10 Cardinal Rules for Surviving the First Year

August 09, 2017

By: Timothy Dixon

So you’re starting your journey to medical school. Congrats! I am certain there’s quite the cocktail of emotions stirring inside of you comprised of excitement, motivation, and relief, mixed in with a little bit (or a lot) of fear and uncertainty of the unknown. Well they say hindsight is 20/20, and as I begin my first day of my second year of medical school, I’ve realized that I’ve developed a mindset that I wish I had a year ago, but am glad I have still this early on.

Medical school is an amazing time. You’re in a new school, on a whole new academic level, meeting amazing people from all different backgrounds and learning from them, all the while actively learning and being trained to be a great doctor one day.  It is true when they say that medical school is hard; however, the hardest part of year one is much more internal than external.  It’s a year where you’re being pushed in a way you have not been before. Making the adjustments, finding your rhythm, and discovering what works for you become the ultimate battle that some win faster than others.

Through all the successes and failures, the highs and lows, I was able to spend the following summer really reflecting on what happened, and what I would do if I were able to do it all over again. Here are my 10 cardinal rules and tips for surviving the first year of medical school–and beyond.

 Tip 1: Treat medical school like a job.

Just like a real 9-5 job, you wouldn’t leave in the middle of your shift to go to happy hour as long as you promised your boss you’d eventually be back. The same thing goes here.  Have the discipline to make your “study blocks” and stick to that. I promise you’ll stay on top of the material if you do. Imagine medical school being like eating pancakes. Every day you need to eat 3 pancakes. That’s not too much to eat at once, right? Ok, say that you skipped day one so now you need to eat 6 pancakes. Or took a week off for a vacation and now have to eat 21 pancakes. Now the idea of eating pancakes just became stressful, when all you had to do is have the discipline to eat those three pancakes every day, and that would have never built up. The same goes with medical school material (sorry if I ruined pancakes for you forever).

Tip 2: Study to pass an exam before studying to ace it.

Identify the major concepts and the high-yield information first. Then, make sure you absolutely master this before you get bogged down on the tiny low-yield details that comprise the extra 5% of points to earn on the test.

Tip 3: Familiarize yourself with First Aid and/or some form of USMLE Step 1 material from Day 1.

Use Step 1 prep material as a supplement to the lecture material you’re learning. Now I’m not saying start studying for Step on your first day of class, however it’s important to stay familiar with and have down the material that will be tested at the end of Year 2. This will save you time and stress when you start your dedicated studying. Some of the most successful people in my class did this and crushed the NBME’s and will most likely do the same on Step 1.

Tip 4: Be cautious about advice from others.

I know it sounds funny as I’m currently giving you advice, but in the end, take in everything for what it is. Use it to find out what works for you because at the end of the day, all the “advice” you hear is just things that worked well for that specific individual and may or may not work for you. Once you find what works for you, stick with that at all costs and don’t second-guess yourself!

Tip 5: FOMO is a real thing and the ultimate focus killer.

FOMO, an acronym for the ‘fear of missing out’ is more real in medical school than ever. The fear that you’re missing out on some get-together here, or some conference there, does nothing but distract you and take time away from studying–and points away from your exam! Facebook and especially Snapchat are the worst for this in my opinion. You could be very focused while studying and completely killing it, only to take a quick break and see that all your friends are enjoying some happy hour margaritas. Two things might go through your mind: (1) “Why didn’t I get the invite?” and (2) “That looks fun. Come to think of it, I’ve put in enough work today. I’ll just catch up tomorrow.” Consequently, points off your test…plus some extra pancakes on your plate.

Tip 6: Be balanced.

The ‘work hard, play hard’ mentality is the way to go in medical school. Have fun, travel, hike, have a margarita, play music, or do whatever you enjoy! Just be a human, because at the end of the day, you’re going to be fine. Your success is reflective upon your school and your administration knows that, so they will be diligent in helping you to succeed.

Tip 7: NEVER compare yourself to others.

Focus on you, and you only.  So many people I’ve talked to said this was by far the biggest anxiety-inducer in their first year. Take studying with a classmate for a biochemistry exam, for example. Your classmate could be rambling on about some insane new research on an enzyme and listing 20 different things about it, then you find out he knows this because he’s personally doing research on it and none of that information is relevant in any way to what you need to know. If you’re not careful, it can make you think that you’re slacking when really, you’re not.

On the other end, don’t get caught up with people calling you a “gunner” or a “nerd” just because you want to stay in all weekend and study (it happens a lot in med school). Do what you feel like you need to do and tell everyone else to mind their business. Just be happy with your work ethic.

Tip 8: Take care of your body.

Your body and mind are one. If you exercise, eat relatively well, and get plenty of sleep, your brain will thank you 1000-fold. One of the things I noticed this year about my upperclassmen friends who scored the highest on Step 1 was that they were constantly in the gym and eating healthily. Overall, they made sure to be in a good place physically and, consequently, mentally.

Tip 9: The more questions you do and review, the better you will perform. PERIOD.

This goes for lecture exams, NBME’s and Step exams (and really any major academic exam). Sometimes people put off doing questions because they don’t feel sufficiently ready and fear that they’ll miss a high percentage of the questions, which will tank their self-esteem. Yes, practicing with questions is an important way to test how well you know the material; however, it’s also vital for learning, retaining, and mastering the material as well. Getting questions wrong early on in your studying is a positive thing as long as you stay consistent in your studying. Review what you get wrong, as well as the concepts behind it, so that you won’t forget. Especially for Step, the more questions you do, the better you will score.

Tip 10: Understand the major difference between working hard and stressing out.

This is the most important cardinal rule or tip of all. You can be a disciplined workhorse without being stressed out. Work hard during your window of study time and then enjoy life and know that you’re doing your best.

Keep these 10 things in mind, and I promise you will not only survive medical school but you will thrive!  Strive to always keep a positive mentality, be a little bit better every day, and most of all, never forget that you are not just a medical student: You are a human being. Good luck!


Timothy Dixon is a second-year medical student at Texas Tech University School of Medicine. He also serves as Student Body President and Class Vice President. Questions for Timothy? Comment below or email us at amsa@amsa.org.

Wellness Wednesday is an AMSA On Call blog series posted by the Wellness & Student Life Action Committee. If you are interested in writing a post, please contact the WSL Chair at wsl.chair@amsa.org.