1) I read somewhere, it might have been here, that at some point, all students will have to choose between medicine and surgery. Do you believe this to be true?
2) I read your tips on how to get through the clinical years and make a solid impression. Any advice on how to do well in the pre-clinical years? Also, some medical students say that the first two years are "basically useless." Do you find this to be true?
1. Sure. That occurs somewhere around the beginning of your fourth year of med school.
2. I'm surprised you've heard anyone say this. The first two years are NOT useless AT ALL, for the following reasons:
a. The preclinical years are what provide the foundation of medical knowledge that will last you for your career. This is when you learn the "language" of medicine. Anatomy, physiology, pathology, pathophysiology, and pharmacology will teach you what you need to know during the clinical years, residency, and beyond.
b. All of USMLE Step I, and a lot of Step II and III test you on what you'll learn in the classroom.
c. A lot of what you'll be asked on rounds during the clinical years and during residency will have been taught to you during the preclinical years. If your attending understands the basic sciences, shouldn't you?
What they may have been implying is that the preclinical GRADES are less important, but this isn't true either. First, while it's true that a good performance in your rotations may compensate somewhat for marginal preclinical grades, the competitive residency programs will be looking at how you did throughout all of medical school. Second, at the time your Dean's letter is written and you're applying for residency, you may only have only completed 8-9 rotations, and therefore more than 50% of your class standing will still be determined by your preclinical grades. Finally, for most people, their classroom grades predict how well someone will do on the boards.
To be successful in the preclinical years, here's my advice: NEVER fall behind. If you can, be ahead, by reading about the upcoming lecture BEFORE the lecture is given. Take notes on the reading assignments in the way of making study sheets that you can memorize. You're going to have to memorize a TON of information, so come up with an efficient system early on. A lot of what you're going to memorize is minutia, and since you won't know (at least initially) what details are really important or what you're going to be asked in the exams, you're going to have to memorize as much of it as you can. Unfortunately, the minutia is often the easiest information to test, and it's the best way for exam-creators to separate the "Honors" students from the rest. I've seen some people on this forum suggest that you shouldn't go to class, but I disagree. You can often identify what details to focus on during your studying based on the content of the lecture. Some lecturers will stick to the syllabus or text, but others will provide additional information that is often on the exams. Unfortunately you won't know which is the case until after the lecture is over. Develop a study system early, and be disciplined about sticking to it. Don't rely too heavily on study groups; they're often an inefficient use of time. Avoid the trap of "taking it easy" for a few days right after exams -- that's when people often fall behind. Remember, it's a marathon, not a sprint.
