HARDEST Part of Becoming a DOCTOR | College, Med School, or Residency

HARDEST Part of Becoming a DOCTOR | College, Med School, or Residency

October 11, 2019 100 By Stanley Isaacs


I decided I wanted to become a doctor when
I was a freshman in college after getting diagnosed with Crohn’s disease. Back then, I was always very curious about
what each stage of the process would look like, and I’m sure that many of you are
as well. College, Medical School and then Residency. Now that I am a doctor, I can share with you
what I’ve learned over the years, and tell you which stages are the most difficult. What’s going on guys, Dr. Jubbal, MedSchoolInsiders.com. If you haven’t already, be sure to check
out our two previous comparison videos, one on College vs Medical School and one on Medical
School vs Residency. Those provide a great foundation and framework
of the big picture differences of each stage in training. In this video, we’re going to focus on the
difficulty of each – the lifestyle, the day-to-day, the up’s and the down’s. There is one single stretch in time, a few
months in duration, that is by far the most challenging time during the entire process. But before we get to that, we first need to
start with college. College, the good old days. At least, it seems that way now. And I’m sure that many medical students and
doctors will say the same thing. But it’s important to note that as humans
we are prone to a recall bias. Sure, it’s easy for us to look back to college,
compare it with the rigors of medical school and residency and laugh at how seemingly easy
it all is. I’m going to do my best to avoid that and
in the process I’m sure I will get a ton of comments from med students and residents with
a very differing opinion. First, allow me to state that my college experience
was far from the average students. Between my health and financial and family
issues, my life imploded in a spectacularly disastrous way. Anti fragile was the name of the game. To this day, the beginning of my college career
remains the most challenging time of my life. I explained those details elsewhere on the
Vlog Channel. But over the course of four years in undergrad,
I got a good understanding of what college for the typical pre-med entails. Being a pre-med in college is certainly challenging. Don’t let anyone tell you otherwise. The main obstacles you’ll face are the following. First, the distractions. You’re finally out of the house and completely
free, entirely on your own. It’s far too easy to get sucked into the
partying and fun of college, and too easily lose sight of the importance of self-discipline
and your professional pursuits. A lot of pre-meds end up changing their mind
about medical school in the process. At my school, it was estimated that over 2,000
students entered their freshman year as pre-med, and by the time graduation rolled around,
only 200 had applied. Second, the competition for a pre-med is fierce. It’s more the culture than the actual quality
of the competition. Think about it, less than 40% of pre-meds
get accepted to medical school, and the average MCAT and GPA of matriculants is higher than
the average MCAT and GPA of applicants. In other words, in medical school your classmates
are going to be higher scoring than your pre-med counterparts, on average. Still, the pre-med competition is more fierce,
and that’s because of the cut-throat culture. Okay, so this was my experience, but I’m
sure that you have likely witnessed worse. I had a run in with an overzealous pre-med
student in chemistry lab that gave me the wrong answer to a question I had on an assignment. He later made it clear that he knew it was
the wrong answer and that I had been tricked. I was taken aback and shocked someone would
intentionally sabotage a colleague like that – it is just something I never would have
considered, something that would never be on my radar. But unfortunately, stunts like these aren’t
uncommon amongst the gunners of pre-meds. So, to all the college pre-meds, I advise
you to be cautious of those who may want you to do poorly. This cut throat culture is obviously highly
variable from school to school but I’ve heard much worse stories than my own. Remember, never ever stoop down to that level,
it will backfire on you. Karma is a B! But more importantly, you’ll grow to despise
and lose respect for yourself in the process. Now, going back to my example, guess who ended
up at a top med school with the highest available scholarship, and who ended up not getting
accepted to any medical school? Third, the increased flexibility and free
time of college is actually challenging in a peculiar way. It’s like the paradox of choice, where having
more options isn’t always a better thing. You see in med school and residency you have
less time so the thought of performing multiple extracurriculars isn’t even considered. In college, you’re expected to have clinical
experience, volunteer experience, research experience, some qualities that make you unique
and memorable, all while scoring a perfect GPA and a top MCAT score. It’s challenging, it’s confusing, as there
are infinite permutations as to the various paths you can take. If you are a pre-med and you need help figuring
out how to situate yourself to be as competitive as possible, check out our advising services
on MedSchoolInsiders.com. For those on a budget, our Pre-Med Roadmap
to Medical School Acceptance Course is a tremendously comprehensive resource. Now, on to Medical School. Medical school will be a challenging adjustment
for completely different reasons than college. First off, the increased flexibility you had
in college is totally gone. Don’t expect to pick up too many extracurriculars. Your expectations as a medical student are
to study, become a competent future physician, and to perform some level of research, particularly
if you’re applying to a competitive specialty for residency. Other than those three things, follow whatever
interests you. For me, that was doing some design work for
my med school’s literary and arts magazine, lifting weights, cycling, and enjoying the
San Diego beach. The main challenge here is the lack of time. You will perpetually feel behind in your studies. There will always be something to do, and
it may be challenging to make time for yourself to unwind or relax when you have deadlines
looming over you. Second and arguably the biggest adjustment
will be the pace of learning. As they say, learning in med school is like
drinking water from a fire hydrant. The material isn’t necessarily conceptually
difficult, but rather it’s staggering in volume. The biggest epiphany I had in med school was
understanding how far my learning methods could be optimized. After a couple months, I was a studying machine. I had active learning, flashcards, mnemonics
– the whole system in place. The funny thing is, if I knew how to study
like this in college, undergrad would have been such a breeze! I go over these study strategies I wish I
had, in my first ever YouTube video, Pre-med Study Strategies -What I Wish I Knew In College. The transition from classroom to the wards
can be very challenging for some. Since grade school, you’ve been studying from
books and preparing for tests. In the second half of med school, gone are
the days of the comfort of the classroom. Instead, you’ll be working in the hospital
for the first time, with the bulk of your grade coming from evaluations from your attending
and resident physicians. Most med students love the transition to the
wards, as this is what you came to medical school for – to take care of patients. But rather than just learning information
from a textbook, you now need to spend long and often unpredictable hours in the hospital
and self study on your own to prepare for your shelf exams. This again requires tremendous adaptability
and self-discipline. Now, the last part of your medical training
is residency that is unless you do fellowship which is almost like a residency part two. Residency is challenging for an entirely different
set of reasons. The main challenges in residency come down
to the increased responsibility. As a medical student, you had the resident
above you who was actually responsible for the patient. If you made a mistake or didn’t know the
answer, it wasn’t that big of a deal. In residency, you are the primary doctor caring
for the patient. And sometimes that’s scary. I remember several nights where I was in call
in the emergency department taking care of some nasty lacs or lacerations or hand fractures. Full thickness, oblique angle, facial lacs,
gruesome hand injuries, you name it. And I was an intern. Luckily, your seniors are there for you. I shot them a text, some photos, and explained
how I was planning on treating the patient – initial management, suture type, number
of layers, closure technique, etcetera. They would either agree with me or use it
as a teaching opportunity and redirect me. And if I was ever in over my head, they would
come to the ED to help me out. Overall, the increased responsibility isn’t
all so bad. It’s actually quite rewarding, since for
the first time, you are the primary physician for a patient and the impact you can make
is quite fulfilling. But this increased responsibility sneaks up
on you in multiple ways. In residency, if you don’t keep on top of
your studying and medical knowledge, you will be doing a significant disservice to your
patients. Your increased responsibility also translates
to many more nights on call, which means even more sleep deprivation than when you were
a medical student! Increased responsibility also often being
the last to leave. Real patients and the attendings are fully
counting on you. As a medical student, you’re primarily there
in the hospital to learn. But as a resident, you’re there to work
and to take care of patients, with learning being a secondary objective. Now that we’ve gone over all three parts of
training to become a doctor in the US, which one do you think is the hardest? In my opinion, it’s the sub-internships during
the beginning of your fourth year of med school. It should be noted, however, that I went into
plastics and your sub-internship, also known as your audition rotation, will significantly
vary based on your specialty. Now, sub-i’s are essentially month-long interviews. You travel around the country and do a rotation
of two to four weeks at a program that you are considering for residency. In my case, I vividly recall the toughest
week of medical school. I was at a top plastic surgery residency program
for my first sub-internship and we were on triple call. That means, when patients came in for hand
injuries, face injuries, plastic surgery related emergencies, we had the pager and we had to
be in the hospital to address it. It’s pretty safe to assume that when you’re
on triple call, you won’t be sleeping. We were on triple call for the entire week,
and as the sub-intern, it was my duty to impress everyone with my work ethic and determination. For better or worse – mostly for worst – that’s
just the surgery culture. I spent three days in a row, working between
18 and 19 hours each day. When I went home, I had to prepare for the
next day’s cases, because it’s a huge no-no to walk into a case unprepared, especially
on your sub-i. And good luck preparing ahead of time, as
the hour schedule is constantly changing. To say it was a rough week would be an understatement. Again, not all sub-i’s are like that. One of my friends went into internal medicine,
and his sub-internship experience was much more relaxed. And if you’re going into something like
psychiatry, it’ll be even more relaxed than that. So, what stage of training are you currently
in, and in your opinion, what’s the hardest part of training to become a doctor? Leave a comment down below. For those of you who enjoyed the brief stories
that I shared here, check out the Vlog Channel where I go more into my own experiences and
the lessons that I’ve learned over the years. And check out Instagram where I’m regularly
posting exclusive content that you won’t see anywhere else. Think of it as “behind the scenes.” Thank you everyone for watching. If you liked the video make sure you press
that like button. Hit subscribe if you have not already, and
I will see you guys in that next one.