From my 2+ years of med school, here's my 2 cents. KNOW WHAT YOU WANT as soon as possible. For the first year, I was perfectly content with just passing everything, studying a few hours everynight, being in the middle of my class, I figured P=MD. I went out almost every weekend. Early in my second year, I realized that I'd be completely miserable going into primary care, and that I needed to really motivate myself and do better, get a good step 1 score, if i wanted a shot at some of the really competitive specialties that I started liking. Having a specific goal and knowing what it takes to get from point A to point B makes alot of the sacrifices more reasonable. Sure I rarely go out, am horrible at keeping in touch with my friends, and pretty much live in the hospital now, but heck, I'd be alot more miserable if I had to look at runny noses all day or manage CHF and HTN for the rest of my life. Sure, alot of people stress that you need to make friends, not be a gunner, and be relaxed...which works for some people, but If you have your heart set on being a neurosurgeon or a dermatologist, then do what you need to do. Keep in mind that these are my views. I know tons of people who have more balance than I do, and really want to go into medicine or FP. Ya just gotta do what works for you.