Medical School 101: The First Two Years

Transitioning into medical school can be both exhilarating and intimidating. It feels like the start of a life-changing experience - and it is. You’ll learn more than you thought possible in an impossibly short period of time. You’ll learn, maybe for the first time ever, what failure feels like. And how to recover from it.

What have I gotten myself into?

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That may be the most important thing any aspiring medical student needs to know. Medical school is nonstop pressure, sleepless nights, intense study, and caffeine overload. It’s a recipe that practically guarantees failure at some point. One of the most important things you’ll learn is how to bounce back. Here are some of the other things you can expect when you enter medical school.

Class Structure

In a traditional medical school setting, you’ll attend a combination of lectures, case-based learning modules, and labs. A lot of your time will be spent sitting in a lecture hall, listening to a professor, taking profuse notes, then poring over medical textbooks to add context and depth to what you learned in class. You start with the basic science and build up to clinical knowledge.

In addition to standard memorize-and-regurgitate for testing, you’ll be assigned to group work. Typically, a small group of students will work together to solve patient cases, just as a medical team would in practice. You’ll have a physician to serve as moderator as you explore the facts of the case, including patient history, symptoms, circumstances, and other factors that may have contributed to the case. By asking the right questions and discussing the possibilities, the group’s goal is to find the correct diagnosis.

Most medical schools work on a system-based schedule, where the curriculum focuses on a single body system for a specified period of time, usually a month. So one month you may focus entirely on the cardiovascular system, and the next may be about the nervous system.

Types of Classes

During your first and second years, you’ll be immersed in basic sciences. Be prepared to memorize everything and build extensively on what you learned in undergraduate science.

Here are some of the major medical school course offerings:

Anatomy - one of the most difficult classes known to man. You’ll learn the human body inside and out, from muscles to nerves to brain stem. You’ll see the amazing complexity of life from the inside…while getting far too familiar with the smell of formaldehyde. The course will require lectures and labs, with lectures generally running about an hour long, and labs lasting four or five hours. A piece of advice: You can’t afford to fall behind in this class, it would be very difficult to catch up.

Histology - if your curriculum is systems-based, you’ll likely take histology and gross anatomy at the same time. Histology is the study of human cells. Prepare to look at a lot of slides under a microscope.

Molecular Cell Biology - this is where you learn the building blocks of life. You’ll study genetics, protein structure, biochemistry, cell structure, and metabolism, and compare normal and abnormal development throughout.

Clinical Ethics - everyone struggles with ethical questions in everyday life, but for doctors, it’s a very sticky issue. You’ll learn to separate personal ethics from professional ethics and to make sound decisions from a professional viewpoint.

Other topics may include Microbiology, Physiology, Genetics, Clinical Psychiatry, and Pharmacology. Some medical schools offer elective courses that tackle doctor/patient relationship concerns, such as how to deal with religious issues, death and dying, or classes designed to improve bedside manner. You may have the opportunity to take classes focused on legal or economical issues pertaining to healthcare.

Also during the first years, you’ll take Objective Structured Clinical Exams (OSCEs) - physical exams on live actors hired to describe specific symptoms where you’ll be able to demonstrate what you’ve learned and interact with real (albeit faking it) people. You’ll be expected to document the patient’s medical history, ask pertinent questions, and perform a physical exam in order to arrive at a diagnosis. If this sounds familiar, it was the plot from an episode of Seinfeld.

USMLE Step 1

At the end of your second year, you’ll take the USMLE Step 1. It’s the first of three licensing exams you’ll be required to pass before you can practice medicine in the US. It is a comprehensive exam that measures your ability to apply the science you’ve learned to the practice of medicine. Once you pass this step, you’re eligible to move on to the next two years of schooling.

Basic Survival Tips:

  • Check your ego. You were accepted to medical school, which means you’re accustomed to being the best and the brightest. Once you arrive at school, that’s over. Everyone around you is the best and the brightest. You might be the top of your class, but even if you’re not, you can choose to learn from your peers and enjoy their company or you can be jealous, resentful, and cutthroat.
  • Don’t beat yourself up. It’s hard, it’s exhausting, and it’s easy to become overwhelmed. You’re smart and capable, or you would never have made it to medical school to begin with. Stay positive and forgive yourself when you make a mistake.
  • Develop good habits. Your best defense is to develop good study habits from the beginning. Some people prefer to study alone, others prefer a group. A little introspection will tell you what works best for you. Organization is another necessary survival skill. Knowing what you’re doing, where you’re supposed to be, what’s due, and what you need at all times is a life-saver.
  • Get some sleep. No matter how busy you are, find the time to sleep. A sleep-deprived brain is less effective, so losing sleep to study is a catch-22.
  • Tame the brain chaos. Schedule some downtime every day just to relax and recharge. Clear your mind and think about nothing. If you can’t find a chunk of time, try five minutes of quiet several times a day.
  • Make friends. Especially if you’re far from home. No matter how far you are outside your element, you can find people who can relate to you. If you are shy or have a hard time making new friends, try joining some groups on campus.

Medical school will likely be the hardest and most rewarding thing you’ve ever done, but you worked hard to get there. You owe it to yourself to follow through from dream to ambition to career.

If you have any questions, please ask below!