Survival of the fittest--either you can hack it or you can't. A roller coaster ride would imply that there are easy downhill parts, which just don't exist (at least not at LECOM, save for your summer break between OMS-I and OMS-II.)
Definitely survival, that is all you can do until you move onto the next stage.
If you wanted to compare it to a roller coaster I would say med school is just the part where you keep going up hill. It only gets harder and you become busier.
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