The Fire Hose is Real - How to Survive Your First Year of Medical School

by Jason Spears

Let me begin with by extending a hearty congratulation on matriculating to medical school. The premed years were tough with organic chemistry, staying involved with leadership activities, chasing down the elusive letter of recommendation, and sitting for the MCAT.

But you did it!

Be proud of what you've accomplished because you're one step closer to becoming a doctor.

You may have fears, concerns or misgivings about what is coming your way and this is where I step in. In June, I completed my first year of medical school so trust me that I am qualified to share advice on making a successful transition to medical school.

Write a letter to yourself.

Now this isn't any letter you'll be writing. I want you to think about why you want to be a doctor, what practicing medicine means to you and recount the euphoria you had upon learning you were accepted.

This letter writing business should be done immediately.

Medical school is a grueling process where you are going to be stretched in ways you never thought possible. For all the myths and rumors you have heard about sleep deprivation, the amount of material you're expected to learn, and the responsibilities you'll have there is an inkling of truth to it all.

Now your letter is something for you to look back on as the school year drags on (yes, you'll think so too after a few months) and your motivation begins to decline under the pressures you're facing. This letter is going to be your pick-me-up that you read with fondness, excitement and renewed passion for the study of medicine.

To be honest my physiology professor who is a physician was the one who encouraged our entire class to write our letter. Not a lot of students took him up on this, but I certainly did.

So before the excitement wears off from your medical school acceptance letter reading: "Congratulations, it is with great pleasure I welcome you to the class of"; write that letter to yourself because it will get you through tough times.

First Aid, a Must Have. To practice medicine and most likely to graduate you're going to have to take and pass a set of exams known as your "BOARDS." I know you just completed the MCAT and we're already talking about Boards which you won't begin taking until your second year of medical school.

But this exam determines your future in medicine so everything you do is centered on the Boards. Even your professors will drill into your head the importance of Boards because material from day one is fair game for this exam.

First Aid is a review book for the United States Medical Licensing Exam (USMLE) aka Boards.

I hate to use religious analogies but consider First Aid to be your medical school Bible. As you progress in your classwork refer to First Aid and make notations from your coursework so by the time you begin studying for the Boards in earnest a large majority of your notes are in one place.

Which reminds, me for First Aid get a physical copy and not a digital copy because you'll want to write and annotate throughout this book.

No Loners, Have a Wolf pack. As I write this, I've recently watched the Hangover, so forgive the wolf pack reference. What I want you to do is make friends with as many of your classmates as possible.

Be social; get out to as many of the orientation and class-mixers as possible (well at the beginning of the year at least). You never know who in your class will become your study buddy or your biggest cheerleader during rough times.

More importantly, your classmates are unique and diverse in their own right each bringing something to the table that will make you a better physician. Although, you may hear about or attend a school with "gunners" this does not have to be the case for your entering class. You have the power to change things and be a class of collaborators.

Here's what I mean...

If you're like me you like to study alone and learn the material by yourself. Often this is an efficient strategy but I wouldn't chance going into your exams not working with your classmates.

I studied by myself but the week before an exam would review with my classmates and it is amazing what some of them picked up as important, need to know concepts whereas I brushed them aside in my original studying as not being high yield. I'll tell you what, after some exams I'd walk up to my classmates and say, "Hey, thanks to you I definitely got the questions on XYZ correct."

So go ahead and collaborate with classmates.

And of course upperclassmen are a great resource too. They can give you the inside scoop on what to expect, how to prepare for exams and general advice on surviving medical school.

Be Selfish. I said it, go ahead and be selfish. But let's put things in context. When you're studying, study. When you're relaxing, rest. When you have personal time, no distractions.

Set boundaries and adhere to them.

It is very easy to study 24/7 and lose touch with yourself along with family and friends while in medical school but you don't want to go this route. Family and friends are your support group and will be the ones who help you in the difficult times you may encounter.

You may have to limit your communications with others but don't shutdown completely where all you know is your textbooks and nothing else. Medical school is about studying very hard, yet having balance.

Specifically, with selfishness it means being laser focused on the task at hand and not multitasking. Therefore, if you plan to take a night off from the books be selfish and indulge; don't sit around and feel an urge to mentally review on your downtime.

The same goes with friends and family. Set boundaries of when you're available and unavailable. I can assure you they will understand in due time.

Most importantly take time out for yourself. Medicine can be all consuming and the only way you'll survive is taking a break to recharge when needed. Please don't feel guilty when you are recharging because you're human and not a machine and there's only so much you can handle.

In the same breath, be prepared to push yourself beyond what you think is possible too. There are going to be times when you'll have to perform what you believe to be superhuman feats of Olympian nature and this is when you have to find your internal motivation to push past the fatigue.

Humility. You'll learn very soon that there are some very narcissistic individuals in medicine. Don't become like them.

Have humility because although throughout your life you may have been the best at everything you've done, medical school brings together everyone who was the best.

A humble person is one who admits when the tasks are greater than him and seeks help when needed. I had a professor who said, "Trust a doctor who tells you when he doesn't know, because when he tells you he knows, then you know he really knows."

Trust me when I tell you the doubt and uncertainty you feel is not unique to you. Medical school is going to test your breaking point and so much more.

If you're feeling overwhelmed whether from personal issues, academic troubles, social concerns or simply adjusting to medical school, reach out to friends, counselors, faculty because everyone is on your side and willing to do whatever it takes so you can be the best doctor possible.

The Fire Hose Is Real. I'm sure at this point you've heard the analogy of how the volume of information in medical school is equivalent to drinking from a fire hose, this is the absolute truth.

If my memory serves me correctly the first year medical student learns approximately 13,000 new terms.

You need to develop a solid system to handle what will be coming your way because it's no longer tee ball - you're in the major leagues. What you know or don't know in the bluntest of terms means whether a future patient lives or dies. You have an obligation to yourself and future patients to be a knowledgeable and competent doctor.

Make a schedule for yourself so you can be efficient in your studies.

I'm talking a schedule where you mark all your class time and obligations. Then input time for eating, hygiene, appointments and sleep. Once you do this you'll see how much time you have available for studying. You'll probably be shocked at the outcome.

Then go ahead and divide your days and week into how much time you'll estimate you need to get through the material and learn it cold. I should remind you that you want to study the material as though you'll never see it again.

I say this when in reality it will take about three to seven encounters with the material before it is put into long term memory. Often times you won't have the luxury to review this often so you have to make every encounter count.

Remember how I discussed being selfish, now is where it comes into play with your study time and not having any distractions while you are hitting the books. No texting, social media, television or multitasking. Basically if it won't help you get a passing grade then it shouldn't be around while you are studying.

Lastly enjoy your journey in medicine. You're going to work hard in medical school but take time out to smell the roses. I don't have to tell you how to have fun because I'm sure you and your peers have imaginations much more creative than mine.

Rest assured by the end of first year you’d be amazed at what you have accomplished. Embrace each and every experience you have in medicine and don't take anything for granted.

March confidently, be thirsty for knowledge and know you have what it takes to be a doctor otherwise you wouldn't be here in the first place.

I commend you, student doctor!