KCU-COM – Page 20 – We're All Med Here

8 Things I’ve learned (so far) in Medical School

Hello loves.

I know, I know, I’m not very good at posting since starting medical school. I’m gunna try to write more when I have a free weekend and have them self post, but ya know, life happens. Okay there, that’s my disclaimer.

I’m 6 weeks into being an OMS-1 (or osteopathic medical student, year 1), and my god can I just get my degree already?? [Insert your favorite laughing but crying emoji here.] I learned a lot last year in COB about myself personally and my perseverance to get through shit, but this year I am learning all about boundaries and being okay with less than perfection. Below I have compiled a list from what I have learned and from what some of my classmates and friends have passed along.

1. Be prepared for long days.

There are many days (you can look at my biochem schedule to see a few) where you will start at 8am and end at 5 or 6 pm. During our MSK (musculoskeletal) block we would have anatomy lab 2-3 times a week on top of our scheduled lectures, OS labs, SP encounters (where we learn to be doctors), etc. We do have anatomy group tutoring (which is usually at 5-6pm at night) and on top of that, we each have small group anatomy lab tutoring now (which is usually from 7 or 8pm to 10 or 11pm). Long days guys. There are going to be days where your schedule is so packed you simply cannot do a lot of studying for the day. Find your pockets to study elsewhere.

Personally, if its super late like that I’m likely to just go to bed early and try again the next day.

2. Get ready for a new kind of tired.

Now, I’m not saying these things to freak you out. Honesty is what I do. Some people love it, most people hate it. If you are about to embark on a journey like this, you shouldn’t be getting a sugar-coated version. You deserve all of the information (from all angles, not just mine) so you can make an educated decision. And even though you are listening to my struggles and triumphs through this, don’t let anybody tell you not to be a physician if that is what you truly want.

You may personally know physical exhaustion, but you will now know what mental exhaustion feels like. If you’ve done any sort of higher education outside undergrad (let’s be real, undergrad wasn’t challenging every day all 4 years, if at all for some people), then you know what I mean. Your brain is going into overdrive to learn so many things and make those connections and recall. You learn to live with it and find ways to slightly recharge yourself. It’s different for everyone with the level of exhaustion, and recharging is different for everyone is well. I’m still working out on how to recharge personally.

3. Be okay with failing or not getting an A.

Getting an A is not your new bar. It’s fine to have this bar at first, but I can guarantee that this will likely fade fast. Passing is your new bar. I’m all for reaching for the stars, but something does have to give. There are times when you won’t have the desired amount of time to study or you are too exhausted from your test a few days before to go hard for this one. Burnout is real, and there has to be time where you choose to sleep, eat, shower, and give yourself a mental break. You will not know everything, and that’s okay. Hopefully you learn to pick the less important stuff to punt. Sometimes I am able to, sometimes I punt things that really they asked too many damn questions about.

Medical school tests are also designed to be hella difficult. Say goodbye to 1st order questions; there are way more 2nd and 3rd order questions. I think the only first order questions I really got were on my anatomy lab practical where it was basically “identify this”. Even then, you had to know where it was coming from to figure out what it was, so really it didn’t feel like an easy 1st order question. These questions are mentally draining, and there are going to be times where you won’t know it. That’s okay. Seriously, passing in medical school is basically where everyone starts celebrating. Getting in the 80’s for most people is hella fantastic. If you do better than that, I applaud you sir/ ma’am.

4. You will not necessarily be the smartest person in the room.

You is smart. You is kind. You is important. – From The Help.

You are intelligent. No one is doubting that. You couldn’t have gotten here if you weren’t smart enough to pass all those hurdles and still be a decent human being. But, you are on a level with a class full of people just like you: incredibly smart, driven, dedicated, and resourceful. This is new compared to your undergrad classmates. You are all on a more even playing field, and some people will excel much better in certain subjects than others.

For example, I did well in biochem, but MSK, even though I love anatomy, is not going well for me. Even though I have always done very well in anatomy in the past, this clearly is not the point in my life where I will excel at it. It’s quite okay. The next test or the next unit I’ll make my bitch.

5. Your grades don’t define what kind of physician you will be.

Yes, you need to learn all about normal and abnormal to be able to help your patients. But honestly, once you pick a specialty you won’t remember half (if you remember that much) of what you learned in medical school. But you will know what you need to know for your specialty so incredibly well. Your grades also don’t dictate your communication skills, your empathy, and your ability to listen to your patients.

Patients, from my experience as a scribe, want to know that you are listening to them. That they are heard, that you have given them a platform to be heard, and that you can empathize with them.

Then they want you to fix them.

Your grades won’t be able to teach you that. Don’t get me wrong, grades are important. But more importantly are going to be your board scores which give you a residency (or job!), and your ability to take care of your patients. Fixing your patients isn’t just about finding the problem, it is also as a whole making sure they are taken care of–> which usually means you’ve listened to them and given them options in some cases so they can have autonomy (or make their own choices about their health- if this is applicable). Again, this is from my scribe experience, not my minimal experience as an OMS-1.

6. Keep up with your mental health.

You need to get into the habit of doing things to keep your mental health at a good place. If that means taking a break that night from studying, do it. Need a glass of wine? Drink it. Need that bath and face mask? Partake in it. Need to play some video games to tune the world out? Make those fingers fly.

Are you getting my point here? It’s okay to not be studying every second. In fact, being in a good mental state, getting enough sleep, and eating well will get you farther than pulling all nighters and constantly studying. Your brain does better in testing situations when you are overall happier and healthier, so don’t let that slip. It’s going to be hard, I know. There are times when I forget to eat or forget that I need to go home to take care of other things, but allowing yourself the decency to be in a good place will get you pretty damn far.

7. You are a resilient human being.

Give yourself credit for this. Again, it’s hard to pass all the hurdles needed to get to medical school, and there are many more you need to pass once here and beyond. There will be times that you will trip, maybe even face-plant a bit. But really, you’ve got this. Failing or doing something that isn’t your best or didn’t exactly go your way won’t stop you from being a great doctor. Use it to help better yourself.

8. Start practicing being humble.

I mean, I can’t believe I have to tell some people this but yes, practice a little humility here peeps. It’s okay to stroke your own ego, just make sure it isn’t so large it’s suffocating everyone around you. You need somewhat of an ego to get you here, but your future teammates and patients aren’t going to return if it’s so large no one else can stand being in the same room as you. Humility also comes into play with knowing that you will be wrong, and you will screw up. Own it. It’s a learning process. You will have greater growth through messing up than doing everything perfectly.

Let me know what you’ve enjoyed about this post or what you would like to see more of on this blog in the comments below! #shoutout to those friends and classmates that responded to help me write this post.

First Block of Medical School: Biochem

Whoa…

Just whoa.

Holy shit balls I did not expect this block to be so intense. I have never felt this perpetually tired yet able to function at the same time. What day is it? Who am I? Do I have an assignment due today? IDK anymore.

These first 3 weeks of medical school have been way more intense than I expected it. I got tired of everyone telling me how hard it was going to be, that it “was like drinking from a firehose”, and that you will feel so incredibly overwhelmed and to remember why you wanted to be here in the first place. At the time, I was thinking “yeah, yeah, I know it’s hard. Getting here was hard and I’m prepared for the hard road ahead.” I was ready to start and to get on with my medical training so I could finally become a doctor.

But my god, there was absolutely no way to prep myself for this.

The only way to describe this is to you is you think you are prepared to get your ass handed to you, but there is no way to prepare or explain it other than you just get through it. You just kind of have to wade through it. It will feel like a lot. Some of you will feel like you won’t be able to handle it. Some of you will be able to handle it but not very well. And others of you will on the outside look like its no big deal, but on the inside be questioning your every move. (I really don’t think anyone gets through their first block completely unscathed here; even for former master’s students who had the same professors the year prior).

Remember: there are thousands, hundreds of thousands of physicians that came before you. There are hundreds of those student doctors who went to your school through the same curriculum who made it through before you. If they can do it, so can you.

Scheduling:

Below is the schedule for our week 1. It was intense, and the first day they started us out with a pretty full plate. Over the course of this week, we had 11 biochem lectures and 1 DSA (or additional reading material/lecture material that did not have time to have a set lecture dedicated to itself).

We also had several PCM lectures (or the “how to be a doctor” class), some OMM lectures and labs (or the osteopathic manipulation course), a med informatics course (a library course? or how to utilize the library resources), and a bioethics class.

Week one schedule (I know my editing is terrible). This is as big as I can get it.

The way my schedule is set up is there is a main course, in this case biochemistry (blue), and there are several ongoing courses running at the time. Biochemistry usually had 1-3 lectures every single day. The next two biggest courses are the PCM (gold) and OMM (purple). We have OMM lab once a week and usually at least one PCM lab and/or interactive group involved each week as well. Everything else is either integrated every other week or at a lesser frequency than 1-2x a week (med informatics- forest green, bioethics- highlighter yellow, tutoring- muted green).

Both in OMM and biochem we had DSA’s. So things to learn outside of lecture itself that are testable material and usually either foundational to learn further knowledge or supplemental to help augment another main idea. So important stuff to put in that brain.

This first week we learned basically nothing but metabolism of the body. We did have the foundational enzyme kinetics, delta G, and things of that nature. But for majority of the week it was metabolism (with the exception of heme metabolism). There was a lot of drawing out pathways to try to understand the steps and process itself, and then ultimately how it all inter-related. As a student doctor, you have to know how things are inter-related in the body in order to see if something goes wrong, does it affect more than one thing? (The answer is usually yes).

We had a quiz on the Friday of the first week. We had our midterm on the Monday of the second week. We had another quiz on the Friday of the second week.

This week, it was less hardcore biochem and more molecular and genetics that were integrated in. So for the whole first week, all of our lectures were straight biochemistry. But this second (and third) week, we had genetics, some biochem, physiology, and histology integrated in.

I did not do a schedule for the third week, but there was a biochemistry quiz on the Thursday of the third week and our biochem final was the following Friday. In total, we had biochemistry and molecular all in 3 weeks.

Compared to COB: we had 15 weeks (1 semester) of biochemistry and another 15 weeks of molecular alone. So yea, it was a wild ride. We did not go as heavily in-depth as we did in COB on the science side, but it helped knowing the background of how it worked which made it a little easier to just focus on what I needed to focus on.

How I Studied:

I mean, I was all over the place. For some lectures I did objectives. For most of them I would write out what was highlighted in lecture in my book as writing for me does more to actively get it in my brain than mindlessly typing. I have a blank sketch book that I have written my notes in so it is all in one place. This way I can easily refer to my notes and what I’ve highlighted and have everything in one place in my own words. That way I could re-organize it in a way that made sense to me and also add in information that I’ve remembered or could easily find to connect different lectures together.

I also drew out a lot of the pathways. The only way to really cement them in my brain was to keep drawing them out. If any of them connected together, I needed to physically see it (the second photo of notes shown is an example).

For most of the diseases, for learning what vitamins needed what cofactors or what diseases are caused by vitamin deficiencies/symptoms, and a few definitions, I used notecards. For biochem specifically I used the Anki flash cards. The computer the app was free, but if you use it on your iPad or your iPhone I believe there is a hefty price of $25. Since I’m cheap, I only used it on my computer.

Why did I use this one? Well for biochem since I had limited time and needed to get more in my brain, Anki has the option to immediately redo the card, come back in 10 minutes to show you, or bring it back in a few days time. It’s designed to help space out your learning for maximal memory and retention. Plus it tracks my progress and I would try to do flash cards everyday. If I needed to make a chunk of them, I didn’t study as many of them. But if I was making less flash cards or didn’t need to make any flash cards, I would do a lot of running through them. The nights leading up to the tests I would try to run through all of them. Anki also has the option of how many cards to provide you each day, and the ones you struggled with the most re-appear more often. So there are new ones that get added in to your pile, a chunk that get reviewed, and the ones you struggle with. If you do well on that block or a chunk of it, they will use different cards.

I do use study blue or quizlet for my OMM course information though, but this one I’m less pressed to learn the information in a small amount of time.

Then on the weekends or the night before a quiz, I would review as many flash cards as possible and read through my book of notes. If I needed clarification, I would go back to the slides.

The more passes on the information you do, the better you will learn it. I have a rule of 3: If I can see the lecture material at least 3 times then I will get a good portion of it in my brain; or at least enough to reason through and make some connections when prompted on a multiple choice test.

I.e.: If I look at the material the night before (which only happened a few times) that would be pass #1.

Attending lecture would be pass #2.

Doing my own notes would be pass #3.

Reviewing repeatedly would be additional passes.

Not gunna lie, it’s hard to fit in that many passes of your lecture when you have several lectures a day to get through and a very limited amount of time. But this way most definitely works. Your brain will make the connects faster (or more connections) the more exposure you have to it. Unless you are one of those loser people who have that weird gene/protein in their brain and they only have to read something once and recall everything–> you suck. I wish I had that ability.

Why didn’t objectives work as well for me this year as it did in COB? Time. I simply did not have enough time to go through all of the objectives and type them out. The ones I did do I filled out during lecture. This helped re-organize things for me so that when I went back to write them in my book they were already organized. However, most lectures I was too busy going “What the fuck is going on?” to be able to really sit there and do objectives and “oh my god I don’t have time to look at all of these”.

So ya know, typical thought process for me on the daily.

Testing:

We had 3 quizzes worth 5 points. After our quiz we would sit for a review. This was still the testing environment so we couldn’t take notes, but our professors would go over each question and why the correct answer was the correct answer. These were here for us to judge how well we were getting along in our studies and where we needed more work.

Midterm was 60 questions. The breakdown was 56 straight biochemistry questions and 4 clinical questions (from our CIS lectures–> they integrate real life cases with what we are learning in biochemistry).

For our final exam it was 90 questions. The breakdown was 43 questions of straight biochemistry, 5 clinical medicine questions, 30 genetics questions, 4 histology questions, and 8 physiology questions.

For both the midterm and final exam, there was a post-exam review. In this review, the questions that you got wrong would re-appear, and you could look at the explanation given to why the answer is what it is. During this the professors do not lecture us, but instead it is in text format on our testing app. You can leisurely look at this and go back to look at each question you got wrong multiple times.

How it is different from COB: well we get reviews. Whether that is instructor lead (after quizzes) or not (tests). We also see our raw scores as soon as we hit submit. Now, this does not take into account if we had an answer that wasn’t multiple choice, because the program (the same one you use in COB) doesn’t grade anything that is in essay format or short answer. That has to be physically graded by someone. But since everything was multiple choice in this block, we did not need to wait on additional answers to be graded. However it is still raw, you usually get 1-2 points back on a test because of ambiguous test questions/answers or the class as a whole did poorly on some questions. Or it was keyed wrong. The class average needs to be 85% (or at least that is what I have been told). So if the class average at the end of the course doesn’t hit this, the class as a whole will be bumped to an 85%.

Passing grade for the courses are 70%.

But thankfully with my raw scores I passed 🙂

Please let me know what you liked about this post or any questions you have in the comments down below!