The Hardest Thing about Medical School…From an MS4

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PMY 509: The Hardest Thing about Medical School...From an MS4

Session 509

A med student on their way to residency, Sabina shares her experiences as a premed and the dedication it took to stay on the right track and set herself up for success. Sabina was back here on The Premed Years Podcast Session 362. Be sure to also check out that episode or find her on Instagram @thecurlymed.

In that episode, we talked about her getting into medical school. Now, we’re talking about her getting through medical school now that she’s applying to residency and the struggles of being a medical student.

For more podcast resources to help you with your medical school journey and beyond, check out Meded Media.

Listen to this podcast episode with the player above, or keep reading for the highlights and takeaway points.

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[03:53] How Her Premed Journey Contributed to Her Success in Medical School

Sabina says the grit, hard work, and energy that she had to put into even getting into med school in the first place characterized her journey through med school. She came in already highly committed to this career as a doctor.

The Importance of Self-Care

Now that she’s on the other side of medical school, she thinks the hardest part was being able to prioritize her personal life. That while also accomplishing all she needed to accomplish through med school. She adds it’s important to not lose sight of yourself and who you are through that process. And that has been really challenging for her.

The Sad Truth About Our Medical Education System

Sabina believes this is because of the culture of medical education. Medical students feel the brunt of that as the “bottom of the food chain” in medical education. They’re thrown a lot of tasks and they’re expected to do research and volunteer, and live a happy, healthy life outside of school. And it’s the first time for a lot of them to be experiencing all of those things needing to happen at the same time.

As a student, you hear about how in residency, it’s difficult to prioritize anything outside of work. And that’s a whole conversation about why that is. And largely, that’s because of perpetuated systemic issues that have trickled down over the years. Unfortunately, we have overworked residents and don’t value them to the extent that we should.

[07:55] Balancing Things Through Medical School

During her first year, Sabina admits she struggled with balancing her relationships outside of med school with those she was fostering inside of med school. All of her friends from undergrad, as well as family weren’t with her in Pittsburgh. So it was very difficult for her to balance a social life with new people in med school. She had to do that while still figuring out how to absorb the firehose of information that was being tossed at them. She also had to keep those other relationships that were really important to her. And so, she spent a lot of first year working on finding that time balance in a way that worked out for her.

The same was true for a second year for the most part. But once Step 1 rolled around, and board exams, it really became clear to her that she had to prioritize her mental health. It was the lowest of lows for her in medical school and life in general so she had to take care of herself first.

[09:36] Why Step 1 was a Challenging Phase for Her

Sabina went through her Step 1 prep during COVID. They had just finished their second year entirely through virtual school. And during that period of time, she was focused on surviving the pandemic and also just mental health-wise. She had to make sure she was not going to stir crazy in her little apartment.

She passed all her exams during second year, but they were all open-book. She thought she didn’t really learn the material as well as she felt like when she might have had it non-COVID time. This took a hit in terms of their knowledge base going into it. She hadn’t really figured out a good way to study in a manner that was right for a board-style exam. 

All of their exams were in-house so it was her first exposure to that. Plus, she had undiagnosed ADHD at the time. Her therapist had pushed her to get diagnosed before Step 1, probably predicting that this would happen. But she decided to wait until after.

All of that accumulated into six weeks of struggle because she wasn’t making any progress. Then she was told by the school that she needed to delay or extend her study month. So she did another four weeks, and then needed more time. It was a total of 12 weeks feeling like she was getting beat up by these practice questions and not seeing a way to pass this exam, let alone score decently. Sabina was in the last cohort before the pass-fail system.

[11:55] Things She Would Have Done Differently for Step 1

Looking back, she thought she should have pursued the ADHD diagnosis sooner. That way, she would have been able to get accommodations for med school exams. That being said, Step 1 exams are quite picky with who they give accommodations to.

She also would have reached out for more help from people who were more similar to her in terms of how they study and learn. Schools provide you with resources and tips from a panel of students, but a lot of times they pick from the cream of the crop. These people are naturally really good at learning, at least that’s her experience with those kinds of panels.

And so, Sabina started chatting with people who were more similar to her average learner level. They are students who admitted to struggling through med school. She also stopped going to lectures. It was something she had never considered because all throughout premed, she would go to lecture. But she found a way she could move forward with absorbing the material.

One of the biggest mistakes students make in medical school is not doing enough self-reflection. It’s important to be aware of what works for you. People learn differently so you need to figure out the learning style that best suits you.

Ultimately, Sabina’s three and a half weeks of Step 2 dedicated time made things much easier for her. It was also a different test from Step 1 and at that time, she had already finished most of her rotations. But it was a huge leg up compared to Step 1.

[17:27] Struggles During the Preclinical Years

Sabina recalls having the biggest breakdown of her life during the Step 1 dedicated study period  that she had to drop out otherwise she wasn’t going to pass the exam. She was already six weeks into the dedicated schedule and she still wasn’t improving at all or showing any signs that she would pass this exam. She didn’t see a way forward and had a large identity crisis.

She remembers struggling during the preclinical years, especially towards the end of first year when things started gearing up. She reached out to see if there are any tips or resources for people who study a little differently than those who thrive on lectures or with flashcards. As what she mentioned, earlier on, she was connected to some students who study more similarly to her.

During Step 1, she found most of the help through her peers, either at her school or at different schools, and through social media where she met Step 1 coaches who coach minority students for free.

[22:25] Prioritizing Self-Care

Sabina says that during her first and second years, she felt much pressure to be studying. And when she wasn’t studying, she was trying to take care of herself. But then she would feel guilt and shame for being lazy or a slacker.

Prioritizing Herself Above Anything Else

In her third year, she decided that she would come out on the other side with the skills that she needed to graduate, but not being burnt out. And that was her number one priority. So she got more confident with taking the time off after work to come home. She would watch TV with her partner and cat, eat dinner, and maybe work on some questions or maybe not, and be okay with that.

Sabina clarifies that she cares about the exams, obviously, to the point where she needs to pass to graduate, but it’s not her number one priority at all.

At the end of the day, you have to realize where your strengths are. And where her strengths lie are not in the standardized tests. That being said, she’s going to learn the information through repetition and through exposure in her rotations in residency.

Doing Well on Her Shelf Exams

Sabina was able to do decently on shelf exams without needing to open a book theoretically or physically. She did the questions as much as she could, to the extent that her mental health could tolerate. But she didn’t try to do 80 questions a day or however many are recommended. Rather, she learned best through actual patient interactions, which was a much more fun way to study. 

[29:12] Advocating for Her Community

Sabina runs the Medical Student Pride Alliance, which is the LGBTQ student organization. They do a lot of advocacy at the national level for medical schools to improve education about LGBTQ health care. Their hope is for those patients to have improved experiences with their providers.

Sabina has also collaborated on a number of other initiatives for similar things all with the goal of improving the patient experience. She knows she will be a great physician when her patients see her but she also wants to do the best she can to influence and impact patient care as a whole through medical education.

She wishes to be an OB/GYN in the future and she also sees herself advocating for her community through her day-to-day work and her research. 

Currently, she does a lot of qualitative research analyzing the experiences that queer patients have, specifically in sexual and reproductive healthcare fields, like OB-GYN. It involves talking to those patients, using that data, and turning them into actionable items at the local and national levels.

[31:18] What the Residency Application is Like

Sabina is now waiting for her residency interviews and comparing it to her medical school applications, there are some similarities as much as there are differences.

There’s a primary application that you submit in September, and then you just wait for your interviews, which she’s currently doing. The application is the same in terms of experiences, essays, and letters of recommendation. However, the expectations are different because you are selling yourself to those programs. But you also are trying to find programs that fit you because it’s a job interview.

She points out the interesting mindset that goes into residency applications versus applying for med school. With med school, she felt the pressure to just make sure that her application reflected her to the very best.

But for her residency applications, she wanted to attract programs that would be the best fit for her to train in. And so, it was less about putting together a great package with a bow on top so that anybody out there would pick her.

[34:14] Final Words of Wisdom

Sabina wishes to tell students out there to keep doing what they’re doing. It’s very difficult to stay true to who you are throughout the process of being premed and in med school. You’ll feel like you’re being pulled in all sorts of different directions and told to do all sorts of different things. But stick to your why, even if it changes, and you’ll be okay and you’ll make it to the end. And take care of yourself which should be your number one priority.


Meded Media

The Premed Years Podcast Session 362: The @thecurlymed Shares Her Journey to Medical School

IG: @thecurlymed

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