The Med School Process

When you are in medical school and let's face, I'm in medical school, you tend to get asked all kinds of  "What's next?" type of questions from friends and family.  And with so many different terms, basic sciences, rotations, clinicals, residency, attendings,  Step I, the Match, Step II, scramble, it's no wonder that things can seem a little confusing. 

I'll be honest here, I really had no idea about any of this when Josh started school.  My thought on the whole process was, getting INTO school is the challenge, then it will get easier.  Ha!  I'm not going to say it's been drastically harder, but there are constant hurdles to overcome once you are in school that I'm not sure the general public or even the general student is aware of when they start school. 

So what does medical school at SGU look like?

Well, first things first, you get in.  Yay! You are going to be a doctor and it is the best day in your life so far (unless you are Josh, then getting married to me was the best day of life so far).  All of your hardwork and dedication to undergraduate school has paid off.  You've just jumped over hurdle #1!  You've been given the OPPORTUNITY to be come a doctor.  I say "opportunity" because that's exactly what it is.  No one is going to hold your hand along the way and then give you an M.D. degree at the end of 4 years. You are going to have to put in some serious hardwork and dedication to school.

When Josh started Term 1 at SGU, I was so nervous.  I wanted him to succeed and be at the top of his class (like any wife would), but mostly, I just wanted him to survive Term 1.  Because if he got through his first term of medical school, then I was convinced that he could get through anything medical school had to throw at him.  When the grades came out four months later and Josh had successfully made it through Term 1, we were thrilled.  Phew! Time to relax!  However, you don't go through SGU without hearing about the dreaded Term 4.  Dun dun dun! 

I agonized over Term 4 all through Term's 2 and 3.  We had heard horror stories.  "More than 120 students decelled (had to drop and retake) Term 4," said one student.  "The 13 credit Pathology course is hard, but Microbiology is just as bad except there's no time to study it because all you are doing is studying path," said a friend.  The rumors just kept coming and by the time 4th term rolled around I was psyched out.  And I wasn't even the one taking the class!  However, Josh made it through 4th term unscathed and we moved on to the last term of basic sciences. 

Josh would probably say that 5th term was one of the easiest terms of his first two years.   But, the first big board exam for any medical student comes soon after the end of the first two years and believe me, the students have been hearing about this test since medical school orientation day 1. The USMLE or Step I MUST be passed in order to move on to Clinical Rotations.  This is what Josh just finished a few weeks ago.  He successfully passed (more than passed!) the USMLE Step I.

Now, he's free to start clinical rotations.  During his 3rd year of school (this starts next week), he will rotate through a set of required clinicals.  These include Internal Medicine, OBGYN, Family Medicine, Pediatrics, Surgery, and Psychiatry.  There is no exact order, but these all must be done.  He is NOT paid during this time in the hospital.  In fact, we are still paying a HEFTY tuition.  He will be worked hard (we've been told 80-90 hour weeks) and will still be expected to study and take shelf exams at the end of every rotation.  He will have both residents and attendings that he reports to daily. 

After 3rd year, he will study for and take the Step II exam.  Yet another national board exam that has two parts, the CK (clinical knowledge) and CS (clinical skills).

Once he's made it through the Step II, he will begin fourth year electives.  During year 4, he can choose which rotations he would like to do based on what he is interested in.  He can do anesthesia, cardiology, neurology, urology, etc, etc, etc.  We hear that 4th year is a walk in the park compared to 3rd year.  In the fall of the 4th year, he will begin applying to Residency. 

Residency is what comes AFTER you get your M.D., and it can last anywhere from 3-10 years depending on your specialty with most in the 4-5 year range.  You FINALLY get paid during residency, but it is pennies compared to what you will make after and oh yeah! you are paying on those few hundred thousand dollar loans that you took out to get you here.  He will apply to his specialty of choice much like he did when he applied to medical school, letters of recommendation, transcripts, test scores, personal statements, the whole she-bang.  Some people apply to upwards of 80 different residency programs.  We will await invitations for him to interview for these programs and he will travel to take as many interviews as he can (did I mention he's still in 4th year at this point).  Once he's interviewed at all the places he can, he will make a list ranking the top programs he would like to go to.  The programs will do the same, ranking the first students they would like.

In February of his 4th year of school, these rank lists will be submitted.  The lists from programs and the students go into the computer where a set of algorithms "matches" students with programs.  This is called The Match.   How scary to think a computer decides!  Match day happens in March and you either are "matched" with a residency program or you are not.  If not, you enter what's called the Scramble, where you are "scrambling" to find a program that didn't get filled and programs are "scrambling" to fill their spots.  If you are unable to match in the match or the scramble, you will be forced to wait an entire year to try and match again.

After all of this craziness that is medical school, nothing scares me more than match day.

After the match, you finish out 4th year and walk across that stage in New York City with an M.D.  following your name.  And at this point, I think it's safe to say you've earned it.