Is 1st year that important?

[MattSmith45]

How important is 1st year? I heard the material isn't very relevant to boards. Is it important to do well to get a solid foundation?

Also is this the best year to be most lenient with the amount of sleep you get, amount you go out, exercise , etc etc?

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[Ismet]

Life doesn't revolve around the boards. That said, there's a lot of biochem and micro on the boards.
You need anatomy to understand physiology/pathology and especially for when you get to your surgery clerkship. You'll encounter a lot of genetic disorders, especially on peds.
Get a solid foundation. It will help for boards and other things.

Not sure what you mean by "lenient" but next to 4th year, 1st year is when you have the most free time. Use that wisely.

 

[LoveIR]

It's not as important as 3rd year or second year, but it still matters.

Maybe the main thing is that you're forming the habits and relationships (studying, exercising, friendships, etc.) that will characterize the next few years.

It's also the only period where you'll have some free time to work on research and other ECs.

 

[cbrons]

I want to say yes it is important, but when you have NPs who have been practicing independently for years who have never seen a plasma cell, dont know what a prothrombin time is, and think Gluconeogenesis is a character from Transformers, I find it kind of difficult.

 

[operaman]

Yes, it's important. Are there other things that are more important? Sure. Does that make first year any less important? No.

I don't know if people ask this question because they don't like studying as hard as it takes to do well or because they just hate the material or because they are doing poorly and need some solace, but no matter the reason, the fact remains that everything is actually important and there really aren't any shortcuts. People talk about this year or that year as more or less important, but the not-so-subtle presumption is that someone who does poorly in one year has the ability to do well in all the others. Sure, other things are valued more by PDs and other subjects are more likely to appear on boards, but the guy who can just squeak by one year and then crush it the next probably rides to class on a flying unicorn.

Be very careful not to construe the advice aimed at fourth year students as applying to first years. There's a huge difference between saying XYZ doesn't matter to a fourth year who has already demonstrated he did well in pretty much everything else, and a first year doing badly currently who may or may not actually turn things around. What I have seen typically goes like this:

1) Ms1 starts getting behind and getting lower grades; decides first year material isn't high yield enough to matter; plans to step it up Ms2
2) Ms2 guns hard for the first exam but does a lot worse than he thought (what, we were supposed to remember all that physio?), so decides M2 classes don't matter and plans to focus solely on Step 1
3) Assuming Ms2 passes his classes, he gets to study period and finds himself plateauing a good bit lower than he hoped.
4) Finally takes step 1 and does so-so on it. Decides he'll kill it 3rd year, take CK early, and maybe do some research to compensate.
5) Ms3 year starts and he treads water for a couple of weeks until he realizes that he can't manage to balance the shelf study with clinical time; misses honors either because of the shelf or because of evals; decides that only IM and Surgery really matter since they're the big ones everyone looks at.
6) Still ends up P/HP in IM and Surg
7) That research he planned to do really isn't going anywhere either, but he'll start working on that later....

I could go on and on. The point I'm beating to death is that importance is probably best talked about only in retrospect. For now, assume that everything matters.

 

[LoveIR]

^^^Great post. I would add:

8) posts on SDN "I'm ranked in the middle of my class, below average step 1 and step 2, all P 3rd year, 1 research abstract. Can I still match in a super competitive field in California?"
9) Forced into a less competitive field they never wanted in a location they hate
10) Years later go on pre-allo and post: "Don't go into medicine, it's terrible, etc. etc."

 

[Jabbed]

How important is 1st year? I heard the material isn't very relevant to boards. Is it important to do well to get a solid foundation?

Also is this the best year to be most lenient with the amount of sleep you get, amount you go out, exercise, etc etc?

The point of M1 is to learn how to be successful as an M2.
The point of M2 is to learn how to be successful as an M3.
The point of M3 is to learn how to be successful as an M4/resident.
The point of M4 is to profit.

 

[Thangbill]

The point of M1 is to learn how to be successful as an M2.
The point of M2 is to learn how to be successful as an M3.
The point of M3 is to learn how to be successful as an M4/resident.
The point of M4 is to profit.

The point of M4 is to learn how to smoothly transition to residency.

 

[Ismet]

The point of M4 is to learn how to smoothly transition to residency.

Lol. Apart from an ICU rotation that you should do sometime in 4th year, that year is for your sub-I, applications, interviewing, and appreciating the calm before the storm that is intern year by taking cush electives in the latter half.

 

[IMdoc2015]

As said earlier, the boards aren't everything but they are definitely a huge piece of your application no matter what else you have going on. I tutor for step 1 and with my students there is an obvious difference in the knowledge and performance between those who put the time in to truly understand the basic physiology / pathophysiology the first time around and the students who did not. As much as it sucks putting the time in now when its hard to imagine how the nitty gritty details are going to help you clinically, it will definitely be in your best interest to set yourself up for success later.

Also, once you hit 3rd year and beyond you will be a teacher of other students, your patients, and (eventually after you graduate) other doctors. And while you aren't going to give your patients a pathophys lesson, being able to explain what is causing their symptoms and why their medicines work in simple terms will help them understand whats going on and maybe even help them go the extra mile to lose the weight or change their lifestyle or take the medicine or whatever it is they need to do.

 

[the argus]

The point of M1 is to learn how to be successful as an M2.
The point of M2 is to learn how to be successful as an M3.
The point of M3 is to learn how to be successful as an M4/resident.
The point of M4 is to profit.

I learned a ton 4th year. You can find electives that are both relaxed (other than Sub-I, ICU) and intellectually worthwhile.

 

[Jabbed]

I learned a ton 4th year. You can find electives that are both relaxed (other than Sub-I, ICU) and intellectually worthwhile.

= profit

 

[the argus]

= profit

I guess I don't understand what you're trying to say.

I took your post as saying M4 was only to make money for the med school. If that is what you mean, then I absolutely disagree.

If you mean to profit as in "to benefit", I agree.

 

[Winged Scapula]

Lol. Apart from an ICU rotation that you should do sometime in 4th year, that year is for your sub-I, applications, interviewing, and appreciating the calm before the storm that is intern year by taking cush electives in the latter half.

If that's what "you guys" (meaning not you specifically or only) believe, then you can't argue that one of the reasons physicians offer better care than mid-levels is because of our 4 years of medical school. You can argue "hours trained", "depth of training" but you must leave the length of training out of the equation if 4th year is believed to be useless.

While I agree that a lot of 4th year is chaff, there is a significant difference in quality between a end of year 3rd year MS and a 4th year (one of the reasons I stopped taking 3rd years on rotation with me). You're learning more than you think you are.

 

[Ismet]

If that's what "you guys" (meaning not you specifically or only) believe, then you can't argue that one of the reasons physicians offer better care than mid-levels is because of our 4 years of medical school. You can argue "hours trained", "depth of training" but you must leave the length of training out of the equation if 4th year is believed to be useless.

While I agree that a lot of 4th year is chaff, there is a significant difference in quality between a end of year 3rd year MS and a 4th year (one of the reasons I stopped taking 3rd years on rotation with me). You're learning more than you think you are.

Oh I know I'll learn and I don't think 4th year is useless. I'll have difficult/work-heavy rotations through October. And the cush electives I chose are just easy in terms of hours, but there will be use to them and learning to be had. It'll just be nice to leave the hospital when it's still daylight in the winter while I can still do it.

 

[Roxas]

1) Ms1 starts getting behind and getting lower grades; decides first year material isn't high yield enough to matter; plans to step it up Ms2
2) Ms2 guns hard for the first exam but does a lot worse than he thought (what, we were supposed to remember all that physio?), so decides M2 classes don't matter and plans to focus solely on Step 1
3) Assuming Ms2 passes his classes, he gets to study period and finds himself plateauing a good bit lower than he hoped.
4) Finally takes step 1 and does so-so on it. Decides he'll kill it 3rd year, take CK early, and maybe do some research to compensate.
5) Ms3 year starts and he treads water for a couple of weeks until he realizes that he can't manage to balance the shelf study with clinical time; misses honors either because of the shelf or because of evals; decides that only IM and Surgery really matter since they're the big ones everyone looks at.
6) Still ends up P/HP in IM and Surg
7) That research he planned to do really isn't going anywhere either, but he'll start working on that later....

I could go on and on. The point I'm beating to death is that importance is probably best talked about only in retrospect. For now, assume that everything matters.

Sadly I find myself in the first step of this story

 

[Thangbill]

To prevent getting behind though, should one start at the MS0 level by studying pathophys and other textbooks in advance? That way, when the individual gets to med school, he would not only not fall behind but also be able to take full advantage of the learning materials therein. Plus repetition improves retention. (I still have a few months before the start, should I do that?)

 

[Ace Khalifa]

To prevent getting behind though, should one start at the MS0 level by studying pathophys and other textbooks in advance? That way, when the individual gets to med school, he would not only not fall behind but also be able to take full advantage of the learning materials therein. Plus repetition improves retention. (I still have a few months before the start, should I do that?)

InB4 all the med students say NO

 

[Dr.Jekyll75]

To prevent getting behind though, should one start at the MS0 level by studying pathophys and other textbooks in advance? That way, when the individual gets to med school, he would not only not fall behind but also be able to take full advantage of the learning materials therein. Plus repetition improves retention. (I still have a few months before the start, should I do that?)

Everyone has said no that I've asked

 

[Ismet]

To prevent getting behind though, should one start at the MS0 level by studying pathophys and other textbooks in advance? That way, when the individual gets to med school, he would not only not fall behind but also be able to take full advantage of the learning materials therein. Plus repetition improves retention. (I still have a few months before the start, should I do that?)

Most schools won't start organ systems until 2nd year anyway so studying pathophysiology would probably be the worst thing to pre-study in that case.

But no, don't pre-study. Enjoy your summer.

 

[mimelim]

Lol. Apart from an ICU rotation that you should do sometime in 4th year, that year is for your sub-I, applications, interviewing, and appreciating the calm before the storm that is intern year by taking cush electives in the latter half.

The better residents that end up with us definitely did not see 4th year this way. Maybe they were going to be better anyways, but your 4th year of medical school is a gold mine of opportunities that you will never have again. As a surgery resident, you will never have another opportunity to sit in radiology for a month learning to read films from them. The same can be said for any number of services. While it is true that as a Vascular surgeon, I will never NEED to do any of those things because I can always call someone else, understanding what other people are doing and the basics of what they bring to the table is invaluable.

 

[Ismet]

The better residents that end up with us definitely did not see 4th year this way. Maybe they were going to be better anyways, but your 4th year of medical school is a gold mine of opportunities that you will never have again. As a surgery resident, you will never have another opportunity to sit in radiology for a month learning to read films from them. The same can be said for any number of services. While it is true that as a Vascular surgeon, I will never NEED to do any of those things because I can always call someone else, understanding what other people are doing and the basics of what they bring to the table is invaluable.

I'm taking a rads elective as well. At least at my school it has great hours. You can learn a lot in 4th year and still have it be a relaxed time compared to 3rd year.

I've heard from countless attendings and residents that they really value the interns that come from my school because they are very prepared for residency. We're pretty well advised how to schedule our 4th year based on what we want to go into.

 

[awared2]

I think it depends on your school. We have organ blocks and learn all of the pathologies for each organ within that block. There's no difference between first and second year other than what part of the body we're doing

 

[W19]

Life doesn't revolve around the boards. That said, there's a lot of biochem and micro on the boards.
You need anatomy to understand physiology/pathology and especially for when you get to your surgery clerkship. You'll encounter a lot of genetic disorders, especially on peds.
Get a solid foundation. It will help for boards and other things.

Not sure what you mean by "lenient" but next to 4th year, 1st year is when you have the most free time. Use that wisely.

I thought micro is taught in 2nd year in most school... I also heard physio is important for the board but I was told that you learn physio again in 2nd year while doing patho. My plan for this summer break was to go over physio, biochem and anatomy again... But a friend in third year told me he does not think that will help me much for step 1...

 

[PL198]

The better residents that end up with us definitely did not see 4th year this way. Maybe they were going to be better anyways, but your 4th year of medical school is a gold mine of opportunities that you will never have again. As a surgery resident, you will never have another opportunity to sit in radiology for a month learning to read films from them. The same can be said for any number of services. While it is true that as a Vascular surgeon, I will never NEED to do any of those things because I can always call someone else, understanding what other people are doing and the basics of what they bring to the table is invaluable.

and because rads electives are hella cush

 

[PL198]

I thought micro is taught in 2nd year in most school... I also heard physio is important for the board but I was told that you learn physio again in 2nd year while doing patho. My plan for this summer break was to go over physio, biochem and anatomy again... But a friend in third year told me he does not think that will help me much for step 1...

do research or chill. don't study

 

[Ismet]

I thought micro is taught in 2nd year in most school... I also heard physio is important for the board but I was told that you learn physio again in 2nd year while doing patho. My plan for this summer break was to go over physio, biochem and anatomy again... But a friend in third year told me he does not think that will help me much for step 1...

Micro is a 1st year course at my school, I'm sure it varies. Here MS1 = basic sciences, MS2 = physio, path, pharm organized by organ system, obviously with relevant micro integrated.

 

[W19]

do research or chill. don't study

I guess it will be a chill summer break then... I already have a research option... It's a place that does clinical trials.. don't know how much that will help my CV. Still looking for something better.

 

[Dr.Jekyll75]

I guess it will be a chill summer break then... I already have a research option... It's a place that does clinical trials.. don't know how much that will help my CV. Still looking for something better.

If I was you I'd get my phd in gains and Netflix. Just remember pre studying is pointless, you don't know how your teachers are like. You don't know what topics they see as high yield for the boards. Just relax and enjoy life before another gauntlet round in your life starts

 

[PL198]

it's called a break for a reason

 

[Jabbed]

Just suck it up and read Guyton/Robbins over summer. M2 will be a breeze.

 

[Cinabonchik]

Yes, it's important. Are there other things that are more important? Sure. Does that make first year any less important? No.

I don't know if people ask this question because they don't like studying as hard as it takes to do well or because they just hate the material or because they are doing poorly and need some solace, but no matter the reason, the fact remains that everything is actually important and there really aren't any shortcuts. People talk about this year or that year as more or less important, but the not-so-subtle presumption is that someone who does poorly in one year has the ability to do well in all the others. Sure, other things are valued more by PDs and other subjects are more likely to appear on boards, but the guy who can just squeak by one year and then crush it the next probably rides to class on a flying unicorn.

Be very careful not to construe the advice aimed at fourth year students as applying to first years. There's a huge difference between saying XYZ doesn't matter to a fourth year who has already demonstrated he did well in pretty much everything else, and a first year doing badly currently who may or may not actually turn things around. What I have seen typically goes like this:

1) Ms1 starts getting behind and getting lower grades; decides first year material isn't high yield enough to matter; plans to step it up Ms2
2) Ms2 guns hard for the first exam but does a lot worse than he thought (what, we were supposed to remember all that physio?), so decides M2 classes don't matter and plans to focus solely on Step 1
3) Assuming Ms2 passes his classes, he gets to study period and finds himself plateauing a good bit lower than he hoped.
4) Finally takes step 1 and does so-so on it. Decides he'll kill it 3rd year, take CK early, and maybe do some research to compensate.
5) Ms3 year starts and he treads water for a couple of weeks until he realizes that he can't manage to balance the shelf study with clinical time; misses honors either because of the shelf or because of evals; decides that only IM and Surgery really matter since they're the big ones everyone looks at.
6) Still ends up P/HP in IM and Surg
7) That research he planned to do really isn't going anywhere either, but he'll start working on that later....

I could go on and on. The point I'm beating to death is that importance is probably best talked about only in retrospect. For now, assume that everything matters.

This is the best post on SDN!
I feel like a lot of med students fall into this trap of "I will do better next time" but reality is there is no next time.

 

[JimmyB123]

do research or chill. don't study

so many contrasting opinions everyone. I've heard from two people that both scored 260+ that after M1 you should just study and review material and worry about research later.

Moral of the story: do whatever the f you want

 

[PL198]

so many contrasting opinions everyone. I've heard from two people that both scored 260+ that after M1 you should just study and review material and worry about research later.

Moral of the story: do whatever the f you want

thats foolish because getting published doesn't happen overnight, and neither does making the connections necessary to get published.

you don't know that much after M1 , unless you go to a systems-based school.

 

[Ismet]

so many contrasting opinions everyone. I've heard from two people that both scored 260+ that after M1 you should just study and review material and worry about research later.

Moral of the story: do whatever the f you want

Over 80% of students at my school do research in the summer after MS1. It depends on the school. I remember on the interview trail when I asked about research at one school, the med student said "oh yeah, a couple people do research each year."

 

[Thangbill]

Over 80% of students at my school do research in the summer after MS1. It depends on the school. I remember on the interview trail when I asked about research at one school, the med student said "oh yeah, a couple people do research each year."

There is something I don't understand.
If a person couldn't complete his research project over MS1 summer, what does he/she usually do? Does the person continue throughout MS2 until the project is complete, or is it abandoned and re-initiated at some point?
How often does incomplete project happen?
Once the students start on research, is it required for them to finish to be acknowledged?

 

[PL198]

There is something I don't understand.
If a person couldn't complete his research project over MS1 summer, what does he/she usually do? Does the person continue throughout MS2 until the project is complete, or is it abandoned and re-initiated at some point?
How often does incomplete project happen?
Once the students start on research, is it required for them to finish to be acknowledged?

there are more years to medical school than m1 and m2. it's not like the docs you're working with evaporate if you don't get it done.

 

[cbrons]

Yes, it's important. Are there other things that are more important? Sure. Does that make first year any less important? No.

I don't know if people ask this question because they don't like studying as hard as it takes to do well or because they just hate the material or because they are doing poorly and need some solace, but no matter the reason, the fact remains that everything is actually important and there really aren't any shortcuts. People talk about this year or that year as more or less important, but the not-so-subtle presumption is that someone who does poorly in one year has the ability to do well in all the others. Sure, other things are valued more by PDs and other subjects are more likely to appear on boards, but the guy who can just squeak by one year and then crush it the next probably rides to class on a flying unicorn.

Be very careful not to construe the advice aimed at fourth year students as applying to first years. There's a huge difference between saying XYZ doesn't matter to a fourth year who has already demonstrated he did well in pretty much everything else, and a first year doing badly currently who may or may not actually turn things around. What I have seen typically goes like this:

1) Ms1 starts getting behind and getting lower grades; decides first year material isn't high yield enough to matter; plans to step it up Ms2
2) Ms2 guns hard for the first exam but does a lot worse than he thought (what, we were supposed to remember all that physio?), so decides M2 classes don't matter and plans to focus solely on Step 1
3) Assuming Ms2 passes his classes, he gets to study period and finds himself plateauing a good bit lower than he hoped.
4) Finally takes step 1 and does so-so on it. Decides he'll kill it 3rd year, take CK early, and maybe do some research to compensate.
5) Ms3 year starts and he treads water for a couple of weeks until he realizes that he can't manage to balance the shelf study with clinical time; misses honors either because of the shelf or because of evals; decides that only IM and Surgery really matter since they're the big ones everyone looks at.
6) Still ends up P/HP in IM and Surg
7) That research he planned to do really isn't going anywhere either, but he'll start working on that later....

I could go on and on. The point I'm beating to death is that importance is probably best talked about only in retrospect. For now, assume that everything matters.

"If you don't get the basic sciences down now, there is no way on God's green earth that you're going to be a good clinician."
- Dr. Ed Goljan (AMSA speech last year)

 

[Ismet]

There is something I don't understand.
If a person couldn't complete his research project over MS1 summer, what does he/she usually do? Does the person continue throughout MS2 until the project is complete, or is it abandoned and re-initiated at some point?
How often does incomplete project happen?
Once the students start on research, is it required for them to finish to be acknowledged?

You continue it. There are various ways of doing this. My school has a required longitudinal research project (doesn't "officially" start until MS2 but most people start in MS1 or the summer after). Some people continue doing the same project they started in the summer, some people find a new project. Some people continue going to lab/working on the project through MS2, some people wait until they take a research month in 3rd year to knock out a bunch of work (if the project permits). Some people like their work so much they take a year off to focus on research.

 

[Psai]

"If you don't get the basic sciences down now, there is no way on God's green earth that you're going to be a good clinician."
- Dr. Ed Goljan (AMSA speech last year)

everything that goljan says is gold

 

[MedSchoolSurvivor]

To prevent getting behind though, should one start at the MS0 level by studying pathophys and other textbooks in advance? That way, when the individual gets to med school, he would not only not fall behind but also be able to take full advantage of the learning materials therein. Plus repetition improves retention. (I still have a few months before the start, should I do that?)

The nice thing about medical school is that the playing field becomes level very quickly since so much information is being presented at such a rapid pace. While those that majored in bio or neuro might have an advantage, I would say that that advantage is slight at best. Anyways, the point is that the material that will be presented in class will be at a furious pace, and far beyond what you might get around to looking at the summer before. While you may be an ounce more prepared, it will likely not amount to much, and will get subsumed into the oncoming whirlwind of study. What is more important is that you start school mentally stable and ready to work. I guess what I am saying is that you should just enjoy your summer.

 

[mcloaf]

everything that goljan says is gold

He taught me everything I know about women and the culturally proper pronunciation of the word "Hashimoto".

 

[xffan624]

He taught me everything I know about women and the culturally proper pronunciation of the word "Hashimoto".

For the record, I will eat food off the floor if it falls for brief interludes (even did it off a cave floor one time) and I have used toilet paper when I cut myself shaving. I hope (for the sake of my step 1 scores), he's more accurate in his pathology than in his knowledge of women.

 

[PL198]

"If you don't get the basic sciences down now, there is no way on God's green earth that you're going to be a good clinician."
- Dr. Ed Goljan (AMSA speech last year)

ugh amsa though

 

[Dr.Jekyll75]

Golijan.... Wow this guys is just amazing

 

[PhysMatMan]

Golijan.... Wow this guys is just amazing

He's so great that he has successfully cloned himself and become plural.

 

[Dr.Jekyll75]

He's so great that he has successfully cloned himself and become plural.

Ha never was one for grammar , but if he could clone himself that would be great. I'm sure all med schools could use a teacher like him

 

[alpinism]

Consistent effort is important. You either buy into the idea that medical school as a whole is the beginning of what makes you a doctor or you don't. Those who take a selective approach become the ****ty doctors who work in the hospitals and clinics today. This is just a personal example but I had a hospitalist ask me to start psychotropics on an anorexic with a 12 BMI, 70/50 blood pressure, a barely functioning heart per echo, and couldn't stand because they had no muscle mass whatsoever. "Maybe there's an underlying depression," he told me. He basically sat on this patient for several days before I saw them and had done nothing except ask the social worker to see if she couldn't get the patient placed in an eating disorders facility.

Bottom line is do what you want in medical school, but at the very least be honest with yourself about what you're doing. Maybe you will see the material again, maybe you won't. But if you do, keep in mind that dismissing the smallest (or biggest) of details can literally kill someone. I can't imagine what kind of psychiatrist I would be if I just kept giving someone psych meds and therapy in the psych ward and completely ignored their vitals, their labs, their other medications, and their medical history.

Well at least he wasn't treating her with Wellbutrin...

Although the all natural ECT might have helped.

 

[thepoopologist]

Well at least he wasn't treating her with Wellbutrin...

Although the all natural ECT might have helped.

You're such an optimist! I guess it could've been worse, he could've actually started psych medications without consulting me.

 

[darklabel]

There is something I don't understand.
If a person couldn't complete his research project over MS1 summer, what does he/she usually do? Does the person continue throughout MS2 until the project is complete, or is it abandoned and re-initiated at some point?
How often does incomplete project happen?
Once the students start on research, is it required for them to finish to be acknowledged?

There are research projects that you can present your research and findings in a symposium at the end of the summer. Granted, its not as good as a publication, but I'm sure it can only help.