Recent fourth-year matcher Samantha Balass out of McGill University School of Medicine gives us her wise words on succeeding in medical school and beyond.
1. Tell us about yourself: Where are you from? What is your undergraduate degree and where did you receive it? Did you do anything between undergraduate and medical school?
Samantha Balass: I was born in Montreal. I did my undergraduate degree in physiology at McGill. I got into medical school right after undergrad. I am planning on working as a family doctor and to be involved in medical education.
2. What residency program will you be joining and where?
SB: I will be doing a family medicine residency in Vancouver, British Columbia.
3. Looking back on your medical school experience, what would you say to the young and naïve “first-year you”?
SB: Learn as much as you can, but don’t worry if you don’t remember everything. You will re-learn things over and over throughout your career, so try to get a solid basic understanding of mechanisms while in first and second year. Make sure to maintain a healthy social life — you know you are going to have to sacrifice a lot of personal time to study, but you can still include seeing friends and doing extracurricular activities. After all, residency programs seek out well-rounded individuals with unique interests. If you like to sing, join a singing group or create your own. Finally, don’t be shy to ask questions, especially in the classroom.
4. What things did you do that you believe were valuable to succeed the first two years in the classroom?
SB: The most important word of advice for the first two years: MAINTENANCE. Just like learning a new language, studying medicine requires you to be constantly learning and studying. This means that on most days of the week, you should be reviewing material you learned in class, or even better, reading ahead for what you will be learning the next day. Sometimes it gets really hectic, or life gets stressful for personal reasons, so you should factor in a day off in your study week, or at least a chunk of time dedicated to yourself and not your studies. For example, I made sure that my Friday afternoons were free so that I could relax, spend time with family, or do something I enjoy.
When studying gets dry, it’s always a good idea to study with friends in the class. Although this may not be as time-efficient as studying alone, at least it will be more interactive and you’ll have the opportunity to teach and learn from others. I would suggest buying the USMLE Step 1 First Aid book right at the beginning of med school just to have as a reference. It’s not an in-depth book, but it has some great mnemonics and important things to remember, so it would be a great adjunct for studying for exams. In terms of shadowing, I would definitely recommend it!
If you are learning something you find interesting and want to explore it clinically, approach the professor or check out the Osler Shadowing society and go for it! You might need to miss an afternoon of class, but once in a while, it helps put things in perspective and get you excited for the application of your hard-earned knowledge.
5. What things did you do that you believe were valuable to succeed the second two years through clinical rotations?
SB: Okay, so this one is super important. One would think that in order to succeed, you need to be super smart and show off your knowledge so that your attendings know how hard you have been studying. Wrong! The most important thing to master on rotations is to be a pleasure to work with. This means showing up early and prepared everyday with a smile on your face and being the last one to leave. This means being a yes-man or yes-woman — i.e. if the resident or staff asks you to check a patient’s vitals or to do a consult, say yes eagerly. This also means being friendly with everyone in the working environment — this includes nurses, unit coordinators, social workers, patients and families. It is definitely noticed when a student says hello to the secretary and is nice to the patients.
If you don’t feel comfortable doing something, ask a resident if they can come and show you or supervise you. Although it may be annoying to deal with, a hierarchy exists in the medical training field, so respect this hierarchy. Don’t go straight to a staff or a senior resident. First, ask your fellow medical student if you’re unsure of something. Then, speak to your junior resident, and then you can move up the totem pole if necessary. Try to do as much on your own before asking for help, given that you are not putting anyone’s life in danger. For example, if the nurse tells you the patient’s blood pressure is high today, check the vitals on the sheet in the patient’s room or on the computer system and look for the trend of his blood pressure in the last few days, verify the patient’s medications, check the relevant labs and go assess the patient to see how they look. This way, you can come to your resident armed with so much more information to deal with the problem. You can even go one step further and suggest what you think the reason is for the elevated the blood pressure (the differential diagnosis) and the treatment you think is appropriate.
It really helps to download and print scut sheets from online resources, like medfools.com, to keep track of your patients everyday. You can start by printing six sheets and bringing them to your first day of your rotation. As you accumulate more patients, you can print more sheets.
Ask about resident learning activities, such as grand rounds and journal clubs, and if you are interested in the specialty, try to attend as many of these as possible so that you can get a better feel of a particular field and also so that you can get to know the residents and staff in this field. If you are very keen on getting into a competitive specialty, ask if you can shadow a resident or staff outside of your required time while on rotation.
Take time with your patients and be kind to them, as being a medical student affords you the most time you will ever have to spend talking to and learning from your patients. They are your best teachers and your biggest fans – they will often be very appreciative of your care.
And finally a tip on studying during clinical rotations. This was the hardest part for me to manage because I had less time and less energy to study. Try as much as you can to read around your cases (because you will remember best what you’ve seen in real life), and also keep up on your readings for your exam. Think of it as two parallel readings — one on the cases you saw during the day in the hospital, and the other on the necessary chapters for your exam. You’ll be happy to know that often, the two readings intersect. Try to read a few hours every night so that you’ll have time to go out on the weekends.
6. What things did you do during your four years of medical school that stuck out or particularly impressed your residency program?
SB: I volunteered as an Osler student leader; I volunteered as the McGill ambassador for foreign exchange students of International Federation of Medical Students’ Associations (IFMSA); I wrote a review article and a commentary on topics related to medicine; I sang at several community events; and I learnt a new language on my own.
7. What things were unhelpful or you wish you hadn’t done in medical school?
SB: Not sure…
8. What was your level of involvement in research and other extracurricular activities, and your opinion on how important that involvement is?
SB: I was not involved in research at all throughout medical school. In my final year, I was the co-author of two small published papers which involved very little research (a review article and a commentary). I was often worried that I wasn’t doing enough research and I think that if I were going for a more competitive specialty, I would have pursued more research in that field. Research is not a pre-requisite as a medical student, but I think it definitely adds a lot to your CV, especially for a residency program that requires residents to publish. In terms of my extracurriculars, I would say I was moderately involved, but involved enough to have an impact on the people I worked with and to have something to say about these activities on my CV and during my interviews.
9. What attracted you to your chosen specialty?
SB: So many things! The long term relationships, the flexibility, the variety of cases, the broad knowledge base, the warm and modest personalities of the people in the field, the lifelong learning, the psychosocial emphasis, the ‘whole person’ kind of care, the rewarding feeling of being a part of people’s lives for so long. I will borrow an expression from UBC’s family medicine program: family medicine is “womb to tomb care.” If you want to get excited about all that family medicine encompasses, watch this very short video.
10. What attracted you to your residency program?
SB: Several things: personal reasons (my significant other lives in BC, I was looking for a new experience as I’ve lived in Montreal my whole life, BC is a beautiful province with so many things do to) and professional reasons (UBC is known to have an excellent family medicine program, the specific site I matched to is a small tight-knit program that allows us to work in various different urban and suburban hospitals).
11. What things did you do to maintain your sanity in medical school?
SB: Spend time with family two to three times a week, go out with friends at least once a week, study with friends, go for walks or bike rides, read books for pleasure, participate in medical school social activities (ski trip, internos), and keep in touch with my personal interests (like learning languages and singing).
12. The floor is yours — what do you wish to share with current medical students?
SB: Medical school is a long, difficult and beautiful journey. It’s important to spend time with family and friends throughout because you will definitely need their support. Although studying can be overwhelming, try to do it with your current and future patients in mind. And finally, be there for your patients. Listen to them with your full attention and learn from them — they are your best teachers. Good luck!