Advice

The classic advice is to keep an open mind, and now in my M4 year, this definitely holds true! In Phase 1, some great avenues to explore specialties include immersions and shadowing. Faculty are wonderful and extremely receptive to cold emails! Explore specialties you are unfamiliar but interested in through shadowing and interest groups. In Phase 2, clerkship year is a great time to really figure out the first big division: if you are interested in surgery or not. This is a good starting place to narrow down to certain specialties. Try to schedule potential specialties you are most interested in before the last block. Lastly, you have more time than you think, and don’t be afraid to change your mind. Dr. Kathy Diemer is wonderful and has helped students who even changed specialties the summer before applications are due in September. In Phase 3, schedule electives and rotations for potential specialties early on to help confirm or rule out specialties you are deciding between!

Medical school is an exciting time and can be all-encompassing. But you need a break. I suggest finding something else that really takes your mind away from it. It should be something you can do regularly without too much planning. Ideally the “something else” gives you real pleasure. When you are doing the “something else” you need to let yourself be fully present to enjoy the activity. This can be harder than it sounds. For me, the things that work are swimming and ice skating. I’m not too skilled at either one, but every time I swim or skate, I always take a moment to reflect on how happy I feel getting to do something I love. I never regret the time I have spent on these activities when I get back to work.

Being a physician is an incredible and humbling experience. You will be invited into the most intimate moments of life with people you may have never met, but whom you will never forget, and who will certainly never forget you. You will become an integral part of their life stories, forever entwined in their most life-changing moments. It’s quite a privilege, and it comes with responsibility that can seem overwhelming at times. With that in mind, my two biggest pieces of advice as you embark on this journey are to invest in relationships and to take care of yourself.

Relationships are essential to the practice of medicine. The relationships you develop with patients, peers, faculty, and other colleagues will impact the care you are able to provide. These relationships — along with those in your personal life — will also help keep you balanced and bring meaning to your work. In every interaction, pause to think about what biases you may have and how you can mitigate their impact, what barriers to care may exist and how you can help overcome them, and above all — remember the person inside each patient, caretaker, and colleague. When we’re tired or stressed, it’s easy to forget that they all have their own stories, but one of the most important things we can do as a physician is to ensure that people feel heard and cared for. Remember the wise words of St. Louisan Maya Angelou: “People will forget what you said, people will forget what you did, but people will never forget how you made them feel.”

In addition to investing in relationships, take care of yourself in other ways — physically, emotionally, and spiritually. There’s a reason they tell you on airplanes to put your own oxygen mask on before helping others; if you aren’t taking care of yourself, you won’t be able to take care of anyone else. So be yourself and make time for what matters to you, whatever that may be. Give yourself grace when things are hard, and ask for help when you need it. There are so many people at WashU Med who truly care about you as a person and want to support you however we can. Remember what motivated you to attend medical school, and keep your eye on your long-term goals. As you experience different specialties and career paths, reflect on what brings you joy, what energizes you, what it is that makes you excited to get out of bed in the morning — because a career becomes a calling if it’s your heart’s work.

Finally, remember that nobody knows everything; being a physician means committing to lifelong learning. So never stop learning — about science, medicine, cutting edge technologies … about life, death, joy, grief, hope … about what it means to be human and to share the human experience with others. I look forward to accompanying you on this exhilarating journey.

Welcome, class!

It is a pleasure to have this opportunity to connect with you. I hope you are as excited about getting started as we are to begin another year.

Other contributors on this page have shared many valuable insights and lessons learned. I agree with it all but want to share a few things that have shaped my own path and academic priorities. I was a Medical Scientist Training Program (MSTP) student and have always been excited by science, and particularly biology. For me, medical school was transformative. I had the opportunity to take deep, and often independent, dives into human biology, the mechanisms of disease, and investigation. I loved it, and it was these experiences that led me first to pathology and independent research, eventually to laboratory management, and increasingly to medical education.

Regardless of your current goals, it is important to find and follow your passions, and when special opportunities present themselves, to also explore new ones and evolve. Nearly every physician will confide that medical school provided the best opportunities to do that exploration. It is an unfortunate reality that you will probably never find a better time. Demands of work and life will inevitably pull you in many directions. The broader the foundation you build today and the more learning skills you master, the easier it will be to succeed in your career, whether as a physician, scientist, educator, and/or advocate.

As faculty, we spend more time than you can imagine trying to create a curriculum that will prepare you for your future careers in medicine. Although it is important to achieve the stated educational objectives, it is just the beginning. There is just too much out there and so many new and important things to learn. Plan to take full advantage of the unique opportunities that Gateway Curriculum will bring to you.

If you would like some assistance, just seek us out. We are always here for you.

Happy learning, happy exploring.

Even before entering your first class and donning your first white coat, I’m sure you’ve already been asked, “So, what kind of doctor are you going to be?” You will likely be asked this every time someone learns you are a medical student. I would challenge you to think of that question differently than typically intended — not what specialty you will pursue but how you will doctor, what patients you will serve, and what attributes you will bring to the practice of medicine. One key way to do this is to keep an open mind in every lecture, patient interaction, and clinical encounter. Even if you are 100% certain you will pursue orthopedic surgery or pediatrics or dermatology, I promise you can learn something unexpected from patients, peers, and faculty in every other specialty you work in. These small nuggets will give you a richer foundation for your future career in medicine. And, you may even find many other specialties you are excited to explore. It’s actually amazing to love multiple specialties and have the freedom to choose among multiple career options!

As a program director, I’m often asked — even by M1s! — how to build a strong residency application. My advice is to put residency applications out of your mind for as long as possible. Trust me, I know that’s hard! I would challenge you to look at medical school not as the time to build your application for residency but rather as the place to develop the foundation to serve as a physician in whatever capacity is most meaningful to you. Remember that a career in medicine is not limited to the clinical practice of a specific specialty. Many physicians (including almost all of those you will work with throughout the next four years and beyond) have multi-faceted careers where, in addition to patient care, they engage in research, advocacy, education, or policy (or several of these!). Pursue the activities and experiences that you find personally and professionally fulfilling — regardless of what specialty they may be attached to. Your journey through medical school should be unique and incredibly personal to your own story, aspirations, and mission. And believe me, if you forge your own path founded on your passions and values, that will shine through when you’re ready to apply for residency. Most importantly, you will be well on your way to crafting a meaningful and fulfilling career that will last well beyond your residency training. Enjoy this time and make the most of it.

The “reminiscence bump” is a psychological phenomenon where older adults preferentially remember autobiographical information from adolescence and early adulthood. Researchers think this is because these memories contribute most to one’s sense of self. You are now (most likely) at an age that you’ll remember for the rest of your life. Most physicians (this one included) would tell you that their profession is a part of their identity. And your process of becoming a physician starts now. Like it or not, these are the times of your life you’ll look back on often.

That said, my advice is that medical school probably matters less than you think it does. “Being a doctor” will only be a part of your identity. Don’t let yourself believe that your success is solely based on what and how you do in school for the next four-plus years. Don’t forget to focus on life outside of the classrooms, hospitals, clinics, and studying, so that you can have experiences that you’ll want to remember.

Think for a minute about all it took for you to be here starting medical school at WashU Med: where you came from, the people supporting you, your hard work and commitment to others, sweating the MCAT, capitalizing on what makes you you, crying in organic chemistry lab because you discarded the solution and not the precipitate (don’t pretend that was just me). Each of your classmates had an equally as interesting journey to medical school. The same is true of all your instructors. Even more so, your patients all live interesting lives, and are a part of amazing communities. One awesome privilege you’ll have as a medical student is meeting and developing relationships with people that you wouldn’t have otherwise. Learn from them all. Let them pull you outside of your comfort zone. Be curious. Share yourself with others. The work of medicine will cause you to grow as a person. Let your experiences outside of medicine do the same. Those two things aren’t mutually exclusive. Have fun. The future of your memories depends on it.

Welcome to WashU Med! My name is Tim Yau, and I am one of your clinical skills directors for the Gateway Curriculum. Our team is here to teach you all the “non-science” stuff that is necessary to becoming a great physician.

The qualities that will make each of you outstanding doctors is so much more than test scores, which all of you already are capable of. We’ll teach you all the things you expect — how to talk with and examine patients, how to formulate diagnoses, how to interpret labs and tests. But you will also learn how to see your patients as individuals, how to involve them in patient-centered decisions, and how to navigate the complicated societal and structural barriers to their health. The amount of information you will learn in the next four years is both staggering and intimidating. Your learning will not end with medical school, and we hope to light a fire for you to never stop learning!

During medical school you will have opportunities over the next four years to do things that you may never again do in your lifetime. I am a kidney specialist, but I still delivered plenty of babies as a third-year medical student! Learn for the sake of learning (rather than just to pass the test) and you will find the pursuit of knowledge more worthwhile, more meaningful, and longer lasting. Your individual path to fulfill your potential to be a great doctor will be decided by you. Faculty like myself are your mentors, role models, guides, and colleagues in this journey.

Lastly, we hope you are eager to learn, but also want you to ENJOY your medical school experience. Some of the strongest bonds are forged here, and you will need support from family, old friends, and the new friends you will make. Get outside, eat some good food, and have a drink to relax. Take time to enjoy things that make you happy, whatever they are! This advice sounds generic, but I live by my own words: Playing music kept me happy during medical school, and even now at the age of 40+ I enjoy competitive video gaming. In 2018, we even started the official WashU Med Gaming Club! I have instruments and consoles in my office, and you’re welcome to stop by for a game or to play a tune!

It’s exciting to be a first-year medical student! You will learn how the human body works in detail, from head to toe, from gross anatomy to subatomic structures. However, some of the current concepts and “facts” you will learn will prove to be wrong. That’s right (actually still wrong!). It’s not that you’re being deliberately taught misinformation. It’s just that we don’t know our own ignorance (yet). Keep in mind, what you’re learning is how we understand things, circa 2025. But we don’t know what we don’t know.

While it is certainly much easier to learn the materials if you just try to absorb it verbatim, my advice is to spend some time thinking about what you’re learning. I can now reflect on the lectures I heard as a medical student touting that the cause of peptic ulcer disease was too much acid. In retrospect, that couldn’t be right because acid is always there! I didn’t think about it then, but I should have, because now we know (I think pretty conclusively) that ulcers are often caused by a bacterial infection! Keep track of things that don’t make sense to you along with those that are incompletely understood (there are lots of them!). For aspiring scientists, they will be great projects on which to work in the future. For future clinicians, they will be the ones that you will reflect on, and cause you to go back over your old medical school texts and notes — if not when you’re practicing, certainly a great retirement project!

It is definitely possible to maintain relationships, hobbies, and self-care during clerkship year! Admittedly, some rotations will be more difficult, with long hours during the day and a lot to study at night, but there is still balance throughout the clerkships. Something that I found helpful was to schedule coffee shop study dates with my friends, so that we could still spend time together even if one of us was busy with shelf studying. I also think it is important to recognize your own limitations and that you do not need to give 100% of yourself to everything, and you absolutely can take sick days if you need to. If you need to attend a wedding or see your family, as long as you communicate with the clerkship team ahead of time, they will support you in making your schedule work. Don’t forget that with each shelf exam you take, you will have more practice under your belt, so things will get slightly easier throughout the year. Most importantly, if a resident tells you that you can go home, GO HOME!

Finding a way to balance academics with my relationships has been a large part of my first semester at WashU Med. As a St. Louis native, I arrived at medical school with an established network of friends and family in the area. In addition to these people and the friends I’ve made at WashU Med, I’ve also met new friends through communities I joined when I moved back to St. Louis. All these people can be challenging to keep track of! My energy is frequently siphoned away by studying, classes, clinical experiences, and extracurriculars. But dedicating time to my relationships outside of medicine has been an important sanity check and source of support. Part of striking a good balance is knowing yourself. Even though I’m an introvert, I need people in my life fairly regularly to decompress. I find it easiest to prioritize time on a weekly basis. The amount of protected time can vary, but I always manage to find open periods each week. My family sets aside Sunday nights as a time when everyone gathers together for dinner. This is usually a big event, since I have a lot of siblings, nieces, and nephews. Back when I was living outside of St. Louis, I would call or FaceTime my parents on Sundays and keep in touch via texting and Snapchat. Scheduling time for friends can sometimes be harder, but I’ve still been able to hang out every week or so. Meeting up with friends outside of medicine can honestly be a lot like dating because you have to be intentional about making space for them in your busy life. Finally, don’t be afraid of a little spontaneity! The WashU Med curriculum allows for some flexibility. If you can, say yes to that last minute coffee, a zoom night with long-distance friends, or even a weekend camping trip! Give yourself permission to take a break and be with the people who give you life.

The Medical Scientist Training Program has a formal process to walk you through the PhD to Phase 2 transition, starting with a meeting about a year in advance that goes over the timeline, requirements, meetings, and paperwork. There are also student-created resources with more in-depth advice, but to summarize:

1) I recommend returning from your research for Block 1 or 2 to have plenty of time to try out potential specialties before residency applications.

2) I booked my May defense the September before. Most people don’t book their defense this early, but it can be helpful if you, like me, have an unusually large and busy committee! If I hadn’t been ready when I thought I’d be, I could have cancelled the room booking, so there’s not much to lose.

3) The Medical Scientist Training Program will tell you to start meeting with the deans a few months before you defend. Stay on top of this! If you think you might need disability accommodations, meet with Disability Resources around then or earlier.

4) Try to put specialties you’re interested in earlier rather than later during your clerkships, so you know what Advanced Clinical Rotations (ACRs) you want in time for sign-ups during Block 5. You’ll get most or all of your rec letters from your ACRs and/or Phase 3 electives, so don’t worry about rotating in your specialty of interest early in Phase 2.

5) Your warm-up rotation is an extremely low-stakes opportunity to remember/learn how clinical teams work, how to get around the hospital, and what the general expectations are for a clinical student. So glad I did this!

6) My first Foundation Week made it clear just how much I had forgotten since preclinical! This is okay. On rotations, you can get by focusing primarily on the diseases your patients have. You’ll need to study hard for shelf exams, but it comes back much easier than it went the first time!

7) Phase 2 is differently busy from PhD, and some weeks you may be in the hospital almost 80 hours. I recommend getting several sets of scrubs, figuring out how you’ll stay fed (quick recipes, meal prep, buying prepared food, etc.), and trying to minimize other commitments (finish your papers, step back from clubs, etc.). You can add things back later if you have more time than you expected.

Big/little relationships in medical school offer a unique opportunity for mentorship and friendship. To make the most of this bond, maintain regular communication — whether it’s through quick check-ins or casual chats. Schedule time to connect in person, like grabbing coffee or attending events together, to strengthen your connection. While the big is there to guide and mentor the little through the challenges of medical school, these relationships can also blossom into meaningful friendships, as it has for me!

Phase 3 is wonderful in that it is really a choose-your-own-adventure. You will get a total of eight weeks for flex (free) blocks, eight weeks for both step 1 and step 2 studying, and the rest of the blocks for three ACRs, two KISCs, and electives. Utilize the flex time to take breaks, go home, or travel! There are certain electives that are asynchronous or via zoom which can give you the flexibility for interviews or traveling. Some examples are humanities in medicine, care for the homeless, EXPLORE (research), medical education, reading electives and more! October through January are the heaviest interview months (but depends on the specialty) so try to schedule these types of rotations during these blocks. Try to schedule your ACRs and KISCs in blocks where you don’t have other obligations like interviews, weddings, etc. Use this opportunity to explore electives or interests areas — there are so many wonderful available electives and you can use this time to hone in your individual interests.

I took four gap years before starting medical school. During that time, I got my master’s in public health and then worked in cancer epidemiology research. Taking these years gave me so much perspective and time to grow that has been so valuable over these first few months of medical school. Though I had concerns about feeling out of place or that I’d somehow forgotten how to study since undergrad, I quickly learned that this wasn’t the case. Plenty of other students have taken multiple gap years too (all of them have really cool experiences to share) and everyone is so welcoming. As for studying, I was definitely a bit rusty, but adjusting to the medical school curriculum takes everyone a little time anyway. Overall, I’ve found that having taken my gap years has added so much value to my time here at WashU Med.

Medical school can be a challenging adjustment for anyone, regardless of whether they are transitioning from undergraduate classes or a full-time job. Most students, myself included, are most anxious about the academic transition — classes, research, finding mentors, and choosing a specialty. However, after going through the adjustment myself, I’ve learned that it’s equally important to acknowledge the social and lifestyle adjustments as well. I would strongly encourage you to take the first few months of medical school to learn more about your peers, the amazing new city you are living in, and to forge new friendships that you can lean on throughout your time in medical school.

You know what I wish I knew as an M1? How everyone you’ve ever known will now turn to YOU for medical advice. Better get ready to look at a whole bunch of moles, rashes, and ingrown toenails. You might think to yourself, “There’s no way I’d ever know any of the stuff they’re asking me.” And the answer is yes, you will — for the brief moment before you take Step 1 and Step 2.

That voice in your head that says “you don’t belong”? — it’s lying. You’ve worked hard to be here, and you deserve to be here. At the same time, the undeniable truth is that medical school is hard. It’s like drinking water from a fire hydrant — except there are four fire hydrants and you’ve only got a paper straw. But I guarantee you, you will figure it out and you will get real good at it. Whether it’s with Anki, study groups, whispering mnemonics into your pillow at night, anything — do what works for you, even if it’s a little weird.

Outside of medical school, it might feel impossible to balance studying, lectures, clinical duties, research, and pretending to have a social life — because it is impossible. But prioritizing what’s important to you is key — schedule time to hang out with your new friends, keep in touch with your old friends, and in between it all, squeeze in a couple of Anki cards.

At the end of the day, medical school is hard, there’s no denying it. But the one thing I wish I knew as an M1 would be to enjoy it all while it lasts. Stop stressing about those extra few points you could’ve gotten on your exam, what you’ll say to your first standardized patient, or what specialty you should apply into. Live in the moment, laugh over the mistakes you’ve made (and will continue to make), spend four hours in the library with your friends only to realize you’ve accomplished nothing. Enjoy the four years of medical school, as best as you can, because it’s over in the blink of an eye.

Welcome to medical school — I promise, it’ll be a great time.