How It All Plays Out (In Case You're Confused)

Seemed like when I was an undergrad I couldn't find 1) a physician that actually gave me the time of day or 2) a pre-med counselor who knew shit from shinola... so I could essentially never get any straight answers from anyone. So if you're thinking about pre-med or a newbie... here's the sequence of events.

PART I - 3-6 years long.... depending on how much work you need to do!

1) You're a pre-med. Yay! Actually this part sucks. All around. You're so excited... yet so far away from anything good. So you'll need a 4 year degree for about 99% of the medical schools (some schools accept 3 years or a credit cut-off). You should DEFINITELY get your degree if at all humanly possibly. It shows follow through, you are more competitive, and you have something useful if the med school idea tanks... (which at this point we're assuming you're golden... and are going to be the next Sanjay Gupta). Your 4 year degree doesn't have to be science related... but you MUST incorporate the "pre-med" curriculum somewhere. This means 2 semesters of General Bio with lab (8 credits), 2 semesters of General Chem with lab (8 credits), 2 semesters of General Physics with lab (8 credits) and 2 semesters of Organic Chemistry with lab (8 more credits). O-chem is a special treat! Just you wait! Now, please note... these can't be pansy versions of these classes... they gotta be the real deal... classes for pre-meds. You'll know. It wont say "Concepts in biology" or "Physics of baseball". If it looks harder than hell and says "for majors".. that's the one. Ok, now I'm only half kidding about this. It's going to be a tough transition for a little while... but it is totally manageable if you do what you're supposed to do. Ok... on to the next....

2. There's only one thing worse than being a pre-med... that's taking the MCAT. I've listed all my MCAT advice below... you can read that in one of my first posts. Basically, after the MCAT, things just get better!!! That's the good news!

3. Then you apply (through the AMCAS for MD or AACOMAS for DO service) for med school, interview, and get accepted.

PART II - 4 years

4. Yay! You're a med student! Now people will mistakenly call you doctor... which is much cooler than it sounds. Med school is 4 years total. The first 2 years are "basic science"...meaning your head is in a book or your butt is in a classroom a minimum of 10 hours a day. 12 hours is reasonable. Class from 8-2, then study from 2-8. You'll get at least an hour a day to eat and shower the barnacles from all your "wobbly bits".

During these 2 years you'll get more science than you can shake a stick at. Anatomy, Histology, Genetics, Biochemistry, Pharmacology, Physiology, Virology, Protozoology, yada, yada, yada. You'll also get sneak previews of your 3rd and 4th year... they'll give you a few days when you can do something clinical... The point of this is basically to throw you a bone once in a while before you throw yourself into traffic. It's well known by all med students that clinical work is like the golden apple from the Garden of Eden. When you hold it in your hand, all else seems very far away... and you're motivated to keep going. But all in all (from what I can tell thus far) med school rocks! At the end of your 2nd year (usually) you'll take STEP I. STEP I is the first exam of your "medical boards".

The second 2 years (years 3 and 4 of med school) are the "clinical years". This is where you do "rotations" or "clerkships". You basically get a 2 year schedule where you rotate around to every possible field of medicine for a learning experience and a taste of the field. You'll do OB, internal medicine, pediatrics, psychiatry, surgery, etc. Your school will require you to do your "core rotations" at places they've approved... usually a set of local hospitals affiliated with your med school. However, you'll also have electives (maybe 4 depending on the school), in which you can rotate out to totally other places. If you have your heart set on doing your ER rotation in New York, do it! Geriatrics in Spain? Knock yourself out! There are tons of opportunities in the US and abroad. Somewhere in these 2 years (usually after 3rd year) you'll take STEP II of your boards.

Your 4th year you will also have a lot of free time, as this is the time when you are required to apply for residency and participate in the MATCH. This will require you to fly all around the US for interviews... usually a minimum of 15... often up to 30 or more interviews. This goes from October until Match day which is in March.

5. MATCH DAY. In March of your 4th year... you and the schools you've interviewed at will mutually rank each other. You rank the schools, they rank you, it gets all matched up in the big residency database in the sky... and every 4th year US medical student finds out where they are going to do residency at on the same day. Happy for most, others not so much. If you don't match, you "scramble" 2 days later during a 12 hour window for any positions that didn't get filled. It isn't pretty folks.

PART III - 3-6 years

6. Yay! You graduated from med school and you're going to be a resident. You'll get a measly paycheck... but you have those all important letters after your name and finally your going to kick some ass! Residency is a training they make you do before you are "hire-able". Sure you have an MD at this point... but no real experience in your field....so you gotta do a residency. Depending on your specialty, your residency will be somewhere between 3-6 years. And there's really no hard and fast rule to which is which. In some places OB is 3 years... someplaces 4. IM is generally 3 years, ER is usually 3 or 4 years. You'll get decent benefits, and make somewhere in the vicinity of $45,000 your first year. This will increase about $2000 per year that you are in residency.

Your first year of residency is called your "intern" year. You're low man on the totem poll, and you get abused pretty bad in some places. Meaning long hours, lots of responsibility, and you still really don't know crap about medicine. Subsequent years get better... cause you'll have interns to abuse... and they'll do your work for you.

You'll also have to pass STEP III sometime early on in residency.... which is what is required to be any physician in the US. In order to be "board certified" in your specialty, you'll also have to pass the "boards" for your specialty (a specific exam just on OB, ER, Peds, or whatever you do).

PART IV - 2-6 years or more!

7. Now you're a real doctor, but you have Stockholm Syndrome now, and don't want to leave your captures. So you do a fellowship if you so desire. A fellowship is a SUB-specialty of whatever specialty you did in residency. For example, Cardiology, Gastroenterology, Critical Care, Endocrinology, Oncology... those are all sub-specialties of Internal Medicine. So if you want to be a Cardiologist, you'll be doing a fellowship. Don't worry, you'll get paid... but only about $55,000. That part sucks. And of course you'll have to pass the "board" exam for whatever your sub-specialty is as well.

PART V - the rest of your life...

8. So now you are 187 years old and you're a doctor. You can now afford to pay off your student loans in about a year, you can buy that Audi you want, and you suddenly realize you don't have to eat top ramen and pop-tarts anymore. Life is good...

Moral of the story?

This is a long long long road. If you aren't enjoying the JOURNEY, you're going to waste a lot of your life. Don't do this for money, because by the time you get it you won't care anymore. This is a great path if you accept each step for what it is, make the best of it, and don't let yourself get caught up in "waiting" to be a doctor. Keep your real self very present in all that you do... so that you don't wake up in 20 years wondering why you waited so long to be happy.

Good Luck!