Sorry for the absence, medical school had me a little occupied. There are a lot of tests and competency evaluations in medical school, especially within the first couple of years — though, let’s face it medicine means a career of learning and evaluation. This post will include some details about my class load, a general synopsis of what’s going on. Another point of this post will be to talk about the summer, a critical time for students transition from first to second year in medical school.
I don’t want to freak any premeds out, but there’s a rumor that circulates quickly during the first year of medical school that you have to do certain things to even have a fighting chance at obtaining a residency later. Besides the obvious Step 1 score, there’s a lot of talk if being busy during summer “secret requirement” of residency programs later. Those with concerns aren’t just being neurotic, graduate medical education is capped and not everyone finds a residency across the country (for brevity I’m excluding this conversation to MD match system). This means that about 5% of US senior MD candidates don’t initially match, though there is another match system ironically called SOAP — this 5% could also merit another debate for another day. With that all said, the word of advice that I’ve heard from upper classmates and faculty is that you don’t need to worry about using your first summer for residency. Actually, I’m of the opinion that your number one goal during medical school, especially in the first year, is maintaining your sanity (in public at the very least). You taking off time might mean a fresher you and better you. In short, for you summer do what’s good for you.
Currently, my class load are medical courses (fun fact: we are the last class year to have this curriculum, the future classes will have a more guided lesson through medicine):
1. Physiology – we just finished circulatory and gastrointestinal. Now we’re moving onto pulmonary and renal. We will end the semester with endocrinology with a unit to itself. For neurology, we had a separate and dedicated neuroanatomy/neuroscience block earlier this winter.
2. Genetics – just finished this course. If I learned anything from this course is that when I’m a physician I will both 1) appreciate that I learned more about genetics and 2) understand that genetic counselors have a large role to play in both short term diagnosis and long term patient education. My program really explored some interesting topics such as sexuality, rare diseases, and ethical dilemmas I will later face from genetic test results.
3. Immunology – we will start this next week. I expect alphabet soup.
4. Clinical Medicine – we have clinic or hospital (or both) hours assigned to us. The first year it’s four hours per week, the second year it’s up to eight, and well the 3rd year you’re just abducted by the hospital. Right now, what you do during your hours depends on who you’re attending is. One reason why I chose this program was because of the early exposure to “doctoring” and the fact that it’s a safety net hospital system. For various reasons we’ll leave unaddressed in this post, a lot of the patients “unwanted” at other institutions are our primary patient population. We do a variety of things, from standing around to randomly helping during a procedure — they don’t call it a teaching hospital for nothing. Most of our time is spent talking with patients, taking their histories and learning more about their story. You learn a lot from patients : you learn that the cute little old grandma-eusqe patient that you like also just quit heroin for years prior, how some people writhing in pain from cancer worry more about their families than their diagnosis, or see even those embroidered with intimidating prison tattoos can still weep in the face of chronic depression and disease. I’m learning a lot about humans, it gets me through the week.
Summer Research Plans
The summer of the first year is a wonderful time. Some feel pressured to keep busy, but I don’t think that’s necessary. They’ll be plenty of time for research later and clinical experience, in fact by that time you’ll probably be more useful of a team member. So, if you’re into traveling (or vice versa, want to curl up for the summer with a book, go for it!). Some students do a lot of things during the school year and nothing during the summer. For myself, the load of medical school was enough so I’m using my summer for my ‘side goals’:
1) Find something to motivate me (I’m goal orientated)
2) Raise money for summer rent and food
3) Become better (useful)
The first two are constant pursuits, the latter is the latest goal I’ve stapled onto my agenda. I think the biggest motivator right now for improvement, besides the obvious clinical applications, are my classmates. It’s really hard to overstate how awesome they are, in how they think, the questions they pose that I did not. It’s not a competition you see, I just really bask in awe at times at their individual geniuses and focuses. As such, it makes me want to work harder so I too can add something.
For myself, I’m planning to get involved in cardiology research for the summer: atrial fibrillation. The great news is that I solved my summer bill problems (and then some) with a stipend I’ll receive for it. So, this month I’m working reading up on atrial fibrillation so that I can submit my proposal. I interviewed a few weeks ago for the research grant, it had a number of steps to undertake because it’s funded through the NIH and the American Heart Association. Fortunately, I passed that phase, and all that’s left is for me to submit the proposal start working with patients that have already been screened from the hard work of another arm of the project done by others. Coincidentally, the turning point for me going into medicine was a cardiology related death of my grandmother, so I’m happy to turn my attention towards heart disease. About the timeline of the research, it’ll be conducted mostly during the summer. However, project and grant requires a longer commitment, so I’ll continue the work in my second year as well — by the way, although it’s unlikely for myself, some students with field changing results choose to take their second year off to publish etc. Though, I think the end point of this research is to add to some patient literature, so it should be an interesting trip.
In case you’re curious how to find a research position in medical school, it’s actually a lot easier than in college. Of course, the opportunities available to you will depend on what medical school you attend. Though, even if your program doesn’t have the clinical or bench research that you want to work with you can always do an externship program — though a lot of the institutions prefer to internally fund their students than others. For myself, I used the time honored tradition of just pestered a cardiologist I found with emails until we could meet. I was awarded for my persistence with an invitation to join in the summer. When I chose my school, one of the reasons was because I already looked up some labs I thought were interesting or cool to me. My main source of healthcare has been clinical trials, I had been enrolled in them for over a decade (in fact, I’ve donated quite a few chromosomes towards the cause of pharmagenetics). So as a former patient, I have a big belief in the importance of medical research and I’m happy to be on this side of the court yard where I can hopefully have more influence.
I need to figure out how to serve my community here in Boston. I’ve lived here for less than a year, and I’m still learning which way is north and where the food is. But, as time goes on I can’t forget that service is one of my main driving forces. I think I just have this fear of being useless, though we can probe into my sanity and self esteem in another post. Luckily for me, part of my research grant includes the requirement that I mentor and “show the ropes” to a trope of premeds who’ll receive a scholarship (from universities across the country, including Puerto Rico) to live in Boston for the summer and learn about research. I believe they’re selecting 10-12 (I’ve seen some of the list so far) people from several thousand applications, interestingly their selection criteria isn’t that different from picking medical school invites. The big goal of the program is to give a chance to those with the mental abilities but lacking opportunity — robust plants that just needed some water and sunlight. We’ll lead them through journal club discussions, and other exercises, and answer random premed questions — aka mentorship arm of the program.
At some point in the summer I’ll figure out how to take a vacation. I have very easy vacations: I go watch jazz or go to drink coffee, I’m easily satisfied. But, I think it’s important to emphasize that you can easily take the summer off during medical school and it likely wouldn’t have much impact on your residency application. But, if there’s something you just want to try or dabble in, the summer is a good time to go for it. Though, if you need to raise money for the summer, then accomplishing your goals and getting rent money is a good way to go about it. If you want more access to scholarship money then be sure to enter your medical school email into interest groups, the research or activity you’re doing might coincide with the requirements for a grant if you’re lucky.