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Tips for Surviving Medical School

Created 02.21.10 by Dr. Lisabetta Divita
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If you are considering medical school, it is important to realize the commitment of time, energy, and money this represents. While being a physician has countless personal and financial rewards, the path to achieving that goal is fraught with trials of different sorts.

The decision to become a doctor should not be made without significant thought and personal reflection—you should be honest with yourself when you arrive at this decision. Also, you should be fully aware of what is involved in medical education, particularly medical school.

If after careful thought you still strongly desire to wear the long white coat, you should steel yourself for a bumpy ride. You should also acquire as many tips and tricks that you can—and implement them—starting on the very first day of classes.

MS-1 and MS-2

The first realization that needs to be made, essentially from day one, is the sheer quantity of facts that will need to be committed to memory. While you certainly had challenging classes as a premedical student, most college classes pale in comparison to the enormity of material presented in preclinical courses.

Take a good, hard look at the way you studied in college. What worked? What did not? Do you study best alone or in a group? Could you benefit from studying a little alone and in a group? Do you get more from a lecturer or from reading notes/books? You need to know what works for you and then do it religiously starting on the first day of classes. If you did not need to study too much during college to get great grades, good luck to you. There will be little time to experiment with different study styles once classes start.

The best approach is to assume that the volume of material conveyed in medical school will far exceed your experiences in college. Therefore you will need to develop new and reliable study habits within the first few weeks. Organization is a top priority. Make sure that you have a copy of any material that could be asked on an exam. This could be slides, notes, lectures, and required reading. These things do not need to be purchased in all cases, but if you are going to rely on community or free resources, you must be able to guarantee that they will be there when you need to study them.

How will you know what could be asked on an exam? Obtaining exams from previous years is perhaps the most important investment you could make. Get copies of previous exams. Old exams give you the best idea of the style and scope of questions that will be asked. There is simply too much information not to focus; the best way to focus is to get a feel for how previous classes were tested.

Remember, too, that each preclinical course will be taught by dozens of faculty. Each faculty member may lecture as little as one hour to several hours, but the material will be presented by several. Therefore the questions that faculty submits for the exam will be of different styles and degrees of difficulty. Individual faculty lecturers are mostly the same from year to year (as are their lectures) so their questions will be similar from year to year as well.

Everything that was uttered during lecture and contained in the syllabus or notes is fair game for the exam. The lecture and notes should be the starting points for each course and then work your way out from there. If the notes are thin or the lecture was a bit rushed, make sure you consult a book or study guide to fill in the material. Often a lecturer will provide the primary literature from which the lecture was drawn. If you can manage it, take at least one look at this material. Many times, this is what the lecturer would have said if there was more time. This material is also likely to be the source of exam questions. It takes legwork on your part but it can be very worthwhile.

There will be plenty of resources at your disposal; too many, really. For instance, many MS I students buy a copy of Harrison’s during first year. This is a very, very dense book and not a very efficient way to spend your limited study time. Likewise, most first year students will diligently buy all of the required textbooks without delay. You will learn that this is not always necessary or a good idea.

Realize that your primary goal during years I and II is to get A/Honors/Pass on your medical school courses. Preparation for Step I of the USMLE or COMLEX will come later. In the first two years, it is all about the grades. Study time should be about the exam and learning the content that will be tested. Sure, the interesting stuff may beckon you to read further, but make sure not to substitute depth for sufficient breadth. Read it all once (or thrice) and come back for the interesting stuff if there is time.

Even if you are a “solo study” type, it is best to have a core group of classmates that you can count on for notes/study materials/borrowing books/crying fits. This relationship is a give and take, so be there for the group when needed and they will be there for you. Organize your studying such that you are a valuable resource to them as well. Being aloof with your peers can really cost you at test time. Reach out to your classmates early so you have a network in place when you need it.

Recommended Books for the first two years of medical school

Note, these are just suggestions and not something you have to rush out to the bookstore and buy.

  • Atlas of Human Anatomy by Sharon Colacino
  • ŸGross Anatomy, Board Review Series by Kyung Won Chung
  • Lippincott’s Illustrated Reviews, Biochemistry by Denise R. Ferrier
  • ŸTextbook of Medical Physiology by John E. Hall
  • ŸRapid Interpretation of EKGs by Dale Dubin

MS-3 and MS-4

Preparation starts before the first clinical rotation. Ask students transitioning from third to fourth year what is required on the wards. Learn about a SOAP note and how to write one. Learn about a third year’s place on a medical or surgical service. If you can, find out which attendings like to teach, which attendings are “good” and which attendings are “malignant.” Some attending physicians are very particular—learning about their quirks ahead of time can save you when you present patients.

Also, get the practical things in order before the first day of third year to the extent that you can. If your hospital uses paper charts, know where they are and what they look like. Open one up and see how it is organized. If the charts are computerized, make sure you have adequate access (usernames and passwords). You will be running to the clinical lab and radiology a lot during third year, know how to get there quickly and where the respective staff members usually hang out. Get a handle on the nursing station and key staff on the floor/unit. You should have a vague sense of the different job titles and functions.

Your goals during third and fourth year expand a bit. Grades are still important, but learning how to take care of patients is really the top priority. If your focus is to always provide the best care of your assigned patient, the learning and grades should fall into place (with hard work and effort, of course).

You will probably have one or perhaps two patients at a time while on the wards. Those patients are also cared for by an intern, primarily. You should try to take ownership for your assigned patients as much as possible without stepping on the intern’s toes. You should know darn near everything there is to know about your patients, which can be a challenge when you are “sharing” with an intern. The intern will be writing orders, getting study results, doing procedures, and making calls of behalf of the patient at lightning speed. Many things will be happening that you never know about until they are old news. The intern will move faster than you (get used to it), especially when you are new to the clinical years.

  • DO NOT slow the interns/residents down
  • DO care for your patient whenever possible
  • DO assist/perform as many procedures as possible (IVs, central lines, arthrocenteses, paracenteses, etc.)
  • DO get all labs/study results as soon as they are ready
  • DO personally experience all interesting physical findings (your patient or not)
  • DO ask the senior resident/fellow general questions
  • DO ask the intern questions about your patient (that you cannot find out yourself)
  • DO NOT switch these last two items. In other words, DO NOT pimp the intern and DO NOT ask the resident/fellow about lab results

Also make sure that you know how to present patients. This skill will serve you for the rest of your career and it will be used to determine your clinical grade. Medical students like to include everything in the H&P during the presentation. This is painful for the attending and the team. Alternatively, if you do not mention the pertinent negatives along with pertinent positives, your attending will wonder what was omitted. Perfect patient presentation is not something you can do right away—however you can certainly practice it. Listen carefully to everyone that presents patients. What causes the attending to interrupt? What causes the attending to zone out or look exasperated? What questions does the attending ask and when? Adjust and improve your presentation accordingly.

Some attendings are impossible to please and are maliciously rude—the so-called malignant attendings. These unique individuals need to be taken with a respectful grain of salt. It is the (bad) luck of the draw if you find yourself with one of these attendings. If you do, keep in mind that 1) your rotation will be over in a few days/weeks 2) what the attending wants, the attending gets 3) your performance in the clinical years and in your career will be based on the input and training of hundreds of doctors (and patients). Do not let a few malignant attendings spoil your clinical experience. Simply cater to their capricious whims for a few weeks and write an appropriate review once the grades are submitted. Malignant attendings are a sad fact of life, but over time they seem to get relieved of most teaching responsibilities, which was probably their goal anyway.

Recommended Books for third and fourth years

  • First Aid for the USMLE Step 1 and 2 by Tao Le and Vikas Bhushan
  • Maxwell Quick Medical Reference by Robert W. Maxwell
  • Tarascon Pocket Pharmocopeia by Steven M. Green
  • Blueprints Obstetrics and Gynecology by Aaron B. Caughey
  • Step up to Medicine by Elizabeth A. Darby
  • Surgical Recall by Lorne Blackbourne

These are just some tips to use during your journey in medical school. Don’t be discouraged throughout your first two years of medical school and patiently wade through the massive amounts of material. Learn as much as you can in during your third and fourth years and do not become discouraged if you encounter a malignant attending. Best of luck on your medical school journey!

Dr. Lisabetta Divita is a physician, medical writer/editor and premedical student mentor.

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Comments

  1. Maiden says:

    Thank you very much Dr. Divita. This is a great eye-opening piece for all pre-medical students.

  2. Justin says:

    Very well written, realistic, honest. Thank you Dr. Divita.

  3. Gabe says:

    First Aid for the USMLE Step 1 should be a required MS1/MS2 book IMO.

  4. hermione khan says:

    It is a very informative article for both medical as well as premedical students. Thank you Dr. Divita.

  5. Kirsten says:

    Thankyou, Dr. Davita!
    To a Freshman undergrad, this is very helpful.

  6. jasmine says:

    thank you dr..
    do writes more!!

  7. Sylvanthus says:

    One thing that a lot of people seem to leave out when giving advice about medical school is how to cope with no longer being the “best.” Most medical students are used to be the top people in their coursework in undergrad and it can be a huge shock to find yourself right in the middle of the pack in medical school. I think people need to come to terms with that earlier rather than later or they can become burned out very very quickly in medical school. I would love to see someone include this in their advice sometime.

    1. amal says:

      Thankss for the advice but i have read it quite late as i am dejected after joing med school andam completely isolated infact i was a bright student in college..ur comment was.a good.relief.thanks again..

  8. Dr. D says:

    thank you guys! I’m glad you find this article very informative!! This is the truth about surviving med school that you don’t really find out til you’re there! Some people liken med school to a war zone—maybe, that’s a bit dramatic. It is a combination of challenges and obstacles though but well worth it!

  9. Shamim says:

    I really enjoyed reading this well-written article and thank you for the book recommendations. Thanks again Dr. Divita

  10. Dr. D says:

    @Sylvanthus

    thanks for your input and bringing up that point. I agree—the transition (of now) being the little fish in a big pond is apparent in med school. THis is like life though. You may be the best at something, but there is always someone that may be considered “better”.

    I think it’s important for med students to realize that it is NOT the end of the world if you don’t honor every single class(kudos if you do). Passing is crucial to survival. period.

    Now, the transition of thought in med school should be to do as best as you can in your classes (pass, high pass/honor…what you are capable of personally achieving…) so that you can learn the best you can for your future patients. Yes, it is a shock to go from top to middle but don’t stress out. If you’re passing, you’re fine. Rotation grades are more important for residency than the basic sciences, at least in my experience.

    I hope this helps!

    Dr. D

  11. mandi moore says:

    thanks so much doctor these are very precious advices i was very confused at the begining of the first year in the medical school but now i know what should i do thanks so much again

  12. Dr. D says:

    @M. Moore

    No problem!

    Dr. D

  13. Chris says:

    Thank you very much for this article Dr. Divita. I am a pre-medical student and it seems that just by reading your article it has given me a lot of insight of what to expect, and how to deal with medical school.

    Sylvanthus,
    I completely agree. Some people are so self-conscious of their performance, they lose sight of what’s truly important; which is, just passing the classes and getting through medical school! If it causes them to do poorly then all of the hard work that was done in undergrad is almost wasted because they are discouraged over someone performing better. It’s just how life works!

    Once again, thank you very much for the article Dr. Divita.

  14. Gysele says:

    Thank you so much, this helps alot!! Just one question, how much time do you get to yourself as a med student? I am still debating whether med school is right for me or not. I love medicine, but don’t know if I want to dedicate my entire life towards it.

  15. buddhi says:

    thanks a lot ,dr.divita!this is really helpful!!!my third year clinical sessions are to begin next month.you provided me with a good base for my future.tank you for it,again.my reading this site is accidental,thus i feel ,i’m really fortunate & i’ll be really successful in my clinical years.dr.,can you give me an idea ,as how ,we , medical students who have just finished pre-clinical years, should get ready for our clinical years?

  16. Jack says:

    Thank you very much Dr. Divita. I am agree with all of that you said.
    But regarding the books, “Maxwell Quick Medical Reference” is very old and not uptodate. A new book came in 2009 that is more advance. “EZ Pass Clinical rotation”. http://www.amazon.com/gp/product/1615844457?ie=UTF8&tag=wholehogbookstor&linkCode=as2&camp=1789&creative=390957&creativeASIN=1615844457

  17. Sam says:

    Dr. D, I came across your article tonight and I have to say that it is exactly what I was expecting to read and discover about Med school. theres a reason its the hardest thing to do. I have tw questions for you.

    First question, how can I be sure that Med school is the right way for me to go? I have been stuck in my mind thinking about this all year. I am extremely nervous about it since I tried out many different college courses and the only field that interests me at all is the medical field.

    Second question, what is a good major to declare? I have a friend who is an oncologist and he told me to stay away from declaring science as my major and to just do the medical prerequisites for my associate degree and then to declare a seperate major for my bachelor degree that is still not in the science department. This, according to him, will make my application look alot better. My problem is, what do you major in then?

    Thanks ahead of time and please get back to me when you get a chance.

    Sam.

  18. vidushee says:

    useful article

  19. Dean says:

    Thank you so much for this article! i just stumble on it while i was surfing the net, and little did i know that it would be very helpful and motivating!
    God bless you!

  20. mayank says:

    a very wonderful article dr divita…….i am a med student from india and aspire to do my residency in the US …this article gives an insight about how med sculs work in the US.

  21. ahmad says:

    this is very useful 4 me..thenx a lot Dr.D

  22. Solomon says:

    Thank you for sparing your time to write this useful article.

  23. Claudio says:

    Dear Doctor, what a great article. The best word I can use to describe it is ‘clean’. You do not beat around the bush and say things as they are. Though I will be studying medicine in The Netherlands, I have heard similar things for medicine there too. I am sure this is an article that could and should be adapted for any medicine student, not just the American students. I’m glad I got to read this article before starting my studies. Thank you !

  24. vasundra says:

    very useful to all medical students.thanks

  25. SRP says:

    Gr8 article, precise n indepth 2 reality !!! Plz continue d goodwork n try `bout writing a book, Surely I`ll be d first 2 buy frm India….

  26. kasenga jr says:

    useful article, thanks

  27. Taha Ali says:

    very informative…..made me more relaxed , just what i need….thank u !!
    hope this helps as i go through Med School in UAE

  28. Jesse says:

    After withdrawing from PA school I see that all of your suggestions seem very useful and realistic. I discovered that my study skills and tips and tricks needed adjusting. But I didn’t realize that since I’d completed a graduate medical education program and I thought I had good study skills. I didn’t realize that they needed some fine tuning until I had the water hose down my throat and like you said it’s a little too late to start changing study habits once you’re in. Also i did not study with groups as much. Now that I’m done, my professors have suggested that the pace of PA school is much too fast for some people because they are trying to slam nearly 4 years of med school into 2, so they have suggested that I try med school. Do you think that it’s reasonable to think that med school would be slightly more manageable pace? I plan to apply to a school again after I hone my study skills but I might consider medical school as well. One of the things that appealed to me about PA school was being completed in a little over 2 years because I have a family. What about med school– since year 3 and 4 are clinical years does the pace taper even slightly?

    1. Jesse says:

      Oh. Let me add that my passing grades were very good, but if I got the slightest bit behind or if I failed an exam and felt my study time for the other classes were effected, I tended to have a repeat failure the next exam or other. my anxxiety level would skyrocket and It was my repeat exam failure that did me in. I was passing all but one course with B+ or higher at withdrawal, but I wasn’t allowed to finish the semester out.

  29. [...] and Study Tips The Student Doctor Network: Tips for Surviving Medical School: Read this article if you want to know some practical ins and outs of the medical studies world. Dr. [...]

  30. Britt says:

    I would LOVE to get copies of old tests, but the instructors at my school don’t provide them, and exams are never handed back, so high-up students never have them. I’m looking for an alternative but nothing is quite as useful as practice tests.

  31. Susana samual says:

    Hellow Dr. I loved ur advice, but i still hv a problem, am second yr student.
    i studied v.hard last year had a v.good result but nw i have a problem,now zis yr i stopped doing zt(studing hard)… I tried many times 2 b as i was last year but it never worked.
    Pls… Dr. Tell me wat i should do, i am on red light here. I beg u:'(

  32. Harold says:

    She whole shebang for urban center University London but a flimsy uptick for
    increased marketing pass, as reflected in tests in California.

    Goldman trimmed its prey terms to 195p but gave the one of which – the prompting he was in Britain
    illegally – stuck. That’s all I knew more or less around a sector, At that place are many choices available.

  33. Flames says:

    I am about to take exam to enter medical school dis yr nd i know dt my GOD is always there for me,i must enter mbbs college dis yr in JESUS NAME,AMEN.

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