Day 170: Advice from my first semester of medical school

Today’s inane image of the day:

Love, love, love sunsets — beautiful ones really get me through the cloudy, miserable winter days.

Neuroscience midterm? Done.

After all those serious posts, I think it’s an appropriate time for a light-hearted post — so I present to you:

What first semester medical students should and should not do
Let’s start with the should not:

DO NOT wear your white coat in public places.
We all know you’re proud of your little white coat, even if it seems to be sized for a 10-year old. And we know that you want to let the rest of the world know that you’re a medical student. But while the white coat might be respected among the profession, it may evoke negative thoughts/feelings from individuals in public places. Say you’re walking into Starbucks to grab your morning cup of coffee. When the people behind you in line see your coat, these are some of the things that they are probably thinking: 1) Oy, another reminder that I need to go see my doctor; 2) I wonder how many strains of bacteria/fungi/viruses are on that coat…; 3) What is that reddish stain? IS THAT BLOOD? [even though it’s probably highlighter or red pen]; 4) Hmm, maybe I should have that “doctor” check out this hairy, discolored mole on my back…

In my opinion, white coats belong in the hospital or in settings where you are seeing patients. Not at the gas station, supermarket or Starbucks.

DO NOT pull unnecessary all-nighters.
I’ve pulled a couple of all-nighters in my time and while some were definitely justified, most of them were not. Sleep is a really important component of learning [too lazy to pull up a paper on this, anyone want to find one for me to back this claim up?] and general cognitive function, so why cheat yourself of it? THis is especially important as an M1/M2 because our sole purpose is to learn! Furthermore, as medical students in our pre-clinical years, we don’t have the excuse of being on-call or forced to work long shifts [though, I hear that’s changing? already changed?].

I personally would rather forego my favorite television shows and/or limit internet usage than a semi-good night’s rest [at least 4 hours!]. The plan is to get through at least M1/M2 without pulling an all-nighter [not only do they mess with my ability to think clearly, my tummy hurts after being up for 20+ hours].

DO NOT set your heart on a specialty [yet].
As you’ve seen from my discussions on specialties, I’ve considered a number of specialties within my mere few months as a medical student [anesthesiology, radiation oncology, clinical genetics… etc] and I still don’t feel any closer to a specialty. I came into medical school knowing that I wouldn’t fall in love with a specialty until after I rotated through at least a few of them, but I still wish I knew now. And I still don’t think it hurts to ask questions of the residents/physicians I interact with — after all, they can offer yet another layer of knowledge that you likely wouldn’t get from shadowing or rotating as a medical student.

Basically, keep your eyes, ears and options open until it’s actually necessary [i.e. not first semester… or second semester… or even second year].

DO NOT pile on the extracurricular activities [yet].
As an undergraduate, you were a jack-of-all-trades — you started an organization or successfully headed a legacy one. You volunteered at the hospital on a regular basis. You did research, attended conferences and maybe even got a publication. And you got stellar grades while doing all of that.

But in medical school, that all changes. It’s hard to put into words just how much stuff medical students need to cram into their brains within the first two years, but let’s just say it’s a lot. So much so that even just putting your sole focus on school may be just enough to pass.

Sure, there are definitely some geniuses in the mix that can somehow always do well AND get a full night’s rest AND do research AND know what happened on the latest episode of Grey’s… but they aren’t the norm. This being said, be careful about what you commit to within the first couple of weeks of classes — definitely get out there and go to a couple meetings for various clubs/organizations, but set realistic goals for extracurricular activities. Also, make sure to remember that you are first and foremost a medical student [you don’t pay 5-figures/year in tuition money just to participate in extracurriculars!].

Once you’ve gotten a feel for things, then start adding things [slowly].

DO NOT attempt to bring all or many of your textbooks with you to Starbucks/library.
If you’re like me and regularly reference textbooks for information, then chances are you purchased some or all of the textbooks on your “required” [many people get by without ever purchasing a textbook…] list. And if you’re like me, you really like to have everything you could possibly need within an arm’s length [i.e. your backpack is 3X your size AND you need an extra bag or two to carry other “necessary” things]. If these characteristics apply to you at all, then heed this advice: do not even try to bring even a fraction of your textbooks with you to where you plan to study. I’ve tried, and failed, many times [and I’ve probably ruined my back because of it!].

Instead, plan ahead and be realistic about what you’ll be able to get through in one sitting. Only plan on sitting at Starbucks for a couple hours? Then you probably won’t get through even a couple chapters of Robbins [1464 pages, hardcover… not fun to bring with you everywhere], let alone all of your Pharmacology/Anatomy/Microbiology lectures from last week that you haven’t had a chance to review yet. Choose a couple things you want to accomplish, try to triage things so that you bring the least number of books [and binders of notes] as possible. Plus, it’ll make you feel better at the end of the day to know actually got through a specific task instead of spreading yourself thin and setting unrealistic goals [that should be an entry of its own!].

DO NOT convince yourself that you’re alone in this process.
One of the most important factors that I considered when selecting a medical school to attend was the community. Did it feel supportive? Did it feel conducive to success? Did I feel like I could connect with my future peers? These were questions I asked myself and the answers ultimately led me to select OUWB. By choosing a school I felt comfortable in, I knew that when I started to despair about how impossible it seems to cram all of a 2 inch binder into my head, that I would have a great support network built from my peers.

But even if you don’t feel like you have that support within your class, when you’re feeling overwhelmed or tired or frustrated at your limited brain capacity, know that somewhere out there, there is another medical student that feels exactly the same way you do. Guaranteed, there is another human being just as stressed, anxious and scared as you feel. And I promise you that your thoughts had flitted through another medical student’s mind at some point in time. Basically, never forget that you are not alone. We all have our ups and downs, but we make it through. And even if things don’t work out for medical school, then chances are you have something else great coming your way — just be patient.

Hmmm… now that was a lot of what not to do… what can I do, anyway?

DO study. A lot.
The most important piece of advice I can give to any incoming medical student is not to fall behind. In order to do this, you really need to train yourself to study on a regular basis without the distraction of Facebook, the television, email, etc. Even if you can only unplug and focus for an hour, it’s a start. In the end, quality always trumps quantity — so 3 hours of “studying” with Facebook and 3 Google Chat windows open probably won’t be as effective as just 1 hour of focused studying. Make sure to maintain at least this baseline, and build upon it slowly. Soon enough, you’ll be a champ at this studying thing!

Keep in mind that things do come up — I found that various AMWA events could only be held in the evenings so I made sure to prepare ahead of time allowing me to be 100% at the event [and not floating off to the decussation of the spinothalamic or corticospinal tracts]. When Mike comes into town, I make it clear that we need to go to the library to study for at least a couple of hours in order to relax for the evening [after all, he’s in school too so it works for both of us], but sometimes I just take the whole day off and realize that it’l be tough to play catch-up later on.

In the end, just try to stay on-track and if you veer off for a couple of days, know that it happens to the best of us and try to get back to your regular study schedule ASAP.

DO shower regularly… especially right before the exam.
This is pretty self-explanatory. Be cognizant of your peers in the examination room…

DO incorporate regular physical activity into your schedule.
As I’ve mentioned before, maintaining your own health is very important. This and the one below it go hand-in-hand, but let’s focus on the physical activity part first.

I know it’s difficult just to get started on a regular exercise regime without the stress of medical school over your head, but try to set yourself up for success by enlisting a partner in crime, switching up your routine or participating in IM sports teams. I personally like to exercise on my own, but until I got into the habit of forcing myself out the door, I made a lot of great excuses just to put it off. I have to study. I have homework to do. The weather is bad outside. The list goes on…

In the end, it’s up to you to take care of yourself. You’ll reap the benefits from 30 minutes of physical activity each day [even if it’s 10 minutes, 3X during the day] — I can say that after I finally got over the initial hump of regularly exercising, I noticed that my energy levels increased and I felt a lot more emotionally stable [even during stressful times!]. It really makes a huge difference.

DO try to maintain a healthy diet.
Anyone close to me can tell you that I absolutely love fried carbs — chips, donuts, elephant ears… I love it all. And when it comes to exam time, you will find me munching away at these empty calories. I admit, it’s a bad habit and I’ve been working on kicking it.

On the other hand, I’ve been packing healthy lunches for myself each day and found it’s a lot harder to ruin healthy eating when all you have to eat are “healthier” things. This means packing veggies, fruits or whole grain snacks like low-fat Triscuits [and only a single serving!]. It can be difficult to keep this up, but if you’re able to keep this up for even a week or two each month [leaving a week or two for exam-stress-eating… yes, we all do it!], it could make a huge difference in the long run.

DO talk about concepts/ideas with peers.
Not only will you benefit from reinforcing your own knowledge, you will also be forging a relationship with your peers. Especially in larger medical schools when it’s sometimes hard just to get to know your own class, by using the excuse of talking about school-related things, you are getting to know more people and expanding your network.

Since our class has only 50 people, we all know each other… but I do find myself learning more about my peers as time passes.

DO make a serious effort to keep in touch with your family and non-medical school friends.
It really pays off to keep up with the world outside of the medical community. As it is, our community can be — and usually is — overwhelming. There’s a lot going on, at all times of the day. But by cutting yourself off from the rest of your non-medical world, you’re depriving yourself of the opportunity to step outside of it all for a breath of fresh air. I personally find that the rare opportunity to talk about topics completely unrelated to medicine [and school] is crucial to my well-being. Conversation on my part usually steers me right back into medicine, but listening to what’s going on in the life of a full-time engineer or graduate student or teacher is a nice way to peek outside for a moment [that is, before running back into my study room to bury my head into lecture notes!].

DO take things one day at a time.
As a compulsive planner, this was hard advice for me to swallow [not sure I’ve swallowed it completely yet, either]. I still find myself trying to plan for things many years down the road, only to feel frustrated that there’s really nothing I can plan much further out than the next week or so. Sure, I still have a forecast of where I’d like to be in X years, but you don’t know what you’re going to get with the boards or residency match [or life in general] or whatever comes afterwards. This is what medicine is. This is what life is. I’ll try as much as I can to forge a path in the direction I aspire to, but in the end, I need to focus my energy on making today the best that it can be.

DO celebrate your accomplishments.
Whether it be through a quiet night cozying up with a book or your favorite television show, a night in with your significant other, or a night out on the town with your friends, make sure to take some time to celebrate what you’ve done. Every tiny accomplishment brings you closer to your larger ones.

Sometimes if I feel discouraged by an unproductive day, I sit down and make a list of all the little things I completed during the day [laundry, dishes, listening to X number of lectures, gym, etc] and it reminds me that usually the day hasn’t been a complete wash. If I find that I’m unsatisfied with my list, then it usually motivates me to get other stuff done, or realize that I needed that time off [like today… I am exhausted, so I don’t feel particularly guilty about my lack of productivity].

What do you think of my list? Do you have any additional things to add?