The following piece was written by Anubodh ‘Sunny’ Varshney. Sunny is a Dallas Fort Worth tutor for Varsity Tutors and a current medical student at The University of Texas Southwestern Medical School. He has accepted a residency in internal medicine at Brigham and Women’s Hospital.
Medical school is a transformative and unique experience. Students begin with very little clinical knowledge and a vast body of material to master. By the end of their fourth year, however, they are confident in their clinical abilities and prepared to tackle the challenges of an internship. Below is a day in the life of a medical student during the pre-clinical (traditionally years one and two) and clinical years (three and four). Note, however, that each medical school’s schedule is unique.
The Pre-Clinical Years
8:00-9:00 a.m.: Wake up at the last possible moment, frantically shower, dress, and eat a poor approximation of breakfast before you drive to school (despite understanding the metabolic basis of why breakfast really is important).
9:00-9:50 a.m.: Attend your first lecture of the day. If you are a first-year medical student, lectures likely cover basic biomedical topics like anatomy, biochemistry, cell biology, physiology, and neuroscience. If you are a second-year medical student, lectures typically describe diseases according to organ systems (e.g. pulmonary, gastrointestinal, or cardiovascular).
9:50-10:00 a.m.: Realize your breakfast was insufficient. Scramble to the campus cafeteria to purchase a snack, along with almost every medical student’s true best friend—a cup of coffee.
10:00 a.m.-12:00 p.m.: Listen to two lectures back-to-back. Absorb as many details as possible about disease epidemiology, symptoms, physical exam findings, laboratory results, imaging, and treatment modalities.
12:00-1:00 p.m.: Ah, lunchtime. If this is a particularly intense week (i.e. final exams), you may consider heading to the library to review your notes. Otherwise, you spend an hour eating with friends.
1:00-4:00 p.m.: The remainder of your day is variable, depending upon your school’s specific curriculum. You may dissect cadavers in the anatomy laboratory, work through patient presentations in small groups, examine slides for cell biology and/or microbiology, log early clinical exposure seeing patients with a mentor, or attend additional lectures.
The Clinical Years
Your schedule (and life) during years three and four can vary dramatically depending on your clinical clerkship (family or internal medicine, neurology, obstetrics and gynecology, pediatrics, psychiatry, surgery, etc.). The outline below is reflective of a non-surgical inpatient rotation (like internal medicine).
6:00-7:00 a.m.: Wake up at the last possible moment, frantically shower, dress (including your white coat!), and eat a poor approximation of breakfast before you drive to the hospital.
7:00-8:00 a.m.: As a clinical student (or clerk), you have responsibilities and expectations at the hospital. Before your supervising resident arrives, you complete your initial rounds. You visit with “your” patients—usually from one to five individuals. You ask them how they are feeling, examine them, update them on their status, review their chart and lab work, and enter your note into their medical record, along with your assessment and proposed plan. As a student, you have fewer patients to follow than the residents have, so you devote extra time and care to each patient. Patients sometimes even view you as their “doctor” on the team.
8:00-9:00 a.m.: Now that your supervising resident is present, you see your patients once again. This time, your resident does the majority of the examining, either confirming or denying your earlier findings. You discuss your assessment and plan with your resident, and you change your note, if need be.
9:00-11:00 a.m.: The attending (who is a faculty member) arrives, and you begin rounds as a team. The team (attending, resident, medical students, and sometimes nurses and/or pharmacists) sees all of the patients they are caring for one-by-one. As the team reaches your patients’ rooms, you present your findings, impressions, and proposed treatment strategies to the attending physician. This is where the majority of teaching occurs. The attending questions you regarding your patient’s illness—in front of the entire team—and expects you to give your best answer. Several questions will be well beyond your current knowledge level, but the attending will be sure to educate you on these topics. As a clinical student, you may realize that you learn far better when correlating information to a patient you are caring for, rather than passively taking knowledge in as you did in your pre-clinical years.
11:00 a.m.-12:00 p.m.: You finish writing and/or editing your notes, and you assist your resident with any miscellaneous tasks that must be done in order to help your patients improve.
12:00-1:00 p.m.: Lunch! Occasionally, there will be departmental educational conferences during this hour that include free food. This is also an excellent opportunity to refresh your coffee mug.
1:00-5:00 (or 6:00, or 7:00, etc.) p.m.: Depending on your rotation and whether or not your team is on call, you will be dismissed early or late in the day. If your team is not on call, you will work with your resident to follow up on patients who need to remain in the hospital. You will also help to discharge patients who are ready to leave. If your team is on call, you will continue to monitor patients, as well as participate in consultations and new admissions.
The transformation students experience during medical school is nothing short of amazing. We often start our journey naïve and optimistic. The massive amount of information we must commit to memory occasionally overwhelms us. Many times, medical students struggle with frustration and intimidation as they go through the seemingly never-ending pre-clinical years. Students may think about their peers who graduated college and started lucrative careers.
However, once we reach the clinical years, we are often rejuvenated; we finally learn what it is like to be a physician. We begin to make clinical decisions—first timidly, then assertively. Yes, a day in the life of a medical student can be rough. We are burdened with debt, and we are at the bottom of the proverbial totem pole – but we begin to realize why we chose medicine in the first place. It is not about getting rich quickly, it is not about prestige, and it is not about feeling like you are on top of the world. There is one thing, and one thing only, that drives us: to make a positive difference in the lives of our patients.
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