Two years of med school have come and gone, and as I hit the hospital tomorrow I thought it was appropriate to stop and take stock of what has happened since matriculation. It is a great feeling to be done with "class". Personally being done with the classroom is an exciting milestone in my education, I like to think that I'm never going to back to the classroom. Through my post-bac program and two years med school (age 26-30), it seemed as though I would never get out of the deathgrip of the classroom theoretical and lecture (picture the difference between reading books on flight and actually opening the throttle on the runway). I like to think that from this point forward the life long learning will be done in the framework of the practical- and real life. Finally, I get to practice a skill in the world, I couldn't be more eager. Looking back on all my big plans and ideas one central theme has become very apparent - there was a wide gulf between what I hoped to accomplish and what was accomplished. Still, a lot got done. Here are some of the key lessons and insights I have gained regarding med school- things that worked, things that didn't, things I'm glad I did, things I wish I would have.
The underlying assumption directing my conduct in the first two years was, "Given that our classes are graded as pass/fail the only reliable marker of preclinical knowledge used by residency directors to discriminate candidates will be the USMLE Step 1 performance." Moving forward from this, all my activities revolved around trying to score high. So right from the first day I read all that was assigned, always, and until the very last day of class. And right from the first day I never missed a day of class, never, and was front and center in lecture. However what I didn't anticipate was twofold
-the shear amount of medical knowledge is completely and totally overwhelming.
-the difference between what was being taught and what was on the step 1 was substantial
This first point is best illustrated by a simple algebraic word problem.
Person X has to approximately 35,000 facts to learn. Person X has two years in which to do it. Given that completing this task would require an average fact acquisition rate of 96 facts per day for two years duration, what should person X do when they realize that at best they could only learn 0.5k (where k is the minimum necessary fact acquisition rate)? Next, how should person X differentiate which facts belong to the set of 35,000 necessary facts when, over two years duration they are presented with a >250,000 fact pool? Finally, how the hell should person X remember all those facts?
Evenso, I loved every minute of it. I gladly traded in my social life. I gladly pawned my outside interest reading. I sold my weekends to the first bidder, so that I had time to spend sorting through all these facts.
But...
I would have shadowed more, I would have gotten more involved in the hospital during those years. I shadowed only neurology and emergency medicine to any significant extent, that was to my detriment.
Also - I would have studied in pairs, or three at the most, not solo. Sometimes it got lonely, and I missed many things that other eyes don't, and I go slower than if other people were there. But - you have to police the screwing around and distraction with groups.
Specifically - I would have bought a subscription to usmle world qbank step1 right on the first day of med school and started doing board style questions. 25 here, 25 there, it adds up, and this addition would have by increased repetition greatly eased the task of rote memorization that was to occur later the following year in pathophysiology. Also this would have focused my studying because too much time was used sub-optimally during first year addressing obscure science that is central only to the researcher and could easily be referenced when needed. As it turned out -the lead up to the boards was slightly tight, even for me the unequivocally non cramming ramper-umper timeline dependent studier.
Thus going forward to third year, I'm getting a jumpstart on step2 by starting the qbank well well well in advance of test day. As well the qbank will double help me on shelf exams and hammer home clinical management.
Other points
-I had the opportunity to travel internationally with friends, that was the right decision, and money well spent.
-Summer of first year I returned home to Rockford, IL to spend time w/family & old friends, learn to fly, and garden. I maybe should have pursued other options - hearing stories of a number of classmates who traveled to Africa and beyond makes me go hmmmm. I would need to return to flying and get my license in order to have made that summer worthwhile.
-I didn't spend the time to write about valuable experiences much beyond the first few months of first year. I never found the time to write. Instead I would put reading and studying marginally yielding subject matter before archiving my experiences. This was a major mistake. Going into third year, much learning will happen on my feet, so I'm going to do a better job of jotting down the medical wisdom that is thrown my way.
- Playing rugby was a lot fun, good decision. However, I sprained my knee in the second to last game of this past season, reminded me that getting older, it is more important at this point to be injury free- makes me think maybe more squash and basketball next year.
- Being in Bard Hall Players theatre group and having the med school band Sister Chromatid was a lot of fun, lots of time but many good friends, good decision.
ok enough for now.
