A Med School Memoir

So, the second year of med school was nothing like I expected it to be. If you refer back to a post I made at the beginning of the year, you’ll see that I had high hopes for this year being interesting and thought-provoking. While I will say that, to me, second year was immensely more engaging that first year, it was still not nearly as awesome as I had hoped. Let’s review the classes:

Pathology–Path was a course that I expected to really like.  I thought I would learn a lot about how diseases affect the body.  Since I have always been interested in disease processes–for instance, in undergrad classes, I was always way more interested in clinical correlations that taught about how the basic sciences we were learning affected human health than by the actual science itself–I figured that I would really enjoy path.  The reality of Pathology class, however, is that you spend about 20% of your time learning about disease processes and the remaining 80% memorizing what Pathology tissue slides look like.  This aspect of the class is basically tantamount to learning how to differentiate between a thousand different kinds of cancer under the microscope, and if you’re not interested in going into Pathology as a career, it doesn’t feel terribly useful.  So, in this regard, the course is basically the beefed up, angry, diseased, sequel to Histology class (which I did not enjoy.)  Nonetheless, that 20% where we actually learned about disease processes was really interesting to me, and I think path might have been my favorite class.

Pharmacology–I was a Chemistry major in undergrad, and so I had a feeling that Pharm would end up being one of my best and most enjoyable classes.  Despite the fact that there were hundreds of drugs to memorize and it could be quite difficult to keep everything straight, the class was, for the most part, straightforward.  So long as you are able to memorize tons of information (as with everything else in med school), this class is not terribly difficult, conceptually speaking.  In many ways it Pharmacology is just applied physiology–if you understand Physiology, Pharmacology shouldn’t be terribly difficult as long as you can keep all the drugs straight.

Microbiology–This was one class that I expected to like, but ended up being a little disappointed in.  I have always been interested in infectious diseases, so I figured that Microbiology would be right up my alley.  However, it turned out that I don’t really care about the virulence factors for bacteria as much as is required to really enjoy this class.  While I think it’s obviously necessary to know all the bugs that cause common illnesses, I found it terribly boring to have to memorize dozens of protein names like M protein, Streptolysin, and Leukocidin, when knowing full well that knowing these protein names will likely not affect the way I practice medicine in the future.  Nontheless, this is the type of thing you have to put up with in med school: learning stuff because it’s there to be learned.  I’m not trying to complain, however, because overall I did enjoy the class more than most of the others.

Behavioral Sciences–I had anticipated that I would enjoy this class.  And to be honest, it was nice to not have 1000 things to memorize every week, as is the case in Path, Pharm, and Micro, but Behavioral Science ended up being a lot less interesting to me than I had anticipated.  Maybe it’s because I felt like it was largely rehashing a lot of stuff I learned a long time ago–I took AP Psychology in high school, and I’d say that there was about a good 50%-70% overlap between that and Behavioral Sciences–but I found the class rather uninteresting most of the time.  I suppose if you’ve never learned about people with Schizophrenia or Bipolar Disorder and all that stuff before, Behavioral Sciences could be very interesting.  I’ve known about it for a long time, so the course felt like old news to me.

Genetics–If you’re like me and you hate memorizing useless trivia, you’ll hate Genetics about as much as I did.  One’s brain can only retain so many chromosomal translocations and gene names before he or she becomes engulfed rage and bloodlust for the sadistic professors who are making him learn the pointless material.

ICM-2–So, this class suffered a lot from poorly written exam questions and a lot of disorganization at my school, so I pretty much hated everything about it except for my preceptorship where I had the opportunity to work closely with an attending physician in the department of Internal Medicine.  That whole experience was great, but it only constituted a very small fraction of the actual class.  Otherwise, ICM is a bit of a misnomer, as there is very little “clinical” about Intro to Clinical Medicine.  A more correct name would be “Intro to the Theoretical Practice of Medicine Wherein You Consider Overly-Simplified Medical Situations and are Judged Harshly and Very Subjectively by Your Superiors, Who Likely Despise You,” AKA “ITPMWYCOSMSJHVSYSWLDY.”  Come to think of it, ICM does roll of the tongue a bit better.

Ethics–Wow, I was really, really wrong about this class.  I thought it would be thought provoking.  With a few exceptions, it was just a giant waste of time, considering that it was the only class that had mandatory attendance all year long.  There’s nothing more sadistic than taking ~150 people who are all stressed and in need of studying, and forcing them to congregate in a room two days before a giant test to listen to a lecture on the ethics of intersexual gender identity from a guy who is so boring he actually yawns at his own lecture.

Overall–The second year of medical school has a bad reputation for being difficult.  And I feel the reputation is well-earned.  I remember at the end of the first year, someone told me that second year was going to be even more difficult than first year was.  I thought they had to be crazy or just plain wrong.  I mean, the first year had Gross Anatomy, which is hard, and obnoxious as hell–surely second year had nothing that could be so bad.

And that is true.  Sort of.

No single class in second year is actually all that bad.  It’s the sum of all the classes combined that makes it so difficult.  The classes come at you so fast, and throw so much information at you all at once that it is very easy to get overwhelmed.  I witnessed several of my classmates who excelled during first year having a difficult time keeping up with the grueling pace of second year.  Second year is tough.  I’m glad it’s over.  But on the upside, it was, to me at least, infinitely more interesting than first year.  While first year was basically just a bunch of science classes telling you about the human body, second year is when you start knowing doctor-like things.

I’m still a long way from being a competent physician, but I know so much more about it now than I did a year ago.  I can thank second year for that.  I remember volunteering at a free clinic last year and knowing essentially nothing about how to treat a common disease like gout or hypertension.  The physician I was working with just looked at me like “why are you even here?”  I felt useless.  Flash forward to a year later–now when I volunteer there, I get mistaken for someone who actually knows what they’re doing.  It’s a big difference, and it wouldn’t have been possible without the difficulties of second year.

Second year is a lot of work, but in the end, there is a reward.  During second year, you work hard to convert information on a page into knowledge that you own.  The reward is that in third year, you can finally use all that knowledge you spent so long learning.  To some people, that may not sound like much of a reward, but to me, well, I’m actually quite excited to put my knowledge to use.

Up next, Step One.  More to come on that shortly.

Tags:   behavioral sciences · ethics · expectations · genetics · ICM · M2 · micro · microbiology · path · pathology · pharm · pharmacology · shattered expectations1 Comment