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Reflections of a first year medical student
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Digitalis: 2007, Barts
Iceman_jondoe: 2007, Peninsula
diamondsky99: 2008, Cardiff
Friar Chris: 2010, Birmingham

Digitalis, Barts and The London, 2007 entry

At the end of my first year at medical school, I have made a list of things that I think would be useful to those applying for or going off to medical school or even things that I wish I had known before coming!

1. Medicine is not as hard as everyone makes out, least not the first year. You will be around intelligent people, true, but you will most definitely not be married to your desk and textbooks. On average, I have 2/3 hours of teaching a day, much less than what I had at Sixth Form! No one gives a toss about your A levels, module grades, GCSEs, UKCAT score, even where you got your degree from at the end of the day. When it is 2AM on a dark and cold ward and you are the House Officer on call, the old lady in front of you drowning in her own fluids will not look at you and ask any of those.

2. Depending on your course (like mine), you may do exams constantly throughout the year. Other courses only have them at the end. Find out early and plan ahead.

3. You will be expected to act in a different way to other students. The GMC and Fitness to Practice committees are always hanging over your head. How many other students can say they had a stroke victim pouring their heart out to them, age 18, or have a young mother hand her two week old baby over to you and expect you to know exactly what to do?

4. Don't rush into buying books. Wait till you get to medical school. Some people may want to buy you textbooks, but a lot of the time a.) your medical school won't use them or b.) they will be so infrequently used it is just a waste of good money.

5. Depending on your course (PBL based), you might want to consider buying a stethoscope. You will certainly need one if your course asseses your clinical skills through OSCEs. There is only one stethoscope you need, throughout your entire junior medical career including when you are a house officer/SHO. The Littman Classic SE. Don't buy anything else, you will just look a tool.

6. Keep up to date with your lectures. It is so tempting not to bother getting up one morning to go to them.

7. Be proud of your medical school. Get involved. You are going into a long and established career you are going into and your medical school provides a shelter for you until you can stand on your own two feet.

8. Learn the important stuff that you will need in practice, anything else just cram for an exam. Stuff like CVAs, MI, hypertension, heart failure etc. Don't bother with the likes of the random genetic disease that only specialist paediatricians see.

9. Get to know your medical news. Keep reading up on the latest developments in medicine. Student BMJ, BMJ, Lancet etc.

10. Enjoy it. Be proud you are a medical student. You are in a privileged position, one that you have fought hard to get to. Don't be afraid of being keen, or geeky...everyone else is as interested in this as you are! Read up on things you don't know about, learn other skills. It's a great feeling diagnosing your first relative!

11. A word about medic house/flatmates: I lived with 14 medics in my first year. I really enjoyed it, everyone had exams the same time, everyone else felt the lows and the awful reality that it is 5 years studying, everyone went out together. It is not bad at all! But you do get some quirky moments, for example sitting at the kitchen table eating food whilst looking over anatomy dissection pictures!

Iceman_jondoe, Peninsula Medical School, 2007 entry

Thats all fair and great. I think your first year of med school will depend entirely on the person and med school that you are at. I'd just like to add my thoughts:

1. I found my first year incredibly hard, and still am. Maybe its the fact that im at a PBL uni, the amount of work is loads!, and with no guidance you dont really know what to revise and what not to revise. I say you should be more prepared for going into a PBL uni. Do a little reading before uni begins it wont hurt. Maybe even learn the anatomy of the arm and the leg in the summer holidays. You have to learn it eventually so you might aswell, it will just be one less thing you wont have to spend time learning when you get to med school.

2. Def dont buy any books, borrow them from the library thats what they are there for. I seriously could not help but laugh at the idiots who spent loads of money on books in my year, and i got through the entire year by just borrowing and renewing them at the library. It left more money for me to spend on more important things like clothes and food!! and i intend to do the same thing for the next four years. I only buy a book if im REALLY finding it helpful, or there is such huge demand for it at the library that i can never get it out, but these situations are rare. If you do decide you want a book, dont blast your money away at rip off places such as waterstones, or the uni book shop, go on the net, there are some real bargains out there, on places like amazon, and ebay, and if your really smart and your familiar with file sharing, some of you can even get online medical books for free ;).

3. Of course, keep up with your lectures if you can, but dont be disheartened if alot of things go over your head. They have done for me, but everyone feels the same, so ALWAYS remember that your fellow medics are in the same crappy boat as you!!

4. Yes BE proud of your med school. This is one thing i was not proud of for almost half the year, but at the end of the day your here to become a doctor and you have to enjoy it. Being a med student IS a priveledge (as already mentioned) at ANY med school (in the UK at least), so dont waste the opportunity to become a doctor.

5. My final point try and interact with people other than medics if you can, they are great fun and all, but it can be annoying hanging out with the same people, not to mention stressful. Some people need a change, so try getting to know people who do other courses at uni, trust me it will help. Medics can be too up their own asses sometimes.

Good luck!

Peninsula Medical School 1st Year.

diamondsky99, Cardiff University, 2008 entry

A few of my comments:

1. I was fortunate enough to have lots of experience at full body dissection - if your medical school does the same then make the most of it! I wish I could do it again to appreciate what an amazing opportunity it was (instead I sat at the end of my cadaver chatting about anything other than anatomy).

2. I'd recommend living with medics (at least one other) when you decide on houses for second year. Having geeky medic chats, appreciating the annoyance of 9 o clock lectures and discussing the emotional strain of something upsetting you've seen on placement is so much easier with people on the same page!

3. Be prepared to grow up pretty quickly - you'll have greater responsibilty than others doing other subjects and your general lifestyle will be more a case of work hard, play hard.

4. Most people who I've spoken to have had a 'blip' where they're not sure it's what they want to do anymore. This often happens in first year with all the stress and lifestyle change with living away from home. My own blip was during horrific revision stress and after I thought I'd failed an exam - I hadn't in the end - it did make me question myself and whether I could hack the rest of the course. Don't be frightened if you do start having doubts, speak to someone (a friend, tutor, parents etc.) or even arrange some summer work experience to see if it is what you want to do.

In all it was a bit of an alcohol-fueled rollercoaster of a year, but I learnt so much and I absolutely loved it!

Friar Chris, Birmingham Medical School (University of Birmingham), 2010 entry

At the time of writing this, I've just finished my first year so (hopefully) it should be fresh in my mind, though occasionally some memories are rather alcohol-blurred!

My top 10 reflections from my first year and my advice in hindsight - at least from my experience at Birmingham - are:

  1. Was it Hard? Well, it certainly wasn't a cake-walk, but it shouldn't be too much to handle. You aren't thrown in at the deep-end with a bucket-load of biochemical equations and left to figure it out. In the first year, they'll ensure you have the basics down - even if you didn't do A-level biology, the basics will be integrated with the degree-level content so even if you are a bit behind others, you'll eventually cope with it fine. Some people are more 'intelligent' academically than others, but if you got into medical school, you should be fine - don't worry about how 'clever' others around you seem. They will actually usually be keen to help out if they are catching on quicker. It's by no means easy, but it shouldn't be impossible. You will struggle with something at some point, even if it's not in the first year, unless you're very lucky. Your friends and the medical school will help you out if you need it - the work is hard, but you will cope.

  2. How big was the workload? Large workload was large. There was no way around it - it's what we signed up for, after all - the work isn't always very hard, but it's almost guaranteed that there'll be a lot of it. Understandably this varies between medical schools and depends on the course - some medical schools, for example, may have far less scheduled work. I'm looking at an old timetable for a week last year, however, and I count 25 hours of scheduled work - lectures, tutorials, cadaveric anatomy et cetera. This was by no means one of the longer weeks in the year; it's one of the less packed. Your scheduled activities - unlike many of your non-medical peers' - will often begin much earlier and end much later, in addition to there being more of it. 9AM lectures, tutorials and even prosection at Birmingham are commonplace (and much resented!) whilst all of these can go on as late as 6PM. In fact, first-years had to train and be qualified to perform Basic Life Support, so for 4 weeks of the year we were in the medical school until 10PM at night.
    • Importantly, it's the unscheduled work that I found you need to keep on top of. It was one thing to go to lectures and tutorials, but to spend the unscheduled hours during the day and some of your free time to catch up on notes, do the reading for the next session, research around a topic you've briefly covered et cetera requires a lot of motivation, which can be hard to find during the daily grind.

  3. Don't Panic, as anyone who has a Hitchhiker's Guide can tell you. Half the problems and fussing and (for some) crying isn't due to the student being incompetent, incapable or 'not cut out' for medicine, but rather down to the hype and expectations that usually are just a figment of the student's imagination. I personally didn't have any crisis moments, but I had to re-assure a handful of colleagues (hey - you're going to be calling other doctors 'my colleague' for the rest of your life, start now ;) ) when they did. The moral from most of these was that it's usually never as bad as you think it is. People don't expect you to be scientific gods and you're not going to be summarily kicked out of medical school.

  4. Go to lectures. All of them (cue dramatic music). Seriously though, there are a lot of very good reasons to go to your lectures, even if like mine they are not attendance-monitored. I admit I missed a few, and I regret it. Here are a few very good reasons to try and make it to all of them:
    • You're paying for them (with interest on that student loan, too)! If you're reading this for starting in 2012, you'll be paying even MORE for them. Something OVER 9000 (or maybe exactly £9000). Don't waste your own money: you don't get to go back and ask for a free second-take of a lecture!
    • It'll save you oh so much pain at the end of the year for your exams. Even if you don't think you're going to make notes, even if you don't make notes, you'll still learn so much that you otherwise would have to spend twice as long researching and revising, or may miss out entirely.
    • It's a common courtesy to the lecturers who are turning up to do their jobs - many of whom are practising doctors and have made time to come and teach you on top of their existing commitments to their patients! In comparison, I think our excuses (yes, I'm not pontificating and saying that I attended every lecture) of being hungover or tired don't really stand up!
    • To make friends! Even if you're a complete slacker you have to recognise that most lectures will have virtually all of your year present, and you can sit anywhere. And you will sometimes not be sat with your existing friends; quite often, actually. The opportunity to meet people is all year round; unless you're some super-socialite who managed to befriend all x-hundred medics in freshers' week alone. In which case, you've probably been neglecting other vital aspects of life, such as eating, drinking tea, sleeping and washing.

  5. Textbooks? Oo err, the advice varies on here, but I'll give you my take. You can take some out of the medical school library (or the uni library), but I advise that you're going to need at least a small collection of your own, and medical textbooks are expensive. When you've got work to do, you do not want to be pulling a small cart-load of textbooks from a library. Forget essays, anatomy preps and 'worksheets' can often take 3 hefty textbooks to get all the details for, and have you seen how big and felt how heavy some of those beasts are? It's inefficient and inconvenient to have to constantly be taking out the same books and returning them. Now, I was lucky; though I was on my own for paying for halls, food, luxuries et cetera during the year, my parents offered to foot the bill for textbooks and equipment (stethoscope et cetera). I understand people may have financial constraints that mean they have little choice, but otherwise, sacrifice a bit of gin (or vodka; I'm just a gin person!) for some very good investments. In my personal view:
    • You'll need at least a basic set of textbooks. An anatomy textbook, a physiology textbook and probably a histology textbook are a functional minimum to have in your room covering a broad spectrum of what you'll learn, and are often some of the heavier textbooks that you wouldn't want to be borrowing constantly from a library - you'll probably use these books very regularly.
    • If you have the funds there are a few other relatively broad-spectrum textbooks that are useful to have. It wouldn't hurt to have your own copies of pharmacology, cell biology and neuroscience textbooks - these aren't quite as broad-spectrum as anatomy and physiology textbooks, but provide more subject-specific information on areas that you'll very frequently encounter, whilst still in themselves covering quite a wide area for the price - Neuroscience textbooks for example typically will aid you when studying not just the nervous system, but also musculoskeletal, respiratory and digestive systems due to the overlap and integration. I personally also found an atlas of pure anatomy (to compliment the anatomy textbook) very useful; but it depends what anatomy textbook you have - some of them are wordier than others and I am rather fond of anatomy, I confess.
    • The library is for specific books. You certainly don't need your own copy of an in-detail embryology or respiratory physiology textbook, or a book on abdomen surgical procedures. For individual assignments, trying to better understand something you're struggling with or learning in-depth about something that interests you or you've been told you'll need to know - then go to the library. Even if you did want to buy these books, there are too many to count, since they cover very narrow subjects in great detail. This is what the library is designed for - you can get a small pile of very specialised books when you need them. Perhaps sometimes there is a book you find interesting and want your own copy of - that's your choice if you want to spend the money, but you certainly won't need your own copies.
    • A medical dictionary and a BNF are always very, very useful. The former you'll often get a free copy of - from your medical school or as a sign-up goodie from the BMA, MPS or MDU. The latter I'd advise you should try to scrounge - you don't need an up-to-date copy; any BNF from the last few years will do fine (new revised issues are released every March and September). See if you can get one from any family friends who might have old ones lying around - since they'll be getting new ones twice yearly, pharmacists, nurse practitioners and doctors will usually have a few of the last issues lying around. You could even ask your GP if you could have their previous copy, at most I'm sure they'd give you it for a discount.
    • FINALLY, do NOT go out and buy these books because you've read them here before you go to medical school. You may be given a reading list specifying what you need (at Birmingham you won't be given a set list), but more importantly your lecturers and tutors will give you advice on which textbooks they recommend, which they feel you'll need your own copy of et cetera. Additionally, if you want to save money and don't mind a battered/very slightly outdated textbook, when you get to medical school you can almost always buy a lot of books from older medical students who are selling theirs off second-hand at a good discount. Apart from the inconvenience of minor disrepair, the only true disadvantage you'll have is that lecturers will often reference lots of specific pages or page ranges for textbooks for you to get the full details, help you understand and read further - and your previous edition's page numbers won't match, so you'll have to find them yourself. Do remember also that these textbooks will last you for yeaaaars.

  6. Don't cloister yourself away with the medics. My best friends are mostly medics - yours probably will be too. This doesn't mean that they have to be, nor does it mean that they necessarily should be. It doesn't help in this respect that many medical schools are situated in institutions separate from the universities that they are attached to, and so - even if just by a 5 minute walk out the front door to the campus - separated geographically from everyone else. Nevertheless, you should have plenty of chance to meet and befriend non-medics, and you should - as much as we enjoy and spend much of our time telling 'medic-y' jokes (a matter proximal to my myocardium), talking in a 'medic-y' way (with too much Latin) and experiencing the cameradery, it's unhealthy to be detached from the outside world. There's plenty of opportunity to socialise outside of medicine, and no reason not to. Your flatmates are unlikely to all be medics, your immediate area in your halls (whether it's stairwell, corridor, block, whatever) will be packed with all sorts of people and often will all be good friends by the end of the year. Being a medic shouldn't stop you; though you'll have medic socials to go to, they don't take up anywhere near enough time to claim that you don't have time for other people. Plus, you may even learn something interesting other than medicine by talking with that English Lit or Chemical Engineering student every day, which might just prove some stereotypes wrong!

  7. Be proud of your medical school, be proud of your vocation, but don't be arrogant. We can sometimes develop an unfortunate - err - ego due to status and reputation... Medical students are widely regarded to be very intelligent relative to some other students, but don't let it go to your head. It's quite probable that you have some of the highest A-level grades in the university - medicine is probably one of the hardest courses to get into there, if not the hardest. This does not mean that you are superior to every other student you meet, and even if you were it doesn't give you any right to be arrogant about it. I once or twice got a bit full of myself - not so much to alienate my friends, but there were a couple of moments when I made someone feel uncomfortable, but luckily I knew them well enough that they let me know. We're only human, but don't fall into the trap of thinking we're better than other people... Even if they're studying an artsy fartsy degree (JOKES, jokes...!) Just remember the line between medic banter, pride in the medical school and being a bit of a tosser to your non-medic friends!

  8. That one lecturer who everyone fears as the spawn of Satan? There's usually at least one lecturer or tutor who may be a bit scary, generally evil or just chronically grumpy. Don't be an idiot about it, even if they are just grumpy for no reason it doesn't give us an excuse not to learn what they offer. From personal experience, a bit of patience and showing interest in such a lecturer's subject will actually show that they're not as bad as you feared from the back of the lecture theatre at the beginning of the year. Indeed, the lecturer who we were all terrified of for the first trimester and had something of a temper turned out to be - despite a slightly warped sense of humour - not only a good lecturer and tutor, but also quite a friendly and sometimes hilarious person if you give her a bit of respect and some patience. It's not school anymore children - lecturers and tutors (and doctors on clinical placement) will often refer to you as their 'colleagues' just as they would another doctor; it's time for us to grow up too and not be petty as if the lecturer was a disliked teacher not to do the homework for. We're not going to get along with every nurse, doctor or manager we work with, so it's best to get a grip now - and perhaps even find out that they're not that bad after all.

  9. OH NO FITNESS TO PRACTISE ('F2P'), THEY WILL NEVER LET ME BE A DOCTOR. A common misconception which we all worried about for a sizeable fraction of the year. With the benefit of hindsight, I refer you back to point 2: Don't Panic! It is true that we can't do certain things that other students would get away with, because not only would the medical school have to do their own F2P investigation even if they let you off the hook, they still have to inform the GMC and they could refuse registration for you on graduation. But what are these 'other things'? A few myths need dispelling - you can get absolutely wasted and party all night, you can express your own political and religious opinions and yes, you can be politically incorrect. You can dress however you like (so long as it's not a civil or criminal offence in its own right) outside of professional hours - professional hours INCLUDES your time in the medical school! Beware! There's no need for suits, but a see-through top and no bra won't go down well for girls, nor will jeans revealing your buttocks go down well for guys. The medical school and GMC aren't looking to get you into trouble - when they say that there are some things you can't do but other students can, it's not a matter of what you can do, but what you can get away with - other students can get away with petty public order offences because they don't have to answer to an ethical and professional standard, but we do. If something is illegal, you can't get off the hook like other students - to be honest, we shouldn't be doing anything illegal in the first place anyway; and I would hope non-medical students wouldn't anyway. There are a few exceptions to this rule-of-thumb about just keeping out of trouble with the law:
    • If you do something exceptionally stupid - like dress up as a Ku Klux Klan member or pretend to be an SS Standartenführer for a night out and get photographed, put it on facebook with no privacy settings and then it gets back to the authorities that be (via a lecturer, family by accident, doctor, WHATEVER), you might face uncomfortable questions. You're politically free insofar as it will not mean that you are a danger to your patients. If they think you have Nazi sympathies or racial prejudices, you could be in trouble simply because you'll deal with Jewish, black, homosexual, bla bla bla patients.
    • If you fail to turn up to attendance-monitored timetabling; fail to attend clinical placements; or are rude to an unprofessional extent etc on a regular basis, turn up to medical school or placement in a mankini or lie to patients, you'll be off to fitness to practise for the exact reason it says on the tin - if you can't be professional, then you're not fit to practise. Duh.
    • If you get a speeding ticket, don't worry. If you make a habit of it, do. In the words of our welfare tutor at Birmingham: 1 ticket? So what, got caught out. 2 tickets? Unlucky. 3 tickets? Hmm... 4 tickets? This seems to be a regular occurrence. Why do they not care if you get 1, but do if you get a few more? They see it as a pattern, a habit and an unwillingness to take advice and conform to the law, and fear this may transfer to your professional attitudes.
    • Anything that a doctor would get into trouble for, you can. Patient confidentiality, consent et cetera are all exceptionally important. Violating confidentialty, pretending to be a doctor, performing unconsented examinations on a patient are all things that can and will get you into big trouble with F2P.

  10. Clinical Placements are fun. They're fun, but make sure you do it right. Ensure you dress professionally and behave professionally - if patients are to respect you then you need to be respectable. It's one thing dressing smart enough to pass the F2P requirements, but start as you mean to go on - even if you are just a student, patients look up to you, some of them can even be reverential; even if you are not a doctor (and make sure they understand this when consenting), they still often see you as 'half' of one, or some sort of 'proto'-doctor - you inhabit a position of privilege and trust that is somewhat elevated above much of society. Don't abuse it - act professionally. In addition, it doesn't hurt to dress respectfully - whilst jeans might satisfy F2P for not dressing indecently, a suit not only fits patients' expectations but also HELPS YOU feel professional, and in turn psychologically reinforce you to behave more professionally. It doesn't have to be expensive; but dressing smart is a good plan. Fit it to your own style too; I personally go for cufflinks and a smartly-tied tie (sometimes even a bow; especially when I've known there'll be babies and children), but there's no need to look out of place or uncomfortable with your clothes to dress smartly - find how you like to dress smart - trendy smart is just as good; skinny ties for example might be more casual, but are better than no tie at all. Tidy appearance, tidy mind. And even if it didn't help you feel and act professionally - which it does - it'll reassure patients that they are confiding in someone professional, trustworthy and competent. A last piece of advice on this - during first year, clinical placements vary - some medical schools do different amounts or types. At Birmingham we spend a day every two weeks in a local (I say 'local', but I have to be in Wolverhampton by 9AM, 'local' my arse!) General Practice clinic. Depending on the doctor who supervises you and then the doctors you end up working with, you may be presented with various opportunities that you wouldn't expect in first year - ranging from patient examinations and participating in the consultation voicing your own ideas of diagnosis to taking blood and giving the winter 'flu vaccinations. Your medical school may tell you not to participate in any such 'hands-on' activities for health and safety reasons. Of course, I would never officially encourage anyone to do anything to the contrary... But if you find your doctor doesn't have time for petty regulations, I might be so bold to suggest that you take any 'opportunities' they offer you.
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