5 Things No One Warns You About In Medical School

1. Your classmates’ career choices will depress the hell out of you.  Back in 1st year, I was constantly just in awe of my classmates – everyone had amazing talents or former careers. It’s depressing to remember how excited we all used to be about our future careers as Real Physicians (!) seeing Real Patients (!!).

It was hard to look around the lecture hall without seeing at least one person and thinking “That person is the most compassionate human on earth. They are going to be the most incredible doctor.

Then 3rd year rolled around and after a year of being largely treated like dirt on the wards, those exact same people are – almost without exception – going into radiology, anesthesiology, or leaving medicine altogether for entrepreneurial or non-profit ventures.

i do all this shit for other people and i wake up and i have nothing

And that’s depressing because you KNOW they’re making the right decision. No matter how much you want to fool yourself into selfishly dismissing their decisions as cynical or self-serving, you know the truth: leaving medicine is actually just kind of smart.

These are good people that were beaten down, chewed up, and spat out by the wards and have the self-awareness to leave because they realize there are careers out there that AREN’T fiscally and emotionally abusive.

2. Which leaves you and your career decision… where, exactly?  I mean, if you’re admitting to yourself that those classmates are making a smart decision, isn’t there an obvious link to be made…?  Like, I don’t know, some sort of natural continuation of this train of thought that indicates something about the wisdom of your own career choice?

You are choosing to ignore this. You are ignoring it so hard that simply acknowledging the possibility that you are making a huge mistake doesn’t even seem like an option.

But that’s okay! Because even though NORMALLY the statement “If I ignore the hints that I’m doing the wrong thing, they’ll go away” is stupid – his time it’s totally not! Because of reasons.

… quick, let’s move on.

3. There are a handful of facts you were better off never knowing.

google it

I’m not referring to useless trivia that’s just taking up valuable room in your head without paying rent – that stuff was once worth valuable USMLE points.  I’m talking about tried-and-trued protocols that became out-of-date while you were on a different rotation and useless buzzwords (“spiral fracture” = “child abuse” has some damned important caveats – many of which have nothing to do with blue sclerae).

It feels like a miniature betrayal each and every time you are posed a question, answer “correctly”, and then hear, “Well.. actually – no. Absolutely not at all.”

4. Your career choice will depress the hell out of your classmates. “Pediatrics? Wow, I could never do that. It’s so depressing. Just think about it… sick and dying kids, every day for your entire career. God, that’d be terrible. Don’t you think it’s depressing?”

The counterpoint to point #1: Every few weeks or so, it’s important to find yourself on the awkward “… er, what am I supposed to say to that, exactly?” end of this exact conversation – it reminds you that you’re kind of a jerk for having similar opinions about the career choices of others and should probably continue to keep them to yourself.

5. You and your entire class will drop off the face of the earth. Between audition electives on the opposite coast, research, Sub-Is, and vacation months, you won’t be together again until Match Week. And even then, a bunch will have taken a year off for research or a second degree, so there’s a good chance you’ll just never see them again.


Lately I’ve been listening to how the M1s on campus talk about each other and honestly, sometimes it depresses me – they all seems so close. I remember feeling that way about our class.

But as soon as 3rd year starts, it becomes so easy for people to just slip away. 50% of conversations are about how much your current rotation sucks and the other half are people trying to remind each other who is actually still enrolled, who’s taking a year off, and who just left entirely without a word to anyone.

So, you know, it’s hard for me not to overhear happy conversations about impromptu M1 dorm parties without thinking things like “ENJOY IT WHILE YOU CAN. You’ve got like, 6 months, tops.”

Does that sound too ominous? That probably sounds too ominous.

… must be why no one ever warns us.

17 thoughts on “5 Things No One Warns You About In Medical School

  1. It gets better…. or at least you learn to cope with it better. Keep your head up, it’s a marathon and taking a rest once in a while means finishing the race!

  2. Personally, I liked 3rd year plus exactly *because* I saw less of my classmates (put another way, I got to hang out only with people I liked), but I also started school when I was a little older (and married) and felt a little peripheral those first two years, and was SO sick of all the junior high BS.

  3. I guess I’m probably never going to forget blue sclera.. The first time I saw it was a 20 year old girl with osteogenesis imperfecta. I remember the details of that case so, so clearly, mainly ’cause my classmates were being such absolute knobheads and poking and prodding her so callously. I mean sure I get being professional or being thorough, but dont you have to remember it’s still a person in front of you? That was so meh =/

    And I definitely couldn’t do Peds either. The idea of one squalling infant after another….. Dx

  4. Appparently nothing has changed in fifty years. As an M3 in the early 1960’s I hated the abusive residents. As a medical resident in the mid 60’s I had become hateful myself.

  5. Very honest. I like it.
    It is interesting how we see other people’s career choices and our own. Some days people tell me my career choice is depressing and I pause and half want to say, “yes.” But in reality you just have to believe that everyone choses correctly and ends up happy. At least for the most part. We had a few people who switched specialties last minute or did other stuff… It does not get less shocking.
    You will stay in touch with the people that matter and it is weird how through M3 and M4 people get out of some of the junior high crap and you actually run into some people at the strangest times. It is very different, but you adjust.

  6. Having a great title or working at the “best place” isn’t everything. Do what makes you happy, pays your bills, and leaves you with time to enjoy your family. Those people in your med school that you’re thinking you have to impress will only exist in your life for this four year window. After that, they’ll probably be fixtures at your med school reunion and that’s about it. You live with the benefits and consequences of your decisions, not them. Choose wisely and be happy. And…if you’re truly as awesome IRL as you are here, you’ll leave your mark on the lives of the children (and their parents) you care for.

  7. A great post, thanks for writing it! I’m a few years out of med school now and all the points you’ve made seem to be true. As one of those doctors whose compassion got the best of them (I’m training to be a pathologist and I really do love my job) I would like to suggest that those colleagues who choose radiology, anaesthesiology, etc may end up being the people you can turn to for sympathy and kindness when times are tough. We generally have more in reserve than our clinical colleagues :).

  8. Great blog. I’m studying for the MCAT right now and reading it is, if not like a breath of fresh air, at least a breath of warm humanity. I am curious about one thing- What are your classmates who are leaving medicine going to go do? You mentioned other degrees (I assume like MPH or PhD, sometimes MBA these days I guess) or non profit work, but a bit more specifically? Are they leaving healthcare altogether? Do they view their first two or four years (not counting undergrad work) as a waste? What are the dual degree folks interested in? I’m just asking to create as big of a professional imagination as I can in terms of roles for the medical mind.

  9. I have not started med school yet, but I think I have seen my friends who are MS4 go through the same thing.

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