This list was months in the making. As I was studying for the final few exams, then finishing the last one and travelling through Indonesia during the Summer. I had time to reflect on the last 6 years - what I learned, liked, disliked and what I would change. Sometimes this came at the expense of my focus to study, but I thought that was natural just before a major milestone in my life.
The list is a culmination of my experiences, advice from doctors and books I read in the past 6 years. Here's a preview of the lessons included in this post:
- Don't be afraid
- Confirmed, they're just grades
- Decide as late as possible
- Don't neglect your health
- Make mistakes
- Be patient
- Stay humble
Please also read the post I wrote after the first 3 years of medical school.
Martin Verbic
Don't be afraid
When the 6 years were coming to an end, all of us started talking about what our plans are in the future. Many with a fear in their voices about what they're going to do, where they're going to work, and how they will miss the student life. The latter then usually leads to extending the study for a year to what's already a long process. You get the feeling that this is the last of the enjoyable years in your life.
The usual arguments for being afraid of the transition are connected with free time, the ability to take vacations anytime, and taking on responsibility as a doctor. They're all valid. It's important to enjoy student life and cherish this phase. However, it's not a good idea to get overly attached to it. The transition to becoming a doctor is what we studied for and should welcome with open hands.
Yes, there will certainly be less free time. But it's not like you have an unlimited amount of time when you're a student. My final 2 months were composed of 4-8 hours of clinical work in the morning and an additional 4-6 hours of studying in the afternoon. The last time I went somewhere, and it was not Summer, was a short hop to Valencia in February 2023. Not to mention doing a skiing trip that I crave since the last one I did in high school. Ergo, if you study and organize life around exams, you don't get a lot of free time except in the Summer.
Second, we will finally stop working for free. Whatever the first paycheck is, we will start working what we studied for. In turn, this also means financial freedom and independence, which is not comparable to the student years. And, unlike in medical school where you're tied to exam periods, you can go on vacation almost any time you like (let's leave the details, but it's theoretically possible).
So instead of being afraid of the transition, look forward to it and enjoy the process!
Confirmed, they're just grades
While it’s important not to fear the transition into working life, it’s also important to keep in mind that grades, which seem so significant now, will matter far less in the long run.
"College is not about grades. No one cares what grades you got in college. College is about exploring. Just try stuff." - Kevin Kelly
Sometime in April I read this quote and I felt content. There are so many variables when it comes to grading a student that I sincerely believe they don't matter as much as we think they do. Instead of focusing purely on grades, students should listen to Kevin Kelly and explore.
One of my recommendations is to invest time to learn as many nonmedical skills as you can. They will make you a lot more valuable.
Languages, for example, give you the opportunity to work abroad and give you access to bigger markets. Erasmus exchanges are perfect for this, and you make lots of new friend from around the world.
Another example is coding and IT skills, which allow you to venture into the world of medical tech startups, currently a very lucrative area.
The second is to keep up the hobbies from high school and try new ones. You surely enjoy them, so why not keep them up? It's a good idea to have an escape from medical school and medicine. Especially beneficial is if it's a sport, as it also keeps you healthy.
Third, read books on relationships, finance, productivity, and psychology. Why? Being a doctor sometimes causes us to think we know everything, way beyond our field of expertise. At the same time, the workload prevents us from learning about these important areas. So take the time to read books during the student years.
Finally, try different specialities to find the one you truly enjoy and want to work in. It's one of the most significant decisions in our lives, as there's a good chance we'll work in that field for the next 40+ years. It's ok to wander around and try out different things. Try them out, not just think about them.
Decide as late as possible
This one is piggybacking on the last point. Some wandering around is always welcome. But it's key to strike a balance between staying in a limbo and making a decision.
Jeff Bezos talks about open and closed doors in terms of making decisions. If a decision presents as an open door - something that you can easily correct or change in the future - make it as soon as possible. If, on the other hand, a decision is a closed door - meaning that you can't easily back-track it - decide as late as possible.
One of the closed-door decisions in medicine is choosing a specialty. The odds that you will work in it for the next 40+ years are high. It's also not very easy to change your mind 10 years down the road.
Therefore, decide as late as possible. If you have the chance, try internal medicine and surgery. Go out of the city and help a primary care physician. Experience how it is being a doctor in a retirement home. Apply for an Erasmus exchange in a better and worse healthcare system. In my opinion, the best strategy is to just try them spontaneously and let serendipity do the work for you.
It might not seem efficient, but it's essential. However, there's certainly a reasonable amount of time you can devote to this without it taking too long.
Don't neglect your health
It takes time, motivation and organization to stay in shape.
But as doctors and medical students, we should be role models of health. It adds to our credibility. Even just the basic pillars of a healthy life - be active and eat a balanced diet without too much alcohol and sugar.
Expecting that you will be in top-notch physical form, be a good medical student and keep a reasonably social life is a stretch. I failed so many times at this. Made a plan and stuck to it, but then came the exams and I let it all go. But in that exact situation, the best thing to do would be to just keep going. My exam performance and study efficiency would've probably been better.
Not an easy task and hard to keep up, but we can at least try and make the most of it, then keep up the good habits throughout our careers.
Make mistakes
While you're a student, young doctor and to some extent a resident, you don't have as much responsibility as a specialist. You can afford to make mistakes and learn.
Success teaches us nothing, and easily makes us complacent. But we will only learn from our mistakes if we admit to them – at least to ourselves, if not to our colleagues and patients. And to admit to our mistakes we must fight against the self-deception that was so necessary and important at the beginning of our careers. - Henry Marsh, Admissions: A Life in Brain Surgery
The sooner you shift your mindset and realize that mistakes are a part of the learning curve, the better. Because when you become a licensed physician and a specialist, the health and life of people is in your hands. Mistakes are on you.
On a side note, many doctors, and professors talk about this as well. But in my experience, students still come under scrutiny when they make mistakes.
Patience
One of the themes that somehow connects all the previous points is to be patient. They say slow and steady wins the race.
Medical school is a marathon, not a sprint. Even though it feels like it's composed of small sprints, you should really be more focused on the marathon. It's a grueling 6 years, so spend your energy wisely. I've seen way too many cases where brilliant students gave up after working too hard too early.
I also remind myself multiple times per month how much I don't know. And this was the case all throughout medical school. But then I figured that I have plenty of time to learn it in the future and I just need to be patient.
Another point that I can re-iterate through the lens of patience is that you don't need to figure everything out today. Not in medical school and not in life. I think this Kevin Kelly hits the nail in the coffin with yet another piece of wisdom.
"Forget trying to decide what your life’s destiny is. That’s too grand. Instead, just figure out what you should do in the next 2 years."
It's just perfect.
Stay humble
Last but not least, and perhaps the most important of all. A lesson from an esteemed professor.
People's perception is that doctors know everything. It can quickly turn on us, and we start believing we actually know everything. This is dangerous.
It's not easy, but please make the effort to keep yourself in check. Stay humble.
5 recommendations from Atul Gawande
Atul Gawande, surgeon and author of several books, shared five suggestions for doctors his book 'Better'. I highly recommend remembering them, if not reading the whole book.
MY FIRST SUGGESTION came from a favorite essay by Paul Auster: Ask an unscripted question. Ours is a job of talking to strangers. Why not learn something about them?
MY SECOND SUGGESTION was: Don’t complain. To be sure, a doctor has plenty to carp about: predawn pages, pointless paperwork, computer system crashes, a new problem popping up at six o’clock on a Friday night. We all know what it feels like to be tired and beaten down. Yet nothing in medicine is more dispiriting than hearing doctors complain.
MY THIRD ANSWER for becoming a positive deviant: Count something. Regardless of what one ultimately does in medicine—or outside medicine, for that matter—one should be a scientist in this world. In the simplest terms, this means one should count something.
MY FOURTH SUGGESTION was: Write something. I do not mean this to be an intimidating suggestion. It makes no difference whether you write five paragraphs for a blog, a paper for a professional journal, or a poem for a reading group. Just write. What you write need not achieve perfection. It need only add some small observation about your world.
MY SUGGESTION NUMBER five, my final suggestion for a life in medicine, was: Change. In medicine, just as in anything else people do, individuals respond to new ideas in one of three ways. A few become early adopters, as the business types call them. Most become late adopters. And some remain persistent skeptics who never stop resisting.
As I move forward from student to doctor, I know these lessons will continue to shape my journey. I hope they resonate with others as they embark on their own paths.