What to Expect in Medical School
What will I learn in medical school?
Many medical schools organize their training into two parts: pre-clinical and clinical. In a traditional four-year curriculum, the pre-clinical phase includes two years of science training when you learn about basic medical concepts, the structure and functions of the body, diseases, diagnoses, and treatment concepts. You’ll also learn the basics of doctoring, such as taking medical histories and other essential competencies. The clinical portion of the training, traditionally the last two years of medical school, involves clinical rotations, during which time you will receive basic instruction and hands-on experience with patients in the major medical specialties. The curriculum varies for each medical school, and some medical schools have a more integrated, multidisciplinary program and begin clinical training and patient interaction during the first week.
Will I be graded?
How students are graded varies from school to school. Some medical schools use a pass/fail system or an honors/pass/fail system, and others use a letter-grading system. There are even some that use a combination of a pass/fail system for the first year or two then switch to another system for the final two years. There are a small number of schools using a competency-based evaluation system that measures student progression in learning a certain set of competencies throughout the course of medical school. Regardless of which approach your school uses, it’s important to keep grades in perspective. Grades do matter in certain instances, but they are only one criteria by which you are evaluated during medical school.
How will I interact with patients?
Traditionally, medical students haven’t had many experiences with patients until their third year, but this is changing. Some schools introduce patient interactions early on (some in the first week!) or may have incoming students receive EMS or EMT certification before the beginning of classes.
Typically, you do clinical rotations, also called clerkships, during the third and fourth year of medical school. Rotations give you first-hand experience working with patients in various specialties under direct supervision of a faculty member, fellow, or resident. The types, number, and length of rotations vary from school to school, but training usually includes clerkships in internal medicine, family medicine, obstetrics and gynaecology, paediatrics, psychiatry, and surgery. Your school may have different requirements. However, in your final year of medical school, you will be given the opportunity to take electives in different specialties and at different institutions according to your interests.
When do I choose a specialty and apply for residency training?
Exploring your future career as a physician begins early in med school, with an ongoing examination of your interests and goals in the practice of medicine along with an exploration of the many specialty options available. Your third-year rotations will give you an opportunity to experience a number of specialties and determine how your interests, values, and skills fit with those specialties. There are also extracurricular opportunities for exploring specialties, such as specialty interest groups and student sections of medical specialty societies.
By the end of the third year, most students have chosen a specialty area (e.g. primary care, surgical care) or patient population (i.e., adults, children, or both) and begin preparing to apply for residency training to support that career direction. If you’re not confident in a career direction, you may choose to take time to complete research, complete a dual degree, gain further clinical experience, or otherwise spend time exploring your career options prior to choosing your specialty and applying for residency.
Choosing your specialty and applying for residency are not solitary activities. Work actively with career advisors at your medical school and find mentors to help guide you.
How do I get licensed to practice medicine?
You’ll start the licensure process during the second year of medical school with the United States Medical Licensing Examination (USMLE) Step 1 exam. Step 1 covers the sciences fundamental to the practice of medicine. The Step 2 exam, which measures clinical knowledge and skills, is usually completed during the third or fourth year of medical school. The final exam for initial licensure, Step 3, occurs during the first or second year of residency training, after you have completed medical school and received your medical degree.
Will my experience be the same at any medical school?
All medical schools share the goal of preparing their students for residency training and practicing medicine, and are required to adhere to national accreditation standards. However, each school has its own specific mission, curriculum, course format, and academic schedule. Before you apply to a school, research that school’s mission statement to see how it aligns with your own goals. Also review the graduation requirements, such as community service, research experience, and specific coursework.
Who can I ask for help if I get overwhelmed?
It’s okay to admit you need help managing the stress that comes with being a med student. In fact, it’s completely normal to reach out to a faculty member, dean, mentor, counselor, or spiritual advisor when you’re feeling overwhelmed. Many medical students often cite the famous analogy that learning in medical school is like trying to drink from a fire hose. It sounds intense, but these same students also speak about learning new study techniques along the way that help them manage time better, integrate new knowledge, and excel as med students. Admitting that something is difficult, but doable, can really improve your outlook.
Rest assured that, yes, as a medical school student you are entering a demanding process, but every successful doctor was in your place at some point. Those anxious feelings are normal, temporary, and manageable.