HealthFebruary 12, 2020

Setting the Right goals during medical school

By: Michelle A. Finkel, MD
During medical school, work on making your residency application as strong as possible, honing your clinical skills and taking care of your own happiness.

At the end of my second year of medical school, my family attended a party at a friend’s house. The host was a physician, and over hors d’oeuvres, he told me that the first two years of med school boiled down to learning the vocabulary of being a physician. Frankly, I was a bit offended: I had just spent thousands of hours learning histology, anatomy, biochemistry, physiology and embryology. The oversimplification of all my hard work felt dismissive.

And yet in retrospect, I now see that what he meant was that the preclinical years are—blasphemous as this might sound—not critical to the daily life of a practicing physician. Much to my surprise (and relief), once I started residency, I found that I rarely used the detailed material I had memorized. Instead, I relied on broader concepts I had learned to understand patient pathophysiology. Concepts that seemed crucial in med school soon yielded to a different class of knowledge that proved more clinically relevant.

With the benefit of time and experience advising medical students, I have a better appreciation of how to set the right goals during medical school. These objectives span the gamut from strategic means of obtaining a residency to avoiding burnout, but all are important in their own way.

1. Find a mentor

If there’s a possibility that you’ll be applying in a competitive field like plastic surgery, dermatology, neurosurgery or orthopedics, to name a few, your mentor must provide you with or direct you toward research early in your med school career. As much as I am a generalist by nature, my admissions advising experience has demonstrated to me repeatedly that research in a chosen field is critical for certain competitive specialties.

If you are not certain what field you might choose (as I was not), then find two mentors. Select either two research projects or one that overlaps several fields. Whatever your chosen field, connecting with a mentor who has a weighty title and name recognition is also advantageous because your goal will be to obtain a strong letter of recommendation from that faculty member for residency.

2. Focus on clerkship evaluations and board scores

The National Resident Matching Program (NRMP) Program would agree with my parents’ friend: Its Program Director Survey found that preclinical excellence is nowhere near as influential as achievement in your clinical rotations in obtaining interviews for residency. The survey also establishes the gravity of the Boards in securing interviews for residency, particularly for very competitive specialties.

No matter how fantastic your application is otherwise, you will have difficulty matching without robust rotation evaluations and acceptable Board scores. What is “acceptable” depends on your chosen field, but if you need a guide, mean scores of successfully matching medical students can be found in the NRMP’s Charting Outcomes in the Match.

3. Seize every clinical opportunity offered to you

Perhaps because a significant fraction of medical students suffer from imposter syndrome (a phenomenon in which high achievers worry they are not as skilled as they are perceived to be), I notice that some shy away from the opportunity for supervised procedures or critical patient management. It’s far better to take these on—medical school is the time you can learn under guidance without being expected to be an expert. Grasping every learning opportunity now will make you a much better resident, which is good for you and your future patients.

4. Be as happy as you can be

This may sound less strategic than my previous recommendations, but your satisfaction is both spiritually important and critical for a robust career in medicine. Research has demonstrated that happiness can come from a feeling of control and the amount of spare time one has, but both of those are limited during medical school. Taking time to see friends, nourishing a partnership and enjoying your hobbies should all be top goals during medical school. Prioritizing wellness is also important in order to reduce burnout, which is an ongoing problem in medicine today.

With the Krebs cycle no longer on my mind, I can appreciate the value of planning for the future, taking advantage of enriching clinical experiences during the journey and enhancing satisfaction while developing habits that promote well-being during medical school training.

Michelle A. Finkel, MD
Lippincott Medicine
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