Med School Advice from a Survivor, Duke – Part 2

Last week I shared practical med school survival tips from a Duke Medical School student. Here are the rest of his insights:

“The following is a really important piece of advice: if you’re one of those people who has known since they are three years old that they want to be a heart surgeon, I strongly recommend that even in the first year or as soon as possible you should start connecting with these people. Make connections and actually figure out if that is work you’d want to do. Because there are a lot of people that should have done this, and then they get through their third year, and they finally get an elective in what they think they like and it is not what they thought it was. The more experience you get early on about what it is that you want to do, the better informed your decision is going to be in the long run and the better odds you’ll have of picking something that you’re going to like. I walked into medical school thinking I was gung ho about surgery, and now I have all these other things floating around my head that I think I could be just as happy doing.

There are lifestyle decisions involved too. It’s really easy when you’re 23 years old to say ‘Oh yeah, I can work 80 hours a week no problem and be able to sleep 3 hours a night.’ But in reality no one can keep that up for a career. And trying to say ‘I can be this really intense person forever’ and not really need a family and social life, sometimes this is more of a lie that people tell themselves because they really think they want something. One of the things that I find myself doing all the time is constantly questioning the lifestyle aspect of parts of medicine; does going into this specialty really fit who I am, what I want to do, and how I picture my personal life.

Second, seek out your school’s student support services. On day one of Duke’s orientation they told us right off the bat ‘We have programs for you’. Our first go-to if we’re having a problem of any kind, literally anything, is our advisory dean. They are more or less our advisors, and they are also our champions. They’re the guys that if we don’t want to create a bad situation for ourselves by butting heads with someone with an ego, then they will be able to approach that person as a peer and have a discussion and possibly come to a resolution over whatever issue you are having with that person. One of my biggest issues walking in the door was I figured I was going to leave Duke with $300,000 in debt. So right off the bat I started just pinching pennies, which was not conducive to keeping myself happy. So I talked to my advisory dean about it, and he reminded me that ‘Look, there’s pretty much no way that you become a doctor and find yourself unable to live at least comfortably and pay that debt off. It might take you forever depending on what speciality you want to do, but you’ll be comfortable and you’ll be able to pay it off.’ That was really nice reassurance for me that I needed to actually live the way that wouldn’t affect my academic performance. In the long run, taking out an extra $5000 over the course of a year to eat better food and buy yourself a TV so you have some source of entertainment, is just a drop in the massive bucket that is your debt. So here’s one drop, you might as well be happy with once you have it.

Third, realize that having a significant other in medical school can be an extra stress or it can a benefit. I came to Duke with a girlfriend and the stress for her of me studying all the time really didn’t fit into her vision of what she wanted our relationship to be like. Finding someone that can truly accept that becoming a doctor entails big-time priorities that often need to come first is a very difficult thing. Inter-class dating among med school students actually happens really often. In our class that happened very early; people just started dating other people in the class right away.

Fourth, think ahead about Step 1 of your USMLE boards. Depending on where you are and who you talk to people will tell you different things about this topic. The most important step is Step 1; it is probably the most important test you will take in determining your options for the future. It is a difficult test and requires a lot of studying. So it is actually extremely helpful to have that in mind and even buy review materials early on and take notes in the margins as you’re studying to go back and look at when you review later. There are also lots of other different test prep tools out there, but when it comes to taking these medicine tests everything just comes down to how many practice questions have you done. The more practice questions, the better.

Finally, in terms of being on the wards every rotation has its own little idiosyncrasy. However, being on the wards is really all about preparation. Never wing anything. That only leads to you looking like you’re not taking it seriously and not being prepared. If you admit a patient during the day, that night when you go home you want to be researching the ins-and-outs of that patient’s disease process and the treatments for it. That way, if there are any changes that you want to suggest to your write-ups the next day, you can do it. And if you want to start impressing people you can look at some PubMed journal articles about that topic to show that you’re going above and beyond.”