Dear MS1s,
Each individual has a unique M1 experience—some good, some bad, often a mix. For me, M1 was hard. Really hard. It’s very difficult for me to parse which parts of it were hard because of the pandemic nightmare and which parts were hard because medical education is, quite simply, a slog. But I think a lot of it had to do with my expectations. I had assumed that medical school would be fun and that I would love it. Why else would I have worked my ass off for over a year to get here? Hadn’t every gleaming brochure depicted students smiling, studious, thriving? I had imagined myself living my best life—studying hard in the library with my totally awesome learning team, shadowing in the hospital, making tons of new friends, running on the Schuylkill (every medical student I spoke to seemed to mention this), trying out all the great Philly food.
But I did not thrive during M1. I fell behind on lectures and spent the weekend before exams cramming facts into my head only to forget them immediately. I could not get the hang of Anki. I frequently could not follow along with my classmates’ rapid-fire pace through our small group PowerPoints—I got so lost during one CTB lab that I ran to the bathroom and cried out of frustration. My learning team did not instantly meld, and often had moments of significant tension. I felt lonely and isolated all the time, and I struggled to connect with my classmates. I rarely exercised, my room was usually a disaster area, and I was angry all the time, often directing that frustration towards the school administrators (who, to be fair, often dropped the ball on communication). I spent an unhealthy amount of time crying or staring up at the ceiling of my room (sometimes at the same time).
I had worked so hard to get here, and I felt like I was letting down everyone who had helped me along the way, most of all myself. Each day I started out with such good intentions and high hopes, only to fall into bed exhausted and feeling like I had failed on every count. There was so much distance between who I felt I should be and who I actually was. I felt like a bad medical student.
Here’s the thing, though. No matter what the glossy brochures and gushing second-look weekend info sessions tell you, medical school is not—never was—supposed to be fun. Its purpose is to train us to be physicians, which is to say to cram our heads full of information to pass certification exams in the hopes that some will stick and be useful, and then to offer us a crash course in suffering and customer service in the hopes that we will be able to alleviate some of the pain. With this baseline purpose, one I think we all tacitly understand (at least according to our applications), I’m not sure why I expected it to be a fun time. But I certainly did expect to love M1, and every day that I didn’t I felt like I was doing something wrong. I expected so much of this year—to get the hang of classes, to quickly make friends, to be doing clinical medicine. High expectations, of myself and my surroundings, helped get me this far. But in a year that was always going to be harder than usual, even without a global pandemic, those high expectations were my downfall.
So here’s my advice: consider, and then adjust, your expectations. You have no idea what medical school will be like—literally nothing can prepare you for M1, much less the clinical rotations that follow. You may have gotten glimpses through previous experiences (hello, all those hours of shadowing on my AMCAS application), but the fact is that you just don’t know what this next year is going to bring. This is a lesson we have all learned over and over in the past 18 months, but it is an important reminder. Medical school is an extremely humbling experience, and at some point you will probably find yourself lost and hopeless. So first, take a moment to think about what you expect the next months will bring, the good and the bad. This way, you might not find yourself as I did, with a constant dissonance between my imagined life and my present reality without ever being quite sure of the distance between. Then, temper those expectations, for yourself and for what this year—and career—will be.
Of course, I’m not saying to go in with absolutely zero expectations. Having expectations and holding our institution to a higher standard is the only way that we can A) see what our curriculum and community are missing, B) bring those things to the table, and C) make them the best that they can be. For me, adjusting expectations is ultimately about being kind to myself. In the spring semester, I took a meditation class desperately hoping that it would help me feel less like I was careening from one failure to the next. The most important thing I took away from that course was an ability to focus on things as they are in the present moment, rather than how I imagine they should or could be. Adjusting your expectations means focusing less on the imagined present and more on what is, right now—and then, eventually, how to move forward. I haven’t perfected this yet, and I don’t think I ever will. But seeing and interrogating my expectations, and how they diverge and meet with my present, has helped me feel less like a failure and more like someone who is just doing the best that she can.
Perhaps you’re thinking, gee, that sounds like a lot of abstract brain work. You got anything more concrete for me? Two other things you may want to do:
Ask for help. I called my parents more than I ever had in college or my gap year. More often than not I would cry on the phone, and although it seems counter-intuitive, crying did make me feel better. I emailed an administrator who hopped on a zoom call with me and comforted me. I called CAPS and talked to a therapist a few times, which I didn’t find particularly helpful but which helped me open up to asking people for help. I texted older students who I had met only briefly to ask for help and advice, and they generously offered it to me, taking phone calls or texting and emailing when they were too busy.
Escape, even if just for 30 minutes. I left Philly more frequently than I thought I would to visit my significant other, friends, and family in other cities. I always felt a sense of relief stepping off the train in New York or Washington D.C., shedding my identity as a “bad medical student” and stepping into the more familiar role of girlfriend or daughter. On weeknights, I read novels before going to bed. Fiction has always been a really important form of escape and relaxation for me, and I got a sense of accomplishment from finishing a book.
Every individual has a different experience of M1, and I hope that yours is fulfilling and grueling and eye-opening and everything else you hope it to be. But I hope, too, that you’ll take time before the onslaught of this year begins to really examine what you expect this year to be—and, even more importantly, what your personal needs will be.
Caroline Weschler is an MS2 at the Perelman School of Medicine.
Image by Tracy Du, an MS2 at the Perelman School of Medicine.
