Over the Hump? M3s Looking Back and Looking Ahead

Med 3 is the turning point in medical school. The leap from pre-clerkship to clerkship can be all at once exhilarating, terrifying, and groundbreaking. For some, this transition can be jarring. For others, it is seamless. It may entrench one student in a specialty they have had in mind since day 1 of medical school. For another, it may send them in an entirely different direction than they envisioned.

Regardless of how one reacts to this change, there is no one right way to experience it. At the end of the day, we all come into medical school with our unique backgrounds and interests, our own thoughts and predispositions, and we all come out as stronger caregivers for our patients. It is an important step that brings us closer to becoming qualified physicians in service of others. Below are the thoughts of some current Meds 3s looking back on their experiences so far, considering where they are at now, and describing what the future holds.

 

Tell us a little bit about your life before medical school.

  • Asha Kothari (AK): Medicine has been a goal of mine since early on in life. I have many memories of joining my father on house calls as a child as he visited patients, or spending time in his clinic, or reading his old medical texts. Entering university right out of high school seemed like the natural progression at the time, although it turned out to be the wrong path for me. I have a vivid memory of sitting down to lunch with classmates while in my second year of university, listening to them talk about writing the MCAT and thinking to myself “I can’t do this right now.” I felt too young and unprepared. Eventually, after a couple more years I left university and joined the army, which is likely the best decision I’ve ever made. Eight years, a tour, and many other experiences later, I finally felt ready to pursue medicine. Now here I am.

 

  • Janet Yuen (JY): I had quite a significant gap between graduating with my Bachelor of Science and med school, so I did a variety of different things. As a background, I was diagnosed with chronic kidney disease near the middle of my undergraduate studies while I was completing a degree in microbiology. At that point, going for medicine seemed like a long-lost dream since there was much uncertainty about how my life would be going forward. Despite all that, I knew I loved helping others through medicine and there was no harm for me in trying. I learned to live with the countless treatments, appointments, [and] surgeries. I was repeatedly inspired by a nephrologist, Dr. David Rush, who took care of me during the most difficult times of my life. He was one of my main motivators in continuing to push toward my dreams. In between my health issues and the ordeals that are associated with it, I was able to squeeze in opportunities that were meaningful to me and help[ed] me become a better doctor. I will name and describe a few below:
    • Aside from medicine, I also loved to teach. I worked as an educational assistant at an alternative high school and focused on helping high school students with their science curriculum. This experience was especially unique to me because we worked with students who did not fit into the traditional classroom due to developmental or behavioural issues. It helped me develop the skills to work with others that do not fit into our “standard box”, which really highlights the real-world in medicine.
    • I worked at an Access Center in the community development department where I was helping with organizing events and providing resources for the low-income communities in the area. Tackling them social determinants of health!
    • I worked in a highly unethical lab that tested personal care/beauty products on human volunteers where we paid them money to participate. I quit in less than a year.
    • I worked as a gym attendant at the University of Winnipeg where I mostly supervised kids coming in at night and making sure they don’t break the rules or our facility (lol)
    • I was hired by The Kidney Foundation of Canada to organize their yearly kidney walk. This was something that is near and dear to my heart.
    • The year before I started medicine, I was working as a research assistant for a large Multiple Sclerosis study. Through this experience, I was able to meet and talk to patients/research participants first-hand, take a brief history and their vitals for the research project. The experience made me realize how much more I wanted to work with these people at an individualized level and help them with their care.
    • Contact me if you want me to elaborate more on any of these!

 

  • Jayce Bi (JB): I’m very basic, did the undergrad straight to med thing. Along the way, I had a stint at McDonald’s, tutored a bit, regular student jobs. I always liked connecting with people and thought I’d do it in a band, except that didn’t end up panning out post-high school; then in undergrad, I ended up on a research project and realized that healthcare was a nifty mix of cool concepts and connecting with people. A year in pharmacy also made me certain that I wanted to pursue medicine instead.

 

  • Angie Woodbury (AW): After getting my BSc. in Biology and spending half a year in Germany on exchange, I came back to Winnipeg to continue to try and get into med school. The plan was always medicine, it just seemed to take a little bit longer than I had planned.
    • In between, I moved out from home and [started] work as a medical office assistant at a family doctor’s office. I loved working there and spent about 3 years learning all the behind-the-scenes operations of a busy clinic. Then I worked a year in homecare for a private homecare company.
    • I don’t regret the time it took to get into medicine (5 applications, 4 MCATs, 2 interviews and 3 agonizing months on the acceptance waitlist) and I think my life experiences have shaped the way I look at medicine and how I interact with patients.

 

What did you expect when you first started medical school?

  • AK: I expected to be challenged intellectually. There’s a lot of mystique surrounding medicine as a profession. The impression is that only those who are significantly above-average are able to handle it. A belief I have since come to realize is incorrect. The stress and difficulty people talk about in relation to medical school is exaggerated in my opinion. If you work hard, are a team player, and have people skills, you can become a physician.

 

  • JY: I can talk about what I did not expect…
    • I did not expect my life would go from being structured and predictable to chaotic and uncertain. The pandemic being in the middle of my studies did not help either. I went from a life working full time (9-5 M-F) to having sporadic schedules, disturbed sleep, and really needing to manage my time to pass school while maintaining health and wellness.

 

  • JB: I thought it’d automatically make you have your ish together. It didn’t, but it speeds up the process. Maybe that’s just my 23-year-old brain speaking.

 

  • AW: Honestly, I had no idea what to expect! I knew a little bit about the curriculum from a friend who had just finished Med 4, but other than that I didn’t know what to think. I knew it was going to be hard but I don’t think I knew which parts of it would be the hardest and which parts the most rewarding.

 

What are some important things you have learned so far throughout medical school?

  • AK: I’ve learned that what makes medicine challenging is not learning algorithms, or memorizing medications and their side effects, or perfecting a physical exam technique. What’s difficult is the interpersonal side of it. Meeting someone in their suffering and being that person who they expect to be the one who will heal them – that is what’s challenging.

 

  • JY: Taking time for yourself, your family, and friends is so important. I luckily went into med school knowing that my outside life will be priority, so I tried my best to give everyone a piece of my time. School can be here forever, but relationships may not be.

 

  • JB: As an attending once told me, “You never know what you can go through until you do.” Realistically, probably basic medical science and pathophys. Just insert the entirety of UWorld here.

 

  • AW: Listen to the patients and don’t interrupt them! There’s no such thing as a poor historian, just a poor history taker. Try to ask the right questions and actually listen to the answers. Care about people and treat them like humans. Try to do the right thing and don’t be afraid to stick up for yourself, your classmates and your patients.

 

How has your time in medical school changed or pushed you?

  • AK: I think it’s made me a more logical person. Medicine is an expression of science, and science is inherently logical. In the process of learning how to conduct myself as a physician, I feel I have transformed into a more logical person who is beginning to learn how to collect and synthesize information in a more rational and coherent way.

 

  • JY: It helped me with gaining appreciation and gratitude. The number of times I needed support from someone to succeed in my studies is too many to count.

 

  • JB: I think it’s sped up a lot of the growth that people typically go through in their 20s in terms of gaining confidence, having more transparency in relationships, appreciating the small things, understanding nuance in the world, [and] prioritizing what’s important to me. I’ve also probably (definitely) become more pretentiously preachy in my writing than I used to be. I call my mom more than I used to.

 

  • AW: I had a lot of imposter syndrome entering medicine (especially being accepted off the waitlist) because I felt like I was too old, not smart enough and not able to keep up after being out of school for so long. Every time I did poorly on an exam or got anxiety about OSCEs, I felt like someone from UGME would look at me and go “We made a mistake! You’re not supposed to be here!”. I’ve had to really challenge that notion in myself and learn to appreciate the unique skills that I have. Maybe I’m far from being the top student in the class but I’m a good communicator, an empathetic person, I care about things and am passionate about seeing them through. I’ve tried to focus more on those qualities in myself as I’ve gone through school.

 

What do you wish you had known before starting medical school? What advice do you have for others either in the years below or for those applying to medicine?

 

  • AK: I think all I’d have to say to those earlier on in their path is that medical school is not impossible. Sure, it’s challenging in a variety of ways, but if you work hard, genuinely apply yourself, and stay motivated, you will succeed. There’s no magic to it. The people above you are no different than you are.

 

  • JY: A pass is a pass.
    • It is ok if your grades are not as high as they used to be.
    • I know every single one of us used to be that student who would calculate how many questions they can get wrong to get their 90% or above. Medicine will change this attitude. Forever.

 

  • JB:
    • M1s and M2s should 1) indulge in hobbies as much as possible, 2) travel, 3) stop sweating the LOC, unless you’re going overboard, in which case, at least have a plan with it.
    • To those applying, ask some practicing residents, newly-minted attendings, PAs, nurses, and other allied health professionals about whether or not they wish they took a different route. It’s tough to get an idea of what med school and residency is like before being in it but that’s probably the best way to make sure it’s what you want.

 

  • AW: I’d wish I’d known that things like summer research, early exposures, tracks and electives really don’t matter. I mean, of course they matter. But how they all end up looks differently for every person. And there’s no right way to do med school.
    • Keep trying if you are applying to medicine and it’s taking a while. Don’t doubt yourself! You bring something that no one else in your class is going to bring. Don’t be discouraged if your MCAT score is a little low, or your grades aren’t the best, or if you don’t have a science background. You’re going to be a doctor eventually, you just have to keep trying! And when you finally get in, it will be worth it 😊

 

What is one thing you really enjoy about medical school that has surprised you?

  • AK: I’ve really enjoyed the discussions on medical ethics we’ve had as part of our program. I had no prior exposure to medical ethics teaching prior to medicine and have come to really enjoy the discussions.

 

  • JY: When you review a patient with your attending and you get the diagnosis right, and your attending agrees with your plan. This is the best feeling ever and I never knew I needed this much validation lol

 

  • JB: I tried really hard in preclerkship to not let my identity be defined by med school but leaning into it this year has been one of the better decisions I’ve made.

 

  • AW: I really liked complicated cases where I have to do a deep dive in the chart and put together the puzzle of the patient’s presentation. I actually like consultant work when you get to go around the hospital and see many different types of patients. I think consultants have more time to step back and look at the bigger picture. I prefer this over busy ward time when you’re just too busy putting out fires all the time!

 

What is something you look forward to learning this year?

  • AK: I look forward to learning anything and everything, to be honest. Clerkship exposes you to such a wide breadth of specialties and knowledge, it’s impossible to pick just one thing.

 

  • JY: Everything.

 

  • JB: Whether or not I match. I mean, where I match. Positive affirmations, right?

 

  • AW: For the end of third year and start of fourth year, I’m really looking forward to more complex stuff and how to manage patient care. I’m at the point in my learning where I recognize the diagnosis but don’t always know what the plan will be. So I’m excited to learn more about that.

 

What’s been your favourite part of medical school so far?

  • AK: As I write this, I’m just over halfway through clerkship which has been my favourite part of med school so far. It’s fun, challenging, and allows you to start really developing the quality of physician you want to be.

 

  • JY: Meeting new people, making new friends, and gaining an incredible amount of knowledge I never knew I could handle!

 

  • JB: Clerkship, especially on rotations that I could see myself going into.

 

  • AW: Actually lectures! An answer that might surprise people but lectures help me learn. I know it’s not the same for a lot of people and we all have different learning styles. I just found that attending lectures live and writing notes helped me learn the material better. And I have been wanting to study medicine for so long that attending lectures is always fun for me.

 

Looking back, what was your favourite course in pre-clerkship and why?

  • AK: I really enjoyed the Professionalism course. It was interesting, thought provoking, and exposed me to ideas I hadn’t ever thought of before.

 

  • JY: UT1 and UT2 because I am very biased, and I was the course rep for them! To be fair though, there are real stats saying that it is the highest rated course in the College of Medicine 😊

 

  • JB: Good question.

 

  • AW: Probably Clinical Reasoning tutorials or Professionalism. Professionalism was always nice to take a break from clinical stuff and just think about what it means to work in healthcare. I really appreciate the conversations we always have in professionalism. And clinical reasoning was always fun- like a mystery game! The only thing I didn’t like was all the statistics.

 

What was your favourite part about Med 2?

  • AK: Probably the anticipation for clerkship. Going through the year knowing that soon you’ll be on the wards exercising what you’ve learned so far was the best part.

 

  • JY: Strengthening the relationships I have started in Med 1 and getting to know classmates more. Low-key loved having Zoom lectures due to pandemic.

 

  • JB: How chill it was with the online schooling and my overall lack of attendance.

 

  • AW: My favourite courses in Med 2 were Neuro 2, Nephro 2, and Population Health. COVID changed everything of course at the end of Med 2!

 

What advice do you have for current Med 2s?

  • AK: Enjoy your summer!

 

  • JY: Clinical Reasoning and Clinical Skills are the most important courses you will take in Med 2 so don’t just cram and forget these. Everything you do in clerkship will reflect on these two courses.

 

  • JB: Enjoy it… and it gets better.

 

  • AW: Take a break this summer! Really, seriously. Get some rest. And go to Costco and buy yourself a chest freezer. Make some meals like lasagnas, soups, casseroles etc. and freeze them in easy portions for clerkship! I bought lots of snacks from Costco and stocked my locker. It really helped me to have an extra pair of clothes, some food and a sweater in my locker for urgent situations in clerkship!

 

What are you looking forward to for the rest of clerkship?

  • AK: I’m looking forward to rounding out my experiences and making my final decision on where I want to take my career.

 

  • JY: Finishing to be honest, as you can tell I am getting so tired being more than midway through Med 3. Med 3 is tough!

 

  • JB: The end of shelf exams.

 

  • AW: Getting to do my electives in topics/areas I really love. All of clerkship is fun and it’s great to finally make a difference to patients. But it’s even more fun when you are on a rotation in something that you are really passionate about. Also looking forward to getting those NBME exams out of the way.

 

What do you wish you had known before starting clerkship? What advice do you have for those starting clerkship soon?

  • AK: There are a lot of horror stories floating around regarding clerkship, many of which are overblown. It’s a challenging year for sure and for younger students without much prior work experience it can likely feel overwhelming. My advice is to remind yourself that you’re a student and your purpose for being there is to learn. Cut yourself some slack and enjoy the process.

 

  • JY: Sometimes you really need to speak up. Being quiet (sadly) is a feature that might work against you. Be vocal, ask questions, and make sure you ask every resident/attending what they expect of you for the rotation.

 

  • JB:
    • The best advice I received regarding clerkship was to treat every rotation as the specialty you want, and especially if you know going into the rotation you don’t want it, you should try harder to make it count.
    • The above goes hand-in-hand with the fact that preceptors care way more about attitude than knowledge base. Obviously you need a solid foundation in order to practice medicine, but you are a learner. Most people in this world, medicine or otherwise, will take the person who shows up with a positive attitude and a willingness to go the extra mile rather than the person who scores high on the NBMEs but pretends to be asleep during 4 am pages.
    • Be teachable! Stay humble, but be confident in your knowledge. This probably says more about my (lack of) skills and knowledge than anything else, but multiple attendings have told me they appreciate my ability to take criticism well. The M3 who thinks they know it all is arrogant at best and dangerous at worst (or maybe that’s just what residents have told me to help me feel better about myself). Most preceptors genuinely want to teach and help you improve, so don’t be offended by their feedback.
    • Something I wish I started doing earlier in the year was really trying to own my patients, but that’s easier said than done, especially at the beginning.
    • Last point: clerkship isn’t as bad as the horror stories make it sound, and things are temporary. Some rotations have worse scheduling than others, and you will feel burned out at certain points. One day your knowledge is “above average”, you vibe with your preceptor, you get your procedures easily – the next, it’s the complete opposite and you miss questions you feel you should have known by now, or your preceptor opens your eyes to layers of a topic you previously weren’t even aware of. Remember the big picture and move on. Medicine can take over your life if you let it, but whether or not it does is totally up to you.

 

  • AW: What I wish I had known- that it’s going to be a lot less scary and a lot more fun than I had thought. My advice- get to know where all the fridges, microwaves and bathrooms are on your ward. It’s super important to stick to your schedule, eat regular meals and go to the bathroom! Sounds like silly advice but no one is going to tell you when to take your breaks. You have to listen to your own body. You also have to learn to prioritize and figure out what’s important to do when. Sometimes you say to yourself, “I could push through and do this next thing or I could eat”. At that point EAT. Cause you never know when you can eat again.

 

Are there any lessons you learned from last year that you would like to take into M4?

  • AK: Yes – don’t make cringe-worthy jokes with patients.

 

  • JY: Again, for me, it is about being vocal. Make yourself a part of the team, even when you have little confidence in yourself or maybe you have no clue what you are doing. Give it your best shot.

 

  • JB: See the answer to Question 13. That being said, I haven’t matched yet, so what do I know? The R1s should be giving me advice!

 

  • AW: I learned to ask all the names of the nurses and staff on the ward every day during rotations. The wards can be chaotic sometimes, so it’s good to know who you can talk to and who looks after who. It’s also important to introduce yourself properly, so everyone (including your patients) know who you are and why you are there.

 

Where do you see yourself in 5 years?

  • AK: Reading

 

  • JY: Hopefully graduated by then! Whether it be family medicine or an internal medicine specialty, I hope to be working with people who are living with chronic conditions.

 

  • JB: In Bali with a FIGS sponsorship. Just kidding. Hopefully working away as a PGY4. Most likely I’ll be in Dr. Ripstein’s office for failing to match for the 5th time or something. ¯\_(ツ)_/¯

 

  • AW: Hopefully finishing up my 4th year of pediatric residency! I don’t know if that will be here in Winnipeg, or somewhere else but we’ll see what the future brings!

A big thank you to Asha Kothari, Janet Yuen, Jayce Bi, and Angie Woodbury for sharing their thoughts and experiences!