This fall, about 20,000 Americans — mostly young people, fresh out of undergraduate programs, and others with a bit of life experience and families to balance — will begin their first year of medical school.
I remember, clear as a bell, how I felt during my first day at med school.
A blend of emotions — overwhelming, at times. I had deferred admission for a year so that I could do volunteer work in Peru and see the world before jumping back into the whirlwind of education. Nervous. Determined. Panicked. Passionate.
And while it’s been a few years since I tossed my graduation cap in the air and added a couple extra letters behind my name, I remember that feeling, too. Vividly.
Becoming a physician is not easy. Being a physician is not easy, either.
There are a lot of misconceptions about what a doctor’s “lifestyle” looks like. Fun TV shows like Grey’s Anatomy and Scrubs depict a world of romance, intrigue, exotic cocktails with your colleagues to celebrate a successful surgery, celebrity clients, and money flowing easily.
The reality is starkly different.
Sure, most physicians make decent salaries, but I wouldn’t want to calculate the hourly rate. And many young doctors are saddled with crippling student loan debt, some over $250,000.
The hours are long. The patients are sick. The rewards are great, but so are the sacrifices.
But I’m not writing this to complain, or to frighten anyone. My real purpose in writing this open letter to med school students, everywhere, is to honor you.
I honor you for choosing such a demanding, but meaningful career. And I’d like to offer the following advice, which likely applies to most other types of students too.
1. It’s tough, but you can do it. Doctors are made, not born, and some liken school to a pressure-cooker. For the first time in your life perhaps, there will be so much that you don’t know. You will be confused, as you are learning several new languages at once. You will doubt your intelligence and abilities. But one day at a time, you show up and engage and do the work to the best of your ability, and you will succeed.
2. Do it your way. Figure out how you best study and process the work flow. Library, coffee shops, lectures, books, highlighters, sticky notes, flow charts…find your own best way. Our entire med class took turns taking notes for lectures, and most of us studied from these. Study groups work for some people, if the other members are focused and efficient. Try not to compare and stress when your colleague has read the microbiology textbook twice. It’s what you retain, not how many words your eyeballs looked at.
3. Be curious. The first two years are usually book and lecture based, but there is usually one class that introduces you to patient care so that you remember why you enrolled: to help others. Talk to your patients. They say that 90% of the diagnosis comes from clues that patients give you when you ask good questions. Also ask them how it feels to be a patient. You will gain empathy from seeing things through their eyes and learn important communication skills.
One of my favorite patients in medical school was a tiny elderly man who came in with dangerously high blood pressure. He also had low potassium. I learned that he was a retired jockey, and still worked with horses. He also chewed a lot of tobacco, a licorice-flavored brand. It turned out that the licorice flavoring caused his body to lose potassium and this caused his blood pressure to rise. Everyone has interesting life stories, and some impact their reason for needing care. Your job is to learn from these stories, in medicine and in life.
4. Get to know faculty in your field of interest. Everyone needs to know the basics, but if you already have an idea that you want to deliver babies, or be an orthopedic doctor, or do dermatology, or ENT, seek out extra learning opportunities. You might get to help with a research project or receive invaluable advice for your future career.
5. Be open. You might think you know what you want to do, but be open to changing your mind. One of my favorite classmates was a 40-year-old man with six kids. He was already a successful dentist, but wanted the MD degree as well to expand his practice to oral surgery. He lived in a dorm during the week and went back home 250 miles away on weekends when he wasn’t on call. Over the course of medical school, he changed his mind, became an OB/Gyn doctor and went on to deliver many babies. As he was a father to six, I thought this was the perfect career choice for him!
6. Pace yourself. They say that medical school is like trying to take a drink from a fire hose. Try to balance and do some productive study and work each day. Cramming is hard on the brain and not very effective for retention. Create an organized study ritual that sets you up for success.
7. Be humble. Every good doctor knows that you can learn a lot from an experienced nurse, lab or X-ray tech. It’s a healthcare team, so play with respect and they will likely save you from making mistakes. Everyone wins, especially the patient.
8. Be assertive and muster up some confidence as best you can. This is no time to be a wallflower. You have to be an active participant in your education. Ask to do procedures. Ask many questions, as attending doctors usually love to teach. Volunteer to answer questions too, and do it with gusto and enthusiasm. Dare to be wrong. Women struggle with this, and rarely raise their hands unless that are 90% confident but most men will give it a 50/50 shot at the answer.
Enjoy your studies. Work hard. But don’t forget to rest, play, and breathe. You need some medical friends, to share the experiences and stresses of med school, but you also need some friends from the real world.
Remember: in order to be the best doctor you can possibly be, you must take care of your own health and well-being. Plan healthy meals, don’t make caffeine your only beverage, and get some exercise. An exhausted, unhappy, resentful doctor isn’t helpful or inspiring to patients. In fact, you’re more likely to make dangerous mistakes.
Take good care of yourself. Lead by example. And you won’t just be a great physician — you’ll be a great human being and role model, too.
Congratulations! I’m rooting for you.
~ Dr. Sue