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Paving the Road to Medical School

The path to becoming a doctor can feel daunting. For those of us that don’t come from a medical family, it can be challenging to navigate what all you need to do to be a competitive candidate. As a third year psychiatry resident looking back on my pre-med days, I realize just how lost-in-the-woods I felt at times trying to figure out how to get where I wanted to go. Here are half a dozen steps you can take to help pave the way to medical school. 
1. Study hard, get good grades, do well on tests: Yeah, I know, this seems dumb and obvious. While grades and test scores won’t get you into med school they will keep you out, or at least create a significant barrier to overcome. Some of the medicine pre-reqs can feel simultaneously difficult and pointless – Organic Chemistry, for example. Who cares whether that’s a double bond or a single? What does it have to do with medicine? Honestly, beyond understanding enantiomers, I can’t say O Chem has proved incredibly relevant in medical school or now as a resident. However, here’s the thing: A lot of med school is studying what can feel like pretty inane drivel – it’s important, no doubt, but doesn’t always feel that way. The tenacity that gets you through O Chem, is the same dogged persistence that will get you through the hours of studying required for your board exams. Don’t like exams? Don’t do well on tests? There are some med schools out there who do no tests the first two years, but, for most, getting through med school, taking your USMLEs, and finally board certification is a lot of exams. If this is going to make you miserable, think about your career choice. Yes, med school is temporary, and eventually you get to the point where you only need to re-certify every decade, but getting there is a lot of studying and tests.
2. Do some research (and it doesn’t have to be about medicine): Whether in the form of careful observation at bedside or multicenter randomized controlled trials, medicine is built upon a bedrock of science. Having a good founding in the research process is likely going to make you a better clinician, or at least a stronger candidate to medical school. Some people can find relevant, cutting-edge medical research to jump into during their undergraduate years. Most of us cannot. Your research doesn’t have to be related to medicine or have a clinical application. In psychiatry, we say there is both process and content, and this is a case where process is most important. Find a lab where you can dive in head-first to whatever they are doing and learn how it is done. Understand the bigger picture, not just your role in what is going on. And don’t sweat if you aren’t curing cancer. My main research prior to med school was on a sex determination in a wasp. I still can’t make it sound applicable without a lot of hand waving.
3. Shadow with a critical eye: Medicine is weird–you have to believe you want to go into it for years before you actually get a true taste of what it means to be a doctors while in medical school and residency. We give a lot of lip service to shadowing to help you get a grasp of whether medicine is right for you. However, even in the best of circumstances, shadowing is like deciding to be a pilot after flying economy class on a few intercontinental flights. It sounds like a good idea, you like to watch the clouds below, but you have no actual idea of what it is like to sit in the pilot’s seat. And before med school you are unlikely to do much more than peek in the cockpit as you board, getting a quick glance at the controls. However, you can get worthwhile information out of shadowing. Watch how the team works together, the various roles. Try to get a sense of the full spectrum of duties for the physician. Also, remember, you are seeing just one tiny piece of medicine–different specialties vary widely. I decided to go to med school while shadowing CT surgeons–they were caring, compassionate people fully engaged in their work and the atmosphere in the OR was collegial. Now I’m a psychiatrist. Go figure.
4. Get creative about getting experience: Shadowing in the medical field has its limitations, mostly restricting you to watching at arms length. Get involved in something related to healthcare that actually gives you an active role. One of my favorite pre-med activities was volunteering at a therapeutic riding center and helping with a dental sealant day for low-income children. Also, don’t be afraid to try something and leave (politely, professionally) if it isn’t providing what you need. I volunteered at a low-income clinic, which sounded perfect, except all I did was move around patient charts. I could alphabetize with the best of them, but it wasn’t telling me anything about whether I was actually interested in healthcare or helping me to build relationships with those in the field–it was just reinforcing that I didn’t want to be a secretary.
5. Seek out mentors: These can be people you meet through your research, shadowing, volunteer work or other academic pursuits. You don’t need one mentor that knows everything; multiple mentors with various areas of interest and expertise can provide a range of advice and perspectives. Mentors with whom you have a long term relationship can also provide letters of reference. Personally, I had two main mentors, one for research and one who was both a professor I took multiple classes form (O Chem, of all things) and also the pre-med advisor.
6. Learn to take care of yourself: This is a marathon, not a sprint. Getting into med school is hard, doing med school is hard, residency is hard, being an attending. . . well, you get the pattern. There are high rates of burnout throughout the process. Each person hits their own bumps in the road; we all do. Things get stressful, work piles up, and we can lose ourselves in a sea of expectations. Learn to take a deep breathe, a step back, and take time for yourself when you need it. You can’t simply always work harder. No one can give their all 100% of the time. Learn when you need to take a break and recharge–and what that consists of. I’ve felt burnt out at some point at each step along the way. I’ve learned what that looks and feels like for me–being more withdrawn and anxious, having trouble sleeping, finding my colleagues really annoying, being irritated by patients. And I’ve learned what I need to do when it happens–walk my dogs, spend some time with non-medical people, get out of the city, talk to friends about how I’m feeling. It has served me well thus far–I’m ending R2 year with three weeks of night float and feeling shockingly not burnt out.

M
Megan Riddle, MD PhD, is a psychiatry resident at the University of Washington. She is a graduate of the Weill Cornell/Rockefeller/Sloan-Kettering Tri-Institutional MD-PhD Program. Megan Riddle, MD PhD, is a psychiatry resident at the University of Washington. She is a graduate of the Weill Cornell/Rockefeller/Sloan-Kettering Tri...