Tips for Medical School: Things I Wish I Knew Before and During Medical School

Congratulations! You made it into medical school. All the hard work you put into your undergraduate classes, countless volunteer and shadowing hours, and research have finally paid off. Oh, and I almost forgot to mention the dreaded MCAT! Wow, that was awful, wasn’t it? But now you’ve been accepted into medical school, and your dreams of becoming a doctor are becoming a reality. This is such an exciting time, so definitely give yourself a pat on the back and be proud of yourself—you are one of the few who make it into medical school.

Now, on to the exciting and more challenging part: medical school! There are so many things I wish I had known before and during medical school, so I want to share some tips and advice with you. Ideally, this is meant to help you before you start medical school, but it can also be useful throughout each year of your journey. Please remember that this blog is solely a matter of opinion, so take it with a grain of salt. My goal is not to stress you out but to prepare you and provide answers to questions I never had.

The Purpose of Medical School

For most of medical school, I thought the purpose was to absorb as much information as possible, gain hands-on experience in the hospital, explore different specialties, network with various doctors, and pass my exams. This could not be further from the truth. The primary purpose of medical school is to match into a residency program. It’s hard to focus on this when you’re just starting out, excited about making it and learning fascinating science. However, looking back now that I’m in residency, I realize that matching into residency was truly the main goal of medical school.

As crazy as it sounds, if you do not match into a residency program, then medical school was nothing but an extremely expensive four years of your life. Nothing about medical school matters if you do not match into residency. You cannot obtain a license to practice without at least one year of residency in most states. Focusing on matching into residency as early as possible is key to ensuring your success in the match process. In this blog, we will dive deeper into this important point.

The Timeline of Medical School

For most of medical school, I always thought I would have more time later to work on research and extracurricular activities, and that the first year or two would be solely focused on studying and excelling in quizzes and tests. This is also false. Now that I have finished medical school, I can provide insight into how the process actually works. Here is a reverse timeline that I think is more helpful for understanding medical school:

• 4th Year (End of September): ERAS applications are due, and programs can view your applications. This means all your research, extracurricular activities, and letters of recommendation need to be complete by this time. Sub-internships (where you work as much as the interns) occur in the months leading up to this deadline.
• 3rd Year: This is when all the clinical rotations begin, and you are in the hospital for a significant portion of the week. Additionally, you must study outside of work to prepare for the SHELF exams, which occur at the end of each rotation. After the third year, most students take Step 2.
• 1st and 2nd Year: These are the pre-clinical years, where most of your time is spent studying and attending classes.

I emphasize this timeline because you won’t have much time during the third or fourth years of medical school to enhance your residency application. This was a shock to me because I kept postponing research, thinking the schedule would lighten up and I would have time to do it. The most time you will have to improve your residency application through research and extracurricular activities is during the first two years of medical school. I had absolutely no idea of this until my third year, when I was wishing I had done more in the first two years. If you can complete most of your research and extracurriculars before the third year, the clinical years will be much less stressful, allowing you to focus on studying for the SHELF exams and Step 2.

My Thoughts on the STEP Exams

Step 1 is now pass/fail, which makes my points even more important. Now that all you need to do is pass Step 1, schools will place more emphasis on Step 2 and extracurricular activities. This makes it even more crucial to complete your research and extracurriculars within the first two years, so you can dedicate your time in the third year to studying for the SHELF and Step 2 exams. I had many classmates who did reasonably well on Step 1 and excelled on Step 2, so I do not believe that performance on one predicts performance on the other. Obviously, it is imperative to pass Step 1 on the first try, but being able to dedicate more time to research and extracurriculars can greatly enhance your residency application.

My Thoughts on Research and Extracurriculars

As I mentioned earlier, early engagement is key. The most time you will have during medical school to work on research and extracurriculars is during the first two years. I cannot stress this enough; I really wish I had understood this concept earlier. Another important point is that your research does not have to be in the specialty you eventually pursue. Most of the medical students I know entered a specialty completely different from what they originally thought or did research in. I did not decide on Diagnostic Radiology until the middle of my third year, and I did not have any research in the field when I applied.

When considering research, reach out to attendings who are known for producing research with a reasonably quick turnaround. The last thing you want is to be on a project that takes more than the four years you are in medical school. Contact multiple attendings and upper-level medical students or residents to ask who would be good to join for research projects. Additionally, try to present your research whenever possible.

My Thoughts on Away Rotations

At the start of your fourth year, you will have to complete sub-internships or away rotations in the specialty you are applying to. For some specialties, like Emergency Medicine and most surgical fields, these rotations are required, while for others, like Diagnostic Radiology, they may be optional. My advice is to absolutely do away rotations if they are somewhat optional in your specialty. Away rotations help you build connections, see what other programs offer that you might not experience during interviews, and experience living in a different city for a month. Another reason to do away rotations is that it demonstrates your willingness to move to a different geographical location.

One of my biggest regrets was not doing away rotations. My roommate did away rotations, and interviewers at different programs would ask about certain attendings because they had all gone to school together back in the day! Try to do an away rotation at a school you would like to attend and one at a top-ranked institution you can get into. For those who know they have to do away rotations, make sure you have your application ready by midway through the third year. The applications for away rotations open in February of your third year, so have your letter of recommendation and application ready since it operates on a first-come, first-served basis.

Wrapping Up

I wish you the best on your journey through medical school. It is an awesome experience, and I want to see you all match into the residency of your dreams. Again, I want to emphasize that the most time you will have during medical school to enhance your residency applications is during the first two years. The whole purpose of medical school is to match into residency, so celebrate that you made it into medical school, take some time to settle into the routine of studying, and then buckle down and start working. The second half of the fourth year is essentially time off, so do not worry—you will have time to rest before residency. As time goes on, I will continue to write blogs about different topics that I think would have been helpful to know when I was in medical school. In the meantime, feel free to reach out to me with any comments, questions, or funny memes about medical school and residency.