantage, that video interview tools add bias, and that AI screening will make it worse. Posts mentioning admissions or the MCAT rose from 7 percent in 2004 to 2009 to 39 percent since 2023, and posts mentioning diversity from 7 to 25 percent.

Jennifer Adaeze Anyaegbunam, then a premedical student, wrote in April 2011 that the application asks whether to be considered a disadvantaged applicant and that “many premedical students find themselves troubled by this question,” in “Does being a disadvantaged applicant affect my medical school application?” Jessica Freedman, MD, an admissions consultant, wrote in February 2012 that many committees screen applications and that below a grade or MCAT threshold “you are automatically rejected, and your application isn’t reviewed,” in “6 reasons why applicants fail to get into medical school.” Zonía R. Moore, then a student, wrote in July 2020 that the AAMC’s one-way recorded video interview prevents interpersonal exchanges, “By reducing this interviewing process to the creation of a vlog for review by admissions committees,” in “AAMC’s video interview tool for admissions is poised to introduce further bias to medical school admissions.” Arthur Lazarus, MD, MBA, wrote in September 2023 after the Supreme Court ruling on race-conscious admissions that UC Davis’s most recent class was 84 percent from disadvantaged backgrounds, 14 percent Black and 30 percent Hispanic or Latino, in “Reactions to eliminating race conscious admissions from medical schools.” Ravinder S. Chale wrote in June 2024 that “lower mean MCAT scores are sometimes a result of socioeconomic disadvantages,” and that schools maximize the weight of scores in admissions “despite these practices being associated with lower diversity,” in “Medical school admissions: an issue of socioeconomic diversity.” Newlyn Joseph, MD, wrote in April 2025 that 87 percent of employers already use AI in hiring, and that in admissions it “may exacerbate the inequity associated with the admissions arms race, selecting candidates more skilled at overcoming AI hurdles,” in “Medical school admissions are racing toward an AI-driven disaster.”

What happened to Step 1, and what do students say about pass/fail?

Step 1 of the licensing exam became, over the 2010s, the number residency programs used to screen applicants, and students on KevinMD describe a pre-clinical curriculum abandoned in favor of test-prep products. In February 2020 the exam’s owners announced that scores would be reported as pass/fail from January 2022. Students and physicians on the site split on whether that relieved the pressure or moved it to Step 2, research, and school reputation. Posts mentioning Step 1 rose from 1 percent in 2004 to 2009 to 18 percent in 2020 to 2022; posts mentioning research or publications reached 50 percent since 2023.

Michael Frazier, then a student, wrote in April 2012 that before preparing for Step 1 “you should have two things clearly in mind: where you are with your score and where you want to be,” in “How I scored a 257 on USMLE Step 1.” Aimee Merino, PhD, wrote in January 2014 that Step 1 scores were “the most highly cited factor that program directors used” to decide whom to interview, and that some students “are turning to prescription stimulants to give them a competitive edge,” in “Intellectual doping: Stimulant abuse in medical students.” Christopher Warne, then a student, wrote in June 2017 that the average Step 1 score for a plastic surgery match reached 250 in 2016, and that students “forego the lectures and material they pay tens of thousands of dollars in tuition for” to study from test-prep products, in “Test prep companies are more powerful than medical school.”

Max Jordan Nguemeni Tiako and Rodrigo Muñoz, then students, wrote in March 2020 that “the NBME should consider accelerating its timeline and grading licensing exams impacted by COVID-19 as pass/fail,” in “Amid COVID-19, make USMLE Step 1 pass/fail now.” Anna Delamerced, then a medical student, wrote in March 2020 that “we advocate for making Step 1 pass/fail now amid COVID-19,” rather than in 2022, in “In the midst of a global health crisis, USMLE Step 1 needs to be made pass/fail now.” Cory Michael, MD, wrote in April 2020 that “the need to achieve certain scores created much anxiety in my medical school,” and that lectures were listened to online at double speed, in “The impact of removing numerical scores from USMLE Step 1.” Bethany M. Erb, then a student, wrote in February 2021 that pass/fail “gives us medical students leeway to learn skills not tested on Step 1,” while quoting a classmate asking whether it would “merely kick the stress can down the road,” in “The USMLE Step 1 score reporting change looks bad. Here’s what it gets right.” Jackson J. McCue, then a student, wrote in March 2023 that even after the change “it still took me a couple of months of studying to consistently pass Step 1,” in “What I think it means to be a medical student in the wake of AI.”

What do students say about being a woman in medical school, choosing a specialty, and going offshore?

Three threads recur that belong to no single section. Women students describe a school and a hospital where they are “not as comfortable here as our male counterparts.” Physicians advising on specialty choice argue over whether lifestyle is a legitimate reason. And the Caribbean schools, where students go when U.S. schools say no, are described by their graduates and by their critics in the same corpus, with attrition and match rates the central dispute.

Michael Kirsch, MD, wrote in October 2014 of a student asking his advice about dermatology, whose physicians “have a soft lifestyle and earn much more money than most physicians do,” in “Should medical students consider lifestyle when choosing a specialty?” Skeptical Scalpel, MD, wrote in February 2017 that accurate “figures on what percentage of each graduating class passes all USMLE steps and matches to a residency program are unknown,” in “Caribbean medical schools: It’s not all palm trees and sunsets.” Pamela Wible, MD, wrote in March 2017, quoting a student that “My starting class began with 1100 students, we are down to 650,” by the second year, in “The truth about Caribbean medical schools.” Jamie Katuna wrote in January 2018 that she collected anecdotes from women in medicine “who have noticed the same thing I’ve noticed: We’re not as comfortable here as our male counterparts,” in “20 anecdotes that describe the world of female medical students and physicians.” Jessica K. Willett, MD, a Caribbean graduate, wrote in May 2019 that the stigma “is built on rumors and they’ve run their course,” in “The truth about Caribbean medical schools.”

What do students say about mistreatment?

Students on KevinMD describe mistreatment in the forms the profession has named for decades, pimping on rounds and humiliation from attendings, and in forms it named more recently, sexual harassment and the pressure to say nothing. Posts mentioning mistreatment or hazing peaked at 15 percent in 2014 to 2016, the years the site published its most direct accounts, and stand at 11 percent since 2023.

Kevin Pho, MD, noted in September 2007 the practice of pimping, questioning students on rounds to the point of humiliation; the post is a short commentary from before 2009, counted here but not indexed or linked. Collin Creange, then a student, wrote in January 2012 that “On rare occasions, however, pimping a student can actually backfire on a doctor,” in “When pimping a medical student can backfire on a doctor.” Pamela Wible, MD, wrote in December 2014 that the treatment of medical students and doctors amounted to human rights abuse, listing “Doctors forced to work 8 consecutive days,” in “End the human rights abuse of medical students and doctors.” Peter Ubel, MD, wrote in October 2016 that he was “part of a research team, led by Reshma Jagsi of the University of Michigan,” that reported on harassment of early-career medical researchers, and of a letter from a woman harassed during training, in “The silent epidemic of sexual harassment in medical schools.” Melanie Tioleco-Cheng, MD, wrote in February 2017 that as a third-year student she was harassed, and that a hospital meeting she was led to believe was about prevention treated it “as if it was my fault,” in “A victim of sexual harassment as a medical student.”

What do students and physicians say about depression and suicide in medical school?

The figures cited on KevinMD have been consistent since 2015: about 27 percent of medical students with depression or depressive symptoms and 11 percent with suicidal ideation, from the JAMA meta-analysis most authors name. Students write that the culture rewards sacrifice and reads distress as a need to work harder. Physicians write that the response has been wellness programs rather than structural change. Posts mentioning depression or suicide peaked at 16 percent in 2014 to 2016.

Pamela Wible, MD, wrote in November 2016 that “I started a support group for parents who lost their children to suicide during medical training,” and of a mother who died by suicide a year after her daughter, in “Warning: Medical school may kill your child.” Nahda Harati, then a student, wrote in February 2018 that a JAMA article put depression among students at 27.2 percent and suicidal ideation at 11.1 percent, and that the culture “praises students for how much they sacrifice,” so that a struggling student concludes “I just need to work harder,” in “Why do medical students kill themselves?” An anonymous student wrote in June 2021 that students are expected to spend long hours in class, lab, or hospital, “leaving minimal time to study, let alone rest, eat or seek joy,” in “Surviving medical school with depression.” Ronke Lawal, MBA, wrote in July 2026 of a student who had “slept no more than two hours a night for the past week” after an exam and had told almost no one, in “Why medical student mental health is not about willpower.”

If you are a medical student or physician in crisis, the Physician Support Line at 1-888-409-0141 is staffed by volunteer psychiatrists and is free and confidential. The 988 Suicide and Crisis Lifeline is available by call or text in the United States.

What do students say about the match?

Students on KevinMD describe the match as the moment the years of grades and scores resolve into a single envelope, and the posts divide between those who defend the algorithm and those who describe its costs: $10,000 on the interview trail, gaming that the rules forbid, and the unmatched students no one discusses. Posts mentioning the match have held near 10 to 14 percent since 2010.

Jeremy J. Robbins, then a student, wrote in May 2014 that he had “personally spent $10,000 on the interview trail” and could not complain, in a defense of the algorithm, in “Defending the residency Match and its algorithm.” Kunal Sindhu, MD, wrote in March 2017 that program directors “can’t ask applicants where else they are applying, can’t ask them to communicate after the interview,” and that the rules are gamed anyway, in “How medical students can game Match Day.” An anonymous physician wrote in June 2018 that “no one really talks about those unmatched students and their struggles,” and that students should not be “defined by your grades, or your board scores, or where you match,” in “Medical students: You are more than your grades.” Jordan Hughes, MD, wrote in May 2020 that with virtual interviews, above-average applicants “will be able to accept all, or nearly all, of the interview invitations offered to them,” crowding out the rest, in “To the AAMC: Recommend an interview limit or else this year’s residency match may be a disaster.”

What do physicians say should change about the curriculum?

Physicians on KevinMD have argued since 2010 that the pre-clinical curriculum is a lecture hall students have already stopped attending, that anatomy and the physical exam are being cut, and that the hidden curriculum of hierarchy and self-sacrifice is the one that sticks. The newest argument, in 21 percent of posts since 2023, is what AI does to all of it.

Marc Braunstein, MD, PhD, wrote in October 2018 that cadaveric dissection had been replaced with prosections and that online resources “may be better than the lectures for which they are paying tuition,” in “The alarming possibility of virtual medical school.” Priya Arunachalam, MBA, wrote in December 2021 that curricula are “primarily focused on imparting scientific knowledge,” and that students groan through the rest that they would rather be doing Anki, in “Educating for the oath: a medical student’s lived experience with the hidden curriculum.” Drew Bergman, then a student, wrote in April 2023 that “Preparing for the countless exams in medical school can be daunting, but ChatGPT can help,” in “6 ways ChatGPT can help you succeed in medical school.” Arlen Meyers, MD, MBA, wrote in July 2025 of a professor who set a tape recorder on the lectern as the hall emptied, and that “One medical school finally got the memo and has eliminated those dreaded lectures,” in “Why medical schools must ditch lectures and embrace active learning.” Kathleen Muldoon, PhD, wrote in June 2026 that “The residency personal statement was never designed to measure who could produce the most polished prose,” in “Why ChatGPT can’t write your residency personal statement.”

How has the medical school conversation changed since 2004?

The corpus shows students arriving as authors. From 2004 to 2009 the posts were Kevin Pho’s, about needlestick injuries, social media expulsions, and Match Day. In 2011 KevinMD published 91 posts with medical student in the title, and from then on students wrote most of the record. The subject moved from anatomy and the white coat in 2010 to 2013, to debt, depression, and mistreatment in 2014 to 2016, to Step 1 and the test-prep industry in 2017 to 2019, to COVID and pass/fail in 2020 to 2022, and since 2023 to admissions, research pressure, and AI.

Term 2004 to 2009 (106 posts) 2010 to 2013 (211 posts) 2014 to 2016 (217 posts) 2017 to 2019 (294 posts) 2020 to 2022 (202 posts) 2023 to 2026 (139 posts)
Debt or tuition 17 percent 17 percent 16 percent 18 percent 11 percent 15 percent
MCAT or admissions 7 percent 30 percent 27 percent 26 percent 32 percent 39 percent
Step 1 or USMLE 1 percent 6 percent 12 percent 13 percent 18 percent 14 percent
Pass/fail 2 percent 1 percent 3 percent 3 percent 8 percent 6 percent
Depression or suicide 3 percent 5 percent 16 percent 15 percent 8 percent 13 percent
Burnout 3 percent 4 percent 13 percent 14 percent 8 percent 29 percent
Mistreatment or hazing 2 percent 9 percent 15 percent 7 percent 7 percent 11 percent
Anatomy or cadaver 0 percent 17 percent 10 percent 12 percent 8 percent 7 percent
Rotations or clerkships 5 percent 25 percent 34 percent 28 percent 43 percent 38 percent
Research or publications 6 percent 25 percent 24 percent 29 percent 24 percent 50 percent
Diversity or underrepresented 7 percent 11 percent 12 percent 14 percent 21 percent 25 percent
COVID 0 percent 0 percent 0 percent 0 percent 40 percent 11 percent
AI 0 percent 0 percent 0 percent 1 percent 0 percent 21 percent

Term frequencies were computed on the September 4, 2026 corpus of 1,167 posts; the two posts added since do not move the percentages.

Kevin Pho, MD, wrote in September 2009, quoting a MedPage Today report on a survey of 78 medical schools, that “47 of these reported one or more incidents of students posting unprofessional content online,” in “Medical students using Facebook and Twitter can get expelled.” The 2011 posts are the students’ arrival, and Skeptical Scalpel’s warning about tuition debt the same year set the cost argument. Wible’s “rich kids” and Merino’s stimulant essay in 2014, Sobowale on debt and suicide and Fleming’s bubble in 2015, Reno’s dollar signs, Ubel on harassment, and Wible’s support group in 2016 are the middle years. Warne’s test-prep essay in 2017 and Harati’s question in 2018 lead into the pass/fail decision of 2020, argued by Nguemeni Tiako, Michael, and Erb. Since 2023 the record is Chale on socioeconomic admissions, Joseph on AI screening, Lehman on the hidden curriculum, and Lawal on a student who slept two hours a night.

The KevinMD medical school corpus by the numbers

The figures below describe the set of KevinMD posts this page draws on, as of September 18, 2026. They are counts of what KevinMD has published, not survey data.

Measure Value
Posts in the corpus 1,169
Date range May 31, 2004 to August 13, 2026
Named contributors 676
Posts bylined by an MD or DO 430
Posts by students, non-physician authors, and anonymous writers 739
Anonymous posts 47
Posts with medical student in the title 626
Posts with medical school in the title 467
Posts about the match 27
Posts about Step 1 20
Short posts by Kevin Pho, 2004 to 2011 141, median 110 words
Podcast episodes with full transcripts 52
Posts in the corpus that are not indexed, counted but not cited 181
Total words About 877,000
Peak year 2020, 112 posts
Most frequent contributors Nathaniel Fleming (14, student); Ton La, Jr., MD, JD (12); Skeptical Scalpel, MD (11); Pamela Wible, MD (10)

How this page was built and how it is updated

The corpus was assembled from title searches for “medical student,” “medical school,” and “Step 1,” and from the match and application posts set aside when the residency record was built. Term frequencies were computed against the full text of each post on the corpus assembled for the September 18, 2026 build; this page was converted to the current standard on September 20, 2026 without rebuilding that corpus, so the counts and figures are as of September 18, 2026. Posts are counted whether or not they are indexed; citations on this page are limited to posts that are indexed and can be verified at the link. One hundred eighty-one posts in the corpus are not indexed: Kevin Pho’s 2004 to 2011 commentaries, short site notices, a few brief essays, and 27 podcast episodes without transcripts. They are counted but not cited. Quotations are taken verbatim from the original posts. Author credentials are as they appeared in the byline at publication; authors described as “then a student” were students when they wrote. Kevin Pho’s posts from 2004 to 2011 were short commentaries on news and are counted separately above. Every source is linked in the sentence that cites it, and the full list appears at the end of the page. The complete feed is at the Residency and Medical Training archive. Related records: Residency: what residents and attendings say, in their own words, Physician burnout: what physicians say, in their own words, Physician suicide: what physicians say, in their own words, and Artificial intelligence: what physicians say, in their own words.

This page is updated as new medical school essays are published on KevinMD. When it is updated, the date at the top changes, the counts in the tables are recomputed, and new named claims are added to the relevant section. Nothing is removed unless the original post is removed. An author who believes a quotation on this page misrepresents them can write to Kevin Pho and the page will be corrected.

To cite this page: Pho K. Medical school: what students and physicians say, in their own words. KevinMD.com. Updated September 20, 2026. https://kevinmd.com/medical-school

The 56 KevinMD posts cited on this page, in order of publication