An Open Letter From MS2

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PanRoasted

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Hello. I am currently an MS2 at a US allopathic school. I graduated from college in May 2014 and matriculated in August 2014. I've been on SDN since my freshman year of college, and I don't think I would've gotten in to medical school without the guidance I received from this forum. I was just thinking about all the **** I have come to realize about medical school/medicine/life and how little I knew about what I was getting myself into. Luckily, I love it all and it worked out for the best. I am writing this to help those of you thinking about a career as a doctor, and for myself. I created this as a separate thread because, well, it's my letter and I wanted to.


As an undergraduate, I think I was more attracted to the idea of being a doctor than anything else. I had watched medical TV shows growing up, and of course it all seemed so exciting. It's designed to seem exciting. So, based on this idea of me wanting to be a doctor, I focused on the immediate next step: getting into medical school. I spent a lot of time and energy focusing on bolstering my application by doing research, volunteering; etc. I got kind of wrapped up in all of it, especially because I was reading SDN. I lost sight of the point, which was to find out whether or not I really wanted to be a doctor and not to put another bullet point on my resume. Over and over, medical school will test how determined you are to actually be a physician and not how determined you are to just have the title or prestige based on whatever impression you have of medicine.


I want to really explain this, because it's something that I heard over and over while I was applying. I thought I had fully appreciated how hard medical school would be, but I was wrong. And it's not that the level of difficulty of learning the information is more or less than I thought it would be (I would say that the average person who can score a 28 on the MCAT probably has the mental capacity to memorize and understand what you need to as a doctor.) For me, the most difficult part was the shift in the ratio of time I spend studying alone vs. fun stuff. Also, unlike a regular job, you’re always “on.” There’s always more work to do, more lectures you can watch, another resource to read.


I'll try to illustrate this as someone who is currently preparing for Step 1 boards. If you haven't heard of the test and/or want to have a fun little thought experiment, peruse a copy of "First Aid for Step 1" (please don't buy it as a pre-med, because that would hurt my soul). It is a 500-600 page textbook of tables and charts full of information about human physiology/pathophysiology and a little bit of social science and statistics thrown in there. Imagine memorizing this book.


Now, I bring up this book knowing that the magnitude of just how much information it encompasses cannot be fully dawned upon someone until they go through medical school themselves. In order to have an idea of what the process of learning all this information is like, imagine that you have to eat 10 pancakes per day, every day, for two years. If you miss any pancakes in a given day, they roll over to the next day in addition to the 10. And so on. You may think, “gee, I like pancakes! I can do that!” Well, we all like pancakes. And the degree to which you enjoy pancakes will make medical school that much more or less difficult. But eventually, everyone at some point in their two preclinical years begins to resent pancakes. Because it never stops, and if you try to take a break in order to re-sensitize your palette, you’re ****ed. So, how do you keep eating pancakes in the face of this seemingly never-ending stream of them? I think that’s a personal journey for everyone going through this process. Or maybe not, maybe the pancakes never get old for some people. I probably shouldn’t assume.


For me, it’s the realization that I actually do like medicine. I do enjoy learning about diseases, identifying them in patients and then working with them to understand, treat, and manage their disease and their overall health. I want to learn more and know everything, because in medicine, if you don’t know about a disease or disease process, then you won’t consider it on your differential. If it’s not on your differential, which is essentially a physician’s working list of possible diagnoses for a given set of signs/symptoms/labs, then there’s a chance you miss something important and then somebody gets hurt. There's something both fulfilling and slightly terrifying about that responsibility that makes me glad I chose this as a profession.


This is just one of many reasons for which someone can want to be a doctor, and it just so happens to be mine at the moment. It’s definitely not the same one I came into medical school with, and I’m sure it will constantly evolve throughout my career. That’s why I urge pre-med students to really take a good hard look at yourself as a person and why you want to become a doctor throughout this entire process. Because when you’re looking down the barrel of a gun halfway through med school and realize you don’t want this, it’s a lot messier than figuring that all out right now.

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Thanks for your insight @PanRoasted. I have heard of you earlier when people touted your verbal strategy to be really helpful, and I'm glad you're enjoying medical school even though it seems like the work never ends.
 
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I love pancakes. and the analogy.
Thanks for the encouraging and insightful post!
 
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Members don't see this ad :)
*waits for all the "cool" med students to come and contradict this post and pontificate about how they are able to balance everything*
 
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Didn't @NickNaylor come up with this pancake analogy?

EDIT: Also would agree for the most part. The biggest part about medical school is coming to the acceptance that you absolutely cannot learn everything. You come to a point where you can accept letting things go and doing things like spending time with friends and family or just sitting around and doing nothing. To follow the analogy, you have to be willing to simply throw some pancakes in the trash.

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Hello. I am currently an MS2 at a US allopathic school. I graduated from college in May 2014 and matriculated in August 2014. I've been on SDN since my freshman year of college, and I don't think I would've gotten in to medical school without the guidance I received from this forum. I was just thinking about all the **** I have come to realize about medical school/medicine/life and how little I knew about what I was getting myself into. Luckily, I love it all and it worked out for the best. I am writing this to help those of you thinking about a career as a doctor, and for myself. I created this as a separate thread because, well, it's my letter and I wanted to.


As an undergraduate, I think I was more attracted to the idea of being a doctor than anything else. I had watched medical TV shows growing up, and of course it all seemed so exciting. It's designed to seem exciting. So, based on this idea of me wanting to be a doctor, I focused on the immediate next step: getting into medical school. I spent a lot of time and energy focusing on bolstering my application by doing research, volunteering; etc. I got kind of wrapped up in all of it, especially because I was reading SDN. I lost sight of the point, which was to find out whether or not I really wanted to be a doctor and not to put another bullet point on my resume. Over and over, medical school will test how determined you are to actually be a physician and not how determined you are to just have the title or prestige based on whatever impression you have of medicine.


I want to really explain this, because it's something that I heard over and over while I was applying. I thought I had fully appreciated how hard medical school would be, but I was wrong. And it's not that the level of difficulty of learning the information is more or less than I thought it would be (I would say that the average person who can score a 28 on the MCAT probably has the mental capacity to memorize and understand what you need to as a doctor.) For me, the most difficult part was the shift in the ratio of time I spend studying alone vs. fun stuff. Also, unlike a regular job, you’re always “on.” There’s always more work to do, more lectures you can watch, another resource to read.


I'll try to illustrate this as someone who is currently preparing for Step 1 boards. If you haven't heard of the test and/or want to have a fun little thought experiment, peruse a copy of "First Aid for Step 1" (please don't buy it as a pre-med, because that would hurt my soul). It is a 500-600 page textbook of tables and charts full of information about human physiology/pathophysiology and a little bit of social science and statistics thrown in there. Imagine memorizing this book.


Now, I bring up this book knowing that the magnitude of just how much information it encompasses cannot be fully dawned upon someone until they go through medical school themselves. In order to have an idea of what the process of learning all this information is like, imagine that you have to eat 10 pancakes per day, every day, for two years. If you miss any pancakes in a given day, they roll over to the next day in addition to the 10. And so on. You may think, “gee, I like pancakes! I can do that!” Well, we all like pancakes. And the degree to which you enjoy pancakes will make medical school that much more or less difficult. But eventually, everyone at some point in their two preclinical years begins to resent pancakes. Because it never stops, and if you try to take a break in order to re-sensitize your palette, you’re ****ed. So, how do you keep eating pancakes in the face of this seemingly never-ending stream of them? I think that’s a personal journey for everyone going through this process. Or maybe not, maybe the pancakes never get old for some people. I probably shouldn’t assume.


For me, it’s the realization that I actually do like medicine. I do enjoy learning about diseases, identifying them in patients and then working with them to understand, treat, and manage their disease and their overall health. I want to learn more and know everything, because in medicine, if you don’t know about a disease or disease process, then you won’t consider it on your differential. If it’s not on your differential, which is essentially a physician’s working list of possible diagnoses for a given set of signs/symptoms/labs, then there’s a chance you miss something important and then somebody gets hurt. There's something both fulfilling and slightly terrifying about that responsibility that makes me glad I chose this as a profession.


This is just one of many reasons for which someone can want to be a doctor, and it just so happens to be mine at the moment. It’s definitely not the same one I came into medical school with, and I’m sure it will constantly evolve throughout my career. That’s why I urge pre-med students to really take a good hard look at yourself as a person and why you want to become a doctor throughout this entire process. Because when you’re looking down the barrel of a gun halfway through med school and realize you don’t want this, it’s a lot messier than figuring that all out right now.
how often do you eat pancakes though?
 
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how often do you eat pancakes though?
It's a well-kept secret (until now): as a medical student, you must eat pancakes every day. In fact, if you stop eating pancakes even momentarily, you will die (or worse...flunk out of med school).

:)
edit: joke credit to Hermione Granger
 
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@PanRoasted I heard that several of the pancakes are inscribed with useful information about glycemic disorders.
 
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I like pancakes A LOT. Like, a lot a lot. Should I update schools with this information? ;)
 
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It's a well-kept secret (until now): as a medical student, you must eat pancakes every day. In fact, if you stop eating pancakes even momentarily, you will die (or worse...flunk out of med school).

:)
edit: joke credit to Hermione Granger
for breakfast, i'm more of a bacon man
 
I want to learn more and know everything, because in medicine, if you don’t know about a disease or disease process, then you won’t consider it on your differential.

Then comes M3 when you promptly forget 80% of what you just spent 6 weeks trying to memorize... :=|:-):
 
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A question as a premed matriculating this fall to a pass fail school. Is it worth being a "try hard" in med school, specifically in a pass fail school? I mean if I can study enough to do well on exams and just get through the tests and material, is that enough for me to succeed as a doc? As the guy above me said, you forget most of what you learn anyway. So is it worth over stressing myself to aim for 100s on every exam and to understand every single bit of material (eating the crumbs of the pancake, I guess)
 
MS1 here at a U.S. allopathic during exam week and I wholeheartedly agree with the initial poster. Med school sucks the glamorous aspect out of being a physician and you really start to see if you are in it for the right reasons. Even those of us who are totally committed have at some point this year had second thoughts, been jealous of our friends working right out of college and having fun after they clock out for the day, realized that the routine becomes monotonous, and so forth. In the end, we pursue on because this is what we want for ourselves, and as much as it can suck at times we understand it is about the delayed gratification we will hopefully achieve as physicians.
 
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A question as a premed matriculating this fall to a pass fail school. Is it worth being a "try hard" in med school, specifically in a pass fail school? I mean if I can study enough to do well on exams and just get through the tests and material, is that enough for me to succeed as a doc? As the guy above me said, you forget most of what you learn anyway. So is it worth over stressing myself to aim for 100s on every exam and to understand every single bit of material (eating the crumbs of the pancake, I guess)

Not really. My school is pass-fail and everyone works really hard still but it takes away an added layer of stress, which is nice. Everyone tries to learn as much as they can because we will need to eventually for Step 1, but there is no need to drive yourself crazy doing so.
 
A question as a premed matriculating this fall to a pass fail school. Is it worth being a "try hard" in med school, specifically in a pass fail school? I mean if I can study enough to do well on exams and just get through the tests and material, is that enough for me to succeed as a doc? As the guy above me said, you forget most of what you learn anyway. So is it worth over stressing myself to aim for 100s on every exam and to understand every single bit of material (eating the crumbs of the pancake, I guess)

Also matriculating this fall. From what I've gathered from my friends that are current residents & medical students, doing well in terms of class rank/Step1&2/AOA is important for matching into a competitive residency such as Derm, ENT, Rad Onc, Uro or if you're looking to land at a place like Cleveland Clinic or Hopkins.
 
A question as a premed matriculating this fall to a pass fail school. Is it worth being a "try hard" in med school, specifically in a pass fail school? I mean if I can study enough to do well on exams and just get through the tests and material, is that enough for me to succeed as a doc? As the guy above me said, you forget most of what you learn anyway. So is it worth over stressing myself to aim for 100s on every exam and to understand every single bit of material (eating the crumbs of the pancake, I guess)

The goal of your pre-clinical years is to learn the basic science behind human physiology/pathophysiology. It's the only chance in your medical career where you get to devote most/all (depending on the school) of your time to this. Sure, you don't technically need to know most of it for clinical medicine, but I try to take full advantage. Some people don't care much for the details. That's fine, too, depending on what you want to do and your specific personal situation. I am even more indecisive about what I want to do than when I entered medical school. Because of this, there's a bit of extra pressure for me to do well, because I don't want to get to the end of third year and realize I can't apply for that specialty I want because my step score is too low.

EDIT: For the record, I go to a pass/fail school. You should know that, unless you are matriculating to Harvard, there is this thing called AOA where you are still ranked against your classmates for some special award that can have a substantial impact on your residency application. HMS I believe is the only school left that doesn't do AOA. Just some other reasons for doing exceptionally well on your exams.
 
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The goal of your pre-clinical years is to learn the basic science behind human physiology/pathophysiology. It's the only chance in your medical career where you get to devote most/all (depending on the school) of your time to this. Sure, you don't technically need to know most of it for clinical medicine, but I try to take full advantage. Some people don't care much for the details. That's fine, too, depending on what you want to do and your specific personal situation. I am even more indecisive about what I want to do than when I entered medical school. Because of this, there's a bit of extra pressure for me to do well, because I don't want to get to the end of third year and realize I can't apply for that specialty I want because my step score is too low.

EDIT: For the record, I go to a pass/fail school. You should know that, unless you are matriculating to Harvard, there is this thing called AOA where you are still ranked against your classmates for some special award that can have a substantial impact on your residency application. HMS I believe is the only school left that doesn't do AOA. Just some other reasons for doing exceptionally well on your exams.
At least a few schools are true P/F for preclinical years, your grades those years don't matter for AOA. Of course that doesn't mean you should just 100% buy into the P=MD mentality, like you said, that's completely an individual decision if that's the type of med student a person wants to be.

But on your original topic, I agree, I've never worked remotely as hard as I have these first two years of medical school (especially the build up to step 1). I wasn't the premed who needed to get a 100% on everything, but I generally just did a tiny bit of work each week, showed up for lectures, and then a few days out from tests crammed. That doesn't work for the vast majority of people in medical school, studying is an every day thing. But I still feel lucky getting to learn what we do, then see patients and get to see what a big progression it has been just from the past 2 years.
 
Is there any way to prepare yourself for the magnitude of information you have to remember? I'm working during my gap year, so I'm not sure if it would be helpful to review anything before going in.
 
Interesting viewpoint. As someone starting med school in the fall, I'm actually not too worried about the workload in the pre-clinical years, but I'm worried about the things that will test how much I really want to be a physician after med school (like the fact that I will be paying $25K/yr of residency because of loan interest accruing, managing over half a million dollars in debt, dealing with bureaucracy, the fact that physicians are ceding their decision-making abilities to performance-based pay models, worrying about malpractice). And I'm worried that all those things will take away from the reasons I want to go into medicine- the preclinical part of med school seemed like the cushy part.

I guess the moral is to worry about everything, haha
 
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