The Seven Wonders of Fourth Year: A Success Guide

Happy Spooky Season folks! In honor of both Halloween and tonight’s episode of American Horror Story, as well as my newfound free time as a fourth year, I decided that I’m going to share my secrets for attaining Supreme status in medical school. Listed below are the Seven Wonders, seven acts so advanced, each pushes the boundaries of craft into art.

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Clerkship: Surgery

Ok so this is super behind since surgery was my first block but at least it’s getting done, ok? I just wanted to share with you some of my general tips for surviving your surgery clerkship! Because it was my first rotation, surgery really scared me. You always hear about how it’s the toughest, most demanding, non-fuzziest rotation. Well, what you hear is right… for the most part. It was also one of the most eye-opening and rewarding experiences that I have ever had. I even considered going into it for a good portion of this year (peds surgeon, anyone?). My point is: go into your clinical years with an open mind, you don’t know what awesome opportunities you’re going to miss out on if you already have a career in mind.

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I’m writing to you from my new apartment! Minus living essentials like floor lamps, a dining set, and anything to sit on or store clothes in, I guess you can say that I’m full-fledged adult now. I feel like it’s been a while since I’ve updated my blog with a personal post, but I especially wanted to reach out to my fellow medical students with this one.

I think I’m still having a hard time adjusting to M2 year. I’m still grappling with the notion that others look up to me as a role model and ask me for advice when I’m just trying to do the right thing for me. It’s scary, it’s intimidating, but it’s inevitable. The “sophomore” year of any point in your education is tough. You’re no longer the baby, but you’re also asked to grow up quickly.

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White Coat Woes to White Coat Wows: Basic Sciences

By now, first year medical students should be a week or so into their curriculum and are starting to get their toes wet. My school, like most, dedicates the first half of M1 year toward laying a foundation in biomedical sciences through a course called Fundamentals. It was broken down into four mini-blocks, each with its own theme and exam.

  1. Biochemistry,  Molecular Biology, and Genetics
  2. Cell Biology and Metabolism
  3. Pharmacology and the Autonomic Nervous System
  4. Immunology and Microbiology

Instead of telling you which pathways to study, I’m going to provide you with what I think is important to take out of what feels like taking all of your upper level bio electives in one semester.

  1. Invest in a whiteboard – Most of the biomedical sciences portion of med school is a rehash of your *favorite* undergraduate nightmares with added depth. One thing that worked for me was investing in a whiteboard with ultra fine tip markers (you’ll thank me when you get them, they save so much space). Unfortunately, much of this module is continuous repetition of biochemical pathways. There’s no getting around it, so get cracking!
  2. Focus on implications – An important caveat to my above point is that there is a reason that you’re learning all of this, and it’s not to drive yourself crazy memorizing these pathways. Defects in gene expression can have a whole host of downstream effects. The point of drawing out pathways is to visualize how enzyme or protein deficiencies lead to disease, such as phenylketonuria (PKU). Additionally, it’s important to know enzymes that can become drug targets in the treatment of disease, such as xanthine oxidase in the treatment of gout.
  3. Everyone is smart – This might be the first time you have felt challenged, and I mean really challenged. Realize that you are surrounded by people who were at the top of their class at top schools. Some of your classmates may have done research on some esoteric gene mutation or have a ton of clinical experience from scribing or from being an EMT. Despite all of this, don’t forget that you too were accepted for a reason; focus on learning the material and becoming a physician instead of how well someone else may seem to be doing compared to you.
  4. Ask for help – Don’t be afraid to reach out for assistance, whether it’s through tutoring or forming study groups with your classmates. I start tutoring my first set of students tomorrow, and I’m getting tutored as well for cardio. I like to take the initiative and preemptively meet with my tutor at the beginning of each block to see how to best tackle the material. Blogs like mine may help you discover study strategies, but they are not as personalized as the students who have come before you. They know what material professors like to test and which textbooks will be the most helpful. They don’t bite, and they’re (usually) free through your school. Take advantage of it!

Now it’s back to cardio for me. Do you have any study strategies that helped you through the first semester of med school? What worked? What didn’t work? Feel free to let me know in the comments or on Instagram!


– TS℞

White Coat Woes to White Coat Wows – Introduction

With my first year under my belt, I’ve found myself in a weird situation: people are actually asking me for advice about med school (I can’t believe I started a year ago). I decided to start this series based on my own journey, since I was always fortunate enough to have mentors tell me about how best to prepare for an exam, or what to watch out for in a class with a reputation for being difficult. It’s only fair that I share some of the things that I believe led to my success this year.

As the year progresses, I’ll be posting guides specifically for each block and how to go from White Coat Woes to White Coat Wows (ba-dum-tch). The posts will be based on my school’s block schedule, so it will most likely vary for your school. Disclaimer: most of the study tips and tricks are applicable to different blocks and I will try to be as specific as possible regarding study strategies, but you should to find your own style and figure out what works for you. Additionally, I’m planning to post some guides for pre-med students as well. Many of my friends from high school and college are in various stages of their medical careers (from premed to med school to residency), so I’ll try to include their perspective whenever possible. The first post, however, is for those who are starting right now.

  1. How much should I study? – This is entirely dependent on you, but no matter how smart you are or how little you studied in college, med school is exactly like the old adage “like drinking out of a fire hose.” Ask Peter Griffin. If you have poor study habits, fix them. If you have great study habits, make them better. Like fellow med school blogger Mary Ella Wood states, “medical school is like having to eat 10 pancakes a day. If you eat 10 a day, it is manageable. However, if you skip a day and have to eat 20 pancakes the next day, it starts to get difficult.”  Procrastinating will catch up to you; believe me, I am a serial procrastinator and I have to actively try to keep up. Study a few hours each day and it will be a piece of (pan)cake. If I can do it, you can do it.
  2. Do you still have a social life? – Contrary to popular belief, med students are allowed to have fun. Yes, it will be truncated significantly, but there is still time for hobbies and things that make you happy. If you treat school like a full-time job and actively pay attention for the hours that you are in school, you won’t need to play catch up at home. Some people, myself included, take advantage of our lecture recordings and study at home at our convenience. Just make time for your mental health and well-being, too!
  3. How do you find time for yourself? – Serial procrastinator and over-committer that I am, I thrive on checklists and Google Calendar. One app that I could not live without is Wunderlist, a checklist app that helps me keep track of everything. Both my day-to-day goals and long-term goals go in here, everything from grocery lists to errands to study topics. I get a little dopamine rush from checking things off, so find what works for you.
  4. What is a typical week like? – Depending if it’s M-W-F or T-Th, the day usually starts with mandatories like our case-based small learning groups (former) or our doctoring class (latter). Those are followed our main block lecture, our biostats/critical appraisal course, or service learning time. Afternoons are spent in “lab” sessions which can either be a second lecture, a practical session/team-based learning assessment, or time in the anatomy lab for dissections. From 3pm onward, you have free rein, more or less. Once a week I’m either in student clinic seeing a patient or at a satellite rotation at an outpatient affiliate. Other afternoons, I might be at a service learning site. The other time that’s blocked off is “self-directed learning” which you can use for studying *ahem* or for completing other tasks. I confess to using it for gym time, cooking, and the occasional Netflix, but as long as you stay on top of studying, it’s a nice time cushion to have.
  5. What did you find was the hardest thing to adjust to? – The rigor of med school is no joke, and even for someone with good coping mechanisms, the stress can sneak up on you. For those who are entering straight out of undergrad or who are coming back from the workforce, adjusting to the pace can be difficult. Most med schools offer student support services like peer tutoring or counseling, for free or at a low cost. If you feel like you need these services, use them. You don’t need to be a hero. Outside of that, find time to enjoy yourself and do things that make you happy. Sometimes, that means taking the afternoon off to call your parents or friends, or go for a run, or watching a few episodes of your favorite series. Here’s an article from the AAMC about stress and suicide in medical education. It’s only going to get more stressful from here, so please make sure you’re taking care of yourself.
  6. What other advice do you have for a new med student? – 
    1. Stick to a budget. Don’t buy useless crap. Ice cream is ok.
    2. Stay in your lane. Don’t worry about what everyone else is doing. There is no golden bullet for med school!
    3. On top of academics, try to learn something new every day/practice a skill every day. Like, you should really learn to cook.

I don’t know if this is sending mixed messages, but don’t stress too much. You made it this far and you should celebrate your accomplishments. Just be sure to self-monitor and ask for help when you need it. Best of luck to the incoming class, welcome to med school!

– TS℞