How to Survive Medical School: The Ultimate Guide

13 min read

Below is the FAQ and ultimate reference guide on how to survive medical school. Some of the topics include applying to med school, studying for Step 1, long-distance relationships, and applying into competitive specialties (like dermatology) as a reapplicant. I will update this page each time I publish a new blog post so check back often!

Premed

Advice for applying to med school?
Check out my post here!
For those of you who didn’t match the first time, check out my dear friend Shirley’s story about resilience and getting into her dream med school as a reapplicant!
How do I know if medicine is for me?
The landscape of medicine is evolving rapidly and may be unrecognizable in 20 years. It’s draining emotionally and psychologically, not to mention financially. But it’s also an incredibly rewarding and meaningful profession. Most of us are drawn to medicine by some lofty ideal — we want to help others and contribute to the betterment of mankind. I also wanted to develop a lifelong craft that enriched my mind and spirit. You’ll be challenged to think critically and help patients during their darkest hours. On a practical level, it’s also financially stable, has good job security despite AI developments, and provides so much autonomy and flexibility depending on what you choose to do.
MCAT study tips?
I took the old MCAT ages ago, so I can’t really comment on the material. In terms of general advice — I took the Kaplan course and didn’t find it to be that helpful. On the whole, I find content covered in test prep courses to be too shallow and only useful if you need someone to hold you accountable for studying. I didn’t really know how to study in college (I took the test spring quarter of junior year), and gave myself way too much time (I started “prepping” beginning of junior year). My most productive study period was over spring break when I plowed through the Kaplan online question bank.
Why MD over DO? PA? etc?
MDs (medical doctors) and DOs (osteopathic doctors) are both medical doctors, just with different degrees. In 2020, the residencies will merge under a single GME accreditation system so there should be no difference in residency training. I personally don’t think choosing one degree over the other affects how good of a doctor you will be. However, it’s important to note that MD residencies will still favor MD students over DO students, especially among competitive specialties. At the end of the day, if you’ve made it into a US residency spot, your title will not matter to future colleagues or patients. Do your research and find a school that best fits you!

I picked MD over PA/NP because of the autonomy. PA/NPs can do a lot now, but the scope of their practice varies state-to-state and still requires physician oversight.

Did you consider Caribbean schools?
I actually didn’t know a lot about Caribbean schools when I applied. Since then, I’ve worked with some incredible Caribbean/IMG/FMG grads in the hospital and think they absolutely rival (and sometimes surpass) the MDs I know. However, the unanimous sentiment I hear is that it’s an uphill battle for them trying to train in US programs. They have to work so much harder than US MD students for the same opportunities. Graduating from a US medical school gives you much more of a competitive advantage for landing US residency spots, and should be something to consider when you’re choosing medical schools.
Does prestige of medical school matter?
Generally no, but it can help when you’re applying into competitive specialties since your pedigree will be a signaling tool to show programs you’re “competitive.” In addition, prestigious schools are usually affiliated with strong residency programs with ample research opportunities.
Will a bachelors in liberal arts hurt me?
Absolutely not! Med schools are constantly trying to diversify their class and studying something non-traditional (not biology or science-related) can help you stand out as an applicant. Just make sure you can fulfill the pre-req requirements (biology, o-chem, physics).
Should I take a gap year?
Refer to my post here.
I've been accepted! What should I be doing before I matriculate?
Congratulations!! But please do nothing. Relax, travel, treat yo self. You’ll learn everything you need to know in med school so there’s nothing to prepare for. Enjoy your last few months of freedom.

Medical school

Study tips

How did you study?
I have some great study tips in my post here. Study smart! In general — med school studying is a lot like HIIT (high intensity interval training). It’s important to dedicate 100% of your time while studying, but don’t give yourself unlimited time because you will burnout/lose productivity. If you make plans Sunday, you’re more likely to study harder Saturday. Rather, if you give yourself all weekend to study, you might end up procrastinating all weekend and feel more burnt out.
Did you go to lectures?
I actually did! But that’s because going to class every day forced me to keep up with the curriculum. But when I felt really stressed (months leading up to Step 1), I stopped going and would just watch lectures at home 2x speed. I don’t think it really matters since medicine is a lot of self-study anyway, and everyone learns differently.
Are study groups helpful?
Once again, it totally depends on what kind of learner you are. For me, I found study groups to be helpful for certain topics like histology and anatomy because we could do Anki decks together. Other than that, I’m very much a reader and learn best by studying alone. You’ll learn a lot about yourself during med school and what works best for you! Don’t let others stress you out.
How did you take notes?
I transcribed all of my lecture notes on Microsoft OneNote (this was before I got a Mac). I’d download the Powerpoint lectures beforehand, upload them onto the blank template, and transcribe my notes from lectures in the margins. I’d recommend uploading everything into the cloud because my laptop has crashed before an exam!! During Step 1 studying, I used a lot of physical textbooks and study aids so I could draw diagrams and highlight the relevant information.

USMLE exams

What are the USMLE exams?
USMLE stands for United States Medical Licensing Exams. They are 3-steps of soul crushing exams that all medical students and residents need to complete to graduate and practice in the US.
Step 1 advice?
Check out my crazy study schedule here. It’s my most-read post!
Step 2 CK advice?
I’ll work on a study guide soon, but it’s essentially a greatest hits version of your shelf exams. Doing well on shelf exams = doing well on Step 2 CK. I took Step 2 CK a month after my last surgery clerkship and was able to retain a lot of the relevant information.
Step 2 CS advice?
Don’t blow this exam off! I’ve already met a few VERY COMPETENT residents who failed the Step 2 CS exam their first time. I spent a week prior to the exam cramming First Aid Step 2 CS and found that to be sufficient. Don’t forget your words of empathy. Schedule your exam EARLY because there’s only FIVE SITES IN THE COUNTRY (Atlanta, Chicago, Houston, LA, Philly). Good dates get booked fast.
When should I take Step 2 CK/CS?
Generally the advice is, if you’ve done well on Step 1, you can delay taking Step 2 CK until after you’ve submitted your ERAS (September). If you didn’t do so well on Step 1, you should take Step 2 CK earlier so that programs see your improvement. Regardless, programs will want ALL of your scores (Step 1, Step 2 CK/CS) by the time they’re ranking you (February), so plan accordingly!
Step 3 advice?
I’ve yet to take this! Typically this is taken during intern year of residency.

Stress, motivation, work/life balance

What's the best part about med school?
Finally matching and knowing that I’ll be a doctor 🙂
How do I not give up pursuing medicine when I can't see the light at the end of the tunnel?
Just remember that you are not alone. The medical path is lonely and arduous, and tests us in more ways than one.

When we start to lose sight of our goal, we have to ask ourselves, why do we feel this way in the first place? Oftentimes, it’s because we feel like we’re going to fail and would rather give up than face disappointment. When I felt overwhelmed, it was usually about things beyond my control. (What if I fail this test? What if I can’t get honors? What if I don’t match into residency?) So instead, I would try to focus on the task in front of me. (Memorize DNA synthesis. Update my CV. Email some professors.)

It’s okay to wander aimlessly in the dark for a bit. Just take each step one day at a time.

What's dating like in med school? Do most people come in with relationships?
I actually don’t have much experience here, but I’d say it’s pretty good! Yes, many students do come in with SOs (and families), but new relationships blossom all the time! Obviously it totally varies from school to school and class by class, but I’d say ~8 couples did couples-matching my year! So if you’re interested, it’s very possible 😉
How do I make long-distance work?
Honestly, it can be very difficult and I don’t have the best advice. It ultimately boils down to, are you willing to make it work or not? If you are, both of you will find a balance that’s acceptable for each of you. There’s no secret sauce or magic formula. Obviously, try to see each other/Skype as much as possible. Communicate honestly and openly. Learn how to prioritize. But everyone already knows that. I don’t feel that it’s fair to share my own expectations and give you an impression that if you follow my “advice” or anyone else’s for that matter, LDR will be easier 🙁 Everyone’s personal situation is different and what works for one couple might not for another. Just remember that plenty of LDR couples make it through med school 🙂

What's the social scene like compared to undergrad?
It’s what you make of it! I know students who went out every weekend and students who never left the library. I will say that it was harder making friends in med school (for me personally!) compared to undergrad, because 1) there are a lot less students (vs a huge diverse pool of college kids); 2) we all have our own lives (SOs, families); and 3) I was a lot more focused on my studies/career. That being said, my classmates are truly wonderful people and I’ve made some very dear friends.
I feel like I need quirky hobbies to stand out/relax. Any suggestions?
It’s okay to have “common” or “basic” hobbies! No one’s judging you. My hobby became watching Netflix. Find something you enjoy doing and set goals for yourself to motivate improvement. Exercise became really important for my sanity so I got into weight-lifting in med school. And don’t worry about having “quirky” hobbies for your application/interviews. Anything goes as long as it’s something that you can speak passionately about!
How do I stop comparing myself to my friends?
Comparison is the thief of joy! I won’t lie that I get so much FOMO when I see my friends living their best lives and making real money out of college. But if you think you’ll only be happy if you reach your end goal (getting into med school, finally earning your MD, etc), you’ll always be miserable because you’ll never enjoy the process. Imagine you’re climbing a mountain. If you’re so focused on reaching the summit, you won’t realize the beauty that surrounds you.

Clerkships

How do I study for each shelf exam?
Check out my post here! I’ve yet to take the neurology shelf so that will be next!
How do I impress my attendings/honor my rotations?
If I’ve learned anything, it’s that rotations are incredibly subjective and unfair. I’ve detailed my experience here. In general — try to be HELPFUL and (appear) eager. Ask for feedback early on so you know how you can improve (and what your evaluators care about). Be sure to read up on your patients and present during morning rounds. But also value your time! Learn how to ask, “Is there anything else I can help you with?” when there’s nothing going on in the hospital (in the most enthusiastic way possible of course). It’s code for “can I go home and study for my shelf exam?” Despite all of your best efforts, you still might get bad luck and end up with a terrible resident/attending. I actually got a pass on my first medicine clerkship 🙁 But I appealed my case and got my grade changed. So if something seems unfair, don’t be afraid to stand up for yourself.
Favorite apps?
UpToDate (iOS or Android): Indispensable. I use this daily.
Epocrates (iOS or Android): Good for looking up drug interactions on-the-fly.
UWorld (iOS or Android): Must-have for shelf exams.
VisualDx (iOS or Android): Great for derm! Huge photo database to help you identify and generate a differential for skin pathology.
Read by QxMD (iOS or Android): Unlock full-text PDFs of journal articles!

Research/mentorship 

How do I get involved in research?
Use all of the resources at your disposal!! If you know what specialty you’re interested in early on, reach out to those faculty members for research projects. Don’t be afraid to cold email people as long as you sound professional. Make sure you have an updated CV. You can always start small (case reports), and then work your way up to bigger projects and/or a research fellowship. It’s important to not overcommit!! The last thing you want is to not follow through on something you’ve signed up for.
How can I balance research with school?
If you feel overwhelmed, prioritize your grades and Step 1 studying. Those two things should take precedence since they can’t be changed, whereas you can always publish more.
Do I need to take a year off for research?
That’s entirely up to you. For competitive specialties, it’s becoming increasingly common. Many derm applicants are applying with 10+ publications, so it might be worth considering if you have little to no research and/or are a late switch. Read more here!
How do I find a good *derm* fellowship?
Check out my tips here. Unfortunately, there’s no easy way to find them beyond word of mouth. Get to know your home department first! If you’d rather go elsewhere, ask upperclassmen who’ve matched into derm or are applying into it. They will be your best resource! Each year, someone on SDN posts a spreadsheet (try googling it) that lists all of the available fellowships.
How do I find a good research mentor?
I’ve written about the importance of having a research mentor and advocate here when applying to competitive specialties. Remember that a good mentor-mentee relationship is a two-way street. As med students, it’s too easy to be taken advantage of, so find a mentor who is invested in helping you advance your career (rather than exploiting your free labor). That’s why the interview/phone call is so important. You’re interviewing them as much as they’re interviewing you.

Applying to residency (General and dermatology-specific)

Why derm?
It’s the best field! Patients with skin problems suffer from serious quality-of-life/self-confidence issues because the skin is so noticeable (it’s the *surprise* largest and most visible organ on our bodies). They can feel ostracized and extremely depressed. Therefore it’s incredibly rewarding when you can actually treat their disease. I was really embarrassed by my acne and eczema growing up (people thought I had a bad infection!), so seeing a dermatologist changed my life.

Also, dermatology has such a bright future ahead, especially with all of the breakthroughs in immunology making headway. Given the amount of research and $$$ pouring into drug development right now, we may soon cure diseases that were once thought to be chronic and lifelong. But be careful about giving a generic answer.

When did you decide on derm and go all in?
I always had derm at the back of my mind but didn’t commit until I got my Step 1 score back. I was too afraid to fail and felt there would be too much pressure to succeed if I committed so early on. I also tried to explore other specialties, but more as a defense mechanism to avoid disappointment. In retrospect, I wish I had more confidence in myself and “went for it” as soon as I knew so that I could’ve started research projects sooner. Early preparation always helps.
What should I be doing each year to match into a competitive specialty?
The sooner you decide on a specialty, the better you can prepare.

1st year: Try to secure a summer research fellowship in the field you’re interested in. Introduce yourself to your home department and start some easy research projects. Join your specialty interest group.

2nd year: Do well on the Step 1 exam! Continue/start research. Maybe join the board of your specialty interest group.

3rd year: Focus on doing well on clerkships. Continue with research if you can. Meet with the program director to strategize a plan. Figure out if you want to take a research year.

4th year: Take Step 2 CK/CS. Apply to away rotations, submit ERAS, and go on your interviews! See more details below.

How do I compensate for a bad Step 1 score in derm?
Do well on Step 2 CK/CS! If you’re not a good test-taker, you can compensate in other ways. For instance, having a ton of pubs, great letters, and a strong research advocate can be hugely beneficial.
When is it too late to switch specialties?
It’s never too late!! People fall in love with derm at different points throughout their training and that’s okay. It’s probably because we don’t get much exposure in our standard curriculum. Obviously there are many advantages to getting involved early on (i.e., you can publish more, find a mentor sooner, know your home program better), but don’t let your fear of “missing the boat” stop you from pursuing derm if it’s what you want to do! I’ve yet to meet a specialty switch (And trust me! There are plenty!) who’s regretted switching into derm 😉
Where's this derm SDN spreadsheet I keep hearing about?
Every year a new spreadsheet is created for the current cycle. It contains anonymous insider tips about each program, away rotations, interviews, research fellowships, etc. I won’t post the actual links here, but I have archived versions in this post. A quick Google search should help you find the real links though 😉

Away rotations

How do away rotations work?
Away rotations are very common but they can be a double-edged sword. Check out my posts How to Pick Dermatology Away Rotations, What to Expect and How to Prepare for Away Rotations, and How to (Actually) Match into Dermatology for basic strategy tips. They can be extremely useful in helping you secure interviews and getting to know a department well, but unless you’re both clinically competent AND well-liked by the department, you’ll kill your chances of matching there.
How many should I apply to? Is it bad to turn down away rotations?
VSAS is way more stressful than it needs to be. Spots open up ALL THE TIME (especially later in the season) so I wouldn’t apply to too many programs. Instead, I’d apply to multiple rotation slots for the same program. Yes, turning down accepted offers can be AWKWARD, even if done well in advance (see my post here). I’m sure students have gotten interviews at programs they turned down, but do you really want to take that chance?
Can I rotate in November? How late is too late?
Depends on what your goal is (i.e., get a letter of recommendation, get an interview invite, get ranked highly, etc). Typically derm programs start sending out invites in November, but the majority will be sent out December/January. Interview season goes from November to February, but December/January are the heaviest months. For in-depth analysis on pros/cons of each month, check out my post here.

ERAS

When should I submit ERAS?
Programs start accepting applications September 15 but there’s no real deadline. However, some programs will start sending out invites on a first come, first serve basis starting September 15.
What if I submit my application 11:58PM EST on September 15?
Everything submitted ON OR BEFORE September 15, 12AM EST will be postmarked as September 15. Anything submitted after 12:01AM will be postmarked as they are submitted. Website crashes occur most frequently on September 15, between 11pm-12AM EST because everyone is trying to submit during this window. To avoid the high website traffic during this time, ERAS allows you to submit as early as September 5. Check out detailed information about the timeline here.

Interviews

How do I prepare for interviews?
The interview is SUPER IMPORTANT! This warrants a separate post but I’ve briefly touched upon this topic here. Check back for a detailed post!

Ranking programs

How does the rank list work?
Refer to my post here about ranking strategy for categoricals and advanced specialties. If you’re confused by these terms, definitely check out the article!

Post-match

What if I didn't match into residency?
First, I’m so sorry if you are in this devastating position. It’s absolutely heartbreaking and I’ve been in your shoes. I’d encourage you to read about my experience dealing with the initial blow my first time. And for some positivity and motivation — check out my updated post about matching the second time around into my dream specialty. Be sure to check out my friend’s story about reapplying and matching while balancing a PGY-1 preliminary internship.

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