As promised, now that I’ve finished my Boards (cross your fingers that I passed them!), it’s time to take on some big themes of the past almost-five years.

I was one of those people that really enjoyed most of clinical med school. (I would say that pre-clinical med school wasn’t so bad, but I certainly didn’t enjoy it much of the time–my post is still the top Google hit for “i hate med school.”) Clinics were great for the most part. You’ve spent your first two years trying to figure out the basics of health and disease, memorizing countless facts, and you’re not really sure how they’re at all useful. And then you get to clinics, and–wow!–this is the stuff I went into medicine for! So let’s start with that:

1. You get to see patients. You get to take your knowledge, everything that you’ve learned, and try to figure out how to make it useful and practical for a person that comes to you with a complaint. I was simply amazed at the level of trust and openness my new patients provided to me. Asking probing, very personal questions and they answered. Men and women who might otherwise not feel comfortable expressing their emotions–be it through laughter, tears, or anger–would open up, for better or worse. And people get better! And many were appreciative! It’s fun to say “you’re welcome” when someone is thank you for helping them. It feels great to shrug, “Hey, that’s what we’re here for,” or “Don’t thank me, I’m just doing my job.” Because it’s genuine. One of the reasons I loved (and continue to love) Geriatrics is that it’s so, so simple to make huge gains in a person’s quality of life. The smallest actions can provide the biggest benefits. Discuss and decide to take a patient off their beta blocker and watch their energy rise! It’s fantastic.
2. You don’t have an MD after your name. I think there’s an assumption (that I hope to dispel) that if you’re a doctor, you have to know everything. That “I don’t know” isn’t an acceptable response to a patient. I think that’s going to change with my generation of physicians, but it certainly still exists today. The best answer you can give a medical student, second to the correct one, is “I don’t know, but I can definitely find out.” ‘Cause see, you’re not expected to know–you’re a student!
   Another semi-benefit: you can’t sign orders. This becomes a pain when you’re ready to sign orders–but nothing annoys a resident more than getting called 20 times a day for stupid little orders to be written. (Brownie points are quickly earned by med students who write the orders for their resident and just ask them to review and co-sign them.)
3. It’s easy to beat expectations. I don’t know if the bar was just set low, but it really seemed like doing well was pretty straightforward:
   • Show up on time.
   • Don’t complain (unless the residents complain first, then you may join in and agree).
   • Try your best.
   • Do what’s expected of you (and know what’s expected of you).
   • Be genuinely interested. (The fake way to do this is to say “Why yes, I’m considering Neurology” when you’re on the Neurology clerkship.) But don’t be so naive to think that what you learn on rotation X will not apply to your chosen specialty Y. Answer: it will!
   • Ask questions if you can’t figure something out by yourself. (I remember my very first day of rotations, we were rounding in the ICU and my intern mentioned “Scids” and had no idea what they were. I finally asked, and found out OOOHHH, those White and Orange things, SCDs, sequential compression devices!)
   • Ahem, ask questions at an appropriate time. I’ve heard of people asking for anatomy tips while a surgery attending and chief are trying to trying to control a big bleeder.
   • All of these rules are actually just this simple gestalt: Do not make more work for your resident and intern.
4. People like to meet medical students. (And it’s fun to have people like to meet you!) After you get past that “Ooooh, a future doctor!” bit, you can easily become the life of the party with stories you’ve stolen from your residents or quirky little anatomy tips.
5. The classmates! I’ve met some of my best friends for life in medical school, and feel incredibly fortunate to have gone through this experience with them. They’re amazing, fun, interesting, creative, compassionate, and brilliant. I’m blessed. And from a larger, life-perspective, I know I have friends in every facet of medicine and in every major city in the country that I can think of if I ever have a question or concern about something going on in a loved one. Truly priceless. (Free lac repairs if you ever need them, guys.)
6. It’s a safe environment to make mistakes and learn. Some of this may be “Why it’s great to be a med student at Stanford,” but I can’t really tell. Thinking through my clerkships, I’d say 80, maybe 90% of my attendings were responsive and interested in teaching and education. Some certainly more than others; some certainly better than others, but it was a rarity to be around a jerk or malignant person. In fact, when briefly swapping stories with friends from other schools, Stanford seems incredibly benign–and incredibly trusting. Once I got the hang of patient care, I was more-often-than-not asked, “Well, what do you want to do with this patient?” forcing me to think through things myself. I wasn’t always right, or someone would teach me something that might be a bit better–the art of medicine–but it made a huge difference that I was even asked. The best rotations were the ones where I was actively involved–that I was treated like a valued member of the team. Just feeling included means a huge deal. Even if the team was going to start lisinopril whether I suggested it or not, just giving me the opportunity to respond instead of writing the order themselves was huge. (And on rotations where I didn’t have this experience, I was asked for–and provided–constructive feedback. They remain nameless, but know who they are!)
7. You can be proud of what you’re doing, if you love it! I’m sure we med students don’t all feel this way, and maybe it’s all just still romanticized in my head, but I feel like I’m truly doing something good. I have friends who hate their jobs; I have others who don’t mind them–that they pay the bills, at least. But I still think I’m incredibly fortunate to be given the opportunity to make this my life’s work. I couldn’t imagine myself doing anything else–and I’ve certainly tried. For some people, optimizing a bottom line is probably as much a thrill as medicine, but this is mine. There’s a lot of crap we have to deal with, and plenty of reasons to complain–but that’s everybody. I’ll take my headaches anyday!
8. It’s amazing to watch your brain learn. It’s a similar feeling to how I felt when my brain just started “understanding” French. I was reading a billboard one day in Paris (lived there for a summer during undergrad), and realized I was reading it in French without the need to translate. Similarly, it’s almost Matrix-esque to be able to spit out the doses of lisinopril without ever sitting down and memorizing them. You wonder, “Where the hell did that come from?” It’s just the osmosis of being around clinical medicine for long enough. (At least for me–I learn best by doing.)

Phew, that’s enough for today. Feel free to add your own. Next up: “Why it stinks to be a medical student.”

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