What is Medical School?

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What is Medical School?

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Everything You Wanted to Know, but Too Afraid to Ask

If you’ve made it to this page, you’re probably a high school or a college student looking to learn more about what medical school ACTUALLY is. What do you learn? When do you get to be in the hospitals? When do you start working with patients?

Medical school is an MD or DO program that, at its core, is designed to give you the foundation to be a physician within any specialty. That ranges from family medicine, to neurosurgery, to psychiatry. While these may seem widely different, the inter-connection between several organ systems, the effects of drug mechanisms, and warning signs for potentially consequential diseases are something that every physician needs to know. The body works in tandem, holistically if you will. Medical school gives you that background, that foundation, and the experiences to hopefully send you on the specialty path that is best for you.

Layout of Medical School

There are various types of medical school programs. Most schools follow a 2+2 format (2 years of pre-clinicals, 2 years of clinicals), but some schools go with a 1.5+2.5 format. Others may have other variations, but this post will cover the most general setup for a basic, 2+2 style medical school program.

Pre-Clinical Years in Medical School

The first two years are coined the “pre-clinical years”. For the most part, these are when you go to class, listen to lecture, and then study for your upcoming exams (which can vary from every 2 weeks, to even every 3 months). Your entire goal here is to learn everything and anything thrown at you. You’ll find yourself immersed in the subjects of:

  • Biochemistry
  • Immunology
  • Pharmacology
  • Genetics
  • Physiology
  • Pathology
  • Anatomy
  • Histology
  • OMT (if you’re at a DO school)

Some schools have some variation in how these subjects are taught, but you will one way or another learn these topics in the lens of the different organ systems (cardiology, pulmonary, musculoskeletal, etc.). Some schools will focus on the organ systems (organ-based curriculum) and others will focus on the subjects (subject-based curriculums). It appears more schools are starting to lean into the organ-based curriculums that integrate all the different subjects but there’s no standardized method. In many ways, this is typically the answer people think of when someone is asked “what is medical school”? 

What is Medical School?: More on the Preclinical Years

In fact, not every curriculum has lectures (what!?). While traditional curriculums with lectures are where most students go, many schools have added the option for Problem-Based Learning, where you work with your peers to learn the subject matter. This comes through the form of patient cases, readings, and presentations. For those who are self-motivated and don’t like the structure of lectures, PBL is a great opportunity.

To cap it all off, you have your first of three board exams at the end of second year: Step 1/Level 1 (MD/DO respectively). These are 8-9 hour exams that are the culmination of everything you covered in the first two years of medical school. It’s a beast of an exam, but with proper mindset, it’s definitely doable.

Additionally, medical schools also have a variation of a “clinical skills” course where you learn how to take a patient history, write notes, and think of an assessment and plan. Basically, its meant to prepare you for clinical years, which is what your 3rd and 4th years are all about.

The Clinical Years of Medical School

Your 3rd and 4th years are all about going into the hospital and learning to think like a doctor. While some schools give you exposure even earlier on, this is the time when you do all your rotations in the different specialties.

Third year is when everyone will rotate through their cores, which usually entail:

  • Family Medicine
  • Internal Medicine
  • Surgery
  • Pediatrics
  • Psychiatry
  • Ob/Gyn
  • ICU
  • Emergency Medicine
  • OMT (for DO schools)

Again, requirements will vary by schools, but these usually are the core rotations every student will have to go through. The goal through third year is to learn how to talk to patients, obtain and assess history, and develop a differential diagnosis and somewhat of a plan in addition to getting exposure to different fields to help you decide your future goals.

To cap it all off, you have your first of three board exams at the end of second year: Step 1/Level 1 (MD/DO respectively). These are 8-9 hour exams that are the culmination of everything you covered in the first two years of medical school. It’s a beast of an exam, but with proper mindset, it’s definitely doable.

Additionally, medical schools also have a variation of a “clinical skills” course where you learn how to take a patient history, write notes, and think of an assessment and plan. Basically, its meant to prepare you for clinical years, which is what your 3rd and 4th years are all about.

Throughout the year, you still have exams at the end of each rotation (which usually range from 4-12) that you need to study for after you finish your shift at the hospital. The end of third year is when you take the second of the three board exams: Step 2/Level 2. It’s another 8-9 hour beast, but you’ll make it through. But this time, there’s a second part, Step 2 CS/Level 2 PE, which assesses your clinical skills via standardized patient interactions. The pass rate is high, but its a costly exam.

Once you’re done with those (or at least done with third year), you enter the final stage: fourth year! This is the time to do electives in the specialty of your choosing, and auditioning at hospitals with residency programs you want to attend. There’s more freedom for you, but the responsibility of setting up these rotations falls largely on your shoulders. Luckily, for the most part, there are not many exams at this time.

Unfortunately, that stress is replaced by the stress of applications. By September, the general application cycle for residency opens up and all your years of hard work get crunched into an online program that join a pile of thousands of other applications for programs to assess before selecting around 5-40 residents for their programs.

Yeah… it’s stressful.

But that’s the end! Once you make it through that cycle (where 95%+ of people match), you’re home free! Residency starts in July, and 4th year is typically over a few months before that, it’s time to celebrate!

Okay, So What Do I Do Now?

This may seem all so far away, preparing for success starts now. The transition from college to medical school is immense. You’ll probably hear every admissions counselor and advisor tell you it’ll be like trying to drink water out of a fire hose. While the subject matter itself may not always be super complex, its the volume of information that starts to drown people.

I like to compare it to getting a steady stream of pancakes. Everyday, you get 3 pancakes. As long as you eat your 3 pancakes, all is manageable. But slip up one day… and now you have 4 pancakes, and then 6, and then 10, and then all of the sudden you hate pancakes and you wonder why you’re drowning in it. If you ever wondered “what is medical school” think of those pancakes.

I think that’s describes medical school a bit more.

For the most part, it is manageable. It takes time to adjust to the volume and stream, but it is doable as long as you stay on top of your game. The best way to do that, is to develop effective study habits and a strong work ethic now. Those are the two biggest skills that will translate beautifully into medical school. You’ll be eating pancakes like a champion.

Aside from that, feel free to start shadowing different specialties! Unfortunately, some specialties are way more competitive than others, and having an idea early on about what you want to do will help you start preparing your resume/CV early. That means getting the necessary research, aiming for high grades, networking, etc. You can also follow some great blogs to learn more about medical school here!

Final Thoughts From a 4th Year Medical Student

Medical school is tough, no doubt. It’ll hurt at times, and you’ll feel overwhelmed. It’s possible you will have to adjust from being the top of your undergrad class to the bottom of your medical school class. That’s totally okay. You’re in the upper echelon of medical trainees, there always has to be a group of below average… in this case you just might be in the bottom half of the top 2% of students in the country. It happens.

But what’s most important is having a support system throughout this. Friends and family that can support you and remind you there’s more to life than just that exam you’ve been studying for from 8AM – 8PM for. You’ll have to sacrifice a few days out with friends, and a party here and there. That’s the cost of medicine, and having people who understand that is invaluable.

This isn’t to scare you, we’d just rather you have a better idea of what medical school really is. It’s not all flowers and sunshine, but it’s also not all gloom and doom. You’ll have time for your hobbies, to go to the gym, to stay healthy… just so long as you manage your time properly.

It’s a long journey, but not one you have to walk alone.

The Path to Medical School Can Feel Long And Unclear

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