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.
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