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Letter to First-Year Medical Students

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Congratulations! You made it! Here is a little secret, that may be not a secret at all: That bad grade you may have gotten in undergrad in that STEM course that was terrible? It doesn’t matter anymore. You have a clean slate. And even better? The next year and a half is pure P = MD. No grades, no ranking, and no GPA. Hallelujah! 

So what is to come? What should you expect? Well, despite the transition to a pass/fail curriculum, be prepared for some stress and maybe some imposter syndrome. 

Medical school can be overwhelming with so much new content that you have to learn in short intervals; who knew the kidneys were more than just a few small beans pumping out pee? So get ready to expand your brain. One of my friends and I would try to cram anatomy info the night before our practical exam (do not recommend), and we would say, “Our brain is a sponge. Our brain is a sponge.” If you find this helpful in the weeks leading up to exams, feel free to adopt. With the vastness of knowledge thrust upon you, you’ll likely need to experiment with some study strategies. Whether it’s lots of Sketchy videos (you’ll find out what that is; the fourth member of the trinity, some might say) or drawing large diagrams to summarize the main points, you will probably have to trial a few things that aren’t perfect before figuring out The One. Just remember, the students before you went through the same thing. Turns out, I should not be making a million index cards in the few days before the test. Not sustainable or fun! 

You will also sacrifice some things. Maybe it’s the eight and a half hours of sleep you’re used to getting and a leisurely morning routine of iced coffee and The New York Times crossword. Well, it’s not necessarily being thrown out the window. You’ll surely have the opportunity to sleep in and try to guess the surname of the first self-made millionaire in the U.S. (Hint: It was a Black woman!) It is still tough — and I write this as an arguably jaded, washed-up third-year — to be in your early-to-mid or mid-to-late 20s and watch your friends on social media traveling when you’re stuck in the library for the foreseeable future. Medical school has its long weekends, its breaks, and even time on weekdays and weekends that you can do more fun things, but it is the grind people tell you about. One statement that has stayed with me since the beginning has been, “Medical school will take what you let it.” Meaning, if you study 24/7 (or 12/7, or whatever), medical school will let you. Likewise, if you make no time to call your nana and ask her about her herb garden, medical school will let you. You have to be intentional about what sacrifices you are willing to make in order to properly maintain your mental health and be a functioning friend and family member. 

Medical school is also one of the coolest opportunities life has to offer. Two years ago, I couldn’t tell you what to worry about if a middle-aged man showed up to the ER with altered mental status and fever. Now? I have a running list of possible diagnoses with different clues and treatments to clue you in to what to look for and how to treat it if needed, respectively. Your outside friends will begin to ask you: Should I worry about this rash? Should I go find a primary care doctor? Do herbal supplements protect against cancer? Where exactly is your liver again? And you’ll realize just how much knowledge you are absorbing even when it feels like all you’re doing is clicking through Anki cards. And, of course, there’s the incredible, meaningful satisfaction that comes from taking care of a wonderfully appreciative patient. You explain to them what heart failure really means and tell them how their medications are helping. And they’ll appreciate the way you took the time to talk to them, and check in on them in the mornings, and their family will smile and wave as they prepare to drive their family member back home. You will remember why you chose medicine, and get excited again about eventually becoming a doctor. 

This letter is getting long, so I’ll end with this: Medical school is impossible to do alone. Lean on your friends, your roommate, your parents, your significant other, pastor, therapist, yoga instructor, or whoever you lean on when times are difficult. Being honest about having a hard time is one of the bravest things you can ever do. Don’t be afraid to reach out if you’re overly stressed or feel the classic symptoms of imposter syndrome. We all want you to do well and enjoy being a medical student the best you can. 

So, buckle up. Buy your favorite coffee grounds, figure out the quickest way to the gym, organize your desktop, make sure your iPad charger works, and get ready to start one heck of a journey! 

Rooting for you,

Sarah Marion

What advice would you offer incoming medical students?

Sarah Marion is a third-year medical student at UVA School of Medicine and is interested in medical storytelling. She studied narrative medicine at Brown and has since been a part of several projects relating to cancer narratives, survivorship, and grief poetry. 

Image by Alphavector / Shutterstock


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