Whenever my friends or family ask, “How’s medical school?” I have a simple, scripted response, “It’s pretty good. I like it a lot. It isn’t as difficult as I thought it would be!” But this response relays a fraction of what medical school has been like. Here is a real look of this first year in medical school (in numbers).
4000 New Words
Medical students learn about 15,000 words during our four years of training. That’s approximately 4,000 words per year. Despite only knowing a few hundred Vietnamese words, I can still carry a conversation in the language. Although I’ve learned countless new medical words, I wouldn’t describe myself as conversational in “Doctor-Speak.” The first few times I stepped into a hospital, I must have looked like a directionless puppy. I’ve been lost in foreign countries before, but in these places, a combination of gestures, grunts and guesses sufficed. In these hospitals, not only was I immersed in a foreign environment, I was surrounded by people that expected me to be fluent. But immersion works. Today, if a doctor walked up to me and said “Tachycardic ICU patient has SIRS and has WBC>12,000 with 20% bands,” I could translate and might even be able to say something relevant back.
206 Bones Palpitated
I have always known there are 206 bones in the body. But, after anatomy lab, I know all 206 of them. As in, I have physically placed my (double-gloved) hands on each and every one of these bones and repeated their names aloud multiple times. We started under the 12 pairs of ribs, meticulously worked our way down each of the 33 spinal bones to the pelvis, explored each of the foramen (holes) in the cranium and finished with the limbs. Some bones, like the humerus, radius and ulna, were familiar; others I had never heard of. “She Looks Too Pretty, Try To Catch Her,” was my mnemonic for the eight bones between the wrist and fingers — scaphoid, lunate, triquetrum, pisiform, trapezium, trapezoid, capitate, hamate. Some days, I wanted to be as far away as possible from lab. Other days, I lost track of time. Words can’t describe holding a split human heart in my cupped palms or running my fingers along the phrenic nerve. Some students loved anatomy; others hated it. Me? I’m still not sure.
143 Study Buddies
Okay, so maybe I study alone. And I only know a handful of classmates. I’ll be honest, I have yet to speak a word to many of them, but one thing is undeniable — we are all going through this together. The only people who can understand this experience are the other 143 students in my class. Celebrating, commiserating and coming to know my first-year classmates was a defining part of this first year. I was inspired by their passion, energized by their curiosity and, sometimes, intimidated by these same exact qualities. In the process of getting to know these people, I gained a better sense myself. Yes, we all are medical students, but we each have different motivations, quirks and passions.
20 Times In Feeling like an Imposter
I still chuckle a little bit each time I put on my white coat. Patients have a higher opinion of this white coat than I have of myself. I always started each conversation with patients by emphasizing that I am a FIRST-year medical student, but that didn’t stop them from sharing their vulnerabilities and requesting advice I didn’t feel qualified to give. I wear this white coat to help people, but, in this first year, I can’t help but feeling like deadweight. Out of the 20 times I’ve worn the white coat, I have felt useful twice. This is an inevitable part of the learning process. Doctors haven’t always known how to act competent and confident. Everyone has to put in the hours and practice. The knowledge gained now will allow me to help others in the future, but I’m still anxiously awaiting this day.
12 Blocks
Instead of semesters, medical school is organized into blocks. Each block, made up of one or more topics, lasts about three weeks and concludes with an exam (and celebration). Over the last year, my brain started tracking time in blocks, rather than months. My birthday was the Saturday after the Biochemistry block. I visited home for the first time after Genetics block. My first time seeing someone pass away? Brain Science I. I started rock climbing during Brain Sciences II. I felt the most burnt out during Blocks 4 (Pathology) and 11 (Infectious Disease I). I went on a meditation retreat in-between the Psych and Musculoskeletal blocks. Yes, medicine made up a majority of my life (and changed the way I conceptualize time), but life continued — I was able to be a human-being and a med student.
5 OSCEs
Also known as “Objective Structured Clinical Examination,” but affectionately pronounced “Os-Ski.” These exams remind me of The Hunger Games: A handful of anxious and naïve medical students are dropped into this weird new world and wait for the overhead voice prompter to tell them “You may now begin.” The students knock on their respective doors and repeat the introduction we have been taught, “Hi, my name is Jeff. I’m a first-year medical student working with Dr. Smith.” We then proceed to play doctor with our “patient” — a paid actor. Afterwards, we give an oral presentation about our findings to a video camera, concentrating on simultaneously making eye contact, not being self-conscious and correctly pronouncing tongue twisters like dysmenorrhea, sensorineural and kyphosis. Physicians will then watch these videos and grade us on our physical exam skills, empathy, professionalism, etc. Unlike The Hunger Games, at least here, we get second chances if we fail.
3 Existential Crises
I went into medicine for the often cited reasons — a desire to help others, to ensure lifelong learning, a love of science etc. But I also went into medicine because I’m a thinker. Medicine requires you to think, not just about diagnoses and pathophysiology, but about life’s “bigger” questions. What is well-being? What happens after death? How do we live a purposeful life? These questions are hard, but in a way, they are why I’m here. Medicine allows us to be part of others’ highest highs and lowest lows, and this has forced me to better define my own [constantly changing] world views.
1 Person
Red blood cells live for about 120 days. Skin cells live for 2-3 weeks. Sperm cells? 3 days. Over the last year, billions of my cells have died and new ones have replaced. This leads us to a philosophical debate about personal identity. Between present me and one-year-ago me, almost all of my cells have died and been replaced by new cells. So am I the same person if nearly all my cells are new? Maybe it was the chemicals inhaled in the anatomy lab, but I felt like my cells turned over a little faster this year. At the very least, they had to adapt quicker. I have had a lot of new “firsts” in this first year. I examined patients, dissected a human-being, and learned well-more than my brain could retain. This has been the first year of medical school. I’m the same person but also permanently changed.
Writer-in-Training
Warren Alpert Medical School
Jeffrey Lam is a second year medical student at Brown University Warren Alpert Medical School in Providence, Rhode Island. Jeff was born and raised in Columbus, Ohio. In 2016, he earned his Bachelor of Science in health and human biology from Brown University in Providence, Rhode Island. Jeff's senior thesis focused on the intersection between positive psychology and public health. Before medical school, Jeff worked on public health research in Hanoi, Vietnam. In his free time, Jeff enjoys thinking, lifting heavy things, having good conversations, dabbling in new hobbies, and learning about himself and the world. After medical school, Jeff would like to pursue a career in internal medicine or psychiatry.