What to Expect During Medical School

You’re about to embark on four years of learning, working, socializing, and then learning and working some more. The best way to prepare for the long road ahead is to know what to expect.

This post will walk you through the various avenues of medical school education, from reviewing what and how you’ll learn to making time for your health and personal growth.

In this article:

• Curriculum styles you might encounter in med school
• Learning opportunities at your medical school
• Note-taking and sharing services
• Finding your bedside manner
• Interacting with patients
• Personal growth in medical school
• Taking care of your health during med school
• Deciding on a specialty
• Year by year: What to expect throughout med school

Curriculum styles you might encounter in medical school

When you initially researched medical schools, you probably noticed that each school emphasizes different styles of teaching – and that some schools offer more than one approach. Here are some of the different curriculum styles you might find:

• Traditional based: In this style of teaching, you learn about healthy normal anatomy and physiology the first year, then pathology and disease processes the second year.
  
  
• Systems based: In a systems-based method, you learn about each organ system (e.g., neurological, musculoskeletal, cardiovascular) and study both the normal and abnormal aspects at the same time. Then you move on to the next organ system.
  
  
• Problem based: In this integrated approach, students are given patient cases through which they learn about a variety of systems in the context of a single patient. For one patient, there might be both cardiovascular and renal systems involved, so you will study the effects they have on one another. Some educators feel this is a more relevant and practical way to learn, while others feel there is a risk of becoming overwhelmed or missing vital information.
  

The good news is that many schools use a blend of all these methods, and almost all schools expose students to problem-based learning at some point during their four years. Whichever style your school emphasizes, it will often monitor your ability to retain and use the knowledge in a practical (e.g., case-based) situation.

Learning opportunities at your medical school

Whether you prefer studying in groups or alone, keep your personal learning style in mind. If you don’t know your learning style yet, this would be a great time to figure it out. If you tend to be a visual or tactile learner, then labs and hands-on situations work best for you. If you are more of a kinesthetic learner, then time spent on hospital rounds will be a great way to reinforce concepts. If you are an auditory learner, then you should make every effort to attend lectures.

Some schools have mandatory lectures, while others make only small group classes and labs mandatory. If you tend to tune out and fall asleep during large lectures, you might decide to spend some of this time studying. However, not all lecture time is boring. Professors usually want their students to do well and will often drop little hints as to what will be on exams. More importantly, you’ll have a chance to ask clarifying questions and hear what other students are struggling with. When another student poses a question that you share, it can reassure you that you are not alone in your confusion.

Note-taking and sharing services available at your medical school

Some medical schools organize a note-taking service, where students take turns creating detailed notes for each lecture and sharing them with everyone else. The benefit of this system is that you can relax in lecture if you are not the assigned note-taker that day, knowing it will all be written and available for you later on. Additionally, if you are sick or need to skip a lecture, you will still have the information that was covered in class.

The drawback of note-takers is that you might not get every detail, especially the questions and answers. If your note-taker is not paying attention, you might miss something important.

At some schools, professors send their lecture notes out before class, so students can read directly from the professor’s notes while they listen. This removes the need for note-taking and might tempt you to skip classes. However, once again, you will miss hearing the questions asked by fellow students (and more importantly, the answers).

In medical school, it is often up to you to decide how best to spend your time. Some days, you might benefit more from being in class than others. Use your time wisely.

Finding your bedside manner

You will learn a variety of approaches to making patients feel comfortable, ranging from chatty humor and small talk to a simple squeeze of the hand or a comforting smile. Your teachers include attendings, residents, nurses, hospital techs, and of course, the patients themselves. In the end, you can pick and choose which styles and methods work best for you.

You will find that your approach varies from patient to patient, depending on their unique concerns, emotional state, and medical condition. Experiment with different ways of connecting and providing comfort, and you will eventually formulate your personal bedside manner.

Interacting with patients

Medical students start by learning to take a complete patient history and review of systems, then progress to the physical exam. The first few times you interact with patients can be a little scary, so many schools ease you into this by having actors pose as patients. Other schools rely on more experienced patients who enjoy working with students. Many patients like teaching students and take great pride in contributing to their medical education. Their main goal is to help make you a better doctor. Let them show you how to make things more comfortable, and you will both come away feeling a positive connection

Want to hear what medical school is like from actual med students?
Check out our What Is Med School Like? series!

Personal growth in medical school

Medical school is not only about the time you spend in class. It also involves a total immersion into the medical culture. Your classmates become your tribe as you share jokes and trivia that only you can understand. You will find yourself talking about medicine all the time, especially during meals (imagine cadaver talk). The benefit of this is that you will develop meaningful friendships with your classmates, which could continue for years to come. The negative is that your family and friends outside of medical school might not understand the all-encompassing nature of your studies.

If someone close to you becomes frustrated with your inability to spend time with them, try to set aside regular times for a phone call or meal. Be sure to ask about their life, too. If you have a partner who is not in medicine, you need to take extra steps to ensure that they feel a part of your world. Introduce them to your med school classmates, bring them to social activities, and take a break from talking about medicine whenever you are together.

On the other hand, many doctor-doctor marriages have origins in medical school. For some, this is an ideal situation because your partner will understand what you are going through and why you need time to study. For others, having a relationship with a non-physician feels healthier. Either way, if a relationship is to flourish during medical school, you need to put effort and time into it.

Taking care of your health during med school

Med students tend to imagine every disease state occurring in themselves while they are studying it. While you should never ignore symptoms, when you think you are dying from a rare condition, do a reality check. If you are convinced that something is wrong, visit student health. They are used to students showing up with a variety of med school–induced symptoms and will do their best to educate and reassure you if that is all that is needed.

On the other hand, medical students can experience all the same diseases that patients suffer from. While serious conditions can occur, students are also prone to anxiety, depression, and stress-induced conditions. Be sure to take care of yourself so that you can care safely for others.

Deciding on a specialty

What kind of doctor do you want to be? At some point in med school, that question starts to take on more weight. It’s now time to do some serious introspection and think about what your passions are, where your skills lie, and who you see yourself as in the future. You might want to ask yourself the following questions:

• Do you see yourself in primary care? If so, will it be pediatrics, family medicine, internal medicine, or ob-gyn?
• Do you imagine subspecializing in an area such as neurology, cardiology, gastroenterology (or one of dozens of other options)?
• Do you like doing procedures? Do you want a medical specialty that does a lot of procedures, or a pure surgical specialty? Or maybe you would like a procedure-based specialty like interventional radiology or interventional cardiology?

Then there are anesthesia, dermatology, emergency medicine, radiology, ophthalmology, pathology, and psychiatry to think about (and all the subspecialties available in these areas). There are also some combo-residencies for those who cannot choose one (internal medicine-pediatrics, and family medicine-psychiatry). If you look hard, you will also find residencies and fellowships in preventive medicine, rehab medicine, occupational medicine, pain medicine, and other areas. See the AAMC website for a complete list.

So how do you choose? The first thing you might want to consider is which clerkships you enjoyed most. Did you like them because of the people you worked with or because of the work itself? This can be hard to tease apart, since an energetic and fun-loving chief resident can make you enjoy surgery, while a grumpy or overbearing attending can take the fun out of an otherwise fascinating rotation.

If you are seriously considering a specialty, be sure to do a fourth-year rotation in it so you can really get to know the work and the lifestyle. Stay overnight in the hospital with the residents to see how much time they spend with patients and how much sleep they get. Go to the clinic to see what the patient interactions are like. Can you see yourself doing this job day in and day out? Is this a lifestyle you can live with in the long run?

Year by year: What to expect throughout med school

Each year of medical school is different, complete with its own set of challenges and expectations.

First year

This year gives you a deeper understanding of the intricacies of human health and disease. Many schools do their gross anatomy cadaver dissection this year. You might also take courses in genetics, microbiology, histology, microanatomy, pathology, and physiology. Most medical schools give first-year students an opportunity to begin seeing patients and learning the basics of the medical history and physical exam.

Many medical students find the first year intensely challenging, while others see it as a more human-focused repetition of what they learned in undergrad. For most, it is a rollercoaster of information and nonstop experiences. Kind of like being a toddler and having the freedom to explore your world for the first time, you might shift between feeling excited and scared. Bonding with your classmates over your shared feelings can be extremely therapeutic and reassuring.

Summer break

Widely touted as “the last summer,” many students use the time between the first and second years to explore their interest in research, while others travel and participate in a global medicine experience. Many schools create opportunities for extra clinical exposures, so you can use this time to look into specialties you are interested in. You should be sure to use some of this time to recover from the intensity of your first year and to relax and catch up with friends and family.

Second year

At most schools, you will deepen your basic science training in the second year, with an emphasis on pathology and disease states. You will develop your clinical skills and get further patient exposure. You might even find yourself in the hospital, though there will probably still be a considerable amount of classroom and lab time. You might delve into pharmacology, immunology, and/or neurosciences.

Year two is capped off with the USMLE Step 1 exam, which assesses your understanding of how the basic sciences apply to human health. Most schools integrate USMLE prep into their second-year coursework and give students extra time to study for the exam.

Third year

The third year often consists of the following:

• Core clerkships: Typical third-year clerkships include internal medicine, family practice, surgery, neurology, ob-gyn, pediatrics, and psychiatry. Some schools also have mandatory rotations in radiology, ER, and ICU. You might have an opportunity to do more specialized electives. If you are considering a specialty, try to get exposure to it as early in your training as possible so you have the time you need to be sure it is right for you.
  
  
• Hospital rounds: You will find yourself on the hospital wards, making rounds and seeing patients. As you work with a team of residents and attendings, you might even have some actual responsibilities, though they will probably be minor. You are starting to become an integral part of the healthcare team, though no one expects you to save lives yet. In fact, one of the best parts of medical school is always having someone above you to make sure your patient is safe. While residents love their med students (you do a lot of work for them), you might sometimes notice they are too tired or stressed to answer your questions. Be sensitive to their readiness and recognize that they can’t put you first all the time. Being willing to help with any small tasks and waiting for that quiet time when they can finally take a deep breath will often pay off. Residents tend to save their best teaching moments for the med student who stays the latest and shows the greatest commitment.
  
  
• Patients: Hospitals affiliated with medical schools attract patients with complex and rare diseases from community doctors and hospitals. You might see things that doctors in private practice rarely get to diagnose or treat. However, it is often the less exciting or “bread and butter” cases that you will get assigned to. Take advantage of this and do your best by each patient you work with. They are allowing you to learn through their illness, so above all, be grateful for the opportunity.
  
  
• MD/PhD students: This is the year when many MD/PhD students find themselves separated from their classmates and delving deeper into research. They might get to do some clinical rotations during this time, with their main goal being not to forget everything they learned in the first two years.

Optional year

Some schools offer a “gap year” between the third and fourth years of medical school for students to accomplish an in-depth research study, participate in global medicine trips, or undertake independent study. In general, you need to be in good academic standing and have a solid plan for what you hope to accomplish during this time. Check with individual schools to learn whether they offer this year and when the deadline is to apply.

Fourth year

Here’s what you can expect during your fourth year of medical school:

• Month-long electives: Depending on your school, this year could include a combination of specialty clerkships, sub-internships, research/independent study, and time off for interviews. Some schools continue to have required coursework in the fourth year, while others leave the program entirely up to you. Your main goal should be to decide which specialty you plan to pursue and to set the stage for acceptance to residency.
  
  
• Clerkships: As a fourth-year student, you will be heads and tails above the third years who are just starting their clinical rotations. Your residents and interns will give you even more responsibility, and with that comes sought-after privileges. You might get to assist in surgery, admit patients, and participate in procedures. You might finally feel like a real doctor, even if only for a few minutes each day. Use this time wisely to get to know your attendings and earn their letters of recommendation for residency.
  
  
• USMLE Step 2: Sometime during this year, you will study for and take the USMLE Step 2. This exam focuses on the clinical applications of basic sciences and understanding of disease states. Together with Step 1, it is the main tool that residencies use when comparing applicants from different med schools. If you are hoping for a competitive training program, you should take your Step 2 preparation seriously. Some medical schools provide tutoring or group preparation classes, and there are online resources available.
  
  
• Visiting sub-internships: Sometimes considered a month-long interview, visiting sub-internships give programs an extended time to see what you are like. However, they also give you a chance to see their hospital and find out if you like their style of training.
  
  Some questions to consider:
  • Are their M+Ms (mortality and morbidity conferences) high pressured or relaxed?
  • Do the residents get hands-on procedures or do the fellows do more cases?
  • Is there a focus on research or primary care training?
  • And perhaps the most important, do the residents seem confident, well-prepared, and happy?
    
    
• Research: Med students often use elective time in their fourth year to complete, write, and submit research findings for publication.
  
  
• Residency applications: Residency applications: Now is the time to apply to residency programs. It’s like your med school application all over again, only with a specialty in mind. Instead of AMCAS, you use the AAMC’s ERAS to complete your application, submit letters, and track interviews. The main difference is that in the end, you match with only one program, and almost everyone matches on the same day.
  
  
• Time off for interviews and other interests: Time off for interviews and other interests: October through December is prime time for scheduling residency interviews. Be sure to spend enough time at each program to get to know the residents and hospitals. Most medical students choose lighter electives during these months to allow for the extensive travel.

How an admissions consultant can help you get into medical school

We’ve covered a lot in this post–and it’s exciting and maybe a little scary to think about the unfolding of the next four years. But before you start planning your schedules and emotionally preparing for patient care, you need to overcome the first hurdle: getting into medical school.

The acceptance rate for many med schools is under 10%, with an overall acceptance rate for all U.S. MD and DO programs of well under 50%. To beat your competition and get accepted into medical school, you need to make sure your application is strategic, compelling, and thoughtful.

And an Accepted admissions consultant can help dramatically.

When you work one-on-one with an experienced medical school admissions consultant, one with decades of experience guiding applicants just like you to acceptance at top medical schools, you position yourself for success. You learn how to identify your competitive advantage and use it to get accepted. Explore our Medical School Admissions Consulting Services, choose the best med programs to apply to, and then confidently submit a stellar application that will get you ACCEPTED!

Dr. Suzi Schweikert has served on the UCSD School of Medicine’s admissions committee, and has mentored students in healthcare programs for over 20 years. She holds a BA in English Lit from UCLA, an MD from UCSD, and an MPH from SDSU. Want Suzi to help you get accepted? Click here to get in touch with Dr. Suzi Schweikert.

Related Resources:

• Get Accepted to Medical School in 2023, a free webinar
• Med School Admissions Veteran Shares Her Experience: How to Get In, a podcast episode
• How to Get the Most Out of Working with a Med School Admissions Consultant

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