Words of Wisdom

Lecture HallStudent with Parents at White CoatStudent with FacultyThe following are some collective feelings about and reactions to the experiences of medical school.  This certainly doesn't cover everything and some parts may not even apply to you and your medical student, but we hope these thoughts from those who have come before you will help in some way. Do you have some words of wisdom to share with other families of medical students? Email your words of wisdom to emily_stevens@med.unc.edu.

  • Medical students get where they are by being exceptional students. They represent the top of their classes, the "cream of the crop." They are used to working hard and excelling. When you take 180 students who are used to being in the top part of their class and you put them in one class, everyone cannot be at the top. Half must be in the bottom half. For most students this is pretty hard to accept. In college, hard work usually resulted in good grades. In medical school, it comes as a shock that very hard work may only result in class average. At least the pass/fail system makes it a little easier with which to deal. Be prepared to provide additional support for your medical student.
  • The first semester of the first year is made more difficult by the fact that neither the med student nor the family and/or partner knows what to expect. After the first few exams, things get a little easier. In college, students are expected to learn all or at least most of the material presented. In medical school that just isn't possible.  There is no way a med student can learn it all and, fortunately, they don't really have to. However, there is probably no point in telling your med student that since he/she isn't likely to believe you, at least at first.  They all seem to think that everybody else is learning it all. Actually, they are all learning more than they realize but compared to the amount of material presented it never seems quite enough. They figure everyone else is learning more and they are afraid to admit to anyone that they are overwhelmed. So they keep quiet (except at home) and sweat it out. After the first couple of exams, most students begin to realize that they are not alone, everyone is overwhelmed, they are doing okay, they can survive. You will too, just wait it out.
  • Even after the medical student realizes he/she cannot learn it all and isn't expected to, some things don't change much. Exam anxiety is one of those things. It occurs to some degree with every exam. It is worse with the end-of-course exams. It is massive at the end of the year.  Reactions vary. If your med student seems more distressed than you or he/she can deal with alone, remind him/her that there are many support services available. A med student should never hesitate to seek help at the Student Health Services Counseling Psychological Services, from an advisor, or from the office of Student Affairs.
  • For many students, there seems to be a short-lived exhilaration immediately following the last exam, only to be replaced by tension that lasts until grades are posted. Some students skip the exhilaration and go straight to tension. It sounds pretty awful, and in some ways it is, but this is a good time to plan on keeping busy, having your conversation needs met by friends and remembering that it's only temporary.
  • You know your medical student is adjusting to medical school when he/she begins to take for granted all the terminology that once was so overwhelming. This is gradually apparent as at first they quit explaining as many terms to you. It seems that once they have integrated a term, they forget everybody doesn't know it. The partner/family may have to prompt occasionally - "Hey, wait a minute - What was that again?" Then around the end of the first year, it hits them that they really understand and take for granted terms that were foreign only a few months before. That realization usually boosts their confidence a little. They need that boost about this time because that is also about the time they realize how very much there is to know. Most students are somewhat awed by the realization that even the very best physicians never know enough and that the science of medicine still has a long way to go.
  • Medical students at UNC start working on their cadavers during October. Yes, that means dissecting a human body. If you are like most people, that arouses some mixed feelings in you and this is likely to be true for your med students too. Responses vary and students cope in different ways, some with humor (often sick or off-color), naming their cadaver, and some with nonchalance. Ultimately for most, the cadaver is depersonalized and the idea that it was once alive is put aside. As emotion-laden as Anatomy lab is, many students say that it is one of the most interesting and enjoyable experiences in medical school. This is all normal. Information regarding the source of cadavers, disposition of and lab procedures are addressed in the Anatomy syllabus.
  • From the time your med student is accepted into medical school, people begin to treat him/her differently. Even family members do it. Most people have an idealized image of physicians. They see them as all-knowing, all-caring, all-powerful and all-sacrificing of self. Some partners/family may feel this way at first, but most agree that, medical school or not, they are still just human beings.
  • Most of us agree that our med students sometimes amaze us. Yes, sometimes even we are a little awed by how much they are learning - but, that's not what we are talking about. We are amazed at what they get excited about. The very things we may find disgusting, frightening, morbid, or just weird are the very things that thrill them. One parent whose med student was starting an OB/GYN rotation was anticipating his fascination with the "miracle of birth." Instead, relatively unimpressed with birth, the student was very excited about an unrelated, near tragic, emergency room incident. Though it is different with each student, at some point you are likely to wonder what motivates your student to get so excited about "weird" things. Relax, it is probably one of the reasons he/she chose medicine.
  • Another particularly stressful time occurs at the end of second year with approaching "Boards" and clinical training. With the longing for clinical years, come new adjustments. This is what they have been waiting for - real patients. At first, they love their white jackets, stethoscopes and even their beepers. But, the newness wears off pretty quickly. Third year is a physically and psychologically exhausting year. Sleepless "on-call" nights don't just make them tired, they make them irritable, moody, and non-communicative. Working with disease, death and dying arouses emotions they do not always have the energy to work through. Being "low man" in status and in charge of all scut work deflates their excitement and enthusiasm for being a physician. As the class is scattered in different rotations, they lose contact with friends. Family is more important than ever. A loving support system can make a rough time easier.
  • The medical student's reactions to patients may be a little disturbing at times. There tends to be some de-personalization of patients from very early on in the medical school experience. In seems sort of sad, but it is necessary to a certain extent, for the physician's well-being. A physician must be able to stay detached enough to use good judgment.  If he/she became emotionally involved with each patient, there would be no energy left for the physician and his/her private life. This detachment, as well as the sheer number of patients seen, may lead to a patient being referred to as "the gall bladder in 301" or a new admission assigned to a student as a "hit." It is important to allow your med student to find the level of detachment that works for him/her and it is also important for you to be able to understand the reasons why this is necessary. In most cases, your med student will not forget that the patient he/she is treating is a human being with emotional as well as physical needs.
  • Don't be surprised at the stresses of the fourth year, which most med students expect to be much more fun and relaxed.  Preparation of credentials and residency application, the "Dean's Letter Interviews" with the Dean of Student Affairs, interviews at residency programs, rank lists, "the match", and commencement are all exciting, yet stressful.