By Nizza Ann E. Regalado
TRIGGER WARNING: A section of this article (Lesson No. 4) discusses anxiety, depression, and other mental health conditions that may be triggering to some readers.
Let me be very clear: medical school is difficult—at least, it is for me.
Just the other week, I was only able to sleep for a little under 30 hours, trying to get in as much study time as I possibly could. When the results came in for the two exams I had the following Monday, I was just a point or two above the passing score.
Hence, I am prefacing this article with a disclaimer: I am not a brilliant medical student.
This article isn’t the one where I teach you how to get to the coveted top 10 of your class because, quite frankly, I haven’t gotten there. I don’t know how to get there. I’m sure there is a brilliant medical student out there who is able to teach you how to get there, but that student just isn’t me—and I’m not going to lie and pretend otherwise.
This article is the one where I share with you what I’ve learned after a little over two years in medical school, and how this average medical student is somehow surviving it all. So if you’re interested in reading about failure and survival, maybe this article is for you.
Here are the six lessons I’ve learned after trying far too hard and still failing far too many exams:
- Intelligence is insufficient.
While some students enter medical school with a good set of study habits already developed from their undergraduate years, I have to admit that I was not one of those students. I wasn’t lazy by any means, but I also wasn’t used to having to exert so much effort just to try to pass an exam. In college, I would be the kind of student who would study a few days before an exam and still come out with an above-average grade. A few weeks into med school and I realized that I couldn’t coast my way through school the same way I always had.
Intelligence is not enough. In order to survive medical school, you have to be more than just intelligent. You need to study hard—and study smart.
Studying hard is prettystraightforward—you have to put in the time. While each medical school has its own curriculum, I’ve found one thing to be true across all schools: with the vast amount of information that one has to learn in such a short period of time, there really is no time for slacking off. Whether you have quizzes every day or exams at the start of every week, you really have to dedicate a few hours a day (personally, three hours at the very least) to studying and schoolwork, lest you be faced with a mountain of backlogs once the test or deadline draws near. You could try cramming everything in the last few hours and see if that works for you, but that’s only ever ended in disappointment for me.
Studying smart is a bit more complicated—you have to make the most out of the time you put in. I might get some heat for writing this, but here’s the thing: you don’t have to read everything. Moreover, it’s near impossible to read everything. Before studying for a test, take a minute to pause and plan how you’re going to prepare yourself for it. Should you read the book or your notes? What are the bits of information that you need to know? Is it really worth the time and effort to make a reviewer? One of the worst habits I had to break in my first year was trying to read all the source material. I would force myself to read the books and take note of every little detail. It took so much time that I didn’t leave myself enough time to review. For a long time, I focused so much on trying to memorize every little thing that I would often end up forgetting the key concepts that could have been easier to retain and recall.
Studying smart also means tailor-fitting your study habits to your learning style. Are you an auditory and visual learner? There are so many great YouTube accounts dedicated to helping medical students: Shomu’s Biology, Osmosis, Armando Hasundungan, KenHub, AnatomyZone, and Khan Academy, to name a few. Do you retain information better if you have a reviewer? Mobile apps like Lecturio, Quizlet, and Studybluealready have premade ones; the apps also let you make your own. Are you spending too much time on your phone or laptop? Mobile apps like Space, OffScreen, and Focus 10 and web extensions like Hyperfocus, Escape, and Go Fucking Work have been designed to help you keep track of your time and make sure you’re spending it productively.
Put in the time and make the most of it. Having said that, do keep in mind that…
- Overworking is overrated.
If you’re so tired that you can’t keep your eyes open despite doing everything you can to 
stay awake and alert, just go to sleep.
Any friends of mine who are reading this will probably scoff and roll their eyes, because I’ve been known to drink four cups of black coffee a day and get an average of four hours of sleep a night. I am currently trying my best to rid myself of these bad habits, because two years of trying out different study habits and sleep patterns has taught me that unless that exam or that patient report is due first thing tomorrow morning, you don’t need another cup of coffee. You need to sleep.
This pattern of working oneself to the bone is not uncommon. Medical school – and, dare I say it, the medical community in general – has long perpetuated the toxic idea that unless you’re overworked, you aren’t working hard.
You may find yourself feeling guilty for choosing sleep over reading your notes, or heading to the cafeteria instead of the library during your lunch break. You shouldn’t have to feel guilty for listening to your body’s physiological needs. I shouldn’t have to tell you that there’s nothing wrong with getting a good night’s sleep or eating three well-balanced meals a day.
You don’t need to read Guyton cover to cover to understand that if you aren’t treating your body well, you won’t perform well. Sure, you read three transes last night, but were you able to retain any of it? Sure, you finished your paper a day ahead, but does it actually have some sense?
If you really need the extra hours, then go to sleep when you’re tired and then wake up early. Scared of not waking up to your alarm? There are alarm clock apps such as Alarmy, Walk Me Up!, and I Can’t Wake Up that are so annoying that you’ll be forced to wake up, lest you throw your phone against the wall.
Working yourself to the point of exhaustion isn’t going to help anyone. Listening to your body won’t make you a bad medical student.
And besides…
- ‘Medicine’ is a profession—not an identity.
If you are like me and you don’t come from a family of doctors, you may experience a bit of a culture shock when you enter medical school and be eager to integrate yourself into this new culture. You will quickly be accustomed to seeing photos of cadavers and diseased body parts. Medical lingo and jargon will be integrated into your daily vocabulary. Sometimes, it may seem like there is too much work to do and not enough coffee to power you through. It can be quite overwhelming, and you may start making less time for the things that you used to love to do.
Don’t let medical school take over your life. You are still the person you were before entering medical school. You’ve just had a change in profession.
Like I said earlier, put in the time and do the work, but don’t let work be the only thing you’re doing with your life. Take it from a writer who only returned to writing after one year in medical school: you have to hold on to your passions. If you’re a writer, keep writing. If you’re an athlete, keep playing. If you’re an artist, keep creating. Your passions will inspire you, especially on the days when the monotony of studying is just a bit too much.
With how much time we spend surrounded by all things medicine, it can be quite easy to forget that at the end of the day, it is a career. Our chosen careers, while being an important aspect of who we are, are not the totality of who we are— no matter how fulfilling.
There is a world outside of medical school. Live in it.
And when the world within and without medical school gets a bit overwhelming, please know that…
- Support will sustain you.
I was a mess during my first year of medical school. There were days when I just didn’t 
want to go to school, and days when I felt like I physically could not get out of bed. There were nights when I couldn’t go to sleep no matter how exhausted I was, and nights when I would just stare up into the darkness asking myself: Am I really cut out for this? Do I really deserve to be here?
It is no secret that symptoms of depression, anxiety, and impostor syndrome are all too common among medical students. The stress can take its toll even on the most mentally strong individuals. However, just because everyone is going through something does not mean that anyone should have to go through anything alone.
I would not have survived my first year of medical school without a lot of help from a lot of people. With how confusing medicine can be, it helps to go through this journey with people who understand you so you can try to make sense of the confusion together. Whether it’s study sessions with your peers or de-stressing over a good meal with family and friends, a good support system can help everything seem brighter, especially on your dark days.
This is not to say, however, that you should make other people responsible for your mental wellness. In hindsight, it really would have helped me a great deal during those first few months if I had consulted with a professional. Other than the stress of academics, I was also dealing with a lot of personal issues that made me quite volatile and not the most pleasant person to be around, and it wasn’t fair of me to lean so heavily on some people who were also carrying heavy burdens of their own.
Being a psychology graduate and having previously consulted with a clinical psychologist, I entered medical school thinking that I was mentally prepared for it—and I was, to an extent. At the very least, I was able to recognize the familiar symptoms of anxiety and burnout that would recur every so often. However, while it is vital that we educate ourselves on mental health, no amount of education renders an individual immune to mental health issues. With the medical community currently steering towards a more open and honest conversation regarding mental health, medical students and professionals should also be open and honest to themselves and seek professional support when needed.
The days can be dark and dreary, and you may need some help to find the light again. Don’t be too hard on yourself. And on particularly dark days, remember that…
- Failure is fundamental.
Even if you are one of those brilliant medical students I talked about earlier, you are going to fail. I guarantee it.
We may not all define failure the same way. For some people, just passing an exam may already be considered a victory. For others, it may be a disappointment. In any case, there will be a lot of instances in medical school where you will fail to meet the standards or expectations that you set for yourself, for one reason or another. Whatever your reason is, don’t beat yourself up over it. Take it as a learning experience. Learn from your mistakes.
In my first year, there was an extended period of time when I would fail or just barely pass the weekly exams. Rather than taking a step back to reevaluate my study habits and see what I could have been doing differently, I stubbornly stuck to my inefficient study habits for the longest time, defensively stating that it wasn’t my study habits, it was the exam coverage. While there was some truth to the latter statement, I eventually admitted to myself that the main reason I wasn’t doing well was that I was going into the process of studying with a negative attitude, which did ultimately doom my performance on the weekly exams. Once I tried to change my outlook and try out different study methods, there was a (slight) improvement in my exam scores.
The medical profession is a profession of lifelong learning, and failure is an important part of the learning process. I am in no way encouraging anyone to slack off and bomb their exams, but I am not telling you to be so hard on yourself for one failed exam, either. If it happens, don’t bottle up how you feel. Scream. Shout. Cry if you need to. Then, when you’ve got that all out of your system, take a step back and try to see how you could have done better and apply that to your future performances. Re-center yourself and focus on making up for the setback. You may not be able to change what’s already happened, but you will be able to control what happens next.
During these moments of failure and disappointment, you may end up asking yourself if this is really worth the mental and emotional stress. My answer to you is…
- It’s worth it— if you want it.
Just in case you needed someone to say this, here it is: There is no shame in walking away
from something that isn’t what you truly want—especially if you’ve tried your best to want it, for one reason or another.
I understand that there is a certain amount of privilege in my being able to say that. I do not come from a family of doctors; there is no pressure on me to continue a legacy. It was my choice to go to medical school; my family did not force me into this. I attend a state medical college; my financial investment is significantly less than that of most medical students.
Despite all of that, however, I still find medical school exhausting, frustrating, and downright heartbreaking.
The truth of the matter is that medical school can burn out students who have wanted this their whole lives. If you put on that white uniform for any reason other than, “This is what I want to do for the rest of my life,” then it’s going to be that much more difficult.
I am not writing this to discourage you from pursuing a career in medicine – if that’s what you truly want. I have found that no matter how various and valid your reasons may be for wanting to leave, if you are passionate enough about something, you will find a reason to stay.
Whenever you get a bad grade on an exam, receive bad feedback from your preceptors, or just have a bad day, try to remember why you entered into this in the first place. If you still want to be here after that, then you are right where you are meant to be.
We may not all be brilliant medical students. Some of us may be average. Some of us may struggle a little (or a lot). I do hope that this article may have helped someone who needed to read some of the things that were written here, or needed to feel that they aren’t alone in their struggle.
We may not all end up with the illustrious title of topnotcher, but we may all end up with the title of Doctor. And really, isn’t there some brilliance to that?
