What is medical school? An explanation for pre-meds and non-medical people

Medical school is the first concrete step of an extremely long and tiring journey to become a physician. It is a rewarding career, but it is fraught with difficulties that only those within the medical world can truly understand. If you or a loved one are intending to pursue medical school, read on to learn what you can expect.

What is medical school?

Medical School is four years of required schooling in addition to the years of undergraduate or post-graduate schooling already obtained. In most programs, the medical student spends two years in intensive academic courses studying for their first and second Board exams. These exams must be passed in order to progress onto the third and fourth years of training, which are spent doing clinical rotations in the hospital. The rotations allow the students to shadow and work with various speciality doctors to gain supervised hands-on experience in each major field of medicine, and allows them to spend additional time in the field(s) they are most interested in specializing in for their residency. The Board exams are very stressful, as they often “make or break” the dreams of the student attempting to apply to a particular speciality their fourth year.

What kinds of subjects do medical students study?

Medical students study anatomy and physiology and spend a lot of time in the laboratory performing human dissections. They study things like histology, biochemistry, microbiology and cell biology, pathology (what diseases look like under the microscope and grossly), pathophysiology (the way a disease progresses in the human body), pharmacology, and infectious diseases. Then they take all of this knowledge and learn how to apply it to the organ systems: cardiac, gastrointestinal, renal, respiratory, endocrine, muscular-skeletal, neurology, immunology, dermatology, psychiatry.

What are clinical rotations like?

Clinical rotations serve many purposes for a medical student. They allow the medical student to see and experience a speciality up close, which may peak or decline their interest in a particular area of medicine. Every student is required to do clinical rotations in all of the core subjects in medicine: internal medicine, family medicine, neurology, general surgery, pediatrics, OGBYN, and psychiatry.  Students may opt to spend time with additional specialities that are not considered core, like dermatology, orthopaedic surgery, gastroenterology, urology. While a student is doing their clinical rotations, they learn important skills like how to obtain a medical history, perform a physical exam, how to correctly perform medical documentation, and how a hospital works. Then there are practical applications for how to perform minor medical procedures and observe major surgical procedures.

Typically, a student will attempt to do at least three clinical rotations in the speciality that they intend to apply for. Oftentimes they will do this by going on “away rotations” at other hospitals and treating that one month rotation as a semi-job interview. They want to get to know the residency program they intend to apply for, make good connections, impress residents, attending physicians, and Residency Program Directors.

What are Board Exams?

The United States Medical Licensing Examination (USMLE) is a huge deal. Medical students and residents spend a great deal of time studying for these board exams, as they require passing scores to continue on with their education and eventually become minted and licensed as fully fledged physicians. Depending on the state licensing laws,  and the particular failure rules within the medical school and residency program, the student or resident may have a limited number of attempts to pass their board exams before they are failed out of the program, or barred from becoming a physician.

The first board exam is called Step 1, and it is taken between the second and third year of medical school. If a student fails, they are offered options by their medical school to take the test again, or repeat their second year and take Step 1 again. Step 1 is a pivotal board exam, as it is one of the biggest factors residency programs look at to determine if they are interested in accepting a student for their program. If a student is interested in a competitive specialty, they must have a score high enough to compete with other students applying for the same program. There is a whole ranking and matching system within the application process for residency programs. (As this is a very complicated process, I will discuss this in a different post.)

When does a medical student become a doctor?

When a medical student graduates from medical school, they have passed their Step 1 and Step 2 board exams. At this point, they have their M.D. (Doctor of Medicine), and they are considered a Doctor. However, they are not able to practice as a fully licensed physician until they complete additional training in a residency program and continue to pass their other Board exams. If someone graduates with their M.D. and does not immediately enter into a residency program or complete their Boards, they can still obtain specific jobs. However, they are unable to practice in a clinical setting, which means they cannot treat patients in the traditional medical setting or prescribe drugs.

Graduating from medical school in of itself is a huge accomplishment. The next step in the journey is the residency program, so keep reading on and follow my blog to learn more about what life is like for physicians in training.

Nicole Davis is the wife of an Orthopaedic Surgery resident and frequently finds herself explaining the confusing world of Medicine to non-medical people. If you are a burgeoning medical professional or a significant other of a medical student or resident, consider sending these simplified articles to people in your life who would like to understand your journey.


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