Date

Yesterday I finished my last non-standardized exam of medical school, Block 12 of M2. Today I chose to call my apartment complex office administrator a "cryptofascist" so it's okay, I can admit it -- I need a break.

It's been tough not writing much of anything public for the past two years, but when you're mixed up in the bowels of the preclinical medical education all you can really do is complain about them. Figured I'd spare you all that, and use this opportunity to thank everyone who had to put up with me irl in the meantime.

There's a whole brand of writing about what medical education is "really like," blogs upon blogs by med students about med students for med students, Netflix specials, books with preciously dramatic titles about the process, writing careers created and destroyed on the subject of depicting Life In Medicine. I just got done with one part of the process, and so my goal is to either provide a unique perspective or heap more red meat upon the pile. My thoughts are organized into three main points.

### 1. How well you can do is mostly already decided.

Anyone who has ever learned a foreign language is familiar with the experience: you bust your ass for four years in classes and manage to attain a certain grasp of the grammar and vocabulary, only to travel to the country where that language is spoken and find third graders conjugating circles around you.

As your relatives and seniors and administrators will tell you, medicine is a lot like that -- there are a lot of new words, new concepts, and it's only a matter of time before you accidentally provoke one of the natives and end up in a screaming match about pronunciation of the word "duodenum." Just me? Anyway, the novelty that allows us to romanticize medicine as a culture won't be distributed evenly among your classmates. We don't like to talk about it, but there are undergraduate programs dedicated to producing competitive premeds and med students. (In my first research internship, my labmate came from one of these programs nearby, and could list the names, mechanisms, and common side-effects of all the beta-blockers on the formulary of the local hospital. It was just part of the curriculum. He was a sophomore.) I'll illustrate the challenge with a sentence.

$CTX\phi$ is a filamentous, lysogenic bacteriophage whose genome encodes the cholera toxin.

What does that sentence mean to you? If you have a strong background in microbiology, probably quite a lot. If you don't you'll probably have to look up every word in the damn thing before spending 20 minutes figuring out what it really meant in its own context. My background isn't biology, it's IT, so here's another sentence:

git-remote manages the set of repositories whose branches you track.

This sentence means a lot to me because I'm familiar with the software this is describing and the problem it was invented to solve. But you can see where git acquired its reputation for being condescendingly terse.

So med school is a lot like taking a hundred or so high-achieving test-takers and having them all learn a brand new programming language. We all have the capacity, and technically we'd all be starting from the same point, but those with software experience would have the clear advantage of having learned dozens just like it. You could make outlines all day, and anki cards like "{{c1::$CTX\phi$}} is a {{c2::filamentous}}, lysogenic {{c3::bactgeriophage}}..." but it won't help you with understanding the context. It's just something that takes time and patience. So if you're reading this and you've just been admitted to med school, I really wouldn't recommend trying to finish the entire Brosencephalon deck before day 1 (holy crap) or reading Robbins or whatever. You'll probably pass either way, and what's going to matter more is staying sane during those first two years. If you're someone who won't settle for anything but pediatric neurosurgery, I don't know what to tell you -- but let's be honest, this advice isn't for you, so you're not reading it.