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My background:
I like making guides and am nearly done with medical school so I thought I’d share my experience and OPINIONS to do my part to quell the upcoming onslaught of questions from the class of 2022. This is also my own way of introspection as I unwind from medical school and look forward to residency. This guide isn’t for everyone. I’ll be the first to admit I was just a bit above average coming into medical school (LizzyM-72) and performed a bit above average in medical school (below average basic science grades, good board scores, good clinical grades). I was a traditional student right out of undergrad and matriculated into a mid to low tier, established M.D. school in state with a few better ranked, but costly OOS acceptances. I do try to be someone who anticipates obstacles and am neurotically proactive about them as opposed to many people who go with the flow. Therefore, if you feel like you’ll be an average medical student more or less and feel like you try to plan ahead, you may find this guide helpful. Also, I don’t think I’ve accomplished anything that impressive by SDN standards so I’m not declaring this an AMA, but I would love to publicly answer questions you may have so feel free to ask me about anything. The one thing is that I do divulge a decent amount of information and inferences and pieced together and I just ask that you refrain from doing so.
A.) Before classes start:
Decide or narrow down your specialty interests. The biggest decision is surgery vs. medicine. If you’ve done some shadowing, you should have seen the difference. Do you want to be in the OR for half or a majority of your time or do you want to be seeing patients, prescribing medications, maybe doing a procedure here or there, and possibly following up on them. There are numerous fields that don’t fit this schism like Emergency Medicine, Radiology, Anesthesiology, Pathology, PM&R, possibly Psychiatry, etc. Pathology and Radiology are pretty unique and relatively limited in patient exposure so if you think you’d want to do it, reach out to someone and shadow before classes start. I believe EM, Anesthesiology, PM&R and even Psychiatry are fields a lot of people end up liking so you should be proactive about exploring them unless you have a particular aversion to one in which case, eliminate it from your list. The next question to ask is what are your goals/interests? Do you want to be a surgeon and won’t quit unless you’re kicked out? Do you want to maximize income/lifestyle? Do you want to be a specialist? Do you actually like human physiology and wish to further advance our knowledge or is it a means to an end? Based off all this, come in with an ideal specialty and then 1-2 back ups that would make you happy. If you cross the Surgery-Medicine schism to do this, do some introspection and see if you’re being honest with yourself. For example, Orthopedics, Gen Surg, and then EM sounds reasonable. For me, the realistic plan was competitive IM and then any IM. I initially entertained some prospects of Ortho and Interventional Radiology but deep down, I knew I wasn’t cut out for it and my heart was never in it. I do wish I looked closer at Anesthesiology and EM closer (which is where I think a bit of open-mindedness is important) but still felt that IM was the best fit for me. The reason you do this is so that you can get a headstart and seek out mentors which is the most important non-numerical thing you can do in medical school. Other than doing that, don’t pre-study before. You don’t even know how you’re supposed to learn things yet. Don’t take orientation that seriously, but attend as many orientation social events as possible and try not to stand out for bad reasons
Treat these individuals like your colleagues, not bffs or potential hook-up buddies (although that could happen later if you’re good looking). The point I’m trying to make is not to overinvest emotionally as everyone (including yourself) is putting up a facade at this point.
B.) Beginning of Year 1:
The few days before medical school, have a plan on how you’ll accomplish your essentials ex. eat/drink/exercise/family/sleep/hygiene. I’ll shamelessly admit I neglected a few of these in the first few months. This isn’t ideal, but medical school is hard! To avoid doing this, it pays to have a plan in place. A good plan of attack is ideally being completely keyed in on weekdays, taking Fridays after classes off. The weekends can serve for review/second pass of the material but you’ll need to set aside half a day for housekeeping issues like meal-prep/hygiene (shaving, etc.), assessing/adjusting fitness goals, laundry, etc. On the first day, put your career aspirations aside for a second and focus on the immediate moment. Despite it being almost four years ago now, I remember this day very clearly. We had our first lecture set and immediately after it was like all the prior commitments like going out to the gym/bar/etc. had been forgotten. Literally everyone was group studying or trying to learn everything about the brachial plexus as possible and spent the whole day committing it to memory as if they were going to be tested on it the next day. Yes, medical school is a marathon, not a sprint but I believe this attitude is kind of how you should treat the beginning of medical school. This idea is not my own, but someone else’s whose username I forgot but the reasoning behind it is you want to see your potential. Some people brag about being the exception to this, but for the most part, no matter how hard I tried, my performance was at best 75th percentile in Years 1/2. It was funny how consistent this ceiling was for me. Close, but still a decent chunk away from honors. You want to see where yours is. If it’s close to honors and your goals are a ROIDSS ( Rad-Onc/Interventional, Derm, Surgical Subspecialties) field or a competitive residency by location/rep, it would be efficient for you to continue to work at this pace. If it’s not, you would be smart to dial it down a TINY bit so you’re still at where you want to be within your class rank (whether that’s passing or above average is up to you). If it’s a good deal below your school’s excellence/outstanding cut-offs, but you need to be above these cut offs because you’re interested in ROIDSS you need to first check that mental health isn’t an issue, then try a different strategy, and if that doesn’t work consider whether you need to change your goals (if it’s really bad as in failed units/bottom of class) or continue onwards doing the best you can and hope to do well enough on Step 1 and Clinical grades which absolutely can turn things around.
C.) Here’s a hard/fast guide for pre-clinical grades:
First of all, a large # of schools have internal rank. Most* have AOA, all have passing/failing, but the key information is to figure out how the report what’s in between on your transcript and Dean’s Letter. I’d pass=X% and there’s no Y% for honors and there is no internal class ranking of what percentage you are in that gets reported on your deans letter, you at at a true P/F school. Otherwise, for the following goals:
ROIDSS: Top 50% to AOA/top ranking is advisable.
Top Residencies in less competitive fields (prime example is IM to open doors for GI/Cards as well as Peds/Gen Surg): Top 50% to AOA/top ranked is advisable.
Midtier Residencies in academic IM/Peds/Gen Surg or EM/Psych/Decent FM programs: Decent class rank helps, but you just need to pass.
If you fail something that will show up on your transcript, scratch off the top tier residencies in most fields and for ROIDSS, I’m not saying it’s impossibly but it’s an uphill battle.
D.) Study Strategy:
In medical school there’s no golden bullet to studying, but the theory of studying is simple.
The two most important variables that add up to maximal retention are active engagement and repetition. Anki Flashcards work for some, but they are a large time sink for others like me. I used them with mediocre results for a few units and once I used Brosephelon’s deck and it took too long to get to the stuff I didn’t know. The best way to study for me was what I called the “Toolbox” approach which is just a mix of a lot of strategies. I needed something to get me a quick first pass of the material. The reason was because I’m someone who tends to perservate unnecessarily on details if I’m not prodded forward. Therefore, the gold standard for me was attending the lectures and if I didn’t get to them I would just pile up the lecture notes for that day and give myself 2 hours to read through all of them quickly. The second pass would then either be done the next day and I would look over the stuff from yesterday. I would start by reading the course notes, but this time if I came across something that I felt I could find an advanced organizer or pattern for, I’d draw out tables/charts on a board or a separate paper. If I felt I was receiving a lot of standardized formatted information (think pharm drugs) I would just cut some paper and make flashcards. For some reason, paper cards always made things easier than messing with ANKI.
E.) Evaluating Your Initial Performance and Scaling Back or Adding New Challenges:
Around Thanksgiving Break is a good time to take a step back and introspect. Are you on target or not? If you’re at your target, you need to start thinking of small things to improve your life. Are you maintaining your health and keeping in touch with your friends? Also, this would be a good time for anyone interested in ROIDSS or competitive residencies to find a research mentor. The first steps are really easy. Find the list that your school keeps, network with people you know who have matched, and figure out who the men and women at your school are who are strong in an area you’re interested in and contact them.
To be continued...
I like making guides and am nearly done with medical school so I thought I’d share my experience and OPINIONS to do my part to quell the upcoming onslaught of questions from the class of 2022. This is also my own way of introspection as I unwind from medical school and look forward to residency. This guide isn’t for everyone. I’ll be the first to admit I was just a bit above average coming into medical school (LizzyM-72) and performed a bit above average in medical school (below average basic science grades, good board scores, good clinical grades). I was a traditional student right out of undergrad and matriculated into a mid to low tier, established M.D. school in state with a few better ranked, but costly OOS acceptances. I do try to be someone who anticipates obstacles and am neurotically proactive about them as opposed to many people who go with the flow. Therefore, if you feel like you’ll be an average medical student more or less and feel like you try to plan ahead, you may find this guide helpful. Also, I don’t think I’ve accomplished anything that impressive by SDN standards so I’m not declaring this an AMA, but I would love to publicly answer questions you may have so feel free to ask me about anything. The one thing is that I do divulge a decent amount of information and inferences and pieced together and I just ask that you refrain from doing so.
A.) Before classes start:
Decide or narrow down your specialty interests. The biggest decision is surgery vs. medicine. If you’ve done some shadowing, you should have seen the difference. Do you want to be in the OR for half or a majority of your time or do you want to be seeing patients, prescribing medications, maybe doing a procedure here or there, and possibly following up on them. There are numerous fields that don’t fit this schism like Emergency Medicine, Radiology, Anesthesiology, Pathology, PM&R, possibly Psychiatry, etc. Pathology and Radiology are pretty unique and relatively limited in patient exposure so if you think you’d want to do it, reach out to someone and shadow before classes start. I believe EM, Anesthesiology, PM&R and even Psychiatry are fields a lot of people end up liking so you should be proactive about exploring them unless you have a particular aversion to one in which case, eliminate it from your list. The next question to ask is what are your goals/interests? Do you want to be a surgeon and won’t quit unless you’re kicked out? Do you want to maximize income/lifestyle? Do you want to be a specialist? Do you actually like human physiology and wish to further advance our knowledge or is it a means to an end? Based off all this, come in with an ideal specialty and then 1-2 back ups that would make you happy. If you cross the Surgery-Medicine schism to do this, do some introspection and see if you’re being honest with yourself. For example, Orthopedics, Gen Surg, and then EM sounds reasonable. For me, the realistic plan was competitive IM and then any IM. I initially entertained some prospects of Ortho and Interventional Radiology but deep down, I knew I wasn’t cut out for it and my heart was never in it. I do wish I looked closer at Anesthesiology and EM closer (which is where I think a bit of open-mindedness is important) but still felt that IM was the best fit for me. The reason you do this is so that you can get a headstart and seek out mentors which is the most important non-numerical thing you can do in medical school. Other than doing that, don’t pre-study before. You don’t even know how you’re supposed to learn things yet. Don’t take orientation that seriously, but attend as many orientation social events as possible and try not to stand out for bad reasons
Treat these individuals like your colleagues, not bffs or potential hook-up buddies (although that could happen later if you’re good looking). The point I’m trying to make is not to overinvest emotionally as everyone (including yourself) is putting up a facade at this point.B.) Beginning of Year 1:
The few days before medical school, have a plan on how you’ll accomplish your essentials ex. eat/drink/exercise/family/sleep/hygiene. I’ll shamelessly admit I neglected a few of these in the first few months. This isn’t ideal, but medical school is hard! To avoid doing this, it pays to have a plan in place. A good plan of attack is ideally being completely keyed in on weekdays, taking Fridays after classes off. The weekends can serve for review/second pass of the material but you’ll need to set aside half a day for housekeeping issues like meal-prep/hygiene (shaving, etc.), assessing/adjusting fitness goals, laundry, etc. On the first day, put your career aspirations aside for a second and focus on the immediate moment. Despite it being almost four years ago now, I remember this day very clearly. We had our first lecture set and immediately after it was like all the prior commitments like going out to the gym/bar/etc. had been forgotten. Literally everyone was group studying or trying to learn everything about the brachial plexus as possible and spent the whole day committing it to memory as if they were going to be tested on it the next day. Yes, medical school is a marathon, not a sprint but I believe this attitude is kind of how you should treat the beginning of medical school. This idea is not my own, but someone else’s whose username I forgot but the reasoning behind it is you want to see your potential. Some people brag about being the exception to this, but for the most part, no matter how hard I tried, my performance was at best 75th percentile in Years 1/2. It was funny how consistent this ceiling was for me. Close, but still a decent chunk away from honors. You want to see where yours is. If it’s close to honors and your goals are a ROIDSS ( Rad-Onc/Interventional, Derm, Surgical Subspecialties) field or a competitive residency by location/rep, it would be efficient for you to continue to work at this pace. If it’s not, you would be smart to dial it down a TINY bit so you’re still at where you want to be within your class rank (whether that’s passing or above average is up to you). If it’s a good deal below your school’s excellence/outstanding cut-offs, but you need to be above these cut offs because you’re interested in ROIDSS you need to first check that mental health isn’t an issue, then try a different strategy, and if that doesn’t work consider whether you need to change your goals (if it’s really bad as in failed units/bottom of class) or continue onwards doing the best you can and hope to do well enough on Step 1 and Clinical grades which absolutely can turn things around.
C.) Here’s a hard/fast guide for pre-clinical grades:
First of all, a large # of schools have internal rank. Most* have AOA, all have passing/failing, but the key information is to figure out how the report what’s in between on your transcript and Dean’s Letter. I’d pass=X% and there’s no Y% for honors and there is no internal class ranking of what percentage you are in that gets reported on your deans letter, you at at a true P/F school. Otherwise, for the following goals:
ROIDSS: Top 50% to AOA/top ranking is advisable.
Top Residencies in less competitive fields (prime example is IM to open doors for GI/Cards as well as Peds/Gen Surg): Top 50% to AOA/top ranked is advisable.
Midtier Residencies in academic IM/Peds/Gen Surg or EM/Psych/Decent FM programs: Decent class rank helps, but you just need to pass.
If you fail something that will show up on your transcript, scratch off the top tier residencies in most fields and for ROIDSS, I’m not saying it’s impossibly but it’s an uphill battle.
D.) Study Strategy:
In medical school there’s no golden bullet to studying, but the theory of studying is simple.
The two most important variables that add up to maximal retention are active engagement and repetition. Anki Flashcards work for some, but they are a large time sink for others like me. I used them with mediocre results for a few units and once I used Brosephelon’s deck and it took too long to get to the stuff I didn’t know. The best way to study for me was what I called the “Toolbox” approach which is just a mix of a lot of strategies. I needed something to get me a quick first pass of the material. The reason was because I’m someone who tends to perservate unnecessarily on details if I’m not prodded forward. Therefore, the gold standard for me was attending the lectures and if I didn’t get to them I would just pile up the lecture notes for that day and give myself 2 hours to read through all of them quickly. The second pass would then either be done the next day and I would look over the stuff from yesterday. I would start by reading the course notes, but this time if I came across something that I felt I could find an advanced organizer or pattern for, I’d draw out tables/charts on a board or a separate paper. If I felt I was receiving a lot of standardized formatted information (think pharm drugs) I would just cut some paper and make flashcards. For some reason, paper cards always made things easier than messing with ANKI.
E.) Evaluating Your Initial Performance and Scaling Back or Adding New Challenges:
Around Thanksgiving Break is a good time to take a step back and introspect. Are you on target or not? If you’re at your target, you need to start thinking of small things to improve your life. Are you maintaining your health and keeping in touch with your friends? Also, this would be a good time for anyone interested in ROIDSS or competitive residencies to find a research mentor. The first steps are really easy. Find the list that your school keeps, network with people you know who have matched, and figure out who the men and women at your school are who are strong in an area you’re interested in and contact them.
To be continued...
Last edited:
