Medicine

Medical School

Year by Year

Each year of medical training brings about unique challenges & I hope these resources can help serve as a guide – essentially the guide book that I wish I had!

There is a lot of information + differing opinions out there, so it can be hard to figure out exactly what will serve you best. My goal is not to make it more confusing, but simply to share what helped + worked best for me, along with some things that I wish I had done – for what it’s worth. However, I totally understand that the same things will not work for everyone + recommendations may vary by individual program. Different things work for different people + it takes time to figure out exactly what works for you!

Medical School // Year One: Zero to 100

The early part of your first year is all about learning to optimize + become your most efficient self. You will be challenged to learn an immense amount of material in a relatively short period of time. By using this time early in school to figure out what works best for you will make everything easier & pay off throughout the rest of school + beyond. The next four years will be a marathon… most importantly, take care of yourself.

Resources

Before you even get started, know that there are so many resources available on the market + you cannot possibly use them all. I quickly became overwhelmed by the recommendations of my friends, classmates, professors, + the internet. Everyone will try to tell you what works for them but it doesn’t matter if it doesn’t work for you. Find what works for you! Pick a few that you think you’ll want to use (many even have a free trial) + give it a try. There are also a LOT of free materials out there – Use them! Medical school is expensive enough. Otherwise, consider renting books, sharing with a friend, or check your school library. 

Figure out how to study smarter, not harder – it’ll pay off big! I highly recommend also using this time to try different ways of studying + different study groups. It can be helpful to try small a study group to share resources, ask questions, + run through material right before the exam. My study group found it helpful for each of us to create about 5 practice test questions per lecture the evening before the exam. It ensured that we covered all of the material, that we each had a good grasp on the material, + it often started a conversation about some of the topics. I found that what worked in college may not always work in medical school given the amount of material you will be challenged to learn, it’s just different.

Along these similar lines, I recommend using board study materials for your in-house exams as early as possible. You will likely need to supplement these materials with your lecture notes, as the board materials tend to not be as detailed, but I always found that being familiar with the board resources + learning the material the second, third, fourth times around was much quicker than the first.

I compiled a full list of the resources that I personally used by year.

Some of my favorites throughout all four years of school were:

First Aid for the USMLE: I didn’t fully appreciate or utilize this book until second year but it was a gold mine when preparing for boards! I had the book spiral bound & often annotated with high yield information as I was going through practice questions or other study materials. I also liked using sticky notes to add notes to have more room to write.

Boards & Beyond: Used these videos all four years & found Dr. Ryan’s White Coat Companion to be such a great resource for Step 2 boards + clinical rotations. I had the book spiral bound + again annotated as I watched his videos.

Dirty Medicine (on Youtube): Free! Great for mnemonics + ways to easily remember various topics. He is always adding more videos + even has a section now for OMM & ethics, which is great for boards.

Ninja Nerd (on Youtube): Free! Longer videos + more in depth, making it better for in-house exams.

Sketchy Micro + Pharm: I found both of these to be so helpful! I would watch the video then go through the Anki deck + found it to be a great memory tool. I still have so many of the Sketchy pictures engrained in my memory. I didn’t start using Pharm until right before Step 1 but wished I started earlier!

Pathoma: Book + videos! All about the fundamentals of pathology.

Anki: Free! Set it up early & start early. 5-10 new cards per day doesn’t feel like much but I promise it will pay off. It utilizes spaced repetition to help you best remember.

There are many decks out there + you’ll likely have to download from Reddit or another website. I personally used Anking because it combined a few of the most popular decks. I also used the Sketchy Micro + Sketchy Pharm decks to keep up with my micro and pharmacology. For boards, I also loved the First Aid Rapid Review for concise facts. It’s a relatively small deck but super high yield – the facts are from the back of the First Aid Book.

Podcasts: Goljan (on Spotify) & Divine Intervention (available on Spotify, Apple Podcast, + his website)

Use your classmates study guides if that works for you! My class often shared study guides prior to exams + it can be more efficient if someone has already put together a good resource. *Just use caution as mistakes can be made, even when copying material, + you want to make sure you’re studying accurate information.

I personally liked making practice questions. I felt like for me to write a good practice question (with wrong answers, too! – which is a lot harder than I ever thought), I needed to have a good understanding of the material myself. It also helped me to pick out material which I thought was highly testable & weed through the extra details. I actually shared my practice questions with my study group & classmates – it often opened up the discussion about a particular topic, which I really appreciated.

Finding Your Work-Life Balance

You’ll quickly learn that medical school (+ medicine for that matter) will take everything that you give it. You have to be diligent about finding your priorities + setting boundaries. There will be times throughout school that won’t be as flexible – you’ll likely miss out on some big holidays + events. But there will be other times that it will be up to you to establish those boundaries.

I found that it was easy to feel like you should always be doing something for school. There will always be more to study + if you’re not studying, there is always a pressure that you should be volunteering, doing research, trying to get ahead. It’s a vicious cycle + it’s hard not to compare yourself to your classmates. But I promise that you can have the best of both worlds if you want it + are intentional with your time. At times, I felt as though a clear mind, getting good rest, was much more important than stressing myself to the point of exhaustion. Over the past few years, I was able to find a way to workout most days, go on multiple trips with friends & family, train for my first half marathon, get a puppy, spend time doing some of the hobbies that I love, run my healthy lifestyle Instagram account, + develop this blog. In order for me to do so, I had to be diligent at times about stepping away from my school work but it was SO worth it. Your school work will always be there waiting for you.

Lastly, ask for help + know that you are never alone. If you are struggling in a class, talk to your professor. It’s always better to ask for help before it’s too late. Talk to your classmates – you’re all going through the same thing + the same time. If you’re struggling with your mental health, find someone that you feel comfortable talking to. Whether it’s a therapist or counselor, a psychiatrist, resources through your school or insurance, a mentor. Know that you are certainly not alone + there is help!

Extracurriculars

As someone that was undecided on my specialty (+ even if you have an idea of what you want to do), I joined a few different interest clubs – both for opportunities to learn more about the specialties but also for the extra skills + experiences that they offered. For example, I was not particularly interested in surgery as a career, but as a member they offered a variety of different opportunities for help in the anatomy lab and intubation simulations. With that being said, like I always recommend, do not feel pressured to join – even for the sake of “your MSPE” or residency applications. Quality > quantity.

Miscellaneous

I know it seems early but the organization will pay off when it comes time to prepare your residency applications!

  • Keep a running list of your achievements, conferences you attended, research, volunteer opportunities
  • Keep a running list of all your ID numbers (AAMC, NBOME, NBME, etc)
  • Keep a folder on your computer or G-drive with all your certifications, PPD and CPR documentation, etc.

Year Two: Gearing up for boards

Board Prep

You’re likely getting the hang of your in-house material + you’re gearing up to take your first round of boards. Even with boards being the light at the end of the tunnel, it’s still important to focus on the material that is left. If you’re able to master that material as much as possible, it’ll require less time to relearn + review during your dedicated study time.

With all of the pressure surrounding boards, I found there to be a lot of debate about when exactly to start your dedicated study time (often just called dedicated). It’s a balance between starting too soon + you’ll be burnt out, start too late + you won’t have time to cover all of the material; but this will be individual for everyone! Since my boards were set for late June/early July, I set a tentative date of January 1 (about 6 months before your test) to just start planning + preparing, slightly picking up my intensity (but NOT starting dedicated). I started my dedicated around April 1st – give or take – giving myself about 3 full months of nothing but review.

Much like when you started your first year, there are SO many resources available – it’s overwhelming + you cannot possibly use them all to their fullest potential. Hopefully you’ve found a few resources that you especially liked during your first couple of years + gradually started incorporating those with your class work. The main resources that I used were similar to those listed above in Year One. Once I found the resources that I wanted to use, I used Blue Print (formerly Cram Fighter) to create my schedule (*they also offer 7 day free trial). Essentially, you plug in your resources + the amount of time that you have before your exam, how many days you want to study + it can give you a good idea of whether you’re too ambitious or right in the sweet spot.

Next, you’ll need a good question bank. These not only introduce you to the types + styles of questions that are asked, they are also a great way to test + expand your knowledge. I used UWorld, TrueLearn + Comquest. When I started, I got more questions wrong than I did right. I was so discouraged, but as you progress through your study plan, your scores should gradually improve. It’s also important to spend time reviewing your questions + have a good understanding of why the wrong answers were wrong just as much as why the right answers are right.

I also found it helpful to incorporate half-length practice exams once/week, at most, as my test date got closer. It not only helped expose me to a lot of questions – written by the actual test writers – but it also helped me build my endurance for the real exam.

Building Your Resume

Not to add more stress to your second year – but this is the time to start getting more involved in volunteer activities, clubs, research, + other activities that you’re interested in so you will be able to add these to your residency applications. At my school, during second year I could also start to consider leadership opportunities. Having gone through the residency interview process, I have found that quality > quantity. For example: having volunteer opportunities that you are able to be involved in on more than one occasion rather than multiple different one-time opportunities was both more meaningful + easier to talk about on my application/during interviews.

As with the rest of your pre-clinical years, the pressure to always be doing something is often present – but I encourage you to find time to relax + reset. I promise you, it is not wasted time. Your mind + body need it! Take study breaks + get outside. Stay social with friends + family. Keep up with your hobbies. Get enough sleep + take care of your body!

Year Three: Clinical Rotations

The start of clinical rotations can be both a relief from all of the constant studying + book work but it is also a new challenge in a lot of ways. I really enjoyed having the opportunities to connect with patients + getting to see some of the things that I once learned about from a book in real life. The hardest part of this year for me personally was the constant change. I felt like as soon as I started to get comfortable on one rotation, I was changing to something completely different.

Rotation Resources

Just like the first couple of years, there are SO MANY resources available for each specialty. In my opinion, it can become expensive & not totally necessary. I personally liked having a universal resource like the White Coat Companion book + the Boards & Beyond videos. I would annotate my book as I went through the videos. A lot of my friends + classmates use Online MedEd – a free resource with videos for each specialty (including OMM) + may be worth giving it a shot. I personally found it to not be as comprehensive + just preferred B&B. Although I loved the first First Aid for the USMLE book, I didn’t use the second one nearly as much – but I know many of my classmates that did. Another frequently used book is Step up 2 USMLE.

I’ve compiled a full list of the resources I either found most helpful or have been highly recommended for the preclinical + clinical years.

If there is a specialty you are especially interested in & think that the resource may benefit you beyond the rotation, then that may be a good idea! If there is a resource that you would really like for the rotation, consider sharing it with a classmate, finding an ebook, or buying a used copy. 

I also bought these medical reference badge cards + thought they were so simple but great for a quick reference. For example, on my peds rotation, I would often reference the vaccination schedule + developmental milestones – there are cards for every rotation!

Clinical Rotations

Be flexible. During your third + fourth years of school, you’ll be working in a wide variety of different settings + you’ll have a different role in each. You’ll have to adapt often.

Ask for clarification. If you don’t understand what the expectations for you are, or what your role is, just ask. 

Be prepared. The night before, spend just a little bit of time reading up + reviewing the patients scheduled for the next day. There may be a particular condition or diagnosis that you need to review. On your surgery rotation, know which procedures are scheduled for the next day – read up on each, the indications, the anatomy, + any relevant information.

Ask for help. This is, for most of us, our first time in the role of a provider + we’re all learning. It’s important to know when + how to ask for help.

Ask for feedback. It’s one of the best ways that we can learn what we are doing right + where we can grow. Don’t take criticism personally, know that we ALL are learning. (+ also know that stress can be high at times – don’t take it personally if someone happens to take it out on you. Sometimes we’re just accidentally in the line of fire.)

Be helpful. As a medical student – you’ll often feel like you’re just in the way. But remember that we’re here to learn + I’ve found that we can actually be a lot of help! Offer to grab supplies for your attending. Gather a thorough history. Get to know your patients on a more personal level. This is the time in our career where we might be able to sit down & talk to our patients. I have heard the most remarkable stories from my patients, I have learned SO much about their backgrounds, who they are as people from simply just talking to them. I promise that it means so much to them during a potentially vulnerable + challenging time. Simply just lending an empathetic ear means so much.

Pack snacks. + a bottle of water. Eat when you can, drink water when you can. Some days will be busy + having a snack that is easy to grab can be a life saver! I’ve also created a post where I rounded up some of the things that I always keep in my bag on clinical rotations.

A few other posts that may be helpful:

Boards: Round 2

*Forewarning: I was the last year that Step 1/Level 1 exam was graded numerically – so my recommendations are based on that.

During third year + with clinical rotations, there is not as much of a dedicated period like there was for the first exam. Although I found myself studying less throughout the year, my preparation for the end of rotation exams was crucial to help me prepare for boards. Prior to my rotation exams, I incorporated the Boards & Beyond videos + focused on the specialty-specific questions in my question banks. I also tried to continue with Anki (specifically the Anking 2 deck) – covering the cards for my current rotation + the prior. Leading up to boards, I only had about 4 weeks of pure dedicated study time for my second exam, so I had to increase the intensity of my studying over the course of the few months prior. I especially used my weekends to review content from specialties that I completed earlier in the year. Similar to the first round of boards, I took a couple half-length practice exams to gauge my progress + increase my test taking endurance.

During my third year, I also found the Divine Intervention podcast + would listen on my commute in the car, on walks, while doing laundry or cleaning. He covers some of the high yield topics on boards + I learned so much!

Preparing for Residency Applications

As you progress through your third year, you’ll likely start to figure out which specialty you want to pursue in residency (or at least those that you don’t). It may change many times + that’s okay too! It’s too early to start stressing about residency applications, but it’s not too early to start thinking about it. One thing that you can do to prepare is start asking your preceptors for letters of recommendation if you have an idea of what specialty you are interested in + you believe that they will write you a strong letter. You’ll need 3-4 letters by early fall of your fourth year so you can plan accordingly (more on that later).

Secondly, as you go through your clinical rotations – keep notes of interesting patient cases + encounters. These will likely come up during your residency interviews + may even help when writing your personal statement. I wish that I had kept track in real time as it was a lot harder to think.

Lastly, I would recommend joining your future specialty organization! There are often free or discounted student rates + they often have a variety of resources/learning opportunities for the specialty that you are considering. It is also something that you can add to your resume to highlight your interest in your specialty.

Year Four: Residency Preparation

For me, fourth year was such a fun time. Of course, the first half of the year requires a lot of preparation + work to prepare residency applications, perform on audition rotations, + attend residency interviews. But I also found the schedule of fourth year (at my school, at least) to be so much more flexible – allowing me to add more rotations that will pertain more to residency + my future career goals. If you would like, it also allows you to travel (either electively or for audition rotations) to be able to see + learn from different hospitals & physicians. Fourth year also doesn’t carry the weight of frequent end-of-rotation exams or board exams, so I found myself with a lot more free time when I wasn’t on a rotation.

Since there is a lot of information regarding the preparation for residency applications + interviews, I have broken it up into different posts: