Med School Done Right

Recognize the Need to Change Course, and then do it

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By Luke Murray

Recognize the Need to Change Course, and then do itI have lots of different regrets about my time in medical school. I should have tried more things professionally, personally, and socially. I can’t tell you how many nights I sat in my room thinking I would go out that night or call someone up to hang out but thought, “I need to get to bed in a hour so I don’t really have time…” So instead of actually spending time with someone for an hour, I’d watch YouTube videos for the next two hours. In hindsight, I should have made this mistake once or twice, wised up, and then spent that time with friends or even strangers – anything really. But I didn’t, and the naturally isolating experience of medical school remained so for much of my time there. I left a lot of memories and potential friendships on the table during those years.

Another regret has to do with the way I studied. Like my social decisions, I should have known and admitted something was wrong much sooner than I did. I didn’t do well on my first quiz in anatomy just a few weeks into medical school (I failed it, actually). At that time, my strategy was to be as thorough as possible with each pass through the material, to just make sure my eyes saw as large of a percentage of the content as there was for them to see. As an obvious consequence, I only got through the material a couple times (if I was lucky) before a test. I did poorly, again, and then vow that I would study even harder, be even more thorough, next time around. No paradigm-altering changes, just doubling down on an obviously losing strategy, thinking that ‘time spent’ was the only variable that needed tweaking. I continued to stay in the bottom of my class, until my second time through my second year. (more…)

How to be a “Good” 3rd Year Medical Student: Get Comfortable

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By Luke Murray

How to be a Good 3rd Year Medical Student - Get ComfortableIn my last few posts I’ve argued that all you have to do to be a “good” third year medical student is be “engaged.” In order to make this insight more actionable, I described the biggest source of disengagement for me (not accepting my circumstances and calibrating my expectations) and what I wish I had done about it. In the third article, I talked about distractions as a source of disengagement, and what I did to minimize my own. In this final post, I’ll talk about the last category of reasons for which I found myself mentally unplugged during rounds: physical discomfort.

There’s no denying that being “engaged” is mentally and physically taxing. And the more physical discomforts you have to ignore in order to keep your head in the game, the more exhausting it is – and the less likely you’ll be able to keep it up. This experience is called ego depletion, which is “the concept that self-control or willpower draw upon a limited pool of mental resources that can be used up. When the energy for mental activity is low, self-control is typically impaired, which would be considered a state of ego depletion.” The following were my biggest “ego depleters” and what I did (or should have done) about them. (more…)

Becoming A Perfect 3rd Year Student: Avoid Distractions

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By Luke Murray

Becoming A Perfect 3rd Year Student Part 3 Avoid DistractionsIn my last couple of posts, I’ve argued that all you have to do to be a “good” third year medical student is be “engaged.” In order to make this insight more actionable, I described the biggest source of disengagement for me (not accepting my circumstances and calibrating my expectations) and what I wish I would have done about it.

In this post, I’ll cover the second category of reasons I would often “check out” while on the wards and how I was able to fix it:

Even if you’ve accepted the fact that you’re going to be ignored by the team for 97% of the day, you will be tempted to do something besides be bored. Perhaps it’s texting your friends, or browsing your favorite website, or playing CandyCrush on your iPad. You know you’re not supposed to be doing these things, but when you’re dying of thirst, it may be too difficult to expect yourself to ignore the wellspring of distraction vibrating in your pocket. (more…)

Avoiding Disengagement: Accept Circumstances and Calibrate Expectations

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By Luke Murray

Avoiding DisengagementIn my last post, I talked about what defined a good third-year medical student. In a word, they are: “engaged.”

If you’re “engaged” as a third year student, you’re constantly improving and your attitude is appropriate, which are pretty much all that matters (that you can control) when it’s time for those that are grading you to do their evaluations.

But engagement is a nebulous concept. And even if we did successfully define it, turning this definition into action items that are clear and universally applicable would be tough.

However, posing the same goal in the negative, “how to avoid being disengaged,” does seem to lend itself to a more actionable approach.

For example, part of being engaged is paying attention. But saying, “pay attention” isn’t really useful. Identifying why you aren’t paying attention and coming up with a strategy to avoid it would be useful.

So, as I’ve thought about my third year of medical school and all the reasons I would end up unplugging from the experience, three categories began to emerge. I’ll talk about the first (and most important) one below along with the strategies I used (or wish I’d used) to avoid them. (more…)

What Is A “Good” Third Year Medical Student?

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By Luke Murray

What Is A Good Third Year Medical StudentAt this point in my training, I’ve spent almost a year working with third-year medical students as a physician, someone responsible for “evaluating their performance” on that specific rotation. Actually, I’ve made it a point to spend more time with the students than any other person on the team. I want to make sure they’re getting something out of their educational experience, because I hated being ignored as a third year. Also, now that I’m asked to determine how “good” third year medical students are in order to give them a grade, I want to be able to articulate what a “good” third year medical student is.

After nine or ten months of thinking about it, I had an answer somewhere along the lines of “a student that’s getting better each day and that has a good attitude.”

What do you have to do to get better every day? Pay attention, know what’s going on with your patients, read a lot, give presentations backwards when appropriate…basically everything we’ve already written about in our Wards Survival Series (here and here, for example) as well as in First Aid For The Wards and other resources. But this answer seemed a bit superficial and sounds close enough to circular reasoning to be pretty impotent (i.e. “A good medical student does all the things it says to do in the ‘How to be a good medical student’ books”).

And the “good attitude” thing was just a vague definition within my vague definition. Students that were “good” didn’t all have attitudes that were particularly positive, or optimistic or any other defining trait. They were universally not-negative, but “don’t be negative” seemed to leave enough room in a not-exactly-the-definition-of-good direction that I knew I wasn’t done.

Then I got it down to a word. (more…)

Hey 4th Year, What Are You Doing This Summer?

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By Luke Murray

Congratulations! You matched! You now have before you a chunk of free time the likes of which you have probably not seen in years and will probably not see again for many more.

Yes, you’ve had summer vacation in the past, but you’ve always had something hanging over your head – research after first year, Step 1 after second year, Step 2 and residency applications after your third year…but now? Nada.

Sure, you need to move and get some logistics in order, but other than that, there’s no resume-padding activity required, no life-or-death test you need to be studying for – nothing. In order to help you think through your options and maximize the general awesomeness of this experience, I’ve put together three C’s you might want to consider:

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Step 2 CK Advice Part 2 – Scheduling

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By Luke Murray

Click here for part 1 of this series.

Step 2 CK Advice Part 2 - SchedulingStep 2CK, in contrast to Step 1, is really NOT about figuring out ‘how to study,’ or at least, it shouldn’t be. We have hopefully, through trial, error, and feedback, figured out how to study for a Step exam already. What IS different with Step 2CK when compared to Step 1 is the importance of planning. Yes, it’s also extremely important to plan out how you’ll attack Step 1, but most of us have time off to study. Consequently, when our study plans don’t match our study reality there’s enough buffer to still accomplish our goals.

In contrast, when you’re supposed to be studying for Step 2CK, you also have the challenges of residency applications and scheduling and attending interviews. This, coupled with the fact that you have much less time ‘off’ to study and will need to do much of your studying during rotations, means that you’ll sink (and be constantly stressed) if you don’t have your ducks in a row. I know this, because I did exactly zero of the things listed below and wished countless times during my fourth year that I had followed this exact advice. Fourth year was far from a vacation for me. In fact it was just as stressful of a med school year as any other, exactly because I did not do the following.

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