Medical School Update #7: What’s The Tea on Third Year?!

Hello everyone! I hope you are all doing well and enjoying your Thanksgiving break! So a common question I get asked is how medical school is going, specifically how my third year is going. And it’s understandable. The third year is kinda hailed as this treasure chest that everyone is trying to get to. After two grueling years of battling in-house exams, being in the classroom, staring at textbooks for hours and hours, and of course, the notorious USMLE Step One exam, it seems like third year is the dream. Finally, you get to see patients and use what you have learned during your first two years. Finally, you get to do what you came to medical school for. Everything you had to go through was worth it….right?

Well, let me tell you. I am halfway through my third year and so far I think it is pretty great because you have to work in the hospital with doctors and residents in different specialties. But it’s not the paradise some people make it out to be. And here’s why:

1. You have to “work” and study

When I first started my third year, I was extremely lucky because I started an Internal Medicine elective. I was working relatively good hours and I did not have to study! Life was great. And then…I started other rotations and realized that I had to study on top of being in the hospital. And it honestly sucks. It is grueling coming from a long shift and having to click through Uworld questions or OME to study for the quiz that’s in a couple days. Some days I just come home and plop on my bed because my brain is literally fried. And sometimes the studying I do is not helpful and I, unfortunately, end up failing the exam. And for our rotations, we need a 70% on all of our weekly quizzes and maybe a final (depends on the rotation if we get a final) to pass. It’s slightly different from other schools that require you to pass and get a 70% or above on an end-of-the-rotation Shelf aka NBME subject exam. I prefer my school’s method because I at least get the opportunity to improve but honestly, it’s not easy. The fact that you could fail a rotation just because you did not get a concept down pat is beyond me.

I would say that having the knowledge from studying for Step One does help some but…we are still in the trenches.

2. The hours

During my first two years of medical school, the hours were pretty great. I only had to go to class for 3 hours and I had time to do other things. That changed when I started my third year. For some rotations, it could be the typical 8-5 pm if you are in clinic, which was not too bad. However, when I started my OB/Gyn rotation, specifically the OB portion, those hours were honestly laughable. I was “working” at least 12 hours, not including the commute. I would be extremely fatigued to the point of wanting to pass out. Night shift was extremely rough and when I would have to be woken up to help see a patient in triage, I honestly wanted to cry.

Some people like the long hours and the rush of things that can occur during that time but haha not me.

3. The criticism

This was a hard pill to swallow. Another thing that is different from the first two years of medical school is that as a third year, you will be evaluated. Sometimes, you will work with attendings/residents you do not seem to mesh with and that’s life. But the fact that they could add that to your MSPE makes it 10x worse. The MSPE is all of the evaluations from each rotation that are sent to residency programs. So say that you want to go into IM but you do not work well with the IM attending you are with and they put a bad comment on your MSPE. That could affect you. I was lucky that the criticism I received on my psych rotation was more so during the middle of the rotation than at the end but it was still very heartbreaking. You can honestly try your best and still feel as if you are not doing enough. Now, I try to take criticism the best way that I can and just try to improve. There’s only so much you can do. πŸ€·πŸΎβ€β™€οΈΒ 

4. Getting honors

When you honor a rotation, it means that you have excelled in it. It’s like passing is a C and honors is an A. But it is extremely hard to obtain, especially at my school. It is given to 1-2 students out of 10-15 students per each rotation. I remember on my neuro rotation, I received great evaluations and scored highly on my exams. But I knew that in my cohort, there were many high achievers, so my chances of getting honors were slim to none. That kind of sucked because I did not have any control over who would be in my cohort. But after going through some more rotations, I just try to pass and learn what I can. Inshallah, I will still get to match at the program that is suited for me, and not getting honors will not impact me too heavily. ☺️

5. The competition

Because everyone is trying to get honors, it can get extremely competitive. There are students who will come earlier than everyone else and try to one-up you aka the gunners. They will do their absolute best to be the best and try to kiss all of the residents and attendings behinds by doing so. It’s kind of sickening. Like…can you chill? These were the same people who were trying to help me out during my first two years, now trying to sabotage the rotation. Honestly, just take your honors and go. Lemme pass in peace.

6. You are paying “to work”

As medical students, we are not getting paid. In fact, the tuition increases during our third year. So when students say “Oh I have to work”, I am usually like what work? Girl, this is still school lol. Granted we do have more responsibilities but uh uh do not confuse the two. Speaking of responsibilities…

7. More responsibilities and liabilities

Welcome to the wards. As a medical student, you are expected to chart review, talk with patients and their families, check on labs, check on any updates, present to the attendings, write notes, and determine the next steps in a patient’s care. It’s a lot, especially when you realize that less than a year ago you were studying for an endocrine exam. Things can constantly change and it’s kind of up to you to step up the pace.

You are also more liable as a third-year student. Now that you have access to patients’ charts, you have to make sure you are only looking at the patients under your care. Say for instance you are interested in a patient that was in the hospital you are in who is not under your care and you look at their charts. Ooop…the hospital can report you to the school. Say that you talk about a patient in front of someone who is an opp. Yikes. Reported. And say that you wanna take a cute picture for the gram and the patient’s info is in the background. Report. Report. 🚨🚨🚨 Worst-case scenario you could be sent to the honor council and fail your rotation and/or be dismissed from the school.😱😱😱 All because of something you did not think was wrong.

This honestly makes me feel like I have to watch my back constantly. The best thing to do is ask your residents and attendings if what you are doing is correct. You will make mistakes and they know that but definitely try to do what’s right.

8. The residents are stressed too

I honestly feel so bad for the residents, especially the interns. It’s their first year as a doctor and they are learning too. And they have to teach us, students, what to do too. Like what? We work fewer hours and have few responsibilities than the residents therefore they have a lot on their plates. This system is absolutely ghetto tbh 😭😭😭

9. Everyone’s experience is different

No two’s students’ experience is the same. I remember telling someone I hated my psych rotation and that person being in shock because they loved it. Or telling someone I loved my neuro rotation and them telling me they hated it. It depends on the residents/attendings you work with, how comfortable you are, your strengths/weaknesses, the overall environment etc. That’s why do not take what people say about their experience as a reflection of how your experience will be. I may dislike something that is the best thing that someone else will have. It’s pretty crazy honestly.Β 

10. You feel like the least important person on the team

As a medical student, you sometimes feel insignificant and that you do not belong. Sometimes the residents will say “oh you are just a medical student” and it makes you feel less than others. You know the least out of everyone. Over time, you learn more about what to do, but to know that the time you put into your work the residents can do in half of that time is kind of disheartening. Whenever I express this to the residents, they tell me that I am learning and that I am right where I need to be. If I knew how to do everything, I would have been an attending already. And it is true, everyone was at this point at one time in their lives. Sometimes it can be hard to recognize that. 

11. Isolation

Lastly, the third year can be very isolating. You are “working” long hours. You are studying. You leave before the sun rises and come home when the sun is down. All of your non-med school friends seem to be living their best lives. Your only friends at the moment are pretty much the residents and classmates you are working with. The friends you made during your first two years of med school maybe not be the same friends you keep because they are also busy and doing their own rotations. 

During the wintertime, it can get pretty depressing. What helps me is knowing that what I am going through is temporary and giving myself affirmations. I am also extremely blessed to be living at home with my family so that I still get to experience life outside of med school. And during my rare times off, I try to get food with friends to catch up. 😊

That’s it y’all! Third year is rough. It’s amazing to get to finally see patients, attend awesome procedures, work with residents and attendings, and see life outside of textbooks and the school. But there are some things that make it really hard. With all of that, I am still truly so grateful to be here and be apart of my patients’ care. Seeing Black patients and even employees acknowledge my presence makes me not want to take this opportunity for granted. So many people have craved to get here and here I am by God’s grace. Just praying that I make it out of my third year alive and that fourth year yields its fruits for me.Β 

Thank you all so much for reading! I hope I did not scare any uprising med students or even 3rd-year students. We got this but we have to be honest about each stage of our lives. Third year is better than the first two years in my opinion but I tend to see more posts/videos highlighting the positives of it and ignoring the negatives and that does not work in my books. I hope this was helpful and good luck in whatever stage you are in now. You got this!

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