Lessons from 1st year

[Otto]

Hi,

 

I'd like some advice from those that are going through or have completed medical school.

 

What is it that you wish you had known during your first year at medical school?

 

Some talking points could be:

 

1. Choosing electives.

2. Summer vacations.

3. Extracurricular activities and research.

4. Effective study methods or materials.

5. Anything else you'd like to add.

 

I'm sure a lot of the advice I'm asking for is on the forum in one form or another but by posting in this thread we can have it in a more accessible format.

 

Thanks for your contributions,

Otto

[Jochi1543]

1) Electives - you can't do formal electives in 1st year, but I think shadowing is a great idea. Start shadowing in stuff you think you are interested in right away - for me it was a huge eye opener as I realized that what I thought was really awesome actually ended up being really, really boring. It was helpful to rule that stuff out right away. Shadow a couple of different docs in family medicine, too, so you have a good idea of the opportunities to find your own niche in that if a tertiary specialty is not your thing.

 

People often suggest shadowing in things you aren't interested in at all just to make sure you aren't missing out on something because of ignorance. I tried that approach and yes, I confirmed that I disliked everything I thought I'd dislike, so it wasn't much of a eye-opener for me personally.

 

Shadowing in the field you are currently studying (e.g. respirology during pulmonary block) seems to help cement your classroom learning.

 

 

2) Summer vacation - this was important to me. I had my opportunity to do research before med school, so I already knew it was not my cup of tea. I was going to do an international elective but that didn't work out due to reasons beyond anyone's control, so instead I did a bunch of random stuff totally unrelated to medicine - and lots of fishing, camping, and other fun activities. I'm definitely happy that I avoided 4 months of misery in a lab somewhere - but then again, I'm not gunning for anything competitive. Plus even so, I still did some organized activities that I can show on my resume and demonstrate that I was doing SOMETHING productive.

 

This summer, we get only 10 weeks, so I'm definitely putting a priority on having a good time. I did sign up for a 3-week elective, mainly for the purpose of making my 3rd year schedule a little less hectic - it will allow me to get 1 or 2 weeks off in between some core rotations. If it didn't provide me with an opportunity to take time off during clerkship, I don't think I would've done it. But for the rest of the summer, I'm not doing anything related to medicine save for a few days of volunteering with a kids' medical camp in town.

 

I guess it depends on what your life before med school was like. For me, there was a lot of FT schooling AND FT work, or two jobs at a time to help pay the bills, so this time off without too much worrying about money (thanks to the LOC) is very valuable. Of course, if I wanted a super-competitive specialty, maybe I'd look at it differently.

 

3) ECs and research = I think I've outlined by position on research above. As far as ECs, I was fairly involved in med ECs in 1st year. This year, school is busier, my personal life is more demanding, and I'm more focused on using my last opportunity to spend a lot of time doing non-medical things, so I've both cut down on my ECs and shifted them into the non-medical realm. E.g. I'm taking a bunch of dance classes, music lessons, etc. I've got enough stuff on my resume to not feel inadequate, but I'm not planning to blow anyone away by getting involved in everything at the cost of my mental health.

 

 

4) Books = I don't read textbooks unless they are required - except for DL research or when I get really confused by a lecture. I don't retain this type of knowledge very well, I learn way more from shadowing and looking things up or having the preceptor explain them to me. Whatever works for you!

 

5) Anything else = apply for bursaries and scholarships, even if you think you have no chance at getting one. I've collected quite a few of both since starting 1st year.

[cardiomegaly]

1. Choosing electives.

 

Do more than one if you can. Do one in something you know nothing about (it will surprise you), something you enjoy and something you hate. (Obviously these are pre-clinical electives, not formal clerkship ones). I shadowed in everything from lab medicine to dermatology to surgery to family medicine.

 

In later years, try to do general type electives early on and then focus in on your desired specialty later when you're more competent and can impress. Useful early electives would include radiology, family medicine, general surgery, emergency. Spend some time getting used to how the hospital works.

 

2. Summer vacations.

 

I did research in my first year because I had zero research on my resume and come CARMs I wanted to be on par with everyone else. It was a great decision because I had a supportive supervisor and I gained a lot from the experience (including a publication). I put in the time in first year so I could enjoy my entire summer in second year. I also travelled a bit in first year and managed to do lots of enjoyable things in the summer.

 

For second year - make some time for electives (I have two) and definitely get yourself out of the country. It's the last chance you have for a couple years.

 

Take advantage of your reading week - our second year class had 60 people go to Mexico, best week of my life.

 

3. Extracurricular activities and research.

 

I think the decision to do research depends on your specialty of choice. Or, if you have NO clue and you want to make sure you've had clinical research exposure in case you do want something competitive - research skills can be transferrable across any specialty. You can always cram in a case report later on.

 

I thoroughly enjoyed my medicine related ECs. Got to know my peers and felt like I contributed to our community. My non-medical ECs kind of went down the drain (my important ones were in my hometown anyways) but I kept up with personal interests - sports, physical activity, cooking etc.

 

4. Effective study methods or materials.

 

Your own will suffice. Don't fall behind, keep up every week. Take a day off per week. It depends on your knowledge base before medicine - i had a strong base.

Useful material - TO Notes to supplement lectures if necessary, Lilly's pathophysiology of the Heart is a must, one of Netter's or Gray's Anatomy, plus a couple extra texts for interests sake in 2nd year.

 

5. Anything else you'd like to add.

 

Enjoy your pre-clinical years but put in the time to stay on top of your material. Don't leave it till the last week to study. Get involved, take care of yourself and meet great friends and future colleagues.

[Lactic Folly]

Start early. Like applying to medical school, knowing what you want to do for residency early is an advantage. It doesn't mean you can't match to a competitive specialty if you decide at the end of 3rd year, but it will save you a lot of headaches trying to arrange electives and secure letters of reference at the last minute.

 

You can do this by reading up on all the different fields and shadowing in the most likely possibilities when you start medical school. You don't need to wait for a formal elective - you can approach the departmental education coordinator or your lecturers/student advisors. Often upper years will have specialty interest groups which set things up for you as well.

 

Ask career-related questions when you shadow. How did they choose this field? What else did they consider? What were they not interested in? What do they see as the most important differences between the field they chose and those other fields - in terms of most rewarding aspects, difficulties, type of work, skills required, average day?

 

If you can narrow down your most suitable fields of interest, this will help you with planning your longer-length electives and summers. If you're looking at something competitive, it may be helpful to spend some time in research during one summer (letters of reference from those known within the field are most helpful). If you are seriously thinking of going to the US, consider writing Step 1 between 2nd and 3rd year.

[gb35]

Awesome info so far, I would looooooooove to hear from more med students on this one.

[Julie]

Hi,

 

I'd like some advice from those that are going through or have completed medical school.

 

What is it that you wish you had known during your first year at medical school?

 

Some talking points could be:

 

1. Choosing electives.

2. Summer vacations.

3. Extracurricular activities and research.

4. Effective study methods or materials.

5. Anything else you'd like to add.

 

I'm sure a lot of the advice I'm asking for is on the forum in one form or another but by posting in this thread we can have it in a more accessible format.

 

Thanks for your contributions,

Otto

 

It depends on what you think you will want to do as a specialty, if you have any idea

 

1. Electives : I would retrospectively have organised more if I had to do it over. I like the advice of doing an elective in the subject you're learning, as you're learning it. I think it'll be beneficial for your exam as well as your career choices. I think it's also great to organize electives in subjects you think you've ruled out. I've been quite surprised more than once about liking a specialty! At the same time, you'll be busy, so don't put too much pressure on yourself to do tons of electives during the year. I did some during the summer after first year, and found that to be a good way to squeeze in elective time without making my life hectic.

 

2. Summer vacation : I guess if you're really gunning for a particular competitive specialty, you may want to do research or an elective in that area. Otherwise, I say do what you like! In the summer after 2nd yr, I would advise against doing many electives. You could always do a few in the beginning of summer if you want to, but in general I would try to do things you enjoy outside of medicine.

 

3. EC's : So the carms application is very similar to the med school application. Keep that in mind. If you can squeeze in some ec's during med school, you'll feel better about your application once it's time to send it. Again, this is more important for competitive specialties and you don't need to put too much pressure on yourself. There's less time to do ec's for everyone, so you don't need as many. And I don't actually know how much this really matters in the match. Like pre-med ec's, my general advice is always to do what you like and not what you think will please adcoms.

 

4. Study methods/materials : Try a few methods. I realized after my 2 clinical yrs that I did better on my exams when I studied on my own & didn't attend classes. Took me a bit too long to figure that out!

 

For books, it depends a bit on your style. For cardio, I highly recommend getting Dubin's EKG as well as Lilly's. (You'll find out what these are fast when you get into the cardio block) I didn't buy Dubin's book for ECGs in pre-clerkship and really regretted it! Ended up buying it in clerkship and reading the whole thing in a day! I also liked Toronto Notes. Not to learn things for the first time, but found they were a good review just before an exam. You read the relevant section and voilà! You've reviewed most of the material!

 

5. Have fun and don't worry, you really were meant to be in this class & will do fine just like everyone else. When the going gets rough, remember how you felt the first day of med school, and how happy you were with your achievement! Think of how few people actually get to do this!

[emma3]

What is the difference between Gray's Anatomy and Netter's? And which would you recommend? Thanks!

[thebouque]

Gray's is a textbook, Netter is an atlas. Gray's for students has great pictures. The actual Gray's textbook is overkill though (huge book). If your school is strong in anatomy, you should think of getting both a text (Gray's or Moore, whatever your school recommends) and an atlas (Netter's has pictures, Grant's, or Rohen for cadavers). If your school doesn't emphasize anatomy too much, then only an atlas should be enough.

 

Peace

[NLengr]

I second buying Dubbins. I used it all throughout medicine, and still use it as a refresher during residency.

[leviathan]

Dubin's book is epic and covers all the basics of EKGs. If you want to do IM or just in general want to learn ECGs better I'd pick up Garcia's 12 lead book after finishing Dubin's.

[thebouque]

Dubin's book is epic and covers all the basics of EKGs. If you want to do IM or just in general want to learn ECGs better I'd pick up Garcia's 12 lead book after finishing Dubin's.

 

I second that. At our school, we're required to get the Garcia book, not Dubin. However it helps to skim through Dubin before reading the Garcia book.

[Student_Doctor]

Don't want to turn this into just a recommended textbook thread but for anyone struggling with electrolytes or acid-base problems check out "Acid-Base, Fluids, and Electrolytes Made Ridiculously Simple". I missed several weeks of our nephrology course and was horribly confused until I found this book!

 

Unfortunately I also bought the "Neuroanatomy made Ridiculously Simple" and didn't like it at all so I can't vouch for the whole series.

[leviathan]

Don't want to turn this into just a recommended textbook thread but for anyone struggling with electrolytes or acid-base problems check out "Acid-Base, Fluids, and Electrolytes Made Ridiculously Simple". I missed several weeks of our nephrology course and was horribly confused until I found this book!

 

Unfortunately I also bought the "Neuroanatomy made Ridiculously Simple" and didn't like it at all so I can't vouch for the whole series.

Agreed. Clinical microbio made simple was amazing. The pharm book was awful. The neuro book was somewhere in between the two, but overall I didn't like it much. They had a couple good mnemonics and explanations for teaching the brainstem cross sectional anatomy and some other stuff which was good though.

[Smurfette]

Everyone will tell you this and none of you will listen. But then you'll tell everyone this when you're a resident.

 

Don't stress about your exams. Obviously, you need to learn something from preclerkship, but your career is really not about your exams. If anything, concentrate on shadowing, talking to staff/residents about their careers, ask about the positives/negatives, learn what the day to day is like, how much people work, how much they make, etc. ie. FIGURE OUT WHAT YOU WANT FROM YOUR CAREER especially what field you want to go into. That will be more helpful than memorizing 15 biochemistry pathways and learning the coagulation cascade.

[RiceWine]

Everyone will tell you this and none of you will listen. But then you'll tell everyone this when you're a resident.

 

Don't stress about your exams. Obviously, you need to learn something from preclerkship, but your career is really not about your exams. If anything, concentrate on shadowing, talking to staff/residents about their careers, ask about the positives/negatives, learn what the day to day is like, how much people work, how much they make, etc. ie. FIGURE OUT WHAT YOU WANT FROM YOUR CAREER especially what field you want to go into. That will be more helpful than memorizing 15 biochemistry pathways and learning the coagulation cascade.

 

does this depend on the school you go to? because it seems getting H's in preclerkship is pretty important as well?

[Larrivee]

does this depend on the school you go to? because it seems getting H's in preclerkship is pretty important as well?

 

It doesn't seem like too many schools have H anymore (tho Ubc still does), so I find it hard to believe that H's will play a big role in comparing candidates. If a student from an H school gets an H and a student from a non H school gets a P... They shouldn't put the P student at disadvantage because of his school's grading scheme when he could have gotten the same score on exams as H student. It makes more sense to me that they would only use H when comparing students from the few schools that still utilize it. Mere speculation though

[lost__in__space]

bumping this thread as I am now in first year and would like to hear more opinions :-)

[rogerroger]

1. Choosing electives.

 

What and where they are matters little. Meds I is about exploring as many specialties as possible. You are on track if you can narrow it down to medicine vs surgery by the end of 2nd year. Third year you should narrow it down to 2 specialty choices which are hopefully related to each other for CaRMS purposes.

 

 

2. Summer vacations.

 

See number three.

 

3. Extracurricular activities and research.

 

Intense research shouldn't be a priority in 1st year unless you simply love it. That first summer is golden. A good and fun option is the IFMS bilateral research exchange offered during the summer. I did this after 1st year and it allows you to live overseas for free, research and travel. This was hands down one of the best trips I ever did and one of my best med school experiences. I made several friends in med schools around the world. Four years later we all have a good excuse to travel and visit each other in all these different places. Fun and cool for long term networking.

 

See this link for the available IFMSA projects: http://www.ifmsa.net/public/searchredb.php

 

If you think you are interested in general surgery, plastics, family, emerg etc. join the relevant professional associations. It shows interest and provides opportunities to explore the respective fields. If you get involved early later on you can become more involved. Many of these groups have elected med student reps etc.

 

Get involved in a niche interest that you love and is also semi-relevant to med. Many people regardless of eventual specialty choice have sub-interests within medicine which they pursue as med student and beyond. Common interests are medical education, under serviced populations, management, global health, various advocacy work and so on. If one of these things interest you then dive right in early. These interests provide chances for you to develop skills that are very practical and useful. I found an interest in medical education during my first year and I stayed involved in this area via extracurriculars throughout meds until I finished. Now as a resident I have stayed involved and neat opportunities for research and leadership are available because of the skill set I cultivated in med school. I'm certain med ed is something I will incorporate into my career as it develops further and it is all because of a 1st year meds extracurricular. An added bonus is that come CaRMS it is these interests and experiences which will make you unique.

 

4. Effective study methods or materials.

 

Whatever allows you you learn efficiently... This is very person dependent. I made notes on my notes during pre-clerkship. Do a little something everyday. I crammed so much during pre-clerkship. It is not fun. Make life easy on yourself and review an hour or two nightly. There is tons of time to stay up all night working in clerkship, don't get an early start in pre-clerkship...

 

5. Anything else you'd like to add.

 

You will feel overwhelmed and it is normal. Lots of people will pretend they are not, but they are too. Your brain will have to absorb stuff at a much higher rate than ever before. Medicine knowledge is not complex. The difficulty is all in the volume. By the end of 1st year if you know your basic physiology and anatomy and your basic clinical exam skills you are on track. Don't get too caught up in pathology or diagnosis. You will have plenty of time for that.

 

Have fun! Seriously, 1st year is fun when you are not cramming. UofT has long painful lecture days, but in hindsight I got just as many fond memories of sitting with the same people day after day and just learning stuff. You have a ton of flexibility. You lose this flexibility later. I worked 50 hours these past 4 days and if I don't show up to work tomorrow that is a problem. In perclerkship you can totally get away with going to class once a week even if it is only to catch up with people. If your lectures are recorded online and slides are provided take advantage of the added flexibility! Go shadow people, enjoy nice weather, explore extracurriculars or whatever your little heart desires! Just remember to be efficient when you are studying and do something everyday for you stay on top of things.

[lost__in__space]

Thanks RogerRoger :-)

[goleafsgochris]

1. Choosing electives.

 

What and where they are matters little. Meds I is about exploring as many specialties as possible. You are on track if you can narrow it down to medicine vs surgery by the end of 2nd year. Third year you should narrow it down to 2 specialty choices which are hopefully related to each other for CaRMS purposes.

 

 

2. Summer vacations.

 

See number three.

 

3. Extracurricular activities and research.

 

Intense research shouldn't be a priority in 1st year unless you simply love it. That first summer is golden. A good and fun option is the IFMS bilateral research exchange offered during the summer. I did this after 1st year and it allows you to live overseas for free, research and travel. This was hands down one of the best trips I ever did and one of my best med school experiences. I made several friends in med schools around the world. Four years later we all have a good excuse to travel and visit each other in all these different places. Fun and cool for long term networking.

 

See this link for the available IFMSA projects: http://www.ifmsa.net/public/searchredb.php

 

If you think you are interested in general surgery, plastics, family, emerg etc. join the relevant professional associations. It shows interest and provides opportunities to explore the respective fields. If you get involved early later on you can become more involved. Many of these groups have elected med student reps etc.

 

Get involved in a niche interest that you love and is also semi-relevant to med. Many people regardless of eventual specialty choice have sub-interests within medicine which they pursue as med student and beyond. Common interests are medical education, under serviced populations, management, global health, various advocacy work and so on. If one of these things interest you then dive right in early. These interests provide chances for you to develop skills that are very practical and useful. I found an interest in medical education during my first year and I stayed involved in this area via extracurriculars throughout meds until I finished. Now as a resident I have stayed involved and neat opportunities for research and leadership are available because of the skill set I cultivated in med school. I'm certain med ed is something I will incorporate into my career as it develops further and it is all because of a 1st year meds extracurricular. An added bonus is that come CaRMS it is these interests and experiences which will make you unique.

 

4. Effective study methods or materials.

 

Whatever allows you you learn efficiently... This is very person dependent. I made notes on my notes during pre-clerkship. Do a little something everyday. I crammed so much during pre-clerkship. It is not fun. Make life easy on yourself and review an hour or two nightly. There is tons of time to stay up all night working in clerkship, don't get an early start in pre-clerkship...

 

5. Anything else you'd like to add.

 

You will feel overwhelmed and it is normal. Lots of people will pretend they are not, but they are too. Your brain will have to absorb stuff at a much higher rate than ever before. Medicine knowledge is not complex. The difficulty is all in the volume. By the end of 1st year if you know your basic physiology and anatomy and your basic clinical exam skills you are on track. Don't get too caught up in pathology or diagnosis. You will have plenty of time for that.

 

Have fun! Seriously, 1st year is fun when you are not cramming. UofT has long painful lecture days, but in hindsight I got just as many fond memories of sitting with the same people day after day and just learning stuff. You have a ton of flexibility. You lose this flexibility later. I worked 50 hours these past 4 days and if I don't show up to work tomorrow that is a problem. In perclerkship you can totally get away with going to class once a week even if it is only to catch up with people. If your lectures are recorded online and slides are provided take advantage of the added flexibility! Go shadow people, enjoy nice weather, explore extracurriculars or whatever your little heart desires! Just remember to be efficient when you are studying and do something everyday for you stay on top of things.

 

Wonderful post. I slacked off quite a bit in first year, and doing so even more would have been just fine.