Table of Contents
How is Medical School Structured?
You smile from ear to ear as your white coat is being put on you during the esteemed White Coat Ceremony. You finally did it! Getting accepted into medical school is arguably one of the most difficult steps to pursuing a career in medicine, but what now? How do you navigate the next 4 years of medical school to get into the residency of your choice so that you can spend the rest of your life doing what you love?
It is a common misconception that the 4 years of medical school will teach you all of the medicine you will ever need to know. Some people assume that once you graduate and are honored with the title of “doctor,” you will have the ability to treat all patients that come your way. In reality, medical school is just the first step of solidifying your knowledge of medicine and practicing patient interactions.
Medicine is truly a field where life-long learning is a necessity and much of the information you learn during medical school will be outdated once you start practicing medicine due to the continuous research going on.
As an overview of how the medical education system is set up in the United States, students complete 4 years of medical school and then apply to residencies. These residencies allow the training doctor to specialize in a specific department such as family practice, emergency medicine, dermatology, surgery, etc… The residencies can vary from 3-7 years depending on the type of specialty.
Once the residency training is complete, the doctor has the choice to become an attending physician or pursue a fellowship to train in a more specific subspecialty. The entire process of becoming a doctor can be long and difficult, which is why TDJ is here to offer support throughout each stage of this journey!
The structure of most medical schools in the US tends to be split into 2 main phases. The first 2 years involve all of the textbook knowledge relating to biochemistry, anatomy, physiology, pharmacology, and pathology. During these 2 years, students are spending a majority of their time learning how the human body is normally supposed to function, what are the different things that can go wrong, and how we can treat patients when they come with different pathologies. The USMLE Step 1 exam, which is now pass/fail (more on that later), marks the end of the first phase of medical school and is a cumulative exam of all the knowledge learned during the first 2 years of medical school.
During the last 2 years of medical school, students start “rotations.” This is where students will spend time in the hospital applying the knowledge from the first 2 years of their medical education in a practical setting. Students rotate through different specialties and gain more experience with actually treating patients under the guidance of residents and attending physicians. During this time period, students take the USMLE Step 2 exam and also apply for residencies. All of this culminates to a very special day called “Match Day,” where 4th-year medical students open an envelope that contains the name of the program that they will complete their residencies in!
What can I do NOW?
So, you are probably wondering what you can do as someone who has just dawned the white coat to get yourself ready to match into your dream residency. The answer is multifactorial and consists of a variety of different milestones throughout all 4 years of medical school. At the end of the day, residency programs are looking for medical students who are passionate about their preferred specialties and who are good fits for the particular program. In the first 2 years of medical school, however, students have not started rotations. So what should students do to prepare for residency?
A mentor once told me that medical school is my protected time for learning. My responsibility as a medical student is to learn and experience all of the things medicine has to offer without fear of being judged or making mistakes. As a student, you have the opportunity to learn about the entire human body, so it is crucial to make the most of it and enjoy the learning process.
If you are dead set on a specific specialty coming into medical school, that’s great! You can tailor your experiences to get more involved with this specialty, but still keep an open mind just in case another specialty also captivates your interest. On the other hand, if you have absolutely no idea what you want to specialize in, that is also great! Learn everything and get involved in different research and volunteer experiences so that you can truly find out what you want to do for the rest of your life.
It can be overwhelming attempting to balance and prioritize what to dedicate your precious time to in medical school. My biggest advice would be to involve yourself in things that you are passionate about and care about. Whether that be doing research, volunteering at clinics, or advocating for the homeless population, it is important to stay true to yourself and engage in meaningful activities that you genuinely enjoy. Your passion for these activities will ensure that you make a real impact in the time that you dedicate and thus maximize your return on investment.
Phase A
Step 1 is now pass/fail, so what is the point of studying hard in the first 2 years of medical school when rotations and other metrics are going to determine the residency I will get? It is still equally important to study the material well and challenge yourself to not only memorize but also understand the information.
Though it is true that Step 1 scores will no longer influence your residency prospects (it is still imperative you pass), the knowledge that you are expected to know for Step 1 most certainly will. This information will help you contribute to conversations with attendings and residents during rotations, perform well in your exams during the 3rd and 4th year of medical school, and most importantly, better treat the patients.
The knowledge accumulated during these years of classroom-based learning serves as the foundation for the rest of your medical education and future medical practice. Properly understanding the concepts associated with the pathogenesis of certain diseases and the mechanism of action of different drugs will create a strong framework in your mind to continue to expand during the 3rd and 4th years of medical school when you are actually on rotations serving patients. This framework will also be beneficial well beyond residency as it will provide a foundation to understand all the new medical research you will be reading as a practicing physician.
Unfortunately, just knowing the material isn’t enough to be a great doctor in the future. It is also important to get practical experience of what you are learning in class through volunteering at clinics, doing research, joining clubs, etc…
It can be overwhelming deciding which activities you want to spend time in and it might feel like you need to participate in everything in order to get “enough” experience for the future. Once again, it is crucial to select things that you are genuinely interested in and have a desire to get more involved with. This pertains to research, volunteering, or any other extra-curricular activity you chose to pursue. Always remember that enjoying the journey is just as important as achieving the end goal of becoming a physician.
How can I Study?
How do you expect me to learn all the material in medical school while doing research and volunteering, while also having time for personal care such as sleeping, eating, and hanging out with friends? The answer to this is efficiency.
When it comes to studying, everything that you do has to be done with 100% percent effort. If you try compromising the quality of your studying, then you will actually spend more time studying because you will have to keep re-doing a specific chapter because you did not truly understand it the first time. By studying effectively, you will be able to free up more time to do the things you enjoy such as conducting research, volunteering, and hanging out with friends.
But how can I study efficiently? This is a trial and error process because each person learns differently. One way that many medical students supplement their class lectures is through 3rd party resources which have proven to make the material more digestible and easier to comprehend while still giving the pertinent information that is essential for understanding the material effectively. The 4 best resources to learn material are: First Aid, Boards and Beyond, Pathoma, and Sketchy.
First Aid is a comprehensive set of notes that covers a majority of the topics that will be covered in the first 2 years of medical school. This is great to supplement the material from school lectures and really helps you focus on the most important things.
Boards and Beyond is a resource that prioritizes understanding concepts in medicine to make the information more meaningful than just memorizing random bits of information without connecting them.
Pathoma is another resource that has a similar style to Boards and Beyond, however, it focuses on the pathology concepts. Both of these are great resources to really understand the material at a deep level.
Finally, Sketchy is a resource that utilizes the method of loci to make it easier for students to memorize information. They draw different sketches in which each detail represents a piece of information you need to know, whether it be symptoms of a disease or infection or side effects of different drugs. Using these resources will help make the material more digestible and will hopefully allow you to have more time away from studying during your medical school years.
Another great resource to help embed information into your long-term memory is a spaced repetition software called Anki. This tool is useful in taking the material that you have already studied and helping you put it into your long-term memory in an efficient way. This is important because you do not want to only learn the material in medical school for a specific test. The sheer volume of information in medical school is so large that it is easy to forget once the test is over. The material is important for the entire duration of your medical practice, thus having software like Anki that helps embed information into your long-term memory will help you succeed in medical school as well into the future. Hopefully, all these tips help you achieve your Doctor Journey!
By Bhagvat Maheta