#27: Wilford Brimley

Wilford Brimley is a genuine American hero. A former Marine turned actor, Brimley has always been on the backburner of the American public stage, and his reputation has only ripened as he has aged. You see, Brimley has never let things like irrelevance or a lack of expertise stop him from achieving his American dream. And Wilford Brimley's American dream is to sell you diabetic testing supplies.

If you are thinking of entering medical school, it's important that you become acquainted with the greatness that is Wilford Brimley. Brimley was born in 1934 in Salt Lake City, which makes him a septuagenarian and a Mormon. He gained prominence as an actor for his work in such films as the made-for-TV movie Ewoks: The Battle for Endor. After deciding that it was important for him to use his acting talents for evil rather than for good, he decided to get into the business of making commercials. After making commercials for a number of no-name companies (e.g., Quaker Oats), he eventually landed the role for which he will forever be known: the spokesperson for the diabetic testing supply company, Liberty Mutual.

In this capacity, Brimley has gained mass appeal within two very distinct groups of people: senior citizens and med students. Senior citizens resonate with Brimley's portrayal as the shining knight who has come to guide them to good health in these confusing and ever-changing times. On the other hand, med students know him as that old guy who can't pronounce the word "diabetes" for the life of him.

You see, when Brimley was made spokesperson for Liberty Mutual, nobody in the company worried that he might not be qualified to talk about diabetes, seeing as he had no medical training whatsoever. However, he did have diabetes and he was folksy enough to relate to their target demographic. In their minds, these two qualities made him the perfect salesperson. But as is so often the case, one group's salesperson is another group's buffoon.

It takes something special to grab the attention of the younger generations, like LOLcats or the Star Wars Kid. Wilford Brimley had that special something. Every time he tried to say the word "diabetes," it would always come out sounding like "diabeetus," and the kids couldn't get enough of it. The halls of medical schools everywhere rang for months with the sounds of "beetus-beetus," and comparisons of Brimley's appearance to that of cats were made (I particularly like comparison #4).

It could have stopped there. If it had been one commercial, the med students would have had a good chuckle for a few days and then went back to memorizing anomalies of the reproductive system. But no, like the Little Train that Could, many more videos with Brimley saying "diabeetus" were released. Wilford Brimley and Liberty Mutual were either unaware of his mispronunciation of this fundamental word, or actively encouraged it (perhaps to make him seem more folksy) ... and so his legend grew. With every new commercial that Brimley made, the narrative of "beetus-beetus" was renewed and retold. Remixes of his videos were produced. Fake motivational posters were created. Videos of him were shown in small group sessions. Wilford Brimley became part of our vocation's heritage.

The lessons that can be learned from the story of Wilford Brimley's diabeetus are many, but the one most relevant to the medical student is that diabeetus is a laughing matter; use this to your advantage. Medical students seem like a homogenous bunch from the outside, but spend a few months with them and you will realize that there are few things that all med students agree on. The hilarity of "beetus-beetus" is one of these things! If you find yourself in a situation where you want to talk to one of your classmates but can't think of a suitable topic, feel free to use "beetus-beetus" as a conversation starter. It can make the difference between an everyday acquaintance and a new best friend.

#26: Intra-class relationships

One word that is used with alarming frequency to describe medical school students is the word "incestuous." In fact, if and when you do matriculate at a medical school, you'll rarely hear the word used more often than in this context. The notable exception to this rule is, of course, West Virginia, but that's just more proof of just how incest-filled med school truly is. However, you'll quickly find out why this word is so frequently used once you get there: like moths to a flame, med students cannot keep their hands off of one another. You will find that medical students pair off quickly and, often, indiscriminately, so it's important to know how to take advantage of this situation (if you desire to do so).

The reasons that medical students fall into the same patterns time and time again are quite simple to understand, when viewed in the proper context. First and foremost, medical students simply don't have many opportunities to go out and socialize with non-med students. This is mostly a consequence of the extreme amount of work they're faced with; time that used to be spent meeting other people now gets taken up studying neural pathways, memorizing cardiac arrhythmias, and learning the mechanisms of action of various neurotransmitters. Simply put, medical students need an outlet. Most of them are young and hormonal, and if they don't have access to people of their choosing, then they will make do with whatever they're given.

However, while much of this behavior can be described as natural, just as much of it is a consequence of sheer stupidity. You'll find that medical students are so desperate to be with someone that they will date people who are completely wrong for them. For example, the following scenario is not uncommon:

You're out one night with a bunch of your friends from medical school who you haven't seen in a while, possibly at a dinner for one of their birthdays. You're making casual talk with them when suddenly you notice that two of your friends are acting more than a little friendly towards one another. At first, you try to remember if the two of them were dating, and you realize that this is a new development. You start recalling your experiences with each of them individually, and you come to the conclusion that these two people are not in any way, shape, or form complimentary to each other. Your mind will struggle to reconcile that knowledge with the information that they are, in fact, dating, and eventually you'll just stop thinking about it because it was never that important in the first place.

When you get to medical school, you will undoubtedly be attracted to someone in your medical class, and will be inclined to date them. It would be unbecoming of me to tell you what to do, but just remember: don't do it. The pros and cons of dating within your class include:

Pros:

• Easy access: It's very easy to meet and spend time with people in your medical class. There are always things going on - house parties, tailgates, holiday parties, etc.
• Quick-forming, intense relationships: One consequence of medical school being so compact and intense is that the students become incredibly close as a result. This same closeness that is found in friendships will also be found in romantic relationships (which, if handled properly, can be a very, very good thing, wink wink nudge nudge).

Cons:

• Too much access: You literally cannot get away from the person. For at least the first two years, you and the person you'll be dating will have almost the exact same schedule, which is suffocating for even the most dependent of individuals.
• Too little privacy: Because medical school class sizes are so small, news travels fast. If something happens in your relationship, you can be sure that most everyone will know about it before you do.
• Messy breakups: It is well known that medical school is like high school - people form cliques, and if you and your significant other break up, people will take sides. The best thing to do in this situation is to get everyone on your side, quickly.
  
  

#23: Obstinacy

Medical students are one of the most brash and opinionated group of people you will ever meet, probably second only to full-fledged doctors. They love sharing their opinions on anything and everything, even if you don't want to hear them. Especially if you don't want to hear them. And especially if you don't care. If you ever watch a television show with a med student, prepare to have every plot, information, and wardrobe inconsistency identified and dissected at the level of a graduate-degree thesis (complete with bullshit theorizing). The importance of this obstinacy as a survival mechanism cannot be overstated, as it has served them well in their previous 20-plus years of life; pre-med classes are not easy, and this obstinacy is often the only thing driving these students to do well in their classes.

A common misconception is that the majority of medical students are obstinate, which is simply not the case. The reality is that the majority of successful medical students are obstinate (while the rest are cheaters). This is because the more obstinate medical students don't have silly things like guilt and morality nagging at them when they make a mistake or hurt a classmate's feelings, and without these psychological hindrances, they are free to to keep moving forward even when they royally screw things up.

There are a few things med students are especially obstinate about, including liberalism. If you are thinking of going into medical school and you hold any conservative viewpoints at all (e.g., that abortion is wrong), you should prepare to have these views mocked without mercy, especially if you go to a top ranked medical school.

Usually this obstinacy will not cause you too much of a problem, as you will quickly learn to avoid these people in your social circles. However, your classmates' obstinacy can become an issue in small group settings, as you will be forced to sit in the same room with other med students for two hours at a time, with everyone being "encouraged" to share their views on random different inane topics. In order to survive in this setting, always remember that there truly is no one "right" viewpoint, no matter what that annoying bitch says or how loudly she says it. The quieter you are and the more you let things slide, the easier it will be to pack up your things and walk out the door when the small group session is over.

#22: Tests

The entire profession of medicine is obsessed with tests. This is unlike most other professions, which have the common sense of realizing that after an individual makes a certain amount of progress in the field, the job becomes less about bullshit basic knowledge and more about specialized knowledge and people skills. It is true that most professions have qualifying exams of some sort, such as the bar examination for lawyers. However, only medicine forces their practitioners to continually retake exams for the entire working life of a given person, even years after the person has received their medical degree. (As you might expect, masochists tend to do extremely well in this system.)

This process of continuous testing starts with the SAT in high school and continues with the MCAT in college. Many students freak out over these two exams, but in reality, these tests are jokes compared to what you'll have to deal with in medical school and beyond. During the first year of medical school, you can expect to have a quiz or exam every single week. (If you are in a systems-based teaching school, you can also expect to have anatomy lab practicals that coincide with the final exam for each sequence.) Thankfully, second year is a little less vicious in terms of exam frequency. At the end of the second year, all medical students are required to take a massive exam called the USMLE Step 1, which is a comprehensive test of the entirety of the previous two years. The USMLE Step 2 and Step 3 come later on, as well as national shelf exams all through the third and fourth years. However, don't think that the testing stops once you graduate from medical school; board recertification exams must be retaken every seven to ten years!

Ostensibly, this incessant testing occurs for the sake of patient safety. If you force people to refresh their knowledge base in order to pass a recertification exam, you might expect them take better care of their patients by drawing upon that knowledge base later on. The only problem with this sort of thinking is that seven to ten years is more than enough time in which to forget all the stupid minutia that you get tested on. The real test of whether or not a doctor is competent is whether or not they do a good job of managing their patients illnesses on a day-to-day basis, including taking it upon themselves to keep up with emerging trends in medicine. One would imagine that such a doctor would also be able to pass a board certification exam, but apparently it is too much to ask to have the exams be a replica of what doctors actually do on a daily basis. It makes much more sense to ask them to partake in an unnatural, non-intuitive process that tests them on knowledge that is marginally relevant to their ability as a clinician.

If you are considering going into medicine, you should come to terms with the fact that the best years of your life will be spent memorizing and regurgitating vast quantities of information (unless you decide to take some time off before going into medical school). You will basically be a glorified parrot, and your position could be better filled by any kind of PDA. The first point is even more true if you are female, as the longer you wait to have children, the more your uterus will shrink down to nothingness.

#19: Rankings

Medical schools have a love-hate relationship with the U.S. News & World Report rankings. On the one hand, they will tell applying students that rankings don't matter, in order to get the applicants to consider the school over more highly ranked schools. On the other hand, if any department of the medical institution gets ranked well in that magazine, you can be sure that they will shove it in your face and never let you forget it. Going to one of U.S. News's Top Hospitals is like walking into an advertisement for the hospital itself; you will see posters up everywhere telling you how awesome they are, as if that knowledge is somehow going to improve the quality of care that you receive.

Medical school rankings are important to some people (like Asian parents), but it is true that they don't really matter in the grand scheme of things. For example, the reason that U.S. News & World Report always ranks Harvard Medical School and Johns Hopkins School of Medicine so highly is because people are always going to be impressed if you attend medical school there. The people at U.S. News & World Report like to state different factors that they "took into consideration" when ranking schools, but overall the statement of these factors is just their attempt at justifying their own bias in school placement. The placement of any school after Harvard and Johns Hopkins is irrelevant, because in the eyes of residency directors, all these other "good" schools are completely equal to each other.

If you are ever told by a school official how well their school placed on the latest rankings, be sure to ask a lot of questions about how the rankings were derived. Ask for a lot of specifics, such as how much improvement there was in the factor of alumni donations from the previous year. Asking for this kind of detailed information allows you to seem like you possess a wealth of knowledge about the process, which will easily fool most administration officials.

#14: Medical television shows

Medical students love shows that are set in a medical environment. Grey's Anatomy, House M.D., Scrubs, Nip/Tuck, Doctor Who - the list goes on. Med students swallow them up like Skittles. In fact, it has been documented that fully 75% of the increase in medical school applications over the past three years is directly attributable to the surge in popularity of these shows. If you're new in the television business and you're desperate to create a hit show, all you need to do is take a bunch of old jokes from other hit television shows, and recycle them into the setting of a medical environment. You don't even need to worry about medical accuracy, since the majority of your intended audience will never even know if you make a mistake.

One reason that med students like these shows so much is that they get to live vicariously through them. Real doctors do silly things like take care of patients and fill out paperwork, but doctors on television shows spend most of their time making snarky comments at each other and having lots and lots of sex. Doctors on television also never have to face the consequences of their actions (unless their real-life actor does something stupid). Watching these shows gives medical students a socially acceptable way to fantasize of doing nothing all day except acting as cool as Fonzie and having unnatural amounts of sex with marginally attractive individuals.

Medical students also like these shows because they give the students a chance to show off how much they're learning in school. This does let them impress people occasionally, but mostly it lets them feel good about themselves. For example, if one of the actors mispronounces a phrase like "bilateral hyperplasia of the adrenal zona fasciculata" incorrectly, they will be mocked for no less than fifteen minutes. A really serious instance of medical incorrectness can be milked for conversation fodder for weeks at a time.

Non-med students also watch these shows, but mostly because of the hot actors and actresses (Katherine Heigl, I'm looking at you) and the ridiculous situations the actors are put into. Overall, these shows have better plot elements and character development than other typical shows like Spongebob Squarepants or Friends, so it makes sense that they've attained mainstream popularity.

#12: Pre-meds

As soon as you get into a medical school, you can expect every pre-med you have ever known to descend upon you like a hobo on a ham sandwich. They will want to know things like what your MCAT score was, what leadership experiences you have, and how many people you had to sleep with. It is flattering at first, but it quickly becomes irritating because all these people are just using you. If a long lost friend who you haven't thought about in years suddenly contacts you, make sure they are not looking for a copy of your AMCAS application before you let yourself get too excited.

Your pre-med friends will send you long emails with all sorts of information about themselves and ask you what you think their chances of getting into med school are. The best way to approach this situation is always to tell them the same thing: with a little more hard work, they would pretty much be the perfect candidate. Be wary of going into any details in your reply, because the more details you go into, the more likely they are to email you for more information. Also be sure to wait a few hours or even days before you reply so they think you actually read what they wrote. If they do email you again, just tell them that you're a little too busy right now, and ask them to email you again in a few weeks. Pre-meds have a very short attention span, and so they will likely forget that the encounter ever happened.

While it would be easy to get angry at those who contact you, remember that there was once a time when you used to do these same annoying things. Suck it up and at least give them the courtesy of a response before you go back to doing something more important.

#9: Professionalism

Doctors sometimes do a lot of really stupid shit, like walking into surgery drunk. Medical schools are pretty fed up with this kind of nonsense, so they have become obsessed with teaching their students "professionalism." What this means is that medical schools assume their students are completely clueless when it comes to professional behavior, and treat them like Eliza Doolittle from the play Pygmalion. There is a lot of hand-holding, down-talking, and wrist-slapping involved. This kind of treatment is usually helpful for those students who have been asleep for the last thirty years, or for those who have had the self-esteem portion of their brain surgically removed.

What this also means is that medical schools have zero tolerance when it comes to "unprofessional behavior," and even the slightest mistakes are blown to planetary-sized proportions. For example, forgetting to wear a tie to anything where a patient is present is the equivalent of calling the patient's mother a whore to their face. Even if you have a good reason for not wearing a tie, like being female, even not wearing it once will probably garner you a "Note of Professional Concern" at the least. In fact, the first time you will even hear that a professor has a problem with your behavior is when you receive a such a Note from them. If you find yourself in this situation, your first reaction will probably be that your professors are acting in a hypocritical manner by accusing you of unprofessional behavior when they themselves do not properly express their concerns to you in a respectful, timely, and empathetic manner. However, remember that an important part of professionalism is accepting that your professors can make up rules whenever they feel like it.

Being on time is another big aspect of professionalism. Medical schools like to operate via the maxim of "early is on time, and on time is late", except that this maxim applies differently to medical students and professors. For medical students, the maxim should read: "Early is acceptable, on time is embarrassing." However, for professors and administration officials, the maxim now reads: "Early is pretty close to the time I said I would be there, and on time is up to fifteen minutes past the designated time of arrival." If you keep these principles in mind, you should have no trouble figuring out what you need to do to keep off your med school's shit list.

Mostly medical schools have to worry about all of this professionalism stuff because they know that the field of medicine treats their doctors like crap. In response, doctors turn to things like alcohol and codeine in order to feel less shitty about their lives. Medical schools don't really care if that's how you deal with your issues; they just want to teach you to keep it to yourself and not let it affect the way you treat patients.

#6: The first month

The first month of medical school is a very strange time. All the different cliques haven't formed yet, so people who usually would never give you the time of day are suddenly overly friendly to you. Of course the cliques will eventually form, but until that happens, you can expect your new classmates to do weird things like inviting the entire class to barbeques and house parties. You will probably find this really unnerving, because you really don't want to hang out with the alcoholics but at the same time you don't have a reason not to. Fear not, soon every group will remember how much they don't like the people in the other groups and everything will go back to normal.

Class is also easiest during this first month, so go ahead and allow yourself to have fun. You might as well go out to all the class-wide parties, because you sure as hell won't once school really ramps up. You might as well get your fill of it while you can. Also, make sure to hook up with that cute guy or girl. This is definitely your best chance to do it, because people in unfamiliar situations have an uncanny propensity for making poor decisions.

If you are totally insecure about yourself and want to try hanging out with the cool kids for once in your life, you should try to take advantage of this month.

#4: Alcohol

Medical students love alcohol. No less than 85% of activities that they partake in have alcohol as a key component, which is probably not that different from most other groups of people. They will use anything as an excuse to get inebriated, including boredom, the end of a sequence, the release of the new Harry Potter movie. If you are thinking of going to medical school, having a hearty love of the bottle and a disregard for the health of your liver is imperative in order to establish yourself in your medical class's social pecking order.

Most potential medical students have already prepared for this situation during college (or high school, for the overachievers). If you fall into this category, congratulations! You are well placed to surround yourself with drinking buddies who you will claim are friends.

However, there are always a few applicants who, for various reasons, do not drink alcohol. This is a straight path to social suicide, so here are a few recommended solutions.

Probably the easiest solution for most is to make up for lost time, and start drinking as soon as possible. Make friends with the alcoholics and follow them to every event they attend (e.g., "Guitar Hero Bar Night Fridays"). When drinking alcohol, go for quantity over quality, as this will help build up both your social standing and tolerance quickly. You should see results within two weeks with this method.

If you don't drink alcohol because of religious restrictions, converting to agnosticism or atheism is your best option. Neither of these religions have any restrictions against anything, so they offer a pretty permanent first step to solving your problem. This method has a secondary mode of action that makes it particularly potent, which is that without the hope of happiness in an afterlife, alcoholism should come fairly easily for you.

Finally, some of you may have moral objections to drinking alcohol. For those of you in this case, your best bet is to consider a different career choice, such as construction, waste management, or teaching. A less popular alternative is nursing (for obvious reasons).