I recently spent a lot of time replying to an email from a friend of the family with lots of questions about my experience in medical school, the application process, life balance and more. Rather than just send it out into the ether, I thought I would post my responses here in the hope that some more people could gain a bit of insight into what my experience has been like. I don't intend to be a definitive source on the right way to do things by any means, so take all that I say with a grain of salt. Good luck with this year's application process and feel free to ask any further questions you may have:
1. For the MCAT, are there certain study materials that you recommend over others? How did you study?
The MCAT was one of the most brutal and stressful parts of the pre-med preparation cycle for me. At this point though I'm glad that I had to go through it since the sad reality is that medicine is a field full of continual standardized test that you have to do well on to pass through to the next level. Training for tests and learning how to make it through is important. By far the best advice for the MCAT and all the subsequent tests (Step 1, Step 2 etc) is to do a TON of questions. Study time is always limited, and in the end it doesn't matter what Organic Chemistry textbook has been read in excruciating detail. What matters is the ability to synthesize information and utilize it to answer questions in a specific test format. Knowing how to use the information that needs to be learned and expecting how concepts will be tested is far more important that just knowing a formula. I have a weakness with self motivation, so found it useful to pay for a Princeton Review MCAT prep course where I was forced to sit through a bunch of classroom teaching. I thought that they had some good strategies and did find it helpful, though many of my peers at UCSF got a content book or two and headed straight for the questions. The official AAMC practice tests seemed to be the most accurate in terms of score prediction and content. https://www.aamc.org/students/applying/mcat/preparing/85158/orderingpracticetests_mcat.html
The people who did exceptionally well did all of the available tests (8+) with careful attention to why they missed certain questions and trying to identify trends in their weaknesses. In the end, the predicted score should be 3-4 points above what your sister's target score is. They say that the score estimation is accurate +/- 3 points or so, and since there is not much margin for error it is best to play it safe. Ideally, there should be no surprises about how well you'd do on the test when walking in, and even with a bad test day with all the stress you could be satisfied with a bellow (your) average performance. Unfortunately I scored 3 points below my best practice test score, and about average for the 3 practice tests that I took, and wished that I had taken just a bit more time for preparation. That being said, there are a few unifying score trends that I've noticed out of the UCSF class. First, I think it is true that with the exception of a handful of minority applicants everybody had a 30 or above, with a 10 or greater in each section. Scores above 35 were the norm, and that would be my target to have a good chance at a lot of schools, with a 37-38 to be in the top tier of competitive applicants for top schools. Its a scary proposition, but one particular thing makes it easier. A lot of my friends actually scored in the 30-34 range on their first test, and then took it again to get 37-39 scores. When I was applying I thought you had to be perfect on your first try, but what I have seen is that you have to do reasonably well on your first try to prove that you didn't slack off and are generally a good test taker, and then you can take it again for a killer score so that schools can also use that number to have better applicant stats and increase their ranking etc (it's a big game unfortunately).
In summary, maybe try out a content book or two, or perhaps take a course...but doing thousands of prep questions and taking some time to learn the information through questions is what everyone I know says did the trick.
2. How was the process of applying to medical schools for you?
It was stressful overall and far worse than anything in medical school itself. I would have cycles during the process, where after completing an application and writing some great essays I would feel really self confident since I had pumped myself up on paper, but then looking back at the numbers of applicants, my average numbers, schools I didn't hear from etc I would get worried and depressed that I'd never get in. Getting the first acceptance was really a sweet thing, and then having choices between programs I loved was even better. I did unfortunately find that there was a lot of regional bias among medical schools. I grew up in California and did all of my schooling in California and did extremely well with medical schools in California. However, despite a track record of getting into some really competitive schools I only got two interviews outside of CA (Yale and Georgetown) that ended with a rejection and a waitlist respectively. By the rumors, others from outside of CA found it equally difficult to get in here, with similar cycles in the New York area etc. I would still advocate applying broadly, but just don't take some rejections personally as there is absolutely a geographic component beyond the state school requirements so far as I can tell.
Without any claim to knowledge from the inner admissions circle... but after talking with various interviewers, students etc who have been involved with admissions discussions I am really confident about one vital but simple component of the application process. It's important to have the grades and test scores that are competitive with the averages of your goal institutions, but what really makes people stand apart after you meet those basic criteria are really intangible things. Almost all of my peers had some really unique and interesting backgrounds, and had found things that they were incredibly passionate about. Beyond just being a passive volunteer with thousands of hours of "experience", most people took on leadership roles to make some change happen within their communities (or lab etc), with ownership over the outcomes.
The key component that I have seen stand out in applications are people who are passionate about something, and who create an application that clearly shows experience in that subject and how their perspective was formed (rather than having essays full of unsubstantiated soundbites). For example, someone who loves community health and underserved medicine who has worked for a year in a local free clinic, lived abroad doing global health policy for a year, and has written an honors thesis on the subject will be a far more convincing and successful applicant than someone who writes an essay about being "inspired" by a 2 week medical missionary trip to Guatemala where they performed procedures they weren't adequately trained to do, and likely took half the experience to be a tourist while beefing up their application. Others may love bench science and have worked for years in a lab, published several papers, and be legitimate experts in certain techniques that they could bring to an institution where they are applying in the MD/PhD track. Building a resume with direction and substantial experiences is hard, especially with all the work it takes to get through the pre-med curriculum. That is where older applicants have the advantage. Taking a few years off after med school is no longer non-traditional. It's the norm. The average entering age at my med school is 25, or 2-3 years of work experience after college. I would be scared to apply straight out of school, and while many of the MD/PhD students are on the younger side, a scant 10-15%? of my classmates were this young. Taking some time to be sure that medical school is the right path, having some wonderful life experiences doing something you are passionate about, AND being a more successful applicant later sounds like a good plan to me (though surely not the only one). I think a set of numbers get your application into consideration and then fade in importance once you made the first few cuts. Most of my peers seems to be well rounded cool people with above average numbers rather than uni-dimensional people with stellar numbers.
The final step in crafting the application is having a clear sense of where you want to go, and directly connect it to where you've been. Schools don't want students with high numbers who are adrift and have the vague goal of "being a doctor." Talk about what you want to do, and what specific strengths of that institution and general medical training will help you get there. Be on a mission, and a school will jump at the opportunity to help you get there and potentially inspire some of your other classmates along the way. Everyone knows that your interests may change, and that's totally fair and what the educational process is all about. But in general, going full out for a goal and talking about it on an application (even if those goals change) and being an active learner who creates and optimizes their own experiences is a really sexy thing to have in an application and will lead to getting more out of med school in general.
Finally, as you may gather from my opinionated statements above, I really believe that writing strong and emotional essays is a vital part of the application process. If you've done really good work for years this is the final chance to put it all together into a compelling package and make the most of it. Admissions officers read thousands of essays and are easily bored by yet another essay that is more of the same. Being a good writer helps, but really being passionate, driven, and excited while conveying that energy is likely more important (and easier) than being the next Emerson.
3. Throughout medical school, what are some of the ways you cope with all the related stress?
Choosing the right school is a VITAL component of how much stress you will encounter in the first place. Ideally, with a few acceptances in hand, student happiness should be a really important factor in deciding where to go since the basic knowledge learned between one school and other really isn't all that different. Besides location, proximity/access to family and a support structure, weather etc, I think that the grading system (Pass/fail or Honors/Pass/Fail vs other permutations) had a huge impact for my friends both at UCSF and those who went to other institutions. A lot of schools are Pass/Fail for the first two years of classroom work and then introduce an Honors component to the clinical work during the second half. With Pass/Fail you can concentrate on the fun of learning and how confident you feel with the material without worrying about your future career everyday. There will always be the gunners with 200 pages of color coded notes who get a 99 on every exam. The difference in a P/F system is you can do the volunteer project that makes you happy, spend time with friends and family, get a solid grasp of the material so you can feel confident about being a good doctor and take your 85% test score home without your residency application being any different. In fact, I think these P/F schools allow you to broaden your interests, and strengthen your application for the next step (yes, it never seems to stop!) while also making you a happier person. The Honors component of 3rd and 4th year at UCSF (and likely most schools as well) was a whole other business, where the perfectionist came out in everybody and the stress came back to some degree. Daily patient interactions were partially about learning and partially being worried about how a presentation went over and what the residents/attendings think. Serious bummer, and a subjective and rather arbitrary review system that made me doubt myself many times along the way as some people loved me and thought I was god's greatest gift to medicine, while others thought I was distracted/lost/or had a below average grasp of material (sometimes based on just a single question like not knowing the mechanism of disease for a particular patient etc). While I gave heavy preference to the P/F schools, I also thought that those with organ based block curriculum were also much better for lifestyle. Some schools have concurrent classes in biochem, pathology, cardiology etc with lots of individualized tests once a week or more. In this system (like college I admit) there is always studying to do. With organ blocks, the pathology, anatomy etc is all rolled into one area of cardiology, neurology, reproductive system etc. This leads to one (admittedly huge) exam every 3 weeks or so, with a nice break to recover and have a life before its time to start getting back to the books. A few friends at schools with H/P/F and subject curriculum with tests that fell on Mondays, Fridays etc 1-2x per week had a radically different medical school experience from me.
Overall, I would actually say that med school wasn't that stressful. It was hard work for sure, but I thought it was rather well balanced. In the first two years I would take a week off from studying and have a lot of fun, then work in a bit of catch up reading for a week and then do 3-5 hour study days for 5-7 days before the next big test. I panicked and had the most stressful study period of my life with 3 straight months of 10-18 hours of studying 7 days a week in preparation for Step 1 halfway through med school which made MCAT look easy. Then for clinic I found I had at most a month of crazy hours 5am-7:30pm or so 6 days a week (1 off day) with q5 day call staying till 10-11pm. This would then blend in with 2-4 weeks of relaxed 8-5 clinics that followed where I could recuperate before the cycle repeated. Busy and hard, but sustainable for two years for sure with time to de-stress and do lots of fun things so long as you could postpone them occasionaly for a few weeks at most. Do keep in mind that this is "relaxed and fun" coming from me, as I have been pleased to find that I actually enjoyed medicine and taking ownership of a patient's case and the ebb and flow of the hospital even if it took a lot of my day. I also really prioritize balance in my life, and found that med school had WAY more balance that I was expecting. I ended up having the best 4 years of my life and went on more trips (Nicaragua, Mexico x2, Hawaii x4, Miami, Las Vegas, Seattle, LA etc), had more fancy dinners, met my closest friends, and went to more parties and bars than college. I also learned a TON of material and found medical school to be the most tangibly high yield educational experience of my life (college and graduate school MPH included). I was confronted by mortality, pain, suffering, birth/saved life, and put through a grueling schedule and have grown more as a person than I would have thought possible. Medical school has been a joy, and while certainly not easy, it has been balanced and well designed educational experience that I can recommend without hesitation.
Finally, a veteran's note on the Honors system of clerkships that I think holds true for a lot of the subjective evaluations people get in any field. I had a good friend say that when people evaluate you, their scoring is based 80% on how they feel about you and 20% on how well you actually did clinically. I stopped agonizing over a presentation failure, and just started having fun with my supervisors and working for the patients. After this realization my grades went from average to excellent and I was on my way to a really competitive residency application while having a lot more fun in clinics.
4. What are your peers like? Did you get along with them or was it more of an isolated environment?
I was really pleased with my peers at UCSF, and found that I had more in common with them and "fit in" better than I ever had before in my educational time. Throughout high school and college I was awkwardly straddled between varsity athletics and the academic/research groups without full fitting into either. Going through the difficult med school experience together was really unifying and produced an incredible camaraderie. While very different to be sure, I can draw some parallels to what serving 4 years in the military might be like, and spending almost every waking moment with a small group of people undergoing very atypical, challenging and formative experiences. I don't love everyone in my class, but I do respect all of them, and the proportion I clicked with was always a really nice surprise for me. All over the city, imagine you have a group of 150 instant peers to go out with. It's pretty cool. The Pass/Fail system again comes into play here, as people were really collaborative since nothing was on a curve and we were all in it together. H/P/F clinics in years 3-4 brought out an unfortunate edge in a few people but the early socialization of the P/F "happy place" system kept it reasonably in check, perhaps as the fear of broad social retribution kept a few of the most brutal gunners in line to the point where they were playing their own game and going the extra 1000 miles without cutting others down.
5. If possible, can you give an overall brief summary of what medical school has been like for you? For instance, some obstacles you have faced? Rethinking you decision to pursue this field in the first place?
I think I addressed a lot of this above. Overall I'd say I'm really happy about decision to go to medical school and have had a wonderful experience. The combination of academic knowledge, personal growth, and exposure to an amazing peer group that humbles me everyday is something I wouldn't trade for the world. I'm now about to head into Emergency Medicine residency and I can only hope it will be as good of an experience. One of the great things about an MD that comforted me in my decision to start medical school is that even if I burn out for some reason it is a really valuable and transferable degree. It seams really easy to laterally transfer into consulting, pharma, biotech and even unrelated jobs where the societal association of MD with "smart," "trustworthy," "hardworking," "previously successful," combines with a key to the good old boys club of academic elitism for access to upper level positions at many companies. Not all of my peers are going into residency, but all of them have great opportunities and are following their passions. I'm excited about my next steps but am glad to know that I should never really have to worry much about being unemployed even if I don't turn out to be a full time clinician. A few major obstacles that I've faced:
Study habits: College wasn't super hard for me. I got good grades but retrospectively didn't study that hard. I was slapped in the face a bit by medical school. I had to learn to read 500 pages, twice, and make study aides and notecards all in a week in order to keep up and just pass with a shred of my dignity intact (thank god again for the P/F system
. It takes more diligence than natural intelligence to succeed in medical school (hidden secret), but I was never able to fake it, and really had to learn how to study for the first time in my life. Hard yes, but before freaking out, please refer to my above notes...med school was really fun and the intense study time was also well balanced.
Defining my own success: Most people who make it this far into medicine are perfectionists. Let's face it, I want high scores, and everyone to tell me I'm doing well. Medical school is a really radical shift in the educational process where the faculty to student ratio is something like 8 to 1. Yes, that's 8 faculty to 1 student. We had about 200-300? instructors for our 2 month cardiology block who lead small group sessions, gave a lecture on their particular area of expertise etc. While rotating on clinical teams there will be several residents, sometimes several faculty each week. Everyone will have a different perception of you. Some will love you, others won't be impressed. I spent more time than I should have hung up on a few negative reviews from 1-2 residents who didn't click with me. Given the total volume of people we work with, you can't please everybody. I started to take more of an active role in my own learning and doing what I wanted with each rotation. I tried to do what I was told in general to help the team, but then pushed to see things that interested me as alternatives to other busy work etc. This lead to more positive reviews surprisingly, but distancing myself from trying to please and "do well" with everyone was a big step, since the alternative of obsequious rotations filled with background anxiety was not fun at all. The goal is to turn into an adult learner where you decide what you are weak on, and work to fix it through hands on supervised experience and study until you feel ready. It's a tough view to take sometimes when the system seems to push us into a track filled with numbers (MCAT, Step scores, number of honors, publications etc).
Blood, guts, and general badness: Back in high school I was shadowing an orthopedic surgeon and passed out after seeing a mangled post motorcycle accident leg. I was told "it's ok, not everyone is cut out to be a doctor." The funny thing I found is that almost all of my peers have passed out at some point in medical school, or at least been severely affected by the stuff we see and do. In all, I found that the system is really carefully built to indoctrinate students into a culture of depersonalizing a person's injuries and medical state from their soul/personhood or whatever you believe. As a ship captain once told me on a sailing trip, "Every sailor gets seasick. Some just haven't met the right wave yet." Starting with cadaver lab in anatomy we see and do things that are decidedly unnatural in the world at large, with progressive exposure and responsibility that builds up at your own pace to the point where I think anyone entering medical school could be a orthopedic/trauma surgeon/ emergency doctor etc. Beyond the blood, I had several days where I just felt heavy and sad, coupled with long hours at work, wondering why on earth I was associating my life with all of this stress and pain and suffering. However, it always faded with time as the newness of a traumatic exposure became more distant and I quickly found other positive experiences to balance the negative. People do suffer, others get better. I leaned on my peers and a few key faculty mentors for perspective and found that while I may have felt isolated at first in my sadness or shock at a situation that I was actually really normal and my feelings were shared by others exposed to the same situation. Seasoned residents were also pulled down as a wonderful man succumbed to cancer while his wife melted down and the vent was turned off etc. It sucks. But it also brings the remaining people together in what, again, has been an amazingly close bonding and personal growth experience. I always gain perspective into my own life and values, and have a richer existence as a result of the things I encounter in medicine. And this is just as an observer or a team member with a limited role as a medical student. I'm excited to continue in the process. Progressive responsibility, progressive exposure, teamwork. The system has trained many people before and it seems to work pretty darn well. When I felt the most down and lost I found I really was just about normal and not so isolated after all.
That's it! Hope some of you feel like my thoughts were helpful as you navigate the application process and medical school itself. Best of luck!
1. For the MCAT, are there certain study materials that you recommend over others? How did you study?
The MCAT was one of the most brutal and stressful parts of the pre-med preparation cycle for me. At this point though I'm glad that I had to go through it since the sad reality is that medicine is a field full of continual standardized test that you have to do well on to pass through to the next level. Training for tests and learning how to make it through is important. By far the best advice for the MCAT and all the subsequent tests (Step 1, Step 2 etc) is to do a TON of questions. Study time is always limited, and in the end it doesn't matter what Organic Chemistry textbook has been read in excruciating detail. What matters is the ability to synthesize information and utilize it to answer questions in a specific test format. Knowing how to use the information that needs to be learned and expecting how concepts will be tested is far more important that just knowing a formula. I have a weakness with self motivation, so found it useful to pay for a Princeton Review MCAT prep course where I was forced to sit through a bunch of classroom teaching. I thought that they had some good strategies and did find it helpful, though many of my peers at UCSF got a content book or two and headed straight for the questions. The official AAMC practice tests seemed to be the most accurate in terms of score prediction and content. https://www.aamc.org/students/applying/mcat/preparing/85158/orderingpracticetests_mcat.html
The people who did exceptionally well did all of the available tests (8+) with careful attention to why they missed certain questions and trying to identify trends in their weaknesses. In the end, the predicted score should be 3-4 points above what your sister's target score is. They say that the score estimation is accurate +/- 3 points or so, and since there is not much margin for error it is best to play it safe. Ideally, there should be no surprises about how well you'd do on the test when walking in, and even with a bad test day with all the stress you could be satisfied with a bellow (your) average performance. Unfortunately I scored 3 points below my best practice test score, and about average for the 3 practice tests that I took, and wished that I had taken just a bit more time for preparation. That being said, there are a few unifying score trends that I've noticed out of the UCSF class. First, I think it is true that with the exception of a handful of minority applicants everybody had a 30 or above, with a 10 or greater in each section. Scores above 35 were the norm, and that would be my target to have a good chance at a lot of schools, with a 37-38 to be in the top tier of competitive applicants for top schools. Its a scary proposition, but one particular thing makes it easier. A lot of my friends actually scored in the 30-34 range on their first test, and then took it again to get 37-39 scores. When I was applying I thought you had to be perfect on your first try, but what I have seen is that you have to do reasonably well on your first try to prove that you didn't slack off and are generally a good test taker, and then you can take it again for a killer score so that schools can also use that number to have better applicant stats and increase their ranking etc (it's a big game unfortunately).
In summary, maybe try out a content book or two, or perhaps take a course...but doing thousands of prep questions and taking some time to learn the information through questions is what everyone I know says did the trick.
2. How was the process of applying to medical schools for you?
It was stressful overall and far worse than anything in medical school itself. I would have cycles during the process, where after completing an application and writing some great essays I would feel really self confident since I had pumped myself up on paper, but then looking back at the numbers of applicants, my average numbers, schools I didn't hear from etc I would get worried and depressed that I'd never get in. Getting the first acceptance was really a sweet thing, and then having choices between programs I loved was even better. I did unfortunately find that there was a lot of regional bias among medical schools. I grew up in California and did all of my schooling in California and did extremely well with medical schools in California. However, despite a track record of getting into some really competitive schools I only got two interviews outside of CA (Yale and Georgetown) that ended with a rejection and a waitlist respectively. By the rumors, others from outside of CA found it equally difficult to get in here, with similar cycles in the New York area etc. I would still advocate applying broadly, but just don't take some rejections personally as there is absolutely a geographic component beyond the state school requirements so far as I can tell.
Without any claim to knowledge from the inner admissions circle... but after talking with various interviewers, students etc who have been involved with admissions discussions I am really confident about one vital but simple component of the application process. It's important to have the grades and test scores that are competitive with the averages of your goal institutions, but what really makes people stand apart after you meet those basic criteria are really intangible things. Almost all of my peers had some really unique and interesting backgrounds, and had found things that they were incredibly passionate about. Beyond just being a passive volunteer with thousands of hours of "experience", most people took on leadership roles to make some change happen within their communities (or lab etc), with ownership over the outcomes.
The key component that I have seen stand out in applications are people who are passionate about something, and who create an application that clearly shows experience in that subject and how their perspective was formed (rather than having essays full of unsubstantiated soundbites). For example, someone who loves community health and underserved medicine who has worked for a year in a local free clinic, lived abroad doing global health policy for a year, and has written an honors thesis on the subject will be a far more convincing and successful applicant than someone who writes an essay about being "inspired" by a 2 week medical missionary trip to Guatemala where they performed procedures they weren't adequately trained to do, and likely took half the experience to be a tourist while beefing up their application. Others may love bench science and have worked for years in a lab, published several papers, and be legitimate experts in certain techniques that they could bring to an institution where they are applying in the MD/PhD track. Building a resume with direction and substantial experiences is hard, especially with all the work it takes to get through the pre-med curriculum. That is where older applicants have the advantage. Taking a few years off after med school is no longer non-traditional. It's the norm. The average entering age at my med school is 25, or 2-3 years of work experience after college. I would be scared to apply straight out of school, and while many of the MD/PhD students are on the younger side, a scant 10-15%? of my classmates were this young. Taking some time to be sure that medical school is the right path, having some wonderful life experiences doing something you are passionate about, AND being a more successful applicant later sounds like a good plan to me (though surely not the only one). I think a set of numbers get your application into consideration and then fade in importance once you made the first few cuts. Most of my peers seems to be well rounded cool people with above average numbers rather than uni-dimensional people with stellar numbers.
The final step in crafting the application is having a clear sense of where you want to go, and directly connect it to where you've been. Schools don't want students with high numbers who are adrift and have the vague goal of "being a doctor." Talk about what you want to do, and what specific strengths of that institution and general medical training will help you get there. Be on a mission, and a school will jump at the opportunity to help you get there and potentially inspire some of your other classmates along the way. Everyone knows that your interests may change, and that's totally fair and what the educational process is all about. But in general, going full out for a goal and talking about it on an application (even if those goals change) and being an active learner who creates and optimizes their own experiences is a really sexy thing to have in an application and will lead to getting more out of med school in general.
Finally, as you may gather from my opinionated statements above, I really believe that writing strong and emotional essays is a vital part of the application process. If you've done really good work for years this is the final chance to put it all together into a compelling package and make the most of it. Admissions officers read thousands of essays and are easily bored by yet another essay that is more of the same. Being a good writer helps, but really being passionate, driven, and excited while conveying that energy is likely more important (and easier) than being the next Emerson.
3. Throughout medical school, what are some of the ways you cope with all the related stress?
Choosing the right school is a VITAL component of how much stress you will encounter in the first place. Ideally, with a few acceptances in hand, student happiness should be a really important factor in deciding where to go since the basic knowledge learned between one school and other really isn't all that different. Besides location, proximity/access to family and a support structure, weather etc, I think that the grading system (Pass/fail or Honors/Pass/Fail vs other permutations) had a huge impact for my friends both at UCSF and those who went to other institutions. A lot of schools are Pass/Fail for the first two years of classroom work and then introduce an Honors component to the clinical work during the second half. With Pass/Fail you can concentrate on the fun of learning and how confident you feel with the material without worrying about your future career everyday. There will always be the gunners with 200 pages of color coded notes who get a 99 on every exam. The difference in a P/F system is you can do the volunteer project that makes you happy, spend time with friends and family, get a solid grasp of the material so you can feel confident about being a good doctor and take your 85% test score home without your residency application being any different. In fact, I think these P/F schools allow you to broaden your interests, and strengthen your application for the next step (yes, it never seems to stop!) while also making you a happier person. The Honors component of 3rd and 4th year at UCSF (and likely most schools as well) was a whole other business, where the perfectionist came out in everybody and the stress came back to some degree. Daily patient interactions were partially about learning and partially being worried about how a presentation went over and what the residents/attendings think. Serious bummer, and a subjective and rather arbitrary review system that made me doubt myself many times along the way as some people loved me and thought I was god's greatest gift to medicine, while others thought I was distracted/lost/or had a below average grasp of material (sometimes based on just a single question like not knowing the mechanism of disease for a particular patient etc). While I gave heavy preference to the P/F schools, I also thought that those with organ based block curriculum were also much better for lifestyle. Some schools have concurrent classes in biochem, pathology, cardiology etc with lots of individualized tests once a week or more. In this system (like college I admit) there is always studying to do. With organ blocks, the pathology, anatomy etc is all rolled into one area of cardiology, neurology, reproductive system etc. This leads to one (admittedly huge) exam every 3 weeks or so, with a nice break to recover and have a life before its time to start getting back to the books. A few friends at schools with H/P/F and subject curriculum with tests that fell on Mondays, Fridays etc 1-2x per week had a radically different medical school experience from me.
Overall, I would actually say that med school wasn't that stressful. It was hard work for sure, but I thought it was rather well balanced. In the first two years I would take a week off from studying and have a lot of fun, then work in a bit of catch up reading for a week and then do 3-5 hour study days for 5-7 days before the next big test. I panicked and had the most stressful study period of my life with 3 straight months of 10-18 hours of studying 7 days a week in preparation for Step 1 halfway through med school which made MCAT look easy. Then for clinic I found I had at most a month of crazy hours 5am-7:30pm or so 6 days a week (1 off day) with q5 day call staying till 10-11pm. This would then blend in with 2-4 weeks of relaxed 8-5 clinics that followed where I could recuperate before the cycle repeated. Busy and hard, but sustainable for two years for sure with time to de-stress and do lots of fun things so long as you could postpone them occasionaly for a few weeks at most. Do keep in mind that this is "relaxed and fun" coming from me, as I have been pleased to find that I actually enjoyed medicine and taking ownership of a patient's case and the ebb and flow of the hospital even if it took a lot of my day. I also really prioritize balance in my life, and found that med school had WAY more balance that I was expecting. I ended up having the best 4 years of my life and went on more trips (Nicaragua, Mexico x2, Hawaii x4, Miami, Las Vegas, Seattle, LA etc), had more fancy dinners, met my closest friends, and went to more parties and bars than college. I also learned a TON of material and found medical school to be the most tangibly high yield educational experience of my life (college and graduate school MPH included). I was confronted by mortality, pain, suffering, birth/saved life, and put through a grueling schedule and have grown more as a person than I would have thought possible. Medical school has been a joy, and while certainly not easy, it has been balanced and well designed educational experience that I can recommend without hesitation.
Finally, a veteran's note on the Honors system of clerkships that I think holds true for a lot of the subjective evaluations people get in any field. I had a good friend say that when people evaluate you, their scoring is based 80% on how they feel about you and 20% on how well you actually did clinically. I stopped agonizing over a presentation failure, and just started having fun with my supervisors and working for the patients. After this realization my grades went from average to excellent and I was on my way to a really competitive residency application while having a lot more fun in clinics.
4. What are your peers like? Did you get along with them or was it more of an isolated environment?
I was really pleased with my peers at UCSF, and found that I had more in common with them and "fit in" better than I ever had before in my educational time. Throughout high school and college I was awkwardly straddled between varsity athletics and the academic/research groups without full fitting into either. Going through the difficult med school experience together was really unifying and produced an incredible camaraderie. While very different to be sure, I can draw some parallels to what serving 4 years in the military might be like, and spending almost every waking moment with a small group of people undergoing very atypical, challenging and formative experiences. I don't love everyone in my class, but I do respect all of them, and the proportion I clicked with was always a really nice surprise for me. All over the city, imagine you have a group of 150 instant peers to go out with. It's pretty cool. The Pass/Fail system again comes into play here, as people were really collaborative since nothing was on a curve and we were all in it together. H/P/F clinics in years 3-4 brought out an unfortunate edge in a few people but the early socialization of the P/F "happy place" system kept it reasonably in check, perhaps as the fear of broad social retribution kept a few of the most brutal gunners in line to the point where they were playing their own game and going the extra 1000 miles without cutting others down.
5. If possible, can you give an overall brief summary of what medical school has been like for you? For instance, some obstacles you have faced? Rethinking you decision to pursue this field in the first place?
I think I addressed a lot of this above. Overall I'd say I'm really happy about decision to go to medical school and have had a wonderful experience. The combination of academic knowledge, personal growth, and exposure to an amazing peer group that humbles me everyday is something I wouldn't trade for the world. I'm now about to head into Emergency Medicine residency and I can only hope it will be as good of an experience. One of the great things about an MD that comforted me in my decision to start medical school is that even if I burn out for some reason it is a really valuable and transferable degree. It seams really easy to laterally transfer into consulting, pharma, biotech and even unrelated jobs where the societal association of MD with "smart," "trustworthy," "hardworking," "previously successful," combines with a key to the good old boys club of academic elitism for access to upper level positions at many companies. Not all of my peers are going into residency, but all of them have great opportunities and are following their passions. I'm excited about my next steps but am glad to know that I should never really have to worry much about being unemployed even if I don't turn out to be a full time clinician. A few major obstacles that I've faced:
Study habits: College wasn't super hard for me. I got good grades but retrospectively didn't study that hard. I was slapped in the face a bit by medical school. I had to learn to read 500 pages, twice, and make study aides and notecards all in a week in order to keep up and just pass with a shred of my dignity intact (thank god again for the P/F system
. It takes more diligence than natural intelligence to succeed in medical school (hidden secret), but I was never able to fake it, and really had to learn how to study for the first time in my life. Hard yes, but before freaking out, please refer to my above notes...med school was really fun and the intense study time was also well balanced. Defining my own success: Most people who make it this far into medicine are perfectionists. Let's face it, I want high scores, and everyone to tell me I'm doing well. Medical school is a really radical shift in the educational process where the faculty to student ratio is something like 8 to 1. Yes, that's 8 faculty to 1 student. We had about 200-300? instructors for our 2 month cardiology block who lead small group sessions, gave a lecture on their particular area of expertise etc. While rotating on clinical teams there will be several residents, sometimes several faculty each week. Everyone will have a different perception of you. Some will love you, others won't be impressed. I spent more time than I should have hung up on a few negative reviews from 1-2 residents who didn't click with me. Given the total volume of people we work with, you can't please everybody. I started to take more of an active role in my own learning and doing what I wanted with each rotation. I tried to do what I was told in general to help the team, but then pushed to see things that interested me as alternatives to other busy work etc. This lead to more positive reviews surprisingly, but distancing myself from trying to please and "do well" with everyone was a big step, since the alternative of obsequious rotations filled with background anxiety was not fun at all. The goal is to turn into an adult learner where you decide what you are weak on, and work to fix it through hands on supervised experience and study until you feel ready. It's a tough view to take sometimes when the system seems to push us into a track filled with numbers (MCAT, Step scores, number of honors, publications etc).
Blood, guts, and general badness: Back in high school I was shadowing an orthopedic surgeon and passed out after seeing a mangled post motorcycle accident leg. I was told "it's ok, not everyone is cut out to be a doctor." The funny thing I found is that almost all of my peers have passed out at some point in medical school, or at least been severely affected by the stuff we see and do. In all, I found that the system is really carefully built to indoctrinate students into a culture of depersonalizing a person's injuries and medical state from their soul/personhood or whatever you believe. As a ship captain once told me on a sailing trip, "Every sailor gets seasick. Some just haven't met the right wave yet." Starting with cadaver lab in anatomy we see and do things that are decidedly unnatural in the world at large, with progressive exposure and responsibility that builds up at your own pace to the point where I think anyone entering medical school could be a orthopedic/trauma surgeon/ emergency doctor etc. Beyond the blood, I had several days where I just felt heavy and sad, coupled with long hours at work, wondering why on earth I was associating my life with all of this stress and pain and suffering. However, it always faded with time as the newness of a traumatic exposure became more distant and I quickly found other positive experiences to balance the negative. People do suffer, others get better. I leaned on my peers and a few key faculty mentors for perspective and found that while I may have felt isolated at first in my sadness or shock at a situation that I was actually really normal and my feelings were shared by others exposed to the same situation. Seasoned residents were also pulled down as a wonderful man succumbed to cancer while his wife melted down and the vent was turned off etc. It sucks. But it also brings the remaining people together in what, again, has been an amazingly close bonding and personal growth experience. I always gain perspective into my own life and values, and have a richer existence as a result of the things I encounter in medicine. And this is just as an observer or a team member with a limited role as a medical student. I'm excited to continue in the process. Progressive responsibility, progressive exposure, teamwork. The system has trained many people before and it seems to work pretty darn well. When I felt the most down and lost I found I really was just about normal and not so isolated after all.
That's it! Hope some of you feel like my thoughts were helpful as you navigate the application process and medical school itself. Best of luck!
