Even if you’re the most dedicated premed student, dead set on applying to medical school, you probably still find the medical world a bit of a mystery.
You may have grown up on TV shows like Grey’s Anatomy, House, E.R., and Scrubs that paint the profession as a boiling concoction of comedy, romance, and drama.
On the other hand, you may have heard medical students and physicians say something along the lines of, “medical school is like drinking water from a fire hydrant.” Perhaps you’ve also gotten wind of stories about burnout or mental health issues among medical students.
With two such polarizing depictions of medicine, how can anyone answer the question: “Should I go to medical school?”
In this piece, I’ll pull from 15+ years of helping students get into medical school to answer the question “What is medical school like?” We’ll also address other key questions, including:
- What can I expect during each year of medical school?
- What’s a typical medical school class schedule?
- Can you have a life in medical school?
Medical school is four years long and is traditionally broken up into two-year “blocks.”
Years one and two are the “preclinical years,” in which you immerse yourself in undergrad-style textbook study, exams, and lectures.
Years three and four are the “clinical years,” in which you begin to get more exposure to medicine as a profession.
However, many medical schools are reducing preclinical time to about 1-1.5 years in hopes of exposing students to clinical experiences as early as the second year of school.
With those changes, students also enjoy some “self-directed” time, usually in their third year. This gives them the space to earn a master’s degree, delve into research projects, and/or perform extended clinical rotations.
The preclinical years largely resemble your undergraduate education, with a few key distinctions (depending on the medical school).
For the most part, you’ll be learning from a series of lectures and textbooks, and you’ll be evaluated by your performance on exams you take on every “block” of material.
For example, you may sit through about 2-3 hours of lecture per day for 10 weeks to learn the physiology behind the Cardiac, Renal and Pulmonary systems.
At the end of the block, you’ll take a single exam, enjoy a couple of days off, and then return to the next block, where you’ll delve into the physiology underlying the Musculoskeletal System.
But you won’t feel like you’re retreading old ground, because medical school differs from college in a few important ways:
1. The Curriculum
To start, the material is very targeted to human physiology, whereas undergraduate science curricula draw more on basic science research, occasionally sprinkling in tidbits relevant to human physiology.
Many medical students also have supplementary anatomy and histopathology labs that serve to supplement their lecture material.
2. The Grading System
Most medical schools in the United States now follow a pass/no pass system for the preclinical years. You either make it through, or you don’t!
Thankfully, your interests are aligned with those of your medical school. Everyone wants to see you succeed, and many medical schools have offices dedicated to academically supporting you.
A pass/no pass grading system aims to remove a great deal of the competitive stress that might come with grading on a curve. As a result, medical student learning communities are laxer and more collaborative than most premed learning communities.
In fact, many medical schools have Facebook groups where students share learning resources in order to elevate everyone’s understanding of human physiology and pathology.
3. The Clinical Experience
Lastly, the preclinical years differ from traditional undergraduate education in that there are often clinical threads that introduce you to the practice of clinical medicine.
At the University of California, San Diego, for instance, students spend two mornings every week in problem-based learning (PBL), where the lecture material is synthesized in a mock case.
These sessions are led by clinicians who walk students through clinical reasoning to apply concepts learned in lectures to the real world.
For example, if the current block is all about renal, you’ll receive a case about a patient who experiences intense thirst and heavy urination.
Together, pairing the minds of your colleagues and your clinician guide, you’ll create a list of differential diagnoses and learn the physiology of the kidney through this patient’s pathology (diabetes insipidus, in this case).
At other institutions, such as UCLA Medical School, students also spend one afternoon a week in a course called “Doctoring,” which introduces students to the basics of interviewing patients, and “Clinical Skills,” a course in which students learn to perform the clinical exam.
Because there is so much to cover in medicine, lecturers run through complex topics in a short amount of time. With two to three hours of lecture per day, this material piles up quickly. Its sheer quantity can be overwhelming.
That said, the material in medical school isn’t that much more difficult than what you study as an undergraduate (e.g., premed requirements). The challenge lies in the amount you must absorb at a rapid pace. On a single day of lectures, for instance, you might learn about a wide variety of drug names and their interactions with anatomy.
Every medical school handles exams differently, but you can expect to deal with a wide variety of core concepts. While you won’t be able to remember every detail, you’ll need to demonstrate competence in the fundamentals of physiology and pathology.
For example, you may receive one or two questions on something hyper-specific, like which ions flow through the ascending Loop of Henle. But then you’d probably get five to ten questions testing you on the broader concepts behind the specifics, such as the forces that drive ion flow and water retention throughout the kidneys.
Getting more granular with the type of exam you should expect, UCLA Medical School assesses students every block through a 100-question multiple choice final.
Multiple choice exams can work to your advantage. They are meant to acknowledge that the amount of material you have to absorb is gargantuan, so recognizing the correct answer will suffice.
Other schools, like UCSF Medical School, still rely on short answer exams. There are advantages to short answer-based tests. For instance, the first part of your licensing exams consists of short answers, so you’ll be prepared for that style of test.
However, the pedagogical tide is turning against short answers, as they can encourage students to memorize and regurgitate information that is appropriate only for a very niche situation.
The two clinical years of medical school most closely resemble an internship.
You’ll don your white coat and become responsible for a portion of a real care team. You’ll support other medical students, residents, and attending physicians in the care of actual patients. And you’ll swap out your classroom environment to learn on your feet on the floors of a hospital.
During these years, your day-to-day might look like this:
At around 8 AM, you’ll “round” with a medical team consisting of residents and attending physicians. This team may also include nurses, social workers, pharmacies, and members of other allied health professions.
But you will have been in the hospital for one or two hours prior, doing “pre-rounds,” collecting vitals, speaking to patients, and gathering enough information to present to your residents and attending physicians.
Here, your attending physicians/residents will grade you on the way you present pertinent information about the patients and your understanding of assessment and treatment plans. The grading scale is typically honors, high pass, pass, and fail.
You’ll also be evaluated on your interpersonal skills. This includes how well you interact with other members of the team and your bedside manner with patients.
Your schedule in medical school will vary depending on whether you’re in the preclinical or clinical years. While every institution is different, here’s an overview of the schedule you can expect, starting with the preclinical years.
Medical School Schedule: The Preclinical Years
A typical med school class schedule involves about 15-20 hours of lecture a week, about two to four hours a day. The rest of the day is yours to study, exercise, socialize, etc.
Most medical schools also require three days a week of mandatory labs led by clinicians and basic science faculty. These labs last between two and four hours. Typically, these labs cover supplementary material. This includes anatomy, histopathology, and other clinically related skills such as patient interviewing.
Overall, you can expect an average of about four to five hours of class time per day.
That said, you don’t need to be physically present for most of the aforementioned events.
Many students forego attending lectures in person to study previous material. They then watch lectures — which are all recorded — in 2x speed on their own time at home.
This is more efficient, as lectures are often a broad overview of material that you’ll need to study further on your own.
Medical School Schedule: The Clinical Years
Your schedule will vary considerably based on the rotation you’re currently on. A surgery rotation will require you to spend more time at the hospital than an inpatient pediatrics rotation will. But regardless of the rotation, your instructors will expect you to read and study further at home.
These clinical years tend to be the most jam-packed for medical students, because you’re both learning and doing. The variability in patient load makes it difficult to predict or describe the “typical med school class schedule.”
Overall, expect to spend 8-12 hour days in the hospital, plus a couple of hours at home brushing up on the material you’ve seen in action throughout the day.
During this time, medical school students develop a real sense of what specialties they might be interested in pursuing.
The term “life” means different things to all of us. Some of us need to spend two hours in the gym, five times a week. Others need to spend weekends wining and dining with close friends or family. Others would just take six to eight hours of sleep a night.
If you learn to properly manage your time to keep up with the material and learn to prioritize—say, skipping the clubbing in favor of the gym—you can certainly have the life you want in your preclinical years.
The first two years of medical school are a grind. But the pass/no pass curricula, in addition to a community of colleagues struggling through the same rites as you, create an environment in which you’ll make your closest friends. You’ll spend a great deal of time studying, exploring your city, and bonding.
The clinical years will be much tougher. But you’ll be able to build on the good habits you develop in the first half of medical school.
Real-life medicine isn’t quite filled with the constant “Code Blues” and the scandalous romances depicted on television. But it certainly is a rewarding path.
After all, medical school is the time that prepares you to comprehend the human body and become responsible for the care of real people.
Want help putting together a competitive medical school application? Check out Dr. Shemmassian’s free guide on getting into medical school.
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