Expectations of Medical School vs Reality?

[DermViser]

I remember telling schools that I only recently decided to apply to medical school. When asked what I would do if I didn't go to medical school, I told them I'd apply to law school. TBH, I was pretty open about it. If I knew about SDN or about the process, I probably wouldn't have been. I probably would have worried about it more. In the end, nobody really seemed to care and backed it up by offering acceptances.

You have to be kidding. What was their response when you said that?

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[NickNaylor]

I suppose I'll give a more substantive and helpful post than my previous one. I have a lot to say about this topic but I'll try and keep it short.

IMO, there are two general categories of people that I've found in med school, and the type of person you are will heavily shape your experience. There are the people who follow some variation of "medicine is my life" and there's... everyone else. The people of the former category tend to love medical school because they don't mind spending (literally) every waking hour either in the hospital or studying. Whether they actually "love medicine" or are just driven by academic success I don't know, but this group of people tends to thrive in the med school environment. Despite what anyone says, it is this exact kind of attitude that the whole scheme of medical education and training rewards. For everyone else, there's more of a struggle. It's not that they necessarily don't "love medicine" - it's just that they have other things they want to do in their lives, and they begin to resent the huge amount of time that medical school takes up - a not insignificant portion of which is total bull**** and so far from valuable from an educational standpoint that it would funny if it didn't make you angry. I find that these people tend to be the non-trads and those with significant life responsibilities (i.e., spouse or SO, kids, pets, etc.) - in other words, the people that actually have more important things than medical school to dedicate their time to. These are gross generalizations, of course, but that's the easiest way I can simplify it for those of you who haven't started med school yet.

On the scale of "hanging out in Hawaii all day" vs. "being in prison," med school isn't all that bad, though I think it falls closer on the "being in prison" part of the spectrum than the "hanging out in Hawaii all day" part. I've made some great friends and during the first two years had a lot of fun. Because I went to a religious undergrad and was generally gunning it, in some ways med school has been some sort of "college experience" that I never actually had in college. Third year was extremely interesting in some ways in that I got to see/do things that I will very likely never see/do the rest of my life. I've learned a lot of interesting things and am blown away by how much general knowledge of medicine I have compared to when I started. In those respects it's been a good time. But on the whole - based on where I am now (which is admittedly not the full picture since I'm not in practice yet) - would I do it again? No, probably not. I happen to think that I'm going to really enjoy being a doctor and I've found a field that I'm excited about, but overall med school has not been a great time (and certainly not the "best time of my life" as @RogueUnicorn put it), and when I see the six-figure debt and the hours spent studying away in the library or at home, there's definitely a little kernel of regret. That said, I fully expect (...or at least hope) that my opinion will change once I hit residency and am actually doing what I want to do and "being a doctor."

As far as the bad parts, they're almost all psychological. I wholeheartedly agree with @ButImLETired's posts. It is difficult if not impossible to maintain a healthy work-life balance unless you're an intellectual god. It's difficult operating under the constant scheme of "there's more I need to study and learn, but I just can't do it anymore." It wears you down to constantly feel guilty about not studying because you know you need to and you know it's important but you just don't have it in you. You can get a little angry and bitter at the hours you waste away in the hospital because your residents/attendings are terrible managers or because you're "expected" to be at the hospital despite nothing worth your time going on. You will come to realize that despite how well you may have done in undergrad, there is ALWAYS someone that is willing to grind it out longer and sacrifice more than you to do better. In third year especially constantly feeling incompetent hurt my self-esteem and whittled away at my confidence. If you have a SO or family that isn't in medicine, they will struggle to understand why you "still need to study" despite the fact that you've put at least 5-6 hours of studying every day for several weeks. "You've always done well in school - I'm sure you'll do fine!" They just don't get it.

I talk about this in my blog (see my sig), but I tend to be a pretty easy-going guy that isn't easily stressed by stuff. I've never "freaked out" at things going on in school or my personal life. I'm just not that kind of person. Towards the end of my last clerkship, though, I developed anxiety that was severe enough that I felt the need to seek treatment for it and have had a couple of full-blown panic attacks when not at the hospital. I won't say that I developed it "because" of med school because, who knows, I may have developed it regardless. But I'm sure that the lack of sleep and constant stress didn't help things.

My only advice to those considering med school is to be honest with yourself about your motivations for going into medical school - not for others, but for yourself. If you're in it for the money or the "prestige" or whatever aim you have that isn't "using science to SERVE others," then you're probably going to have a bad time. If there's anything else you would seriously consider doing or want to explore, then you should do that before committing to medical training; you'll most likely regret not doing so if you don't prior to starting med school. Again, I want to reiterate that I think I chose well when I chose medicine. But med school was nowhere near what I expected it to be - and I expected it to be bad and thought that I had done my research before going into it. It's difficult to have any realistic basis for it until you get into it yourself. There are certainly people like @mimelim and @RogueUnicorn which sing the praises of med school, but in my experience they are by far the minority. I'm probably a bit more extreme when it comes to my resentment of medical training, but the average is probably closer to me than those other two guys.

 

[mimelim]

You have to be kidding. What was their response when you said that?

Nobody cared. Most just said, "that is interesting". Some wanted to know what kind of law (usually said consitutional or criminal), some asked what held me back from law instead of medicine. Usually responded that my strengths were in the sciences, I didn't particularly like legal reading and I thought that I could have a bigger impact. One or two asked if I'd considered MD/JD.

 

[mimelim]

I don't know that "ample free time" is a fair or representative assessment. In truth about 20% find they have ample free time, 30% wish they could find another 10 hours in the day to get through all the material, and the rest are somewhere in the middle. I personally was in that second group. Ended up where I wanted, but it definitely wasn't by coasting or enjoying the weekends. Clinical years were more fun but certainly some rotations were very very long hours. Intern year was even "better" in terms of day to day work, but with much longer hours still. And so on. It's not a bad existence, but anyone who tells you it's easy and you'll have a lot of free time may very well be representative of a portion of the med school class you won't be in. So take it with a grain if salt.

I'm not very good at memorizing things. I usually cite that as my biggest weakness. I also get a huge mental block when I don't think studying something is worth it and generally go and do something else (at that time, mostly Starcraft and then Minecraft). I can't remember a time in my pre-clinical years where I was "busy" to the point of not being able to do what I wanted to. This isn't about being overly intelligent or having an eidetic memory. It really doesn't take a whole lot of effort in order to pass the pre-clinical classes. With schools going over to more P/F curriculums, it is even easier to do with little to no consequence.

The only time I guess was remotely close was in anatomy lab when things were somewhat more time consuming because of the lab, but other than that...

 

[DermViser]

I'm not very good at memorizing things. I usually cite that as my biggest weakness. I also get a huge mental block when I don't think studying something is worth it and generally go and do something else (at that time, mostly Starcraft and then Minecraft). I can't remember a time in my pre-clinical years where I was "busy" to the point of not being able to do what I wanted to. This isn't about being overly intelligent or having an eidetic memory. It really doesn't take a whole lot of effort in order to pass the pre-clinical classes. With schools going over to more P/F curriculums, it is even easier to do with little to no consequence.

The only time I guess was remotely close was in anatomy lab when things were somewhat more time consuming because of the lab, but other than that...

That's so funny in that I tend to like memorization, factoids, zebras, etc. Now I understand why you didn't like the basic science years but liked MS-3, while it was completely flipped for me. Explains your specialty choice (and I guess mine lol).

I agree though that it's easier if you do go to a "true" P/F school in the first 2 years. However, this is available at very few select schools.

 

[VisionaryTics]

I started to write a response and then remembered that I had no idea what medical school was like or even really thought about it. My decision to apply to medical school was probably best described as a whim. So... in conclusion... I guess I'm useless for this.

I honestly have no idea why I applied to medical school. I think I just decided I hated lab research and what else could I do with a biochem degree.

A lot of the pre-meds here seem discouraged by what the med students and residents are saying. I think the take-away is that there is no magical land over the rainbow. Your happiness in life is what you make of it, and that's true for pre-med as well as med school. It's harder in med school because you have more demands competing for your time.

Personally, I had no expectations going in to med school (I was a rare SDN user and didn't hang out with other pre-meds). It was difficult, but I adjusted quickly to preclinicals. I was a mediocre undergrad student, but scored very well preclinically. I really surprised myself how much I enjoyed clinicals. I never saw myself as a future surgeon 5 years ago, but here I am.

I didn't leave without some scars. People say med school changes you, and that's true. It's not always for the best. I am probably less fun of a person than I was, I find it hard to switch off now, and my social skills have deteriorated in general.

 

[Law2Doc]

That's so funny in that I tend to like memorization, factoids, zebras, etc. Now I understand why you didn't like the basic science years but liked MS-3, while it was completely flipped for me. Explains your specialty choice (and I guess mine lol).

I agree though that it's easier if you do go to a "true" P/F school in the first 2 years. However, this is available at very few select schools.

Agreed. Very few p/f schools and many which claim to be add in high pass and low pass and essentially create a letter grading system. In most cases you'll still get a different letter written for you when you apply to residency based on how well you "passed". Also the USMLE isn't just used by residencies as a pass fail test, so you need to learn all the med school stuff at some point.

 

[pmarank]

I suppose I'll give a more substantive and helpful post than my previous one. I have a lot to say about this topic but I'll try and keep it short.

IMO, there are two general categories of people that I've found in med school, and the type of person you are will heavily shape your experience. There are the people who follow some variation of "medicine is my life" and there's... everyone else. The people of the former category tend to love medical school because they don't mind spending (literally) every waking hour either in the hospital or studying. Whether they actually "love medicine" or are just driven by academic success I don't know, but this group of people tends to thrive in the med school environment. Despite what anyone says, it is this exact kind of attitude that the whole scheme of medical education and training rewards. For everyone else, there's more of a struggle. It's not that they necessarily don't "love medicine" - it's just that they have other things they want to do in their lives, and they begin to resent the huge amount of time that medical school takes up - a not insignificant portion of which is total bull**** and so far from valuable from an educational standpoint that it would funny if it didn't make you angry. I find that these people tend to be the non-trads and those with significant life responsibilities (i.e., spouse or SO, kids, pets, etc.) - in other words, the people that actually have more important things than medical school to dedicate their time to. These are gross generalizations, of course, but that's the easiest way I can simplify it for those of you who haven't started med school yet.

On the scale of "hanging out in Hawaii all day" vs. "being in prison," med school isn't all that bad, though I think it falls closer on the "being in prison" part of the spectrum than the "hanging out in Hawaii all day" part. I've made some great friends and during the first two years had a lot of fun. Because I went to a religious undergrad and was generally gunning it, in some ways med school has been some sort of "college experience" that I never actually had in college. Third year was extremely interesting in some ways in that I got to see/do things that I will very likely never see/do the rest of my life. I've learned a lot of interesting things and am blown away by how much general knowledge of medicine I have compared to when I started. In those respects it's been a good time. But on the whole - based on where I am now (which is admittedly not the full picture since I'm not in practice yet) - would I do it again? No, probably not. I happen to think that I'm going to really enjoy being a doctor and I've found a field that I'm excited about, but overall med school has not been a great time (and certainly not the "best time of my life" as @RogueUnicorn put it), and when I see the six-figure debt and the hours spent studying away in the library or at home, there's definitely a little kernel of regret. That said, I fully expect (...or at least hope) that my opinion will change once I hit residency and am actually doing what I want to do and "being a doctor."

As far as the bad parts, they're almost all psychological. I wholeheartedly agree with @ButImLETired's posts. It is difficult if not impossible to maintain a healthy work-life balance unless you're an intellectual god. It's difficult operating under the constant scheme of "there's more I need to study and learn, but I just can't do it anymore." It wears you down to constantly feel guilty about not studying because you know you need to and you know it's important but you just don't have it in you. You can get a little angry and bitter at the hours you waste away in the hospital because your residents/attendings are terrible managers or because you're "expected" to be at the hospital despite nothing worth your time going on. You will come to realize that despite how well you may have done in undergrad, there is ALWAYS someone that is willing to grind it out longer and sacrifice more than you to do better. In third year especially constantly feeling incompetent hurt my self-esteem and whittled away at my confidence. If you have a SO or family that isn't in medicine, they will struggle to understand why you "still need to study" despite the fact that you've put at least 5-6 hours of studying every day for several weeks. "You've always done well in school - I'm sure you'll do fine!" They just don't get it.

I talk about this in my blog (see my sig), but I tend to be a pretty easy-going guy that isn't easily stressed by stuff. I've never "freaked out" at things going on in school or my personal life. I'm just not that kind of person. Towards the end of my last clerkship, though, I developed anxiety that was severe enough that I felt the need to seek treatment for it and have had a couple of full-blown panic attacks when not at the hospital. I won't say that I developed it "because" of med school because, who knows, I may have developed it regardless. But I'm sure that the lack of sleep and constant stress didn't help things.

My only advice to those considering med school is to be honest with yourself about your motivations for going into medical school - not for others, but for yourself. If you're in it for the money or the "prestige" or whatever aim you have that isn't "using science to SERVE others," then you're probably going to have a bad time. If there's anything else you would seriously consider doing or want to explore, then you should do that before committing to medical training; you'll most likely regret not doing so if you don't prior to starting med school. Again, I want to reiterate that I think I chose well when I chose medicine. But med school was nowhere near what I expected it to be - and I expected it to be bad and thought that I had done my research before going into it. It's difficult to have any realistic basis for it until you get into it yourself. There are certainly people like @mimelim and @RogueUnicorn which sing the praises of med school, but in my experience they are by far the minority. I'm probably a bit more extreme when it comes to my resentment of medical training, but the average is probably closer to me than those other two guys.

What would you have realistically done instead of med school? I know a lot of posters here will say something like "firefighter" but the reality is we all seek the prestige/money/etc. to at least some degree. Would you have just gone into another high stress field?

 

[NickNaylor]

What would you have realistically done instead of med school? I know a lot of posters here will say something like "firefighter" but the reality is we all seek the prestige/money/etc. to at least some degree. Would you have just gone into another high stress field?

I probably would've gone into teaching. I was really into music in high school and was seriously considering music education. I also would consider teaching at the high school level in the sciences.

 

[mimelim]

Agreed. Very few p/f schools and many which claim to be add in high pass and low pass and essentially create a letter grading system. In most cases you'll still get a different letter written for you when you apply to residency based on how well you "passed". Also the USMLE isn't just used by residencies as a pass fail test, so you need to learn all the med school stuff at some point.

Not everyone is the same, but I found studying for Step 1 to be far more tolerable than studying Histology.

 

[mimelim]

That's so funny in that I tend to like memorization, factoids, zebras, etc. Now I understand why you didn't like the basic science years but liked MS-3, while it was completely flipped for me. Explains your specialty choice (and I guess mine lol).

I agree though that it's easier if you do go to a "true" P/F school in the first 2 years. However, this is available at very few select schools.

I've said it before. I really think that a very wide variety of people can find what they are looking for in medical school. You and I are pretty good examples when compared.

 

[DermViser]

I suppose I'll give a more substantive and helpful post than my previous one. I have a lot to say about this topic but I'll try and keep it short.

IMO, there are two general categories of people that I've found in med school, and the type of person you are will heavily shape your experience. There are the people who follow some variation of "medicine is my life" and there's... everyone else. The people of the former category tend to love medical school because they don't mind spending (literally) every waking hour either in the hospital or studying. Whether they actually "love medicine" or are just driven by academic success I don't know, but this group of people tends to thrive in the med school environment. Despite what anyone says, it is this exact kind of attitude that the whole scheme of medical education and training rewards. For everyone else, there's more of a struggle. It's not that they necessarily don't "love medicine" - it's just that they have other things they want to do in their lives, and they begin to resent the huge amount of time that medical school takes up - a not insignificant portion of which is total bull**** and so far from valuable from an educational standpoint that it would funny if it didn't make you angry. I find that these people tend to be the non-trads and those with significant life responsibilities (i.e., spouse or SO, kids, pets, etc.) - in other words, the people that actually have more important things than medical school to dedicate their time to. These are gross generalizations, of course, but that's the easiest way I can simplify it for those of you who haven't started med school yet.

On the scale of "hanging out in Hawaii all day" vs. "being in prison," med school isn't all that bad, though I think it falls closer on the "being in prison" part of the spectrum than the "hanging out in Hawaii all day" part. I've made some great friends and during the first two years had a lot of fun. Because I went to a religious undergrad and was generally gunning it, in some ways med school has been some sort of "college experience" that I never actually had in college. Third year was extremely interesting in some ways in that I got to see/do things that I will very likely never see/do the rest of my life. I've learned a lot of interesting things and am blown away by how much general knowledge of medicine I have compared to when I started. In those respects it's been a good time. But on the whole - based on where I am now (which is admittedly not the full picture since I'm not in practice yet) - would I do it again? No, probably not. I happen to think that I'm going to really enjoy being a doctor and I've found a field that I'm excited about, but overall med school has not been a great time (and certainly not the "best time of my life" as @RogueUnicorn put it), and when I see the six-figure debt and the hours spent studying away in the library or at home, there's definitely a little kernel of regret. That said, I fully expect (...or at least hope) that my opinion will change once I hit residency and am actually doing what I want to do and "being a doctor."

As far as the bad parts, they're almost all psychological. I wholeheartedly agree with @ButImLETired's posts. It is difficult if not impossible to maintain a healthy work-life balance unless you're an intellectual god. It's difficult operating under the constant scheme of "there's more I need to study and learn, but I just can't do it anymore." It wears you down to constantly feel guilty about not studying because you know you need to and you know it's important but you just don't have it in you. You can get a little angry and bitter at the hours you waste away in the hospital because your residents/attendings are terrible managers or because you're "expected" to be at the hospital despite nothing worth your time going on. You will come to realize that despite how well you may have done in undergrad, there is ALWAYS someone that is willing to grind it out longer and sacrifice more than you to do better. In third year especially constantly feeling incompetent hurt my self-esteem and whittled away at my confidence. If you have a SO or family that isn't in medicine, they will struggle to understand why you "still need to study" despite the fact that you've put at least 5-6 hours of studying every day for several weeks. "You've always done well in school - I'm sure you'll do fine!" They just don't get it.

I talk about this in my blog (see my sig), but I tend to be a pretty easy-going guy that isn't easily stressed by stuff. I've never "freaked out" at things going on in school or my personal life. I'm just not that kind of person. Towards the end of my last clerkship, though, I developed anxiety that was severe enough that I felt the need to seek treatment for it and have had a couple of full-blown panic attacks when not at the hospital. I won't say that I developed it "because" of med school because, who knows, I may have developed it regardless. But I'm sure that the lack of sleep and constant stress didn't help things.

My only advice to those considering med school is to be honest with yourself about your motivations for going into medical school - not for others, but for yourself. If you're in it for the money or the "prestige" or whatever aim you have that isn't "using science to SERVE others," then you're probably going to have a bad time. If there's anything else you would seriously consider doing or want to explore, then you should do that before committing to medical training; you'll most likely regret not doing so if you don't prior to starting med school. Again, I want to reiterate that I think I chose well when I chose medicine. But med school was nowhere near what I expected it to be - and I expected it to be bad and thought that I had done my research before going into it. It's difficult to have any realistic basis for it until you get into it yourself. There are certainly people like @mimelim and @RogueUnicorn which sing the praises of med school, but in my experience they are by far the minority. I'm probably a bit more extreme when it comes to my resentment of medical training, but the average is probably closer to me than those other two guys.

Your post should be read by every premed on SDN.

Several things I would add (just from my perspective):

Don't just go to med school bc you "like science", or just so that you "can help people" or bc you like "learning about medicine". Medicine is SO much more than reading and being proud that you can retain and regurgitate information like a trained seal. There are many professions that truly "help people" much more than medicine often can. Medicine is so much more than basic science of the first 2 years. It's dealing with patients who are not at their best and may not appreciate what you do for them, crabby attendings (depending on specialty), crabby residents (depending on specialty), nurses who second guess you and don't do their jobs so you have to, etc. As a medical student, you will be blamed for stuff that you had no way of controlling bc someone didn't do their job and many times you'll have to do it. You will have to grow a hard skin and quick. I believe at the end of med school - you will definitely be a changed person. How much this change is will vary and you will lose a lot of altruism and empathy. If you can't tolerate that possibility, don't go to med school.

Even if you are the best studier, who can study for >10 hrs. per day and who never procrastinates, the medical school experience will wear you out. Everyone will feel some sort of burnout sometime. It may not happen in MS-1/MS-2, may not be even in MS-3, but sometime during the 4 years you will. You WILL need your reserves and outlets that aren't medicine-related to cope. What makes the experience so daunting is: the level of debt even if you have no debt coming into med school, the constant studying and the shortened time you have to process and spit it back out and understand, with a little bit of sleep deprivation and maybe some resident/attending mistreatment thrown in, not getting time to eat/drink (which you'll fully experience in MS-3). Finding a really good few friends in med school and watch out for eachother. You'll need them. Don't do this completely alone.

Don't go to medical school bc you feel like it will fill a void in your life that you have now. Medical school will NOT fill any defect or void you have right now: not financial, not your love life, etc. When people say medicine is a "calling" it's bc it will require a lot of sacrifice in time and money (sometimes your relationships), sometimes your sleep, and the public/hospital many times will expect you to do your craft without extra pay (ask any general surgeon or anybody with call duties/admitting privileges). You will also have to constantly prove your competence again and again and again and the general public/licensing bodies/regulatory bodies will never be satisfied: class exams, OSCEs, USMLE (incl. USMLE Step 2 CS), residency in-training exams, specialty boards, oral boards for some specialties, CME, maintenance of certification and now continuous maintenance of certification. You will be doing this rigamarole till the time you hang up the white coat.

Don't go to medical school bc you feel it would give you a self-esteem boost or so you can prove to your high school friends what a great "success" you've become. Don't go to medical school bc you feel like it will be a great way to get women/meet your future wife when you become a doctor (when you haven't been able to get a date or relationship so far). You will become a resident/attending and nothing will change.

Don't go to medical school for admiration from the public, or from your family or your friends. Esp. the public - they don't care, and if anything will denigrate you for choosing to become a physician by labeling you as lazy, corrupt, greedy, only spending 5 minutes with them, and many times will see you as paying for you to fill out a prescription pad. Don't believe me? Read the comments section of any article on doctors. The "halo" that physicians have of being held up on a pedestal is long, long over and there will be many people as you go up the ladder: PhD basic science professors, attendings, M.Eds, med school deans, nurses, NPs, etc. who will try to stomp on you bc you can't fight back (as that would be "unprofessional"). Many patients will see you as giving a service for payment and no more and feel they deserve it bc as a taxpayer they "paid" for your residency training.

Don't go to medical school bc you feel like it would be a great step up coming from a low/middle/upper middle family and this is your chance to make it in the top tax bracket (esp. when you have baby boomer doctors actively trying to destroy this aspect in their quest for "social justice"). I've had classmates who felt that med school was something to do bc they felt a familial duty to take care of their parents with their perceived salaries (quite altruistic, IMHO). Med school curriculum alone is stressful enough and you'll realize how foolish your thinking is and these people wore out the most and were most disillusioned by the end of 4 years.

You will have classmates (and I think this %age is getting larger) whose families are ridiculously affluent (many of them physicians themselves) who can pay in cash their entire tuition bill. Medical school is a way of trying to maintain that affluence. 9 times out of 10 you WILL NOT fall into this category as a doctor and if you do, you'll be much older and many years outside of the end of residency training.

You'll see people in your med school class who don't deserve it get everything they want thru out medical school and you'll also see the nicest, altruistic people who deserve to become doctors not get what they want or even drop out/fail out of med school. And vice versa. The medical school system as it is conducted now favors the highly academic, very little sleep requirements, who are good actors with a little bit of sociopathy, gunnerism, overachieving, and butt-kissing to the right people thrown in.

Don't go into medical school with the attitude of I would ONLY become a doctor if I can become a _____________ (insert medical specialty here). It will only set yourself up for a huge world of hurt. You have to be flexible and realistic for any possibility of not getting to do what you want.

Unless you have family or friends in medicine, NO ONE will understand. They just won't. When family/friends tell you everything will be ok, give them a kiss or a hug, and just realize they're just trying to help the best way they know how, even though they can't truly understand what you are going thru whether in med school or in residency.

I agree, with @NickNaylor with respect to @mimelim, whom I respect, (I don't know @RogueUnicorn that well), in my experience, people who have @mimelim's type of experience in med school and personality/worldview are a very very small minority of your med school class.

Edit: So much for only several things. LOL.

 

[DermViser]

I've said it before. I really think that a very wide variety of people can find what they are looking for in medical school. You and I are pretty good examples when compared.

Yes, I very much agree. I don't have experiences with any other occupation (obvi), but medicine truly does have a specialty for every possible personality type and that can bolster up one's inherent likes and strengths. Even if you "hate patients" there are specialties for those type of people too - Radiology/Pathology.

Medical students just need to realize what those are and not try to fit a round peg into a square hole so to speak (w/in reason) and listen to what their feelings are telling them with respect to what they want in their specialty career choice. I think these come out loudly during the basic science years, and esp. during MS-3.

 

[DermViser]

I probably would've gone into teaching. I was really into music in high school and was seriously considering music education. I also would consider teaching at the high school level in the sciences.

Me too!!! I would have loved being a teacher (at a private school though so they don't have to teach to state mandated standardized tests).

 

[mcloaf]

M1 was a pretty good time for me. Flexible schedule, cool things to do, mostly interesting stuff to learn. I expect M2 will be relatively similar, but with more work that's also more interesting. I am nervous for M3.

I also go to a true P/F school with streaming lectures, and could easily imagine myself being miserable if I had to sit in lecture from 9-5 every day and/or deal with a curve on all our exams.

 

[NickNaylor]

M1 was a pretty good time for me. Flexible schedule, cool things to do, mostly interesting stuff to learn. I expect M2 will be relatively similar, but with more work that's also more interesting. I am nervous for M3.

I also go to a true P/F school with streaming lectures, and could easily imagine myself being miserable if I had to sit in lecture from 9-5 every day and/or deal with a curve on all our exams.

Just to provide some context for my comments, I also go to a true P/F school and 100% followed the home school plan.

 

[pmarank]

I probably would've gone into teaching. I was really into music in high school and was seriously considering music education. I also would consider teaching at the high school level in the sciences.

Would you have considered med school light aka PA school?

 

[Planes2Doc]

Your post should be read by every premed on SDN.

Several things I would add (just from my perspective):

Don't just go to med school bc you "like science", or just so that you "can help people" or bc you like "learning about medicine". Medicine is SO much more than reading and being proud that you can retain and regurgitate information like a trained seal. There are many professions that truly "help people" much more than medicine often can. Medicine is so much more than basic science of the first 2 years. It's dealing with patients who are not at their best and may not appreciate what you do for them, crabby attendings (depending on specialty), crabby residents (depending on specialty), nurses who second guess you and don't do their jobs so you have to, etc. As a medical student, you will be blamed for stuff that you had no way of controlling bc someone didn't do their job and many times you'll have to do it. You will have to grow a hard skin and quick. I believe at the end of med school - you will definitely be a changed person. How much this change is will vary and you will lose a lot of altruism and empathy. If you can't tolerate that possibility, don't go to med school.

Even if you are the best studier, who can study for >10 hrs. per day and who never procrastinates, the medical school experience will wear you out. Everyone will feel some sort of burnout sometime. It may not happen in MS-1/MS-2, may not be even in MS-3, but sometime during the 4 years you will. You WILL need your reserves and outlets that aren't medicine-related to cope. What makes the experience so daunting is: the level of debt even if you have no debt coming into med school, the constant studying and the shortened time you have to process and spit it back out and understand, with a little bit of sleep deprivation and maybe some resident/attending mistreatment thrown in, not getting time to eat/drink (which you'll fully experience in MS-3). Finding a really good few friends in med school and watch out for eachother. You'll need them. Don't do this completely alone.

Don't go to medical school bc you feel like it will fill a void in your life that you have now. Medical school will NOT fill any defect or void you have right now: not financial, not your love life, etc. When people say medicine is a "calling" it's bc it will require a lot of sacrifice in time and money (sometimes your relationships), sometimes your sleep, and the public/hospital many times will expect you to do your craft without extra pay (ask any general surgeon or anybody with call duties/admitting privileges). You will also have to constantly prove your competence again and again and again and the general public/licensing bodies/regulatory bodies will never be satisfied: class exams, OSCEs, USMLE (incl. USMLE Step 2 CS), residency in-training exams, specialty boards, oral boards for some specialties, CME, maintenance of certification and now continuous maintenance of certification. You will be doing this rigamarole till the time you hang up the white coat.

Don't go to medical school bc you feel it would give you a self-esteem boost or so you can prove to your high school friends what a great "success" you've become. Don't go to medical school bc you feel like it will be a great way to get women/meet your future wife when you become a doctor (when you haven't been able to get a date or relationship so far). You will become a resident/attending and nothing will change.

Don't go to medical school for admiration from the public, or from your family or your friends. Esp. the public - they don't care, and if anything will denigrate you for choosing to become a physician by labeling you as lazy, corrupt, greedy, only spending 5 minutes with them, and many times will see you as paying for you to fill out a prescription pad. Don't believe me? Read the comments section of any article on doctors. The "halo" that physicians have of being held up on a pedestal is long, long over and there will be many people as you go up the ladder: PhD basic science professors, attendings, M.Eds, med school deans, nurses, NPs, etc. who will try to stomp on you bc you can't fight back (as that would be "unprofessional"). Many patients will see you as giving a service for payment and no more and feel they deserve it bc as a taxpayer they "paid" for your residency training.

Don't go to medical school bc you feel like it would be a great step up coming from a low/middle/upper middle family and this is your chance to make it in the top tax bracket (esp. when you have baby boomer doctors actively trying to destroy this aspect in their quest for "social justice"). I've had classmates who felt that med school was something to do bc they felt a familial duty to take care of their parents with their perceived salaries (quite altruistic, IMHO). Med school curriculum alone is stressful enough and you'll realize how foolish your thinking is and these people wore out the most and were most disillusioned by the end of 4 years.

You will have classmates (and I think this %age is getting larger) whose families are ridiculously affluent (many of them physicians themselves) who can pay in cash their entire tuition bill. Medical school is a way of trying to maintain that affluence. 9 times out of 10 you WILL NOT fall into this category as a doctor and if you do, you'll be much older and many years outside of the end of residency training.

You'll see people in your med school class who don't deserve it get everything they want thru out medical school and you'll also see the nicest, altruistic people who deserve to become doctors not get what they want or even drop out/fail out of med school. And vice versa. The medical school system as it is conducted now favors the highly academic, very little sleep requirements, who are good actors with a little bit of sociopathy, gunnerism, overachieving, and butt-kissing to the right people thrown in.

Don't go into medical school with the attitude of I would ONLY become a doctor if I can become a _____________ (insert medical specialty here). It will only set yourself up for a huge world of hurt. You have to be flexible and realistic for any possibility of not getting to do what you want.

Unless you have family or friends in medicine, NO ONE will understand. They just won't. When family/friends tell you everything will be ok, give them a kiss or a hug, and just realize they're just trying to help the best way they know how, even though they can't truly understand what you are going thru whether in med school or in residency.

I agree, with @NickNaylor with respect to @mimelim, whom I respect, (I don't know @RogueUnicorn that well), in my experience, people who have @mimelim's type of experience in med school and personality/worldview are a very very small minority of your med school class.

Edit: So much for only several things. LOL.

This should be a sticky.

 

[DermViser]

This should be a sticky.

Funny you should say that, as I was going to say @NickNaylor's post should be a sticky. I think his post stirred up emotions/recollections of experiences in me to write my post. So I credit him.

 

[Planes2Doc]

Funny you should say that, as I was going to say @NickNaylor's post should be a sticky. I think his post stirred up emotions/recollections of experiences in me to write my post. So I credit him.

I think you both deserve stickies. Thanks so much for your honesty, which is much needed.

 

[RogueUnicorn]

snip

I'm far from intellectual god and with the exception of a 2 month period studying for Step 1, and all of third year, all of med school has been way more like hanging out in Hawaii. Honestly a lot of the unhappiness you guys are claiming are entirely self inflicted - why the eff are you spending so much time studying? I'm sure school environment has a lot to do with this as well as previous expectations etc but preclinicals were a complete joke that required little to no studying to pass. This isn't a humble brag, it's just a fact at least at my school that most people come to realize in time - I just did so sooner.

I think you both deserve stickies. Thanks so much for your honesty, which is much needed.

Funny how you only thank the honesty you agree with

 

[KnuxNole]

Expectations: Holy ****, med school requires you to study a lot with no life, and you have to be insanely smart to make it through. Better say goodbye to all my hobbies, dating, and booze.
Reality: Holy ****, this is hard, but I still have a life, I don't have to be intelligent at ALL to make it through, and HELLO hobbies, dating and booze

Med school was really a rollercoaster. Basic sciences were a biatch. Learning about biochemistry, molecular biology, the small details my path professors cared about, BIOSTATISTICS(****,this was hard!), the fact that in undergrad I would study two to three days to get an A or a B to now studying daily(a new concept) to catch up with daily lectures piling on and on. The first semester was the worst, getting used to this concept. After that, everything went smoothly. I stopped going to class, studied off of notes and review books, and was smoother.

I liked rotations overall. THIS was the reason I went to med school. Not the science stuff and definitely not for research/academics. Surgery was a nightmare, after 6 weeks I wanted to stop coming in. But, it passed. Labor and Delivery was a horrid experience in med school. Other than that, I liked all my experiences in 3rd-4th year. Studying was better since it was clinical based, I would read one review book and it was smooth as well. The problem was feeling like an idiot daily. I always felt like I was subpar, but regardless I focused on learning and taking away what I can.

I think the best thing is the friends/family that support you. In addition to friends/family you have before school, the ones you make during school are key too. You don't have to befriend everyone(anyone who says this is lying....or they view acquaintances as legit friendships). A strong support system gets you through any tough times!

 

[KnuxNole]

I'm far from intellectual god and with the exception of a 2 month period studying for Step 1, and all of third year, all of med school has been way more like hanging out in Hawaii. Honestly a lot of the unhappiness you guys are claiming are entirely self inflicted - why the eff are you spending so much time studying? I'm sure school environment has a lot to do with this as well as previous expectations etc but preclinicals were a complete joke that required little to no studying to pass. This isn't a humble brag, it's just a fact at least at my school that most people come to realize in time - I just did so sooner.


Funny how you only thank the honesty you agree with

I'm 100x further than that, A TON of basic science was brand new material I've ever seen or heard of in my life. If I barely studied, I would have made a 40-50% in every test, guaranteed. A lot of the vocab/science is jibberish that makes no sense just listening to. Plus, I am a slow reader, so I can't power through things quickly .

For ex: Anatomy. That was a test I legit failed(in the low 40s). I had to re-work how I thought/studied to a complete 180 to re-wire my thinking and approach. Physio requires critical thinking, which was challenging. Micro/Pharm required memorization, which if I required one pass, would forget every damn bug/drug in existence(since a lot of those drugs/bugs were new words I've never heard of). And path, terminology was crazy.

So, while it was manageable once I learned how to study, I was someone who needed to put effort/time daily, since a dumb **** like me wouldn't have gotten through otherwise.

 

[PTPoeny]

I'm with mimelin, if you just don't care that much about the stupid stuff, medical school can be very enjoyable in a hard work way. Medical school absolutely should not mean you have no hobbies or dating life or with friends. It is still hard work, But the first two years I got together with friends to hang out every Saturday night (not staying out as late college... but still hanging out) and my husband and I took our dogs hiking every week. I had plenty of time to date and marry my now husband. I never competed with my friends, we all hear different strengths and helped each other out. Ignore the those who want to compete with you. The goal should be for everyone to learn as much as possible, your classmates week be your colleagues even after graduate. Third year was fun and challenging in a very different way but I still gamed every other week with friends on most rotations.

Yes, studying for step 1 really sucked, no way around that.

For me doing a PhD was absolutely soul sucking and made me hate my life in a way medical school never did.

One way to think about med school is that you are learning how to live your life while busy. Because you won't have any more time as a resident or fellow and not necessarily as an attending. But this doesn't mean that you aren't living your life during all these stages.

 

[xffan624]

I expected to have my free time taken from me that I enjoyed while working full time. That happened, but I still have some free time. In MS2, as a non-trad who was well out of school when I started. I honestly didn't remember what I did as an undergrad so I started from scratch. My study mentality has been to study smarter, not harder. I don't like to waste my time, so I try to be efficient in my studying. Flashcards and study schedules (when tests approach) are my way of doing this.

I left a decent job that I could have kept doing for a while. I wanted a challenge and medical school gave me that, so I guess it met my expectations. You won't hear any complaints on my end. I chose to be here and I'm still happy with my choice. * Had to do my first rectal exam on a standardized patient today. Not a bag of laughs, but still cool.

*Disclaimer: My school is being paid for through veterans' benefits so I am incurring no military obligation for zero debt, so my view may be a bit skewed due to that.

 

[cbrons]

There are certainly people like @mimelim and @RogueUnicorn which sing the praises of med school, but in my experience they are by far the minority. I'm probably a bit more extreme when it comes to my resentment of medical training, but the average is probably closer to me than those other two guys.

I'm proud I got to know you before you started med school... I'm surprised but also very pleased to see someone like you leaning toward psychiatry.

As far as my experience, I would really advise people think hard about why they want to go to medical school. If you just want to "help people" then you are really taking a bad route, there are plenty of other careers out there without the hassle and more of the actual "helping people" without the rubbish. If you are like me and love basic medical science so much that it makes up for all the bad professors, horribly written exams and other rigamaroles a lot of schools put you through, you won't have a big problem with depression and learned helplessness. Of course in my case I also think my family support (taking a year off, getting married and then coming back to school after sorting out personal life stuff) helped significantly.

 

[ButImLETired]

You don't get a feature article in the New York Times on how happy your students are if you let the realistic students start opening their mouths!!

I really don't want to bad mouth my med school. The vast majority of the faculty were remarkable, caring people who wanted us to succeed. I think the advisory program was genuinely a great addition to the school, and my advisor was a godsend and one of the reasons I didn't quit. I genuinely think that my experience was in large part my fault because I'm just awful at maintaining a work/life balance and I think I expected to love med school and love other med students and have so much fun, and reality hit me like a ton of bricks. I wasn't miserable every day, I thought a lot of the material WAS interesting, and I liked quite a few people. But overall, sure, I wouldn't go through that again especially now that I feel so much more at peace. For what it's worth, I think plenty of people were just as frustrated with me being a naysayer as I was with them drinking the wellness kool-aid, so I'm sure they have a very different perspective on the whole thing.

I will say though to some of the posters here, don't lose the excitement and the passion. As much as I hated med school, there was never a doubt in my mind that I still loved medicine. It's true that it's not the perfect career, and that you shouldn't go into it for money, prestige, the expectation of praise, etc. I do think that we absolutely help people, and in a remarkably unique and important way. This isn't martyrdom. Sometimes I think posters here take the whole "it's not a field of flowers and a chocolate fountain" approach a little too far and make it seem like the light at the end of the tunnel is an incoming train, and we're all here whipping ourselves as penance by working as physicians. Yes, the lack of sleep sucks- I switch between days and nights multiple times a week and my body is a disaster. Yes, the time commitment is rough, the debt sounds like make-believe money, and yes you will get yelled at by patients, attendings, nurses, and pretty much everyone else you can think of. But you'll also find yourself learning more than you could ever imagine- and this is different from the memorization you do in med school, i'm talking about ACTUAL learning. You'll find yourself giving advice to people 3 times your age and actually sounding like you know what you're saying, and on some days you'll feel like you actually played a part in saving a life. The better you get at your job, the more confident you become in your knowledge and abilities, and the more the sacrifice makes sense. Med school is a blip in the scheme of things, as will residency be. I don't regret going into medicine because I wanted to help people, and because I wanted people to look up to me, and because I wanted to afford my own house, and because I wanted to learn science- thank God for all that, cause it's what got me through it. I also don't think any of these motivations were wrong, and even after intern year, I still want all those things. This isn't masochism, you're supposed to actually LIKE this stuff, you're not supposed to live in misery and regret.

 

[singergirl18]

I probably would've gone into teaching. I was really into music in high school and was seriously considering music education. I also would consider teaching at the high school level in the sciences.

That's what I said in my secondaries! (the music ed part)

 

[DermViser]

I'm far from intellectual god and with the exception of a 2 month period studying for Step 1, and all of third year, all of med school has been way more like hanging out in Hawaii. Honestly a lot of the unhappiness you guys are claiming are entirely self inflicted - why the eff are you spending so much time studying? I'm sure school environment has a lot to do with this as well as previous expectations etc but preclinicals were a complete joke that required little to no studying to pass. This isn't a humble brag, it's just a fact at least at my school that most people come to realize in time - I just did so sooner.

Congrats. Keep up the good work. Hard to tell if you're just trying to intentionally get jimmies rustled, are actively trolling, or actually believe what you just posted.

 

[DermViser]

I really don't want to bad mouth my med school. The vast majority of the faculty were remarkable, caring people who wanted us to succeed. I think the advisory program was genuinely a great addition to the school, and my advisor was a godsend and one of the reasons I didn't quit. I genuinely think that my experience was in large part my fault because I'm just awful at maintaining a work/life balance and I think I expected to love med school and love other med students and have so much fun, and reality hit me like a ton of bricks. I wasn't miserable every day, I thought a lot of the material WAS interesting, and I liked quite a few people. But overall, sure, I wouldn't go through that again especially now that I feel so much more at peace. For what it's worth, I think plenty of people were just as frustrated with me being a naysayer as I was with them drinking the wellness kool-aid, so I'm sure they have a very different perspective on the whole thing.

Well Vanderbilt is now changing to a 1 year preclinical so I'm guessing that the usage of "wellness" services will go up dramatically.

 

[Planes2Doc]

I'm far from intellectual god and with the exception of a 2 month period studying for Step 1, and all of third year, all of med school has been way more like hanging out in Hawaii. Honestly a lot of the unhappiness you guys are claiming are entirely self inflicted - why the eff are you spending so much time studying? I'm sure school environment has a lot to do with this as well as previous expectations etc but preclinicals were a complete joke that required little to no studying to pass. This isn't a humble brag, it's just a fact at least at my school that most people come to realize in time - I just did so sooner.

Funny how you only thank the honesty you agree with

Then how do you explain people working non-stop only to receive passing grades? These aren't gunners that are getting 100% on every test that are making themselves miserable because they work too hard. Surely a large portion of medical school aren't incapable people who have no idea what to do, right?

 

[mimelim]

Then how do you explain people working non-stop only to receive passing grades? These aren't gunners that are getting 100% on every test that are making themselves miserable because they work too hard. Surely a large portion of medical school aren't incapable people who have no idea what to do, right?

They don't have to work non-stop to receive a passing grade, they choose to do that. Certainly there are some people that get past the application screens and are not academically sound and may actually need to put in hours and hours and hours to just pass. I honestly think that that group is a very small minority. Most of the people that I know who did that in medical school did the same in undergrad. That is how they learned to study and it is incredibly inefficient. This is like 95% medical school's fault for having ****ty pre-clinical curriculums that lack focus and clinical relevance.

 

[DermViser]

They don't have to work non-stop to receive a passing grade, they choose to do that. Certainly there are some people that get past the application screens and are not academically sound and may actually need to put in hours and hours and hours to just pass. I honestly think that that group is a very small minority. Most of the people that I know who did that in medical school did the same in undergrad. That is how they learned to study and it is incredibly inefficient. This is like 95% medical school's fault for having ****ty pre-clinical curriculums that lack focus and clinical relevance.

That's bc the NBME who writes Step 1 emphasizes things that are not clinically relevant. Don't blame the medical school for this. Only PhDs can run basic science courses (as MDs have clinical obligations and RVUs to crank out), and they naturally won't know what is clinically relevant and what is not. Heck even if you had MDs course directing basic science courses, you would only get the clinical day-to-day practice exposure bias, and not learn the other stuff you need to know.

And once again, very few medical schools in the U.S. are "true" P/F in the first 2 years - those happen to be the elite schools that can do so due to institution name alone.

 

[NickNaylor]

I'm far from intellectual god and with the exception of a 2 month period studying for Step 1, and all of third year, all of med school has been way more like hanging out in Hawaii. Honestly a lot of the unhappiness you guys are claiming are entirely self inflicted - why the eff are you spending so much time studying? I'm sure school environment has a lot to do with this as well as previous expectations etc but preclinicals were a complete joke that required little to no studying to pass. This isn't a humble brag, it's just a fact at least at my school that most people come to realize in time - I just did so sooner.


Funny how you only thank the honesty you agree with

I think you're selling yourself short. I'd agree with you about MS1- past the first few weeks it was a complete joke. MS2 was nice in some respects since I never went to class and basically had 5 days/week to do with what I wanted, but I certainly wouldn't say I could do "little to no studying" in order to pass.

And by the way, I follow the philosophy that, for most of the pre-clinical courses, any point scored above the passing threshold was indicative of too much time spent studying. There was so much information that had zero correlation to clinical medicine that it didn't make sense to learn all of it as a good chunk would never be used again.

I think we just had vastly different experiences. And again, I had a good time overall during the pre-clinical years. But I think you're selling yourself short and stand by my argument that you are definitely not the norm and your experience should not be what the average aspiring medical student should expect.

 

[jsmith1]

I think you're selling yourself short. I'd agree with you about MS1- past the first few weeks it was a complete joke. MS2 was nice in some respects since I never went to class and basically had 5 days/week to do with what I wanted, but I certainly wouldn't say I could do "little to no studying" in order to pass.

And by the way, I follow the philosophy that, for most of the pre-clinical courses, any point scored above the passing threshold was indicative of too much time spent studying. There was so much information that had zero correlation to clinical medicine that it didn't make sense to learn all of it as a good chunk would never be used again.

I think we just had vastly different experiences. And again, I had a good time overall during the pre-clinical years. But I think you're selling yourself short and stand by my argument that you are definitely not the norm and your experience should not be what the average aspiring medical student should expect.

J/c @RogueUnicorn would you two guys mind sharing the residency field you are applying to along with a range that your step 1 falls into?

 

[NickNaylor]

J/c @RogueUnicorn would you two guys mind sharing the residency field you are applying to along with a range that your step 1 falls into?

Psychiatry, mid 230s.

I believe @RogueUniorn is going into ortho.

 

[KnuxNole]

I guess that explains rogues stance, being able to power basic sciences and do well on the step

I'll admit i have no academic prowess, or intellect. As we all know, you don't have to smart or be an expert at critical thinking to be a doctor...I think there is a myth that only really smart people can go to med school. What made basic sciences lame to me is the whole school aspect. Reading sucks, critical thinking sucks, tests sucks...

 

[KnuxNole]

In my unpopular opinion, no. There's a certain baseline, but if people who got a 25-30 wouldn't be allowed to be doctors, med schools will have vacant seats all across the country.

I hate reading, and the mcat had a lot of it. Coupled with physics...which is something I never ever deal with on rotations and in residency. In fact, outside of step 1, it was very little science based and way more medicine based. Which made things more comfortable. Also, for readings, there is less emphasis on the science aspect and more so the clinical recs, which is what I try to increase knowledge with.

 

[DermViser]

And by the way, I follow the philosophy that, for most of the pre-clinical courses, any point scored above the passing threshold was indicative of too much time spent studying. There was so much information that had zero correlation to clinical medicine that it didn't make sense to learn all of it as a good chunk would never be used again.

What about with respect to Step 1?

 

[NickNaylor]

What about with respect to Step 1?

I don't think so. There were people who performed similarly but did better on step 1. I just choked (scored about 10 points below my practice scores before the test). Out curriculum really isn't "boards focused" in any sense.

 

[DermViser]

I don't think so. There were people who performed similarly but did better on step 1. I just choked (scored about 10 points below my practice scores before the test). Out curriculum really isn't "boards focused" in any sense.

Well also, the Step 1 exam draws from a bank of questions of who knows what combo of subjects you get that day that plays to your strengths or weaknesses.

 

[RogueUnicorn]

Congrats. Keep up the good work. Hard to tell if you're just trying to intentionally get jimmies rustled, are actively trolling, or actually believe what you just posted.

Then how do you explain people working non-stop only to receive passing grades? These aren't gunners that are getting 100% on every test that are making themselves miserable because they work too hard. Surely a large portion of medical school aren't incapable people who have no idea what to do, right?

I echo @mimelim in saying that these people are a miniscule minority, at least as it pertains to people who actually have to do that in order to pass. there are definitely peers who studied non stop for preclinicals, shelfs, step 1, etc. they were super stressed all the time and the rest of us collectively referred to them as crazy. almost all of them are great people, but just couldn't let the anxiety go. If your institution is a place where a significant portion of people need to study non stop just to chin over pass, then either they need to immediately re-examine the caliber of students they are admitting or their preclinical curriculum or both.

I think you're selling yourself short. I'd agree with you about MS1- past the first few weeks it was a complete joke. MS2 was nice in some respects since I never went to class and basically had 5 days/week to do with what I wanted, but I certainly wouldn't say I could do "little to no studying" in order to pass.

And by the way, I follow the philosophy that, for most of the pre-clinical courses, any point scored above the passing threshold was indicative of too much time spent studying. There was so much information that had zero correlation to clinical medicine that it didn't make sense to learn all of it as a good chunk would never be used again.

I think we just had vastly different experiences. And again, I had a good time overall during the pre-clinical years. But I think you're selling yourself short and stand by my argument that you are definitely not the norm and your experience should not be what the average aspiring medical student should expect.

The bolded seems more Hawaii than prison to me ;-). I am also wondering if we actually had very similar experiences yet recall/choose to view it differently. I also think we might be singing opposite tunes had we gone to each other's schools but that is 100% conjecture and bias on my part. Definitely something to ponder about next time I'm altered. Ultimately I wonder if it's a coincidence this thread is shaping up to be kind of a surgeons vs. physicians kind of discussion, just looking at the battle lines that have been drawn. (Not calling myself a surgeon. Just saying.)

J/c @RogueUnicorn would you two guys mind sharing the residency field you are applying to along with a range that your step 1 falls into?

Ortho, a bit above average for the field.

I'll admit i have no academic prowess, or intellect. As we all know, you don't have to smart or be an expert at critical thinking to be a doctor...I think there is a myth that only really smart people can go to med school. What made basic sciences lame to me is the whole school aspect. Reading sucks, critical thinking sucks, tests sucks...

I agree that intelligence is at best a secondary quality, in my opinion it's all about attitude and work ethic.

Slightly off topic I suppose, but do you (or anyone else who wants to answer this) think the MCAT is a any indication of all of how well you will do in medical school or how good of a doctor you will be? I have heard from other undergrads, several times in college, that people with 25 - 30 MCAT scores don't deserve to go to medical school and will be poor physicians. But this seems like kind of a ridiculous statement to make....

I am certain there are people with 25 MCAT scores who will trounce me at everything related to being a physician. I do think the MCAT an indication of how well you test and an outside/weak indicator of "intelligence" but as noted above this is a secondary quality at best.

What about with respect to Step 1?

How much of your preclinical studying was actually useful for Step 1?

 

[KnuxNole]

The key though, is that the min to be able to pass is different for everyone. I can't get away with an hour or two daily to pass. 95-99 percent of all med school classes were on information I've never seen or heard of in my life. I dunno what it was for everyone else. It was concepts, terms that I needed to integrate. And, I am someone who sucks at memorizing, you need to tell me your name 5 times before it clicks

Thankfully there was no physics or calculus in med school.

 

[mimelim]

That's bc the NBME who writes Step 1 emphasizes things that are not clinically relevant. Don't blame the medical school for this. Only PhDs can run basic science courses (as MDs have clinical obligations and RVUs to crank out), and they naturally won't know what is clinically relevant and what is not. Heck even if you had MDs course directing basic science courses, you would only get the clinical day-to-day practice exposure bias, and not learn the other stuff you need to know.

And once again, very few medical schools in the U.S. are "true" P/F in the first 2 years - those happen to be the elite schools that can do so due to institution name alone.

Couple of issues. First, how much of your pre-clinical time was spent on things that were Step 1 relevant? Mine was next to zero. I picked up a 2 year old copy of First Aid maybe 3 months into MS1. I saw the level of detail and literally every person I talked to said that if you simply memorized First Aid, I'd get a 230. While a loose approximation, the take home point is that your pre-clinical years, if they were anything like mine or the vast majority of my classmates (we surveyed them), didn't help you prepare for step 1. It IS the medical school's fault for doing that. I'm not saying that they should turn the pre-clinical years into a Step 1 cram session. This isn't the Caribbean. I'm saying that they 'massive volume' or the 'time consuming' part of pre-clinicals is an archaic remnant of a teaching style, not even remotely necessary. PhDs can teach basic science all they want. If their curriculum is designed/edited by students/MDs it become far more clinically relevant and also gets rid of a lot of the silly stuff that they drone on and on about.

And, I don't think that you are correct about "very few medical schools are pass/fail" or that they are only the 'elite schools'. Off the top of my head, HMS, Yale, Stanford, Alpert, SLU, UMass, Mayo, Case Western, U of C, Mount Sinai, and UConn are all P/F. That is a pretty good mix of 'elite' and random schools.

 

[DermViser]

Couple of issues. First, how much of your pre-clinical time was spent on things that were Step 1 relevant? Mine was next to zero. I picked up a 2 year old copy of First Aid maybe 3 months into MS1. I saw the level of detail and literally every person I talked to said that if you simply memorized First Aid, I'd get a 230. While a loose approximation, the take home point is that your pre-clinical years, if they were anything like mine or the vast majority of my classmates (we surveyed them), didn't help you prepare for step 1. It IS the medical school's fault for doing that. I'm not saying that they should turn the pre-clinical years into a Step 1 cram session. This isn't the Caribbean. I'm saying that they 'massive volume' or the 'time consuming' part of pre-clinicals is an archaic remnant of a teaching style, not even remotely necessary. PhDs can teach basic science all they want. If their curriculum is designed/edited by students/MDs it become far more clinically relevant and also gets rid of a lot of the silly stuff that they drone on and on about.

And, I don't think that you are correct about "very few medical schools are pass/fail" or that they are only the 'elite schools'. Off the top of my head, HMS, Yale, Stanford, Alpert, SLU, UMass, Mayo, Case Western, U of C, Mount Sinai, and UConn are all P/F. That is a pretty good mix of 'elite' and random schools.

The basic science years have 2 purposes in theory: to lay a foundation of medical information in which you build off that base during the clinical years and to prepare you for Step 1. The format of USMLE Step 1 (and before that I believe it was called the NBME Part I), has drastically changed with respect to how test questions are written and formatted. I guarantee you that today only memorizing the lines from First Aid won't get you a 230 (esp. with the mean being 227). First Aid is a well-known and used resource and is better used as a detail recall tool - but it's not everything and there are many test questions which you won't even find in First Aid. I'm sure when it first came out - it was a Godsend to doing well. Just knowing the factoid alone now will get you the gimme questions. It's when you're asked to apply it to a previously unknown problem or where the question is more interdisciplinary or requires you to cross disciplines is where it gets tricky.

Not everything you will learn during the basic science years will have some common clinical scenario/relevance. There will be information that for all intents and purposes, is the way that it is, and you have to know it. Knowing what/where the caudate and putamen are, may seem like rote memorization facts, but if you have ischemia there and can't identify the structure on a scan, as a Radiologist/Neurologist, then you're in trouble. Sometimes you just have to be able to memorize, store, and retrieve that information later. What has changed with respect to residency is the amount of weight given to the USMLE Step 1. The exam has effectively served as a gate to barrier to entry to certain specialties. Don't have a certain score? Then your chances of matching go tremendously down. That's not your med school's fault as Gross Anatomy, Histo, Embryo, Neuro, Physiology, etc. haven't changed in decades.

UMass just recently changed their grade scheme, as did Alpert and SLU. UConn doesn't have an AOA chapter so that's not surprising. The rest - Harvard, Yale, Stanford, U of Chicago, Mount Sinai, Mayo, Case Western are pretty darn good med schools.

And yes there are certain medical schools that tailor their basic science curriculum quite well to also cover Step 1 material. Baylor College of Medicine is a perfect example, which is well known on SDN, and their board score averages are fantastic.

 

[AndyQC]

Couple of issues. First, how much of your pre-clinical time was spent on things that were Step 1 relevant? Mine was next to zero. I picked up a 2 year old copy of First Aid maybe 3 months into MS1. I saw the level of detail and literally every person I talked to said that if you simply memorized First Aid, I'd get a 230. While a loose approximation, the take home point is that your pre-clinical years, if they were anything like mine or the vast majority of my classmates (we surveyed them), didn't help you prepare for step 1. It IS the medical school's fault for doing that. I'm not saying that they should turn the pre-clinical years into a Step 1 cram session. This isn't the Caribbean. I'm saying that they 'massive volume' or the 'time consuming' part of pre-clinicals is an archaic remnant of a teaching style, not even remotely necessary. PhDs can teach basic science all they want. If their curriculum is designed/edited by students/MDs it become far more clinically relevant and also gets rid of a lot of the silly stuff that they drone on and on about.

And, I don't think that you are correct about "very few medical schools are pass/fail" or that they are only the 'elite schools'. Off the top of my head, HMS, Yale, Stanford, Alpert, SLU, UMass, Mayo, Case Western, U of C, Mount Sinai, and UConn are all P/F. That is a pretty good mix of 'elite' and random schools.

Out of curiosity: why do you think some schools within the same tier have Step 1 averages in the mid-220s while others are all the way up at 240+? I had previously assumed that it was due to the caliber of students, but there does seem to be a big difference even between schools that are similarly ranked.

 

[mimelim]

Out of curiosity: why do you think some schools within the same tier have Step 1 averages in the mid-220s while others are all the way up at 240+? I had previously assumed that it was due to the caliber of students, but there does seem to be a big difference even between schools that are similarly ranked.

Last I checked there was no central repository for actual Step 1 scores at different schools. For example, at the school I went to, there were 2 people (Deans) that got the full data set from the NBME regarding scores for every student. They presented some of the data to the students and yet there is a different average score on US News. Nobody at our school could figure out where they got their number since it didn't reflect reality. Then you will see reported step 1 scores from random people on the internet. My conclusion? It is all bull****. Unless a school publishes their score (which would be entirely self reported and non-verifiable), those scores that you see are meaningless. Unless the NBME is selling the data to 3rd parties, which I guess is possible, just haven't heard about it.

 

[DermViser]

Last I checked there was no central repository for actual Step 1 scores at different schools. For example, at the school I went to, there were 2 people (Deans) that got the full data set from the NBME regarding scores for every student. They presented some of the data to the students and yet there is a different average score on US News. Nobody at our school could figure out where they got their number since it didn't reflect reality. Then you will see reported step 1 scores from random people on the internet. My conclusion? It is all bull****. Unless a school publishes their score (which would be entirely self reported and non-verifiable), those scores that you see are meaningless. Unless the NBME is selling the data to 3rd parties, which I guess is possible, just haven't heard about it.

There's only 1 school that reports their scores by posting their NBME score reports on their website and that's UVa: http://www.med-ed.virginia.edu/handbook/academics/licensure.cfm The rest usually post the number in a school newsletter if they choose to reveal it.

 

[AndyQC]

Last I checked there was no central repository for actual Step 1 scores at different schools. For example, at the school I went to, there were 2 people (Deans) that got the full data set from the NBME regarding scores for every student. They presented some of the data to the students and yet there is a different average score on US News. Nobody at our school could figure out where they got their number since it didn't reflect reality. Then you will see reported step 1 scores from random people on the internet. My conclusion? It is all bull****. Unless a school publishes their score (which would be entirely self reported and non-verifiable), those scores that you see are meaningless. Unless the NBME is selling the data to 3rd parties, which I guess is possible, just haven't heard about it.

Thanks, mimelim.

Average Step 1 scores were reported at several of the interviews I attended. It seemed crazy to me that School A and School B would accept academically comparable students, yet School A would report an average score of 241 while School B would report 220. Based on what you said, it seems like prospective students shouldn't put a lot of stock into these numbers.

 

[Cyberdyne 101]

Aside from being a recruitment tool, what other purpose does disguising step 1 averages serve?