What exactly is so "hard" about medical school?

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DrFizition

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So I'm starting medical school next August and I just wanted to see what I'd be getting into.

There's no doubt that medical school is difficult, but what exactly is tough about it? I understand the work load is tremendous, but are the exams themselves challenging/critical thinking, or more like a "memorize and repeat mass amounts of info back to me" kind of thing? Are they generally multiple choice or "explain this process in a paragraph" kind of thing? Aside from exams and studying, what else is tough? Are we expected to do lab reports, papers, etc?

I guess after dealing with four years of undergraduate level exams I really don't know what I'm walking into, which I guess is true for almost every other first year student as well!

Thanks!
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The volume and pace of the pre-clinical years is higher than virtually any other academic arena. People who struggled in pre-med classes because they couldn't keep up will find medical school hard because your MS1/MS2 years will be like pre-med, but faster.

MS3/MS4 function like a job. Except that you don't get paid (you pay tuition actually). People don't like jobs and many find jobs to be harder than what they have been used to (school). There are bosses, there are colleagues, there are ancillary staff etc. Dealing with any of those groups can be challenging, but for some people the concept of interacting with people is difficult and they want a checklist of things to do in order to get an A. Unfortunately, that isn't how jobs (and the real world) work and the culture shock makes life hard. In addition, you will be expected to do things, "just because". There is usually good reason for you to do it, even if it doesn't help anyone else (classic example are MS3 chart notes, it really does help if you practice, but the reality is that virtually nobody is going to read your note). But, sometimes, there is legitimately no reason for you to be doing something and your bosses simply expect you to do it anyways. Dealing with that for some people is difficult.

There are very few, if any, things that are truly difficult/hard to understand. Most medical concepts can be explained to the lay person fairly effectively.
 
Memorize and repeat mass amounts of info with some critical thinking. Generally multiple choice. Studying and exams is tough. Knowing a lot of things is tough. Being able to apply it to patient care is tough. The good thing about med school is that there's not a lot of extra nonsense involved, it's mostly learning medicine.
 
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mimelim said:
The volume and pace of the pre-clinical years is higher than virtually any other academic arena. People who struggled in pre-med classes because they couldn't keep up will find medical school hard because your MS1/MS2 years will be like pre-med, but faster.

MS3/MS4 function like a job. Except that you don't get paid (you pay tuition actually). People don't like jobs and many find jobs to be harder than what they have been used to (school). There are bosses, there are colleagues, there are ancillary staff etc. Dealing with any of those groups can be challenging, but for some people the concept of interacting with people is difficult and they want a checklist of things to do in order to get an A. Unfortunately, that isn't how jobs (and the real world) work and the culture shock makes life hard. In addition, you will be expected to do things, "just because". There is usually good reason for you to do it, even if it doesn't help anyone else (classic example are MS3 chart notes, it really does help if you practice, but the reality is that virtually nobody is going to read your note). But, sometimes, there is legitimately no reason for you to be doing something and your bosses simply expect you to do it anyways. Dealing with that for some people is difficult.

There are very few, if any, things that are truly difficult/hard to understand. Most medical concepts can be explained to the lay person fairly effectively.
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That was a perfect explanation to his question. Bravo.
 
mimelim said:
MS3/MS4 function like a job. Except that you don't get paid (you pay tuition actually). People don't like jobs and many find jobs to be harder than what they have been used to (school). There are bosses, there are colleagues, there are ancillary staff etc. Dealing with any of those groups can be challenging, but for some people the concept of interacting with people is difficult and they want a checklist of things to do in order to get an A. Unfortunately, that isn't how jobs (and the real world) work and the culture shock makes life hard. In addition, you will be expected to do things, "just because". There is usually good reason for you to do it, even if it doesn't help anyone else (classic example are MS3 chart notes, it really does help if you practice, but the reality is that virtually nobody is going to read your note). But, sometimes, there is legitimately no reason for you to be doing something and your bosses simply expect you to do it anyways. Dealing with that for some people is difficult.
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This all sounds great to me, tbh.
 
Cotterpin said:
This all sounds great to me, tbh.
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Many feel that way. It is liberating to actually be a part of a team and doing a job. I think that a lot of nontraditional students really hit their stride during that time as well because they are typically better equipped to deal with the random **** that gets thrown your way on the wards (mainly because they have had jobs in the past and dealt with the same things). They can focus on the aspects of why they went into medicine and don't get as bogged down by the bs.

But, rest assured, it is still a job and starting in MS3, there will be times when you simply can't believe that things really function that way in a modern US hospital and you are expected to simply go along with it.
 
Psai said:
Memorize and repeat mass amounts of info with some critical thinking. Generally multiple choice. Studying and exams is tough. Knowing a lot of things is tough. Being able to apply it to patient care is tough. The good thing about med school is that there's not a lot of extra nonsense involved, it's mostly learning medicine.
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This strongly depends on the school. Anatomy is almost never multiple choice, which is a very hard thing for many students to adapt to. Then there are clinical skills exams, which many schools have during preclinical years. Histories and physicals aren't all that difficult, but there is a massive amount of stuff to recall on the fly and perform properly. These are difficult scenarios for many students to adapt to, as the stress, testing methods, and material is vastly different than anything they've learned before.
 
mimelim said:
Many feel that way. It is liberating to actually be a part of a team and doing a job. I think that a lot of nontraditional students really hit their stride during that time as well because they are typically better equipped to deal with the random **** that gets thrown your way on the wards (mainly because they have had jobs in the past and dealt with the same things). They can focus on the aspects of why they went into medicine and don't get as bogged down by the bs.

But, rest assured, it is still a job and starting in MS3, there will be times when you simply can't believe that things really function that way in a modern US hospital and you are expected to simply go along with it.
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Though to give you the cynical perspective on MS3... (mine). I was a happy resident, but a really miserable MS3/4.

To this day the reasons I hated it so much were probably multi-factorial, but part of it was the entire experience didn't seem so much like a "job" but a perpetual "pretending to do a job"...more of a "performance" or "putting on a show" than "work".

In residency and above, or any "real job," you're assessed on how competent you are at your job (or a set of milestones depending on how far along you are in your training as the ACGME has it now). As a resident I was able to develop a reputation for being someone who got his work done, knew what he was doing, and was someone that people went to for help and advice when they were struggling with a judgment call, ended up chief resident of a highly respected and large (by my specialty's standards) residency, and was someone that was actively recruited by people I worked with to come to my current job. However, as a med student all you get is a couple weeks at a time with some preceptors who only get to see you in a few superficial interactions. Everything you're doing, you're essentially doing for the first time, so it's nearly impossible to walk into a rotation and feel confident, because realistically, as a med student, you don't know what you're doing. No one expects you to be fully competent, but you're still judged on your preceptor's superficial impression of you, which, despite what many in med education admin will say, plays an outsized proportion of how you're evaluated compared to the actual development of your skills. As an MS3, I got really really tired of showing up every day at 5AM, getting my **** done, staying late, then having some a-hole attending tell me I "lacked enthusiasm" for what I was doing.

I'd do MS1/2 again if I was forced to. I'd do intern year again if I had to. Even if my medical career depended on it no f-cking way I'd do MS3 again.
 
Goro said:
What's so hard about med school? Imagine drinking from a fire hose....while running after the fire truck.
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Actually, I hear that analogy a lot, and I'm not a fan of it. Drinking from a fire hose is an impossible task, which as many will attest, med school isn't.

My favorite is "med school is like having to eat five pancakes per day." It's not exactly the most pleasurable task, you'll feel kind of gross afterwards, but you can do it. The problem is, maybe you decide to take a day off. Tomorrow, if you want to make it up, you have to eat ten pancakes. Or then maybe you space your pancake debt out, so you're eating six for the next week, but if you don't keep up, you'll be stuck trying to eat 20 pancakes the day before the exam without throwing up.
 
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WingedOx said:
Actually, I hear that analogy a lot, and I'm not a fan of it. Drinking from a fire hose is an impossible task, which as many will attest, med school isn't.

My favorite is "med school is like having to eat five pancakes per day." It's not exactly the most pleasurable task, you'll feel kind of gross afterwards, but you can do it. The problem is, maybe you decide to take a day off. Tomorrow, if you want to make it up, you have to eat ten pancakes. Or then maybe you space your pancake debt out, so you're eating six for the next week, then it gets even more difficult, and you're less likely to want to keep up. If you don't keep up, you'll be stuck trying to eat 20 pancakes the day before the exam without throwing up.
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OH MY GOD THAT ANALOGY.
 
WingedOx said:
Actually, I hear that analogy a lot, and I'm not a fan of it. Drinking from a fire hose is an impossible task, which as many will attest, med school isn't.

My favorite is "med school is like having to eat five pancakes per day." It's not exactly the most pleasurable task, you'll feel kind of gross afterwards, but you can do it. The problem is, maybe you decide to take a day off. Tomorrow, if you want to make it up, you have to eat ten pancakes. Or then maybe you space your pancake debt out, so you're eating six for the next week, then it gets even more difficult, and you're less likely to want to keep up. If you don't keep up, you'll be stuck trying to eat 20 pancakes the day before the exam without throwing up.
Click to expand...

So as long as they serve them with chocolate chips sounds like I've been in med school for 15 years then.
 
WingedOx said:
Actually, I hear that analogy a lot, and I'm not a fan of it. Drinking from a fire hose is an impossible task, which as many will attest, med school isn't.

My favorite is "med school is like having to eat five pancakes per day." It's not exactly the most pleasurable task, you'll feel kind of gross afterwards, but you can do it. The problem is, maybe you decide to take a day off. Tomorrow, if you want to make it up, you have to eat ten pancakes. Or then maybe you space your pancake debt out, so you're eating six for the next week, then it gets even more difficult, and you're less likely to want to keep up. If you don't keep up, you'll be stuck trying to eat 20 pancakes the day before the exam without throwing up.
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Thanks everyone for the responses. So from what i'm getting here, the hardest part of med school (at least the first two years) is keeping up with the pace? And years 3-4 is dealing with the bull****?
 
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WingedOx said:
Actually, I hear that analogy a lot, and I'm not a fan of it. Drinking from a fire hose is an impossible task, which as many will attest, med school isn't.

My favorite is "med school is like having to eat five pancakes per day." It's not exactly the most pleasurable task, you'll feel kind of gross afterwards, but you can do it. The problem is, maybe you decide to take a day off. Tomorrow, if you want to make it up, you have to eat ten pancakes. Or then maybe you space your pancake debt out, so you're eating six for the next week, then it gets even more difficult, and you're less likely to want to keep up. If you don't keep up, you'll be stuck trying to eat 20 pancakes the day before the exam without throwing up.
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I like the analogy. Learning and retaining everything presented to you in med school is impossible.

And... five pancakes per day? That sounds like heaven. It's like having to eat 50 pancakes per day. You can't eat them all, day after day.

You learn to prioritize. Get the gist of things. Memorize key details and information. Try to derive or figure out the rest during tests, and look up what you need to later. Unless you're some super-wizard with the world's best memory you're not going to get everything.
 
It's one that my students use a lot, and what they tell me when I ask them "what's the most challenging thing about med school?"


WingedOx said:
Actually, I hear that analogy a lot, and I'm not a fan of it. Drinking from a fire hose is an impossible task, which as many will attest, med school isn't.

My favorite is "med school is like having to eat five pancakes per day." It's not exactly the most pleasurable task, you'll feel kind of gross afterwards, but you can do it. The problem is, maybe you decide to take a day off. Tomorrow, if you want to make it up, you have to eat ten pancakes. Or then maybe you space your pancake debt out, so you're eating six for the next week, then it gets even more difficult, and you're less likely to want to keep up. If you don't keep up, you'll be stuck trying to eat 20 pancakes the day before the exam without throwing up.
Click to expand...

22031 Alum said:
OH MY GOD THAT ANALOGY.
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Now I just really want to eat some pancakes.
 
I will add, that most students come into med school after being high achievers and consistently being at the top of the class. Now half of them will be in the bottom half of the class, and 90% won't be in the top 10%. That is hard for most of those people to get used to.

In the clinical years, the hours are worse than in most jobs, the expectations more poorly defined, and often contradictory, the chain of command more complex, the personalities more pathologic, and people have more motivation to undermine each other. No one ever really walks you through what you're supposed to do as a medical student,and each rotation will have different expectations in terms of how much responsibility you should take on, but they won't articulate their expectations, but it will be you fault for not doing it right. If you miss something you will be blamed, but you'll also be blamed if you catch something that your superiors missed, and it will be your fault for either not bringing it to someones attention forcefully enough, or for pointing it out too obviously and embarrassing a superior. Whatever you do will be wrong, and you will be criticized for it. You'll read up for an operation, but will be reassigned the next morning to a different operation and then criticized for not reading in advance and not studying enough. Even if you're doing well you won't know it, because the attendings will keep pimping you anyway. Grades are random, they could love you on your first month of surgery, and hate you on the next, and your future will depend on those evaluations.

I could go on, but that should be enough to answer the question.
 
I feel like the amount of pancakes in your analogy correlates indirectly with your learning capacity.

Edit: Or maybe just directly with your abdomen circumference.
 
Well I'm a lazy procrastinator who generally studies 0-1.5 hours most days, and maybe 2-4 hours most weekends. I'll cram a couple days before the exams and do fine.

Then again, I could probably eat 20 pancakes twice a week.
 
You'll need to study 4-8 hrs every day outside of class time (5 hrs per day) every single day and you'll still feel you don't know all that you have to know.
 
My girlfriend is getting her PhD in mathematics and I'm sure she would gaffaw @ the med school is the hardest thing ever in academics statement. You can't win a Fields Medal by rote memorization.
 
Professors who talk 500mph (impossible to keep up) as if we already know everything they are saying, then only put about 4 words and a really small, blurry diagram on each slide. Buts it's okay, because "don't memorize, just understand." You then spend approximately 29 hrs sifting through books (both review and text books) trying to find the information that is relevant to what your professor mentioned. Once you have found the relevant information, you can finally proceed to learning it which of course takes time. And then they throw poorly written test questions at you that either have more than one equivalent answer, the answer is directly contradicted by something in their slides, or the answer is buried in some obscure table on a slide that the professor told you not to memorize. After all this you are given the opportunity to formally argue against certain questions on the exam, but they never actually consider it.

Oh that's just my med school? Shoot.

I'm only half joking. So far I've found that it hasn't been as hard as I expected, but the poor organization of stuff has definitely been the biggest drain of time and cause of stress.
 
That sounds like it sucks. Every now and then I'm disappointed at the lack of organization in our curriculum, but my school sounds like NASA compared to that.
 
Godspeedyou said:
My girlfriend is getting her PhD in mathematics and I'm sure she would gaffaw @ the med school is the hardest thing ever in academics statement. You can't win a Fields Medal by rote memorization.
Click to expand...

Well, it's not a competition first of all. Secondly, most people who've gone through it are clear on the distinction between "difficult concept to understand" hard and "simple to understand but in vast amounts" hard.
 
Monster_Cat said:
Getting into it is probably the hardest part. Don't get me wrong medical school is hard, but all the med students I know who are getting hammered by the step 1 say what makes them really happy is thinking about how they never have to apply to get into med school again
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This is very true. There are too many variables in admission and you are not really in control except for your application. I think even the best applicants become humbled through the application process because of this lack of control. Whereas in med school (and undergrad too) you are for the most part fully in control. Study hard and you'll be fine.
 
I'm a fairly new M1, so take my words with a grain of salt.

But med school isn't so bad. Honestly, I would say the material isn't difficult at all. it's just the volume is higher. there are a lot more lectures. testing is frequent. But they do not try to trick you on exams like they do in undergrad. Grades in preclinical years really do not matter. the material is interesting. And the people are awesome and supportive

I agree with the poster above that getting in is harder than staying in. If you can get in you should have no problem keeping up
 
jonnythan said:
Well I'm a lazy procrastinator who generally studies 0-1.5 hours most days, and maybe 2-4 hours most weekends. I'll cram a couple days before the exams and do fine.

Then again, I could probably eat 20 pancakes twice a week.
Click to expand...

Perfect illustration of how study habits differ from student to student. In undergrad I could get good grades with 3-4 hours a day, however many of my friends would still struggle with 6-7 hours of studying a day.
 
bc65 said:
I will add, that most students come into med school after being high achievers and consistently being at the top of the class. Now half of them will be in the bottom half of the class, and 90% won't be in the top 10%. That is hard for most of those people to get used to.

In the clinical years, the hours are worse than in most jobs, the expectations more poorly defined, and often contradictory, the chain of command more complex, the personalities more pathologic, and people have more motivation to undermine each other. No one ever really walks you through what you're supposed to do as a medical student,and each rotation will have different expectations in terms of how much responsibility you should take on, but they won't articulate their expectations, but it will be you fault for not doing it right. If you miss something you will be blamed, but you'll also be blamed if you catch something that your superiors missed, and it will be your fault for either not bringing it to someones attention forcefully enough, or for pointing it out too obviously and embarrassing a superior. Whatever you do will be wrong, and you will be criticized for it. You'll read up for an operation, but will be reassigned the next morning to a different operation and then criticized for not reading in advance and not studying enough. Even if you're doing well you won't know it, because the attendings will keep pimping you anyway. Grades are random, they could love you on your first month of surgery, and hate you on the next, and your future will depend on those evaluations.

I could go on, but that should be enough to answer the question.
Click to expand...
Basically it's hard for emotionally weak, narcissistic people that can't handle being the best snowflake their ever was.
 
FindMeOnTheLinks said:
Professors who talk 500mph (impossible to keep up) as if we already know everything they are saying, then only put about 4 words and a really small, blurry diagram on each slide. Buts it's okay, because "don't memorize, just understand." You then spend approximately 29 hrs sifting through books (both review and text books) trying to find the information that is relevant to what your professor mentioned. Once you have found the relevant information, you can finally proceed to learning it which of course takes time. And then they throw poorly written test questions at you that either have more than one equivalent answer, the answer is directly contradicted by something in their slides, or the answer is buried in some obscure table on a slide that the professor told you not to memorize. After all this you are given the opportunity to formally argue against certain questions on the exam, but they never actually consider it.

Oh that's just my med school? Shoot.

I'm only half joking. So far I've found that it hasn't been as hard as I expected, but the poor organization of stuff has definitely been the biggest drain of time and cause of stress.
Click to expand...
Do you guys not have recorded lectures or something?
 
It's the volume compounded with when you want an evening off when it can't happen (unless you're willing to sacrifice any edge you may have by falling behind).
 
Mad Jack said:
Do you guys not have recorded lectures or something?
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Haha we do and most of our lectures aren't mandatory but we have certain school-specific circumstances that result in you having to attend many of the lectures in person even if they aren't mandatory. It's hard to explain.

But really I was just half joking and trying to illustrate the point that a lot of people think the bullsh*t ends once you get to med school. That is not the case.
 
To put the volume of material in perspective. My next course will be 8 weeks (82 lecture hours + misc hrs) and the course director said the total amount of information will be equal to 4 classes for 2 full semesters in undergrad... So, assuming each undergrad course is 3 credit hours. You have 12 hrs each week x 16 weeks (4-month semester) x 2 = 384 hours of class. So basically in undergrad you have over 4x the time to learn 1/8th of the material you will in a 8 week med school course. To be fair, this course in particular is known to be very information heavy whereas the courses I'll take in the spring are relatively lighter. After finishing my first med school course, I have tremendous respect for those who are on a graded system as opposed to pass/fail. Even though I've heard from many people that preclinical grades (other than P/F system) don't matter as much as your step I scores. P/F however reduces the feeling that you have to know everything. In medical school, you will learn many things, forget about them, and then look them up when you need to. The most important things will be hammered into your brain repeatedly and relentlessly and you'll start to notice what's important to know and what's not. This is where P/F shines and is of benefit. But, I digressed enough.
 
I've heard the drinking from a firehose analogy and read the 5 pancakes a day analogy, which to be honest should really be read in its original context here: https://rumorsweretrue.wordpress.com/2006/11/01/pancakes-every-morning/

But my favorite studying in med school quote is this one:

"Studying in medical school is like having sex when you're drunk. You never actually finish, you just keep going until it's not worth it anymore."
 
WingedOx said:
Actually, I hear that analogy a lot, and I'm not a fan of it. Drinking from a fire hose is an impossible task, which as many will attest, med school isn't.

My favorite is "med school is like having to eat five pancakes per day." It's not exactly the most pleasurable task, you'll feel kind of gross afterwards, but you can do it. The problem is, maybe you decide to take a day off. Tomorrow, if you want to make it up, you have to eat ten pancakes. Or then maybe you space your pancake debt out, so you're eating six for the next week, but if you don't keep up, you'll be stuck trying to eat 20 pancakes the day before the exam without throwing up.
Click to expand...

And every year, hungry "accepted med students" come here to tell us that taking several months to pre-eat two pancakes is a good use of their time.
 
jonnythan said:
Well I'm a lazy procrastinator who generally studies 0-1.5 hours most days, and maybe 2-4 hours most weekends. I'll cram a couple days before the exams and do fine.

Then again, I could probably eat 20 pancakes twice a week.
Click to expand...
im even worse lol. i dont study until the day before my exam and, sometimes just 2 hours before it. 🙁
 
FindMeOnTheLinks said:
Professors who talk 500mph (impossible to keep up) as if we already know everything they are saying, then only put about 4 words and a really small, blurry diagram on each slide. Buts it's okay, because "don't memorize, just understand." You then spend approximately 29 hrs sifting through books (both review and text books) trying to find the information that is relevant to what your professor mentioned. Once you have found the relevant information, you can finally proceed to learning it which of course takes time. And then they throw poorly written test questions at you that either have more than one equivalent answer, the answer is directly contradicted by something in their slides, or the answer is buried in some obscure table on a slide that the professor told you not to memorize. After all this you are given the opportunity to formally argue against certain questions on the exam, but they never actually consider it.

Oh that's just my med school? Shoot.

I'm only half joking. So far I've found that it hasn't been as hard as I expected, but the poor organization of stuff has definitely been the biggest drain of time and cause of stress.
Click to expand...
may i ask what school you go to?
 
n00b_pwner said:
i would think its the difficulty in balancing the hard work ur doing with not feeling too isolated / having a relationship. any med students / physicians down to comment on whether having a partner helps or detracts from school?
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I found it helpful... Though I'll say this:
Helpful if the person is the right one and you get married or are married...
Terrible and can destroy you if they are NOTthe right one.
My wife and I got engaged Nov of m1... Did long distance for preclinical years then got married BTW m2 and m3. Married 5 years now.

For me, the relationship removed me from the drama, let me focus. The most helpful thing I did was introduce her to everyone. My wife now has some of her closest friends from my med school class. It helps that I was more or less independent study and studied alone.

So take this with a grain of salt because I honestly think I'm more of the rarity. In the right circumstance, its a blessing. Good luck!
 
Neuroscience. Neuroscience is hard.

Yes, that is what I'm procrastinating from currently.
 
WingedOx said:
Though to give you the cynical perspective on MS3... (mine). I was a happy resident, but a really miserable MS3/4.

To this day the reasons I hated it so much were probably multi-factorial, but part of it was the entire experience didn't seem so much like a "job" but a perpetual "pretending to do a job"...more of a "performance" or "putting on a show" than "work".

In residency and above, or any "real job," you're assessed on how competent you are at your job (or a set of milestones depending on how far along you are in your training as the ACGME has it now). As a resident I was able to develop a reputation for being someone who got his work done, knew what he was doing, and was someone that people went to for help and advice when they were struggling with a judgment call, ended up chief resident of a highly respected and large (by my specialty's standards) residency, and was someone that was actively recruited by people I worked with to come to my current job. However, as a med student all you get is a couple weeks at a time with some preceptors who only get to see you in a few superficial interactions. Everything you're doing, you're essentially doing for the first time, so it's nearly impossible to walk into a rotation and feel confident, because realistically, as a med student, you don't know what you're doing. No one expects you to be fully competent, but you're still judged on your preceptor's superficial impression of you, which, despite what many in med education admin will say, plays an outsized proportion of how you're evaluated compared to the actual development of your skills. As an MS3, I got really really tired of showing up every day at 5AM, getting my **** done, staying late, then having some a-hole attending tell me I "lacked enthusiasm" for what I was doing.

I'd do MS1/2 again if I was forced to. I'd do intern year again if I had to. Even if my medical career depended on it no f-cking way I'd do MS3 again.
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Were you simply a victim of bad luck in terms of your rotation sites and supervisors? Do you think your impressions of MS-3 would have been more positive at different sites (i.e. programs that some of your colleagues actually felt good about)?

As always, your feedback is appreciated!
 
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