Medical school. Simultaneously some of the best and worst years of my life. Though it seems as if I was just reciting the Hippocratic Oath and pledging to uphold the values of the profession yesterday, I’ll be trading in my short white coat for a big girl one tomorrow. Finally with the ever so coveted title of “Dr. Brooks,” I look back at the important, and sometimes rather unexpected, lessons I learned during the past four years and want to share some high-yield tips on excelling in med school with the next generation of physicians-to-be. 1. If you’ve been accepted and you’re pre-studying cardiac physiology or glycogen storage diseases: STOP. No, really. Put that book down right now. What you’re doing is like trying to update the paint job on a restored 1966 Buick Skylark with a sharpie. It’s not going to make a dent in the material you have to know and you should spend the remnants of freedom doing awesome, fun things. 2. Okay, so school’s actually started and you’re terrified of the first exam. Find someone or a few people in your class with compatible study habits and quiz each other. It’s amazing how differently our brains process the same information. You’ll pick up catchy mnemonics from classmates and remember tidbits of information you associate with hilarious, sleep-deprived, antic-filled late-night study sessions. 3. Don’t forgo exercise and social activities. You may find yourself so wrapped in learning the complexities of the brachial plexus that you don’t think you have time for the gym or to hatime for the gym or to have coffee with your buddy. Skipping time to unwind is a big mistake. Cognitive abilities and memory are known to improve with exercise! Plus, it’s just good for your emotional state of mind. 4. Learn, I mean really, actually learn physiology. The kidneys suck. They really do. Don’t get me wrong. They’re extremely important organs that do a myriad of things for your body, but learning about renal physiology and acid-base homeostasis is really a bore, I’m sure even for nephrologists. You might be able to skate by on your school exams with some memorization skills, but not on your boards and not in real life. The different body systems are so complicated and interrelated that medication selection and complex patient management is really contingent on a deep understanding of how the body works, not just a cramming of facts. 5. Do some shadowing. So, you may think you want to do pediatric cardiothoracic surgery, specializing only in Fontan procedures, but the perception and reality of what a specialty entails can be markedly different. You may find that the type of doctor you entered med school to be, isn’t a good fit for you at all. When you meet cool attendings at interesting talks or during engaging lectures, ask if you can observe (perhaps a part of) a Whipple with them or join them for inpatient ID rounds. This is especially true for specialties such as anesthesiology, dermatology, ophthalmology, ENT, urology, and emergency medicine, all of which you’ll likely not have any third year rotations in and may miss out on a fulfilling career due to lack of exposure. 6. Speaking of shadowing, start networking early and find potential letter writers in support of your residency candidacy. ERAS (the national residency application service) opens September 15th of each year and most places require 3 letters before they even consider interviewing you for a spot. Explore different career options, as previously mentioned, and get letters from attendings in specialties you think you might be interested in. This way, when it’s 4th year and you’re applying for your first real doctor job, you can hit that submit button the first day your application goes live. Be late getting letters in and some programs will have given out all their interview spots by the time they even see your name. 7. USMLE World is essential. You’ll start out batting under 0.500 and suffer frustration greater than you’ve ever experienced before when starting this question bank, but it really is essential for boards. Do the questions at least twice and make note cards for questions you got wrong or ones you get right accidentally. For more Step I tips, see “15 Steps to Rocking the USMLE I (And Celebrating Afterwards).” It’s also a great tool for 3rd year NBME shelf exams. 8. Be your patient’s advocate You’ll often feel like a non-essential presence on rounds and doubt as if anyone reads your progress notes (and most of the time you’d probably be right), but realize that you know your patients and their charts better than anyone. You can potentially be the only person who has a light enough patient load/are also not on your 11th consecutive work day to notice a critical medication error or recognize when Ms. Jones is unsatisfied with her treatment plan. The best moment I can recall in med school was asking my team to give a cancer patient some time to process her end-stage diagnosis when they were initially pressuring her to sign on with hospice during the same conversation. She later told me how much it meant to her to be able to have the privacy to grieve with her family. 9. Your patients will be your greatest teachers No amount of questions or hours listening to Goljan will afford you with the same level of knowledge that pathology on a real live, talking, thinking, and feeling human can. Read up on how rare it was for you to encounter a patient with recurrent Miller Fisher Syndrome or what the treatment regimen is for your adorable little princess with dermatomyositis. You’ll remember these individuals far better than the knowledge you gain falling asleep on your Robbins textbook. 10. It only takes one. Person to ruin your rotation, that is. You realize rather soon after starting on the wards, that your grade can depend less on your actual knowledge and more on how you are perceived by your evaluators. Ace an entire rotation just to piss off some random person, on some seemingly non-significant day, and you could find yourself with nasty comments and a lower mark on your transcript. Always be on guard. Source
