I don’t know about you, but before starting medical school, I was excited. Having not grown up with a medical background (no one in my immediate or extended family worked in medicine in the U.S.), I gained all of my initial perceptions about the medical field through media. It may sound silly, but my first exposure to the field of medicine was through watching and idolizing the television depictions of medicine in shows like Scrubs, House, or Grey’s Anatomy.

Since I didn’t have many real-life examples of medicine, I feel that I was more susceptible to developing unrealistic expectations about medical school. Even if you had exposure to medicine prior to starting medical school, the field is so broad that you’ll probably still end up with some misrepresented expectations. These are a few medical school “expectation vs reality” moments that stuck with me throughout the years.

#1: Medical Knowledge

Expectation: You’re going to learn everything you need to know in medical school. 

Reality: Your learning is just beginning!

I thought that once I graduated medical school with the prestigious “MD” after my name, I would have everything I needed to know about medicine tied neatly into a bow. After all, it’s four years of intensive graduate education—surely, that would be enough! This turned out to be quite a common expectation, considering all of my non-medical friends and family assumed that because I was a third-year medical student, I must know how to cure all of their ills and ailments.

In reality, medical school merely provides the foundation of knowledge. It gives us the building blocks of human physiology, anatomy, pathology, and pharmacology, and directs us down a path of further learning and specialization. With all of the available knowledge and research out there, it’s close to impossible to “know it all.” The truth is, you’ll be learning well past medical school, residency, fellowship, and even being an attending physician–and you’ll still feel like there’s ever more to know. So it goes, “medicine is lifelong learning.”

#2: Time Management

Expectation: You’re never going to have enough time.

Reality: You will if you prioritize.

The stereotypical medical student portrayed is the classic type A, constantly stressed, sleep-deprived bookworm who only has their mind on medicine, and eschews everything else. That gave me some concern before starting medical school—was my life as I knew it now over?

The truth is a bit more complex than that. I won’t sugarcoat it, medical school is very difficult. There will be stressful times, tests covering almost too much material, and certain days that make you want to pull your hair out. On the other hand, many medical schools and the medical training system are taking steps to make the day-to-day of medical school more pleasant. For example, many schools now use a pass/fail system for preclinical courses. Even USMLE Step 1 is now a pass/fail exam!

There is also now heavy emphasis placed on student wellness. Most schools have duty hours limits for their clerkship students, programs aimed at promoting physical and mental health, as well as required time off. With these recent implementations and support systems in place, there has never been a better time to be a medical student. 

Realistically, you have to prioritize what is important in your life. If you want a high-profile career in a residency that’s extremely competitive to get into, you may resemble the classic medical student archetype. You will expend a lot of energy producing publishable research, impressing your evaluators on rotations, and acing all of your exams. Furthermore, you’ll be expected to participate in leadership roles and volunteer, among other activities to build your CV and residency application. Doing all of this eats up your time and means you may have to sacrifice pursuing your hobbies or focusing on your health and wellness.

Optimistically, I do know many medical students who are at least taking some time to prioritize the things they enjoy, while still working hard to pursue aspirational career goals. This is preferable, to prevent burnout. As someone who went into a less competitive field, I did not feel as short on time as some of my peers, even though my schedule was harder in medical school than it was in college or high school. With a little forethought, I was able to make time for things that were important to me.

#3: Studying

Expectation: You can use your college study skills to prepare for medical school exams.

Reality: The volume of material is significantly higher.

Some people humble brag about breezing through their classes in college and high school, barely having to study, or cramming before the night of their midterms or finals. Admittedly, that was me. I was not a model student and spent much of my class time in college and high school on my phone or laptop, dozing off. I rarely took notes and was often late. Even for exams, I would procrastinate and postpone studying until the day before. Medical school was a huge wake-up call. 

With the volume of material in medical school being significantly higher than in college, my old study habits did not work. I struggled my first year and remember feeling overwhelmed by material in the first week of medical school alone. The expression that medical school is “like drinking from a fire hydrant” is, to me, one of the most accurate comparisons. Every hour of lecture seemed to go a mile a minute, and I felt like I could barely keep up. It did force me to re-evaluate the way I study, however, and to find more efficient med school study methods.

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Flashcard applications and typing notes/outlines became the best way for me to study. I also spent a lot more time studying in medical school than I did in college. My peers, some of whom were college crammers, and the others, though, more prepared and studious, all seemed to be studying all the time. Each of us had slightly different methods and study schedules to master the same material, but the consensus seemed to be that everybody had to adjust their approach to studying.

#4: Clinicals

Expectation: The wards are like the ones on TV: full of glitz and glamour.

Reality: The hospital is not Hollywood.

Your time has come. You have finally completed the preclinical curriculum and now it’s time to tackle clinical rotations. This means you are privileged to rotate as part of the patient care team. You’ll have the chance to see, care for, and learn from patients, work as part of a team, and be directly involved in making a difference in the lives of your patients. This is just like that one medical show! Surely, you’ll diagnose that obscure, tropical disease everybody else misses because you bonded with the patient and he revealed his travel history to you.

However, you’ll come to learn that being in clinicals is not as glamorous as TV portrays. Sure, if you’re at a large hospital serving a diverse population, you’ll work up some interesting pathology and interesting patients. But the diagnosis of rare diseases is only a small part of what being on wards is all about. There is a saying in medicine, “common things are common,” which means you’ll likely see nine cases of eczema for every one case of actinic prurigo (if that). The reality is that there’s so much more to patient care that you probably did not anticipate, including aspects that are decidedly not glamorous. 

For example, what is the appropriate disposition for the patient? They might not have anywhere to go even after you’ve medically “cured” them. Coordinating patient care often involves multiple lengthy phone calls to family or other facilities. How are they going to get the medications and outpatient medical care that they need? How do you prevent and care for bed sores that might develop during a long hospital stay? Who is going to call and update the family? These take time and effort and can be mentally draining if you have to make 10-20 calls per day. 

As a medical student, your job on the wards is primarily to learn medicine from real patients. Maybe you’re not directly managing all of the above issues as a student, but you’ll find that they are incredibly important to patient care and will factor heavily into your future work.

#5: Teamwork

Expectation: The best way to stand out in rotations is by demonstrating your superior knowledge.

Reality: Being a good team player will always pay off.

You spent countless hours studying and preparing during preclinicals, and you want to display your knowledge. Intellect and natural curiosity are talents that drove you toward the field of medicine. In medical school, you might find that you’re surrounded by similarly talented minds. You may fear blending into the background—would that make you unremarkable? Will that put a damper on your career goals? How do you stand out? By knowing more and looking better than your peers, of course!

You’ll find that this is not exactly the case. Knowing a lot about your patients and knowing the science of medicine is necessary and will aid you in success, that’s for sure. But it’s not the only thing you need to be a good clinician. Medicine is not separate from the real world. There is so much teamwork involved in patient care. You need to learn to work as a team with your fellow peers and your superiors. You have to connect with your patients and their families. You have to be someone who people want to work and interact with.

So rather than prioritizing your appearance of intelligence, especially if it’s at the expense of someone else, prioritize working together as a team to make everybody look good. Lift others along with yourself. If you show a collaborative spirit and kindness in addition to knowledge and expertise, it will reflect favorably and make your clinical rotations go by smoothly. 

These are just a few medical school “expectation vs reality” moments that stand out to me, but aren’t often discussed. Of course, these experiences will surely vary based on the individual. What are some expectations that you have, or had, going into medical school? Did real-life experience prove you wrong?

Further Reading

• Day in the Life of a Medical Student: Preclinicals
• Day in the Life of a Medical Student: Clinicals
• Day in the Life of a Medical Student: Elective Rotation