The Preclinical Years
One of my biggest questions as a premedical student was wondering what the first half of medical school would be like, specifically in comparison to undergraduate courses. The most common analogy I heard was that learning in medical school was “like drinking from a firehose” and that was just terrifying and obviously sounded impossible. Based on the fear of the unknown, I tended to conceptualize medical students as these super-humans who must have much more advanced study skills than I had. Now that the first 2 years of medical school are behind me (which is still a very surreal feeling), I’d like to share my thoughts on how the didactic/lecture-based portion compares to undergraduate classes. I hope this post helps premedical students feel a little less scared than I did!
Is learning in medical school really like “trying to drink from a firehose?”
The short answer to this question is no, because that is a physically impossible task. However, I definitely understand why this analogy continues to be used because there were absolutely multiple times during the first months of school when I felt this way. The difficult part of the information in medical school isn’t usually the actual content, it’s the sheer amount you have to get through with each exam. And to be honest, there definitely is a component of impossibility, because it is not feasible to memorize every single detail of every body system as you go through for the first time. The content itself is similar in difficulty to mid to upper level science classes from undergraduate coursework, but the fast pace definitely feels comparable to a firehose much of the time.
One way I try to quantify the pace is to consider the topic of immunology. I didn’t take the course in undergrad, but immunology tends to be a 15 week / 1 semester course. In my medical school curriculum, we get through the entire topic of immunology in 2 weeks, and are also responsible for learning clinical correlations that aren’t typically included in undergraduate immunology.
I wish I could remember exactly who it was that said this to me, but in a medical student panel at a PhiDE meeting someone shared an analogy that I like much better than the firehose one. They were commenting on the fact that the most important and often most difficult part of studying in the first half of medical school is keeping up and being consistent in studying each day and each week. They said something along the lines of medical school studying being comparable to having to eat 3 large fluffy pancakes with lots of syrup every single day. Some days it’s not bad, but if you take a few days off in a row and you suddenly have 15 pancakes to eat that day, it can be difficult to get through. I think this analogy is better because it’s physically possible, but helps you start to picture how difficult it can be to keep pushing through each day.
Something that I didn’t fully realize as I went through the preclinical years was that learning this information for the first time is just the first of many more passes that you will take to build your medical knowledge, and the first pass is the most difficult as you’re really trying to learn a new language. You’ll learn as much as you can during the first 18-24 months of medical school, but then you’ll review it all again and gain an even better understanding during Step 1 studying, and in your clinical years and beyond as you apply this information to patient care you’ll continue to review and build on this foundation.
“Be comfortable being uncomfortable”
– Peter McWilliams
One of the most difficult things for me to adjust to was never really feeling caught up with the information, or often feeling as if I was behind in my study schedule or behind my peers in understanding the information. Another factor that adds to this discomfort is that you have much more frequent exams in medical school compared to undergrad. I believe most medical students experience intermittent anxiety and discomfort about keeping up with the fast pace, even if we don’t talk about it openly, and it’s just an inevitable part of the process. You eventually get more used to “being uncomfortable”, but for me it still causes intermittent increases in anxiety when I think of how much studying and experience I have between where I am now to being the physician I hope to be in the not-so-distant future. I think the best thing for this discomfort is to try to take things one step at a time and ask for advice and lean on those ahead of you in the journey.
Weekly Schedule
Your weekly schedule will vary depending on your medical school curriculum. If you have the opportunity to interview at multiple medical schools, definitely try to find out how their curriculums are different especially in the day-to-day schedules. For us, we had about 30 hours of the week in lecture or problem-based-learning, as well as 4 hours of clinic time in a primary care setting.
Most premedical students have extremely busy schedules that includes classes, volunteering, extracurricular activities, research, work, etc. In medical school, you still have extracurricular activities, but the time commitment is usually much less than in college. Overall, you have more “free time” or more control of your time in medical school, but that time is primarily filled with studying.
Skills from undergraduate years
Whether you continue to study the same way you did in undergrad when you’re in medical school will vary for each person. For me personally, I always found color-coding my notes helpful in undergrad, and in medical school I’ve continued this. (For example- drugs were orange, bugs were green, labs/diagnostic studies were blue, etc.) However, in undergrad I tended to take very detailed notes when I’d read textbook chapters, but due to the speed of medical school I was not able to do that consistently any more. My advice in terms of study skills is to start with what is familiar to you, but don’t be afraid to try out new methods, and also expect to have to switch up your methods depending on the subject.
One of the most important things you can work on now that will absolutely help you in medical school is dedicating time to your mental and physical health. Figure out what activities help you feel grounded, energized, and feel like a whole-person rather than just a student, and start integrating those activities into your daily life as soon as possible and as often as possible. Whether it’s cardio, weight lifting, dancing, yoga, walking, reading, meditation, or anything else, start making time for yourself now so it’s an established habit by the time you’re starting medical school. For me, spending time with my dog has always been my wellness, and I’ve also started enjoying workout classes. That being said, don’t make your wellness a source of stress. Be patient with yourself now and in the future, and know that everyone will wax and wane on how successfully they integrate their wellness into their schedules.
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The most important message I’d like to portray in regards to the preclinical years of medical school is that anyone who is passionate enough to be on this path towards becoming a physician WILL make it through, and everyone’s journey will be unique. Medical students are not super-humans in a different category from premedical students, we are people just like you who are just passionate enough about becoming a physician to keep pushing forward each day and each year. We also face a lot more struggles and setbacks than you’re likely to see on social media or hear openly discussed. People often say to me “you must be so smart, you’re in medical school!” but I disagree. It’s not some type of intelligence that helps us succeed, just being passionate enough about becoming a doctor that you keep drinking from the firehose, keep eating those pancakes, keep moving forward one step at a time.