Navigating the Phases of Medical School

As a post-match medical student awaiting graduation day, I have had plenty of time to reflect on the past four years of my life. It has been quite a ride to say the least. It was demanding, but it was significantly more enjoyable than originally anticipated. I met some great people along the way and watched myself grow both personally and professionally. With my diploma nearly in sight, I would like to offer one piece of advice for each year of medical school before I graduate.

My medical school experience may have been structured slightly different than yours. Here is my breakdown of each year:

• MS1: Preclinicals
• MS2: Preclinicals + USMLE Step 1
• MS3: Core clerksips + career exploration electives
• MS4: USMLE Step 2 +/- away rotations + ERAS + additional optional/required electives

M1

For me, the first preclinical year was the most challenging of medical school, and the fall semester was more difficult than the spring. There is little one can do to prepare themselves for the demands of medical school. Starting on day 1, you are exposed to a firehose of content that you must learn in a shorter amount of time than you are used to. What worked for you in undergrad will likely not be sufficient in medical school, and you will probably have to adjust your study strategy multiple times. I remember feeling overwhelmed and worried that I would not be able to manage the workload. Academically, I was doing fine, but I felt like I was not quite where I wanted to be. This is the year to find and trust your process. This requires some trial and error, but I assure you that you will eventually discover a strategy that works best for you, and you should stick with it indefinitely. It may be flashcards, cycling through the presentations repeatedly, studying in groups, using third-party resources, etc. Whatever it may be, find a method that produces the results you are satisfied with and keep it.

M2

Now that you are in the groove of medical school, you naturally will have more time on your hands. That might sound crazy to say, but it is the truth. The workload did not decrease; you are simply more efficient with your time. With the same amount of content on your plate, you are better prepared than you were a year ago. This extra time you have created for yourself makes the second year the time to get involved on campus and in your community. While there is inherent pressure to do research, volunteer, and take on leadership positions, stay true to yourself. Emphasize pursuing extracurriculars that interest you. Don’t sign up for things just because you feel like you must, and remember that a few strong, long-term commitments are more impactful than many one-and-done experiences. You will have less control of your schedule in the third year, so use this year to be proactive and add substance to your CV.

M3

The most important piece of advice for the third year is to keep an open mind. This may sound cliché, but it is a good approach for three reasons. First off, you may surprise yourself with what you end up liking and not liking. This is exactly what happened to me. I went into my third year 90% sure that I was going into internal medicine, and I ended up applying to general surgery. I had many rotations throughout the year that I liked and could see myself doing. Second, giving each rotation an equal chance will help to immerse yourself in the field. This mindset will help you show up ready to learn and perform well each day. Lastly, demonstrating interest in the specialty to residents and attendings is in your favor. There may be an element of human bias, but people will naturally think of you when learning opportunities arise if you have displayed an interest. This is not dishonest if you equally consider each rotation, even if it isn’t your pre-season #1.

M4

The fourth year of medical school is very different than the others. You will hear many times, “Fourth year is the best time of your life, make sure to enjoy it!” Yes, there is much more free time to go on vacation, get married, work on your hobbies, etc. However, portions of the fourth year are just as busy as previous years. You take USMLE Step 2, do away rotations, apply to residency, and complete interviews. It feels less “school” oriented and more about getting a job. On another note, it is an expensive year when you factor in testing fees, application fees, room and board for away rotations, and interview travel. The “year” people talk about being great is the time between Match Day and July 1st. This said, my advice is not to “make fourth year the best year of your life.” It is to spend time as much time as you can with friends and family who will be harder to see during residency. It is a reality that you may be moving to a different location, work many hours, and have less time off. You will soon be displaced from your medical school friends, as they are doing the same. This is a golden year for availability, but I am a believer that there are still great years ahead of you and me. Make sure to spend this valuable and exciting time with people that you cherish.

Isaac Hembree, BS, a member of SMA's Physicians-in-Training Committee, is currently a fourth-year medical student at UTHSC and a soon-to-be general surgery resident.