I entered medical school 20 years ago in 2003. I look around the hospital sometimes, struggle to fathom that it was that long ago, and wonder whether I ever looked as young as the medical students on their rotations. As they say; the days are long but the years are short. Time has certainly gone by at warp speed.
One of the things I distinctly remember about medical school is how hard it was. Everyone assumes medical school is hard, but few truly realize how challenging it is until you’re actually there. Up until that point as a premedical student I had been focused on prerequisite courses, extra-curricular activities, research and the MCAT – but I wasn’t learning medicine. Despite never being the smartest student throughout my college tenure, I was one of the hardest working. I didn’t have much of a life outside of academics. My hard work, coupled with the fact that I trained myself to become a pretty good test taker meant that I did very well in college. In fact, unlike some of the students around me who struggled with their courses, I had no doubt I would get into medical school – it was only a question in my mind of where I would go. My ego was boosted by the fact that I was once asked to stand up and take a bow in an auditorium with 200+ students because I got 97% on organic chemistry II final exam. In 2003 I graduated magna cum laude and was admitted to a handful of medical schools, but I admit I was a bit disappointed that I was waitlisted at my top choices in Manhattan. Nonetheless, I felt pretty good that I had overcome what I perceived as the biggest obstacle to becoming a physician.
My medical school journey seemed to be at first a completely different story from college. Throughout medical school the ‘high passes’ and ‘honors’ in most of my courses did not come easily (our medical school was not on a pass/fail system at that time). It was easy to reminisce about the glory of my college days and be disappointed by my grades. Unlike in college, I was full of doubt. I was shocked that after my first Anatomy lab practical exam I received a grade of only 70/100 and a warning letter that I may not be studying in an effective manner and to arrange a meeting with the section head. When I took Step 1 of the USMLE I was a bit disheartened that I hadn’t performed to the level of my expectations. Although I did manage to match in an ultra competitive specialty (Ophthalmology), my journey there was far from pleasant. I wasn’t the only one struggling. A few of my colleagues simply vanished (having ultimately chosen a different career path), some took leaves of absence for medical/mental health reasons, a handful failed Step 1 and had to retake the exam, and a couple actually had to repeat an entire year of medical school. Many of us undoubtedly struggled in silence.
What made medical school so hard?
Firstly, most of medical school is a completely new language and the sheer volume of information that medical students are expected to learn is immense. Medical students must memorize a vast amount of complex information about the human body, diseases, pharmacology, and treatments, among other things. I remember well that the sheer size of the pathology and anatomy textbooks was intimidating. The strategies I had used in college simply did not work. There was no way to cram for 3 days for an exam and then do well. I was delusional expecting that this would work. I found that if I did not keep up with the course materials every single day, I would fall behind, and become despondent because there was no hope for recovery in time for the exam. All of the subject matter was also equally important. One could not simply decide that you would focus more on X while temporarily ignoring the ‘other’ courses e.g. a liberal arts course that your undergraduate college required simply to graduate.
Secondly, medical school is very demanding on a student’s time and energy. Medical students must work long hours, often staying up late to study and prepare for exams. By the time you’re a third year medical student you have to have to balance your performance on clinical rotations with studying for shelf exams after hours. Additionally, you have to line up research experiences, meet with mentors, fulfil family/friend obligations and all of this can obviously be physically and emotionally exhausting.
Thirdly, the level of competition in medical school is high. Medical schools typically admit only a small percentage of applicants, and those who are accepted have already demonstrated exceptional academic ability. This means that medical students are surrounded by highly motivated and intelligent peers, which can be both inspiring and intimidating. I can honestly say despite going to a great college, I had never before encountered so many smart people in one place. I used to see my classmates sit in a study hall we called ‘the airplane’ and not move for 6 hours at a stretch. I would need to take breaks for lunch, the bathroom, to go have a quick chat or game of ping pong with a good friend to ensure my sanity – and they would still be sitting there in a Buddha-like posture. It was hard not to compare my own work ethic with theirs and wonder why I wasn’t built differently. There was absolutely no point in comparison. I also noticed after a semester that some of my classmates wouldn’t even come to class at all – they would just listen to the lecture tapes (yes we still had old school tape recordings) and then later MP3s on the school website. Every student has their own learning style and study habits – and I should have just focused on developing and honing my own.
Finally, the stakes are high in medical school. Medical students are training to become doctors, and their decisions and actions can have a significant impact on the lives of their patients. This means that the pressure to learn the material well, perform well and develop the judgement to make the right decisions is intense, and can lead to a lot of stress and anxiety. The thing you don’t realize in medical school sometimes though is that your journey is just beginning. If you want to practice clinical medicine, the real life journey takes place in the intense on the job apprenticeship called residency. That is where I learned to truly take care of my patients.
Varun Verma M.D. is a board-certified internal medicine physician, entrepreneur, patient advocate and author. He is the co-founder of Andwise – a platform designed to empower physicians with the financial knowledge and resources they need to make smart non-clinical life decisions.