Medical School is Just OK

“How’s medical school going?” That’s a common question, and I don’t think I have the most cheerful answer. Maybe my bitter honest sentiments were strengthened by living in Ukraine- where one never responds to an inquiry with “Great!” or “Good.” I can’t bring myself to respond that medical school is “cool” or “amazing.” The best word that comes to mind lately is “ok.”

Yes, just ok. Why just ok? Well, has anyone ever told you that medical school was the best time of their life? I doubt it. That’s because it’s really pretty hard. Medical school hard- that’s no surprise, right? It seems that many medical students must be a special breed of people that thrive on academic torture as much as helping others. Indeed, there has to be a high level of willingness to sacrifice, delay gratification, and self-discipline for students in this odd regime, and it’s no cheerful matter.

The US medical education system is undoubtedly an “odd” thing to take part in. First of all, there are the prerequisites and admissions—basic science classes, the dreaded $250+ MCAT, the expense of submitting an AMCAS online application, and the drawn out selection process which can last from June of one year until August of the following year. It’s a self-selecting process that fills all applicants with self-doubt, and often a competitive mindset. Is this what it takes to become a recognized, practicing healer in our country? Being a basic science wiz, having a lot of money, and knowing how to get ahead of others? What about kindness or compassion?

I recently read an article, “Most Likely to Succeed“ in the December 2008 New Yorker magazine in which Michael Gladwell explores how difficult and unpredictable the NFL quarterback selection process has been. He writes, “There are certain jobs where almost nothing you can learn about candidates before they start predicts how they’ll do once they’re hired.” He goes on to make a connection to medical admissions saying, “We now realize that being a good doctor requires the ability to communicate, listen, and empathize—and so there is increasing pressure on medical schools to pay attention to interpersonal skills as well as to test scores. We can have better physicians if we’re just smarter about how we choose medical-school students.”

It’s true—there is a new movement in medical education to select people who have done community service, and who show dedication to humanitarianism in their essay and interviews. In fact, I think this is probably the reason that I was accepted to medical school. Yet, most schools continue to value the test scores and basic sciences just as highly as humanistic skills.

The result is that I am surrounded by amazing people- who I deeply admire—but who also happen to have trouble breaking out of the competitive and over-achieving mindset. I occasionally am drowned by this sentiment myself. For example, after a recent exam, I found myself unable to hold back tears. Meanwhile, I made myself feel worse because logically I knew how stupid it was for me to be crying over my grades. I know that as life challenges go—this one is not so bad.

For most people I study with, it seems being in medical school is the most important part of their lives. What’s the problem with that? Well, maybe nothing if you think that Dr. House is the best doctor ever. Personally, I’d prefer a well-balanced doctor who cared about me—even if it meant delaying the right diagnosis. But I think many Americans might choose the cynical, distant, and brilliant physician, if they had a choice.

This past month of rigorous anatomy, physiology, development, physical diagnosis, and pathology—has not given me much time to ponder about my solutions to choosing good future physicians. I briefly considered using “shoe-selection” as a qualification (those wearing practical, but professional shoes during their interview would receive high marks in this category). However, ultimately changing future physicians would require a change in curriculum as well as admissions.

I would change the amount of basic science material covered to include less of these sciences, and more classes about public health, social work, and practical skills. I would also have less multiple-choice testing, and more options to extend medical school to 5-6 years, instead of just 4. I would try to admit some regular achievers along with the high achievers, out of which more people might be satisfied with general medicine rather than the highest specialty possible (although some argue that students choose specialties for the salary, maybe it has to do with personalities). Medical students currently are not the type to be satisfied with anything less than the best, most, and highest they can be- which is causing a huge shortage in primary care and family doctors.

My medical school is even supposedly non-competitive, and encourages the importance of listening and personal connection more than other schools. I am especially honored to be surrounded by many great physician role-models who act differently from most medical norms. My recent family practice mentor challenged my notions of American doctors by being extremely personal—making jokes and always hugging people when appropriate. She was so gifted, and developed a deep bond with patients—one that I dream of having someday too.

Yet, my days as a first year are normally so far removed from this type of experience. This semester has been more fulfilling than last one with anatomy and physical diagnosis being more hands-on and interactive than my previous courses. However, I am still bogged down by the exams, especially tonight. And I must remind myself constantly—like a mantra—that two years of classroom time is nothing compared to a career full of clinical joy, and the opportunity to get deeply involved in people’s health—something that’s special and sacred work. And maybe… just maybe… I will hold on to some sense of happiness, balance, and idealism, even if medical school is just ok.