Becoming a Medical Student – The Real Things to Know Before Med School

Becoming a Medical Student:

 The Real Things to Know Before Med School

By Dawn Barlow

Ever wondered what it’s really like to be a doctor? Thinking of applying to medical school? Before you hit that submit button on the UCAS website, read my candid blog post about what becoming a medical student is actually like.

I’m going to talk about the non-boring shit. You’ll have heard all of the “it’s long” and “it’s harder than you think.” Here’s the actual stuff you didn’t think about.

You’ll constantly be told it’ll be really difficult and you realize this, duh… And yes medical school is not only time consuming, but also academically challenging. However, there are things you only learn from being a medical student, exploring the wards, and landing yourself a post as a junior doctor.

Here I will talk about 8 things they don’t tell or teach you at medical school, which you should know before applying to medical school:

1. Your personality will be ripped apart (and put back together)

Personally, I think medical school has changed the way I am for the better. Obviously a lot of that has come down to time and age. But don’t think this is an easy ride; you’ll go from being high flying and successful, to mediocre at best. And that’s a real ego hit. 

But how will you change from medical school?

Apart from being unbearable to be in a conversation with, as you talk about someone’s leg that you scooped up off of the floor, you’ll gain SO many positive qualities.

• Compassion
• Empathy
• Listening skills
• Communication skills – I can start and hold a conversation with a shoe
• Articulation, presentation skills, and public speaking
• An analytical mind coupled with amazing knowledge of humans and how they work, behave and communicate
• Teamwork
• Professionalism
• LIFE experience – you’ll have met everyone and anyone… Most people are sheltered from this

And that’s what makes a medical degree so sought after. Your skills are so transferrable and they will bleed into everyday life.

2. You’ll cry about work

It’s sad but it’s true. Whether it be a tough consultant, a really sad case that hit home, or that you can’t handle the incessant workload. Something is likely to get on top of you at some point.

You’ll get attached to some patients, they’ll become sick and die. Some will hit home because they remind you of a family member.

If you don’t cry at work, you’ll cry about work. I’ve cried at work more than once and I’ve cried at home more than once… I’ve seen colleagues cry and other fellow students. We won’t be the last. 

And of course, there’s no problem with crying. In fact, I actively encourage it as a healthy outlet of emotions. Generally, I would avoid crying in front of patients or on the ward, but instead, go to a private place and talk it through with someone.

This goes to show the emotional intensity that working in medicine brings. 

3. You’ll experience “Medical Student Syndrome”

Sounds cool! No, it’s not. The prognosis is poor! 😉

So you’ve learned all this new really interesting information about diseases, EXACTLY what you went to medical school for! But now you’ve developed medical student syndrome. It’s a widely known phenomenon within medical school where you start to believe that you have all of those funky diseases in Kumar and Clarke.

Headache = brain tumor and/or subarachnoid hemorrhage

Red face = Systemic Lupus Erythematosus

Enlarged lymph node = mantle cell lymphoma (I’ve seen one patient with this, and I don’t think I’ll ever see it again)

Feeling a bit tired? = anemic/hypothyroid/leukemia (almost definitely not the fact that you’ve stayed up partying all night in the student union)

Nausea and vomiting? (again, definitely not the hangover) = you’re having an Addisonian Crisis.

Short of breath = you’re not unfit… you’ve got a pulmonary embolism!

The list could go on. 

It’s interesting how, in writing this, I’ve realized that I’ve forgotten all of the absurd diseases which you’re taught in medical school. Because as they say, common things are common, and the likelihood is you’ll only see 5% of what the diagnoses that the books teach you.

P.s. patient.info/patientplus got me through Medical School, so I’ve linked some of the pages to the diseases. It’s simple, no BS and it’s reliable. They are worth checking out and keeping as a favorite in your bookmarks.

4. You’ll have to see, touch, smell, and cut open dead bodies

I know this one might sound obvious to some of you, but pre-medical school  I really didn’t consider it if I’m honest. My first time seeing a dead body was in an autopsy and I was not prepared. I stood in the corner for about 75% of it and I’ve never felt so terrified in my life. 

In our society, we are sheltered to death and what corpses really look and feel like, and also how they make us feel. Our family members used to die at home, now most people die in hospitals or hospices and children especially are hidden from death. 

To this day, I still struggle with doing death confirmations. But obviously it’s part of the job. I employ many techniques to get on and do it. 

• Recognize that it has to be done
• Realize that it’s very quick
• Relaxation techniques – breathing
• Don’t be afraid to really explore what they look like
• Understand that they won’t wake up and scare you (genuinely one of my thoughts)

What would’ve helped me?

• A better understanding of death as a child (obviously you can’t change your experiences now, but you can help the future generation – your children or children visiting loved ones on the wards)
• If you can, get involved in a loved one’s funeral 
• Getting some work experience with a funeral directors
• Addressing my anxieties around death. It’s a natural human response to fear death, but this can be worked on
• Recognize that death is not always bad and you can help them die more comfortably

5. You will talk about medicine all the time and probably get in trouble for it

I couldn’t count on one hand the number of times medical students (not necessarily myself, because I’m an angel of course) were dobbed in by the public for discussing cases on public transport. 

Unfortunately, as a first or second year, your trips to the hospital will be like riding to Hogwarts. Except imagine your ride to Hogwarts is half full of muggles and all you want to talk about is a spell you learned, but you mustn’t reveal your secrets. 

You won’t be able to contain your excitement about Bob; your first patient you spoke to about their total hip replacement. The likelihood is people on the bus probably won’t know who you’re talking about, but doesn’t mean you should be discussing your confidential information on the bus. 

What’s more, it becomes even more awkward when Bob is sitting a couple of rows behind you…

While it’s fair to say you won’t have learned much medical lingo at the beginning of your studying, so you’ll be pretty understandable by laypeople.

By the end of your degree, most people will think you’re speaking a different language and non-medics in the conversation will glaze over at the first sign of medical chat. 

“I saw a patient today who came in with increasing SOB. They had a cap refill of 4 seconds, hypotensive at 90 systolic, sats of 90 on a 15L non-rebreathe, bibasal creps, displaced apex beat, a JVP up to their TMJ, bilateral pitting edema and signs of PVD with venous ulcers.”

Really, what I’m trying to say is keep medical chat confined to places where people can’t hear you. And try to keep the medical chat to a minimum, you don’t want to make your whole life about medicine and you’ll bore your non-medical friends.

6. Existentialism after becoming a medical student

Becoming a medical student really opens up your eyes to how other people live their lives. Many people live their lives in a co-morbid state and will bounce in and out of the hospital. As a result, you don’t see their normality. You don’t see them in their best states, so you assume their whole life is full of illness, pain, vomiting, and lying in bed. For some people, this is the case.

But working in hospitals, you start to forget that not everyone is unwell. When you work in a speciality, e.g. urology, you think everyone has a catheter/prostate cancer/BPH. Your view is directed by what you have in front of you, and it’s quite difficult to remember what’s behind those hospital windows walls (there are no windows in hospital). 

You will also, depending on which hospital you’re in, see the sickest of the sick and the really unfortunate people who are the 1 in a million. You’ll see that 25 year old with metastatic breast cancer, you’ll see that 12 year old that hanged themselves, you’ll see that 70 year old with 7 cancers infiltrating all of their body (yes I’ve seen all of these). And you’ll start to think everyone is done for. 

In reality, you’re seeing a very small percentage of the population, so it’s worth remembering how many people outside of the hospital grounds, are walking around disease-free, or even with a disease but enjoying their lives. 

7. Eventually, someone will vomit/urinate/poo on you

Sorry to break it to you, but I’ve had all varieties of bodily fluids sprayed across my person through the years. It probably didn’t help that I worked as a healthcare assistant during medical school; this meant that I dealt with more personal care than most. But alas, I’ve had my fair share of soiled clothes.

Obviously, this depends on how involved you get with your patients, but it WILL happen and often when you least expect it. If you expect to get through medical school squeaky clean, you need a wake-up call. And hopefully, this is it. 

Just because you have an aversion to stinky bodily fluids, doesn’t mean medicine isn’t for you. It’s something you get used to, the first time I went onto the ward, I gagged at the smell. 

The first time I went into theatre, I nearly fainted at the sight of someone’s arm getting cut open. Within 30 seconds, it was all over and I just got used to it. For some people, this might take longer. For some people, this isn’t possible. But really, you’ll be amazed at what your mind can do when you put it to work.

If you aren’t sure whether this is something you can handle, do small things; pick up some dog poo (with a bag), smell a steak (theatres smell like iron, the smell of blood), get a pig trotter from the butchers and dissect it, see if you can help tend to someone’s injury. You’ll slowly get accustomed to gross things!

8. Becoming a medical student is fraught with expectations

These will be expectations not only from other people but from yourself. You’ll have gone from a high flying A* student, to getting ‘satisfactory’ grades. How demoralizing… You’ll put pressure on yourself to get good grades when in actual fact the more important part of being a doctor is being able to talk to your patients. 

I think I realized fairly quickly, that trying to get 99% in everything, genuinely wasn’t going to be possible. I got 15% on my first exam (a progression test so scores tend to be lower). I

 stopped trying to get top grades and relaxed my expectations of myself because, for god’s sake, I got into medical school! I aimed to pass, if I did better, then cool, if not then I still passed. And here we are. I got through medical school in 5 years. Bosh.

Family Expectations

Secondly, you’ll get expectations from your family. If your family are non-medical like mine, they will almost certainly have no idea what you’re doing. I think I completed my first year of medical school and my dad thought I’d become a consultant surgeon… 

If your family are non-medical then great, they’re probably just so proud you got into medical school that they won’t expect you to get top of the year. But they’ll expect medical advice, as will many friends and other lay-people. As a medical student, you can usually ward this off by saying you can’t give medical advice. That starts to become a bit more difficult when all you do every day is give medical advice. 

Sometimes these things are simple – they have a nosebleed, how should they hold their nose, for example. Often it’s best for them and for your own sanity to redirect them to their own GP/specialist. 

Things can get awkward when someone hasn’t asked you for medical advice, and you see something wrong or hear something that puts up your red flags. You then face an ethical conundrum – you need to tell them, but you don’t want to worry them. 

Usually, it’s better not to give them ideas of what they could have – “oh dear, you’ve lost 2 stone in weight in 2 weeks, sounds like cancer.” They won’t take this well. Ask them if they’ve spoken to their doctor about it and recommend that they do, just to be sure. You don’t have the luxury of medical investigations etc, so it;’s better that they go discuss it with their doctor. 

Public Expectations

And lastly, you will be expected to behave in a certain way. Usually, by the public and although generally you won’t need to be a complete plank with no personality. But you’ll need to maintain a sense of professional composure, which can be a bit frustrating when you’re out at a pub and you see a patient you looked after and their family. 

The public trusts you, and it’s important not to ruin that trust. Medical students have the best fun, they are just good at being conspicuous.

Summary:

• You will change as a person, but for the better.
• Your work will be emotionally and physically tiring and that’s ok.
• Medical student syndrome will haunt you, but just remember how uncommon these diseases are. 
• You’ll suddenly be exposed to dead bodies, where you may not have been before. It’ll enlighten you to the natural course of life although it may take some getting used to.
• Medicine will become your life. Try to take some time away from it and limit medical conversation topics during downtime.
• You will start to question your own existence, your health, and what the meaning of life is. This can be unsettling but death is something we all need to face. 
• Get ready to get soiled but 1 or more bodily fluid.
• People will expect things of you, you won’t always be able to fulfill them. This doesn’t make you a bad person/doctor.

Biography:

I’m Dawn Barlow and I’m a new blogger at Diaries of a Doctor. I trained at medical school in Plymouth, UK and qualified in 2018. I’ve been doing my foundation training (similar to residency) in England for the past two years. Having had my fair share of difficulties through training, my blog aims to help others who may be going through the same issues.

We all face a bumpy road in medicine (and in life), it’s about modifying the suspension on your ride so life events appear less turbulent. I’ve considered quitting medicine, I’ve pondered as to whether I really am good enough and ultimately, most will have the same thoughts. 

My blog covers how I got through medical school and how I am forging my way through my ongoing medical training. I love to hear from my readers, so please drop me an email at contact@diariesofadoctor.com, visit my site at diariesofadoctor.com or my YouTube Channel – Dawn Barlow. 

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