#15: Recommendations

A recommendation letter can make or break your med school application. A sparkling letter is equivalent to applying as a fifth generation legacy, so you should make sure to get as many as possible (stealing them from other students if necessary). Obviously the easiest way to secure these is to sleep with your professors, but generally speaking, the more mature or more female a professor is, the less likely they are to entertain this possibility. (Note that this is not true if you are in middle school.)

A more realistic way to get a good recommendation letter from a professor is to take a lot of classes with them, like more than five. Make sure to be that annoying kid who asks lots of questions during lecture and needlessly prolongs class for everyone else. It's a surefire way to guarantee that your professor - and everyone else - will never be able to forget you. If you can manage to do this for more than one professor, you should have no problem getting the recommendations you require. You will also be universally loathed by your classmates, which is a small price to pay for something so important.

If you have trouble burying your self-consciousness long enough to enact the previously mentioned tactic, you will need to take more subtle routes to remind your professor of how awesome of a student you were. One thing to do is to make a packet for your professors that has all the information they need in order to write the recommendation. Make sure to include a cover letter, a transcript with your best classes prominently highlighted, and a gift card to their favorite restaurant or department store. Feel free to blatantly lie about your accomplishments in your cover letter; as professors have to deal with upwards of 100 students per semester, it is highly unlikely that they will know anything about you. Finally, people often say to write professors a thank you letter once you've been accepted to a school, but this is entirely unnecessary; since you'll never see these professors again, you are under no obligation to pretend to care about what they think of you any longer.

If you can help it, try to get actual copies of the recommendation letters to see what they say about you. This can be easily accomplished by renting a P.O. Box from the post office for a fake program (e.g., "Tidewater University Summer Scholars Program"), and having your professor send in a recommendation to that P.O. Box for you. This course of action has many benefits, the most obvious of which is that you will be able to find out exactly what your professors will write about you. With this knowledge, you will now have the power to prevent them from backstabbing you in the future.

#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.

#13: Problem-based learning

As previously mentioned, some schools try to buck the mold by using a teaching method called "problem-based learning." This entails having students do lots and lots of problems instead of emphasizing lectures. It was developed at a university in Canada, which explains why it sucks so hard.

Problem-based learning is touted by its proponents as being a non-traditional way of teaching, which is a surefire way of knowing that it's not quite as good as the usual method. One big drawback to problem-based learning is that doing problems over and over again becomes really tedious after about 13 seconds. However, the bigger drawback to problem-based learning is that students never actually learn the principles behind the problems that they solve. They become like little monkeys who can apply the right equation to a given problem, but have no deeper understanding than that. When it comes time to study for a national exam such as the USMLE Step 1, which asks questions requiring integration of fundamental concepts in medicine, these students are basically screwed.

Most lecture-based schools include a little bit of problem-based learning in something called "small group." Small group sucks really hard too, but it is only a taste of what problem-based schoolers go through. Every night before they sleep, lecture-based schoolers offer this prayer: "Dear God, please keep me and my family safe. And thank you for not sending me to a problem-based learning school. Amen."

#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.

#11: Faculty interviews

Interviews are a way for medical schools to separate the normal people from the weirdos. Of course, they have a quota for weirdos that they need to accept, but overall they try to keep this number to a reasonable minimum. The reason they do this is that if anyone asks, they want to be able to talk a lot about diversity and then point to a few key statistics. This is what they like to do with minority applicants as well.

Med school interviews are different at different places. Traditionally, they are conducted by faculty members, although some schools are moving to interviews by medical students as well. If you interview at a school that has both faculty interviews and student interviews, remember that the faculty interviews carry about forty times more weight. Med students are only allowed to interview you so they can say they contributed to the school and feel good about themselves.

Before conducting the interview, faculty members will have read over your application very superficially for things that stand out at them. They will then ask you about these things in the interview. Don't mind that if they had just read the application more carefully, they would already have all the answers to their questions. They are just trying to classify you as either normal or weird based on the way you answer the questions.

Faculty members will also ask you if you have any questions for them, and it is important to prepare with a few:

• What kind of student would do well at this school?
• What has been your best experience here?
• What are the biggest hurdles that most students face?
• What are some mistakes you've seen students make?
• What are some recent changes the school has undergone?

The answers to these questions probably don't matter to you. The goal is to make yourself look good so that the school will accept you.

Remember that it never hurts to be a sycophant. Ask them about all the degrees they have cluttering their walls or about the important and cutting-edge work they do. While these topics have nothing to do with you as an applicant, it will make the faculty members feel good about themselves and report positively about you.

#10: Lectures

The first two years of medical school are the basic science years, during which medical schools attempt to cram as much clinically-relevant basic science information as possible into the brains of their students. Medical schools generally choose from one of two teaching methods for these two years: lectures, or something called "problem-based learning" (to be discussed in another post). The lecture-based teaching method is the more traditional of the two (as it came about in Italy during the Medieval Ages or something), and is therefore the method of choice of most medical schools. So, if you're thinking of going to medical school, it would behoove you to be ready to sit through at least two more years worth of horribly-taught lecture material.

Overall, lectures in med school are run mostly the same way as their college counterparts, although there do exist a few significant differences that you should be aware of. For example, if you decide to matriculate at a school that engages in lecture-based teaching, you'll be happy to know that the first few sequences will start their lectures for the day at fantastic times like 10 a.m. - a nice change from college that should give you plenty of time late in the night to bond with your friends. Another change from college is that many med schools distribute packets containing all of the Powerpoint presentations for a given sequence at the start of that sequence, theoretically giving you all the material you'll need for your exams right from the get-go. A final difference between college and med school is that lectures in med school will usually be scheduled back-to-back, meaning that there will be less dead time in the middle of the day for you to waste.

Things like these will make you feel like your medical school administration really cares about you, and that they want to help you be as happy, efficient, and productive as you could possibly be. Don't be naïve enough to believe this! Lectures during the first few months of med school are only set up in such a humane fashion in order to ease you into the hell that you've entered, and like almost everything else in medical school, these things will only serve to make your life harder in the long run.

For example, you'll quickly notice that as you progress from sequence to sequence, the time at which your medical school lectures begin will slowly creep earlier and earlier; during some sequences, your lectures for the day will even start at the ungodly hour of 8 a.m. (I'm looking at you, second year neurology sequence). While this is a major issue in and of itself, the severity of this problem is compounded by the fact that more of your nights are spent studying because of how dense and complicated the material becomes in these later sequences. Thus, the late start times that you'll enjoy at the beginning of med school do not adequately prepare you for the bulk of how your medical school curriculum will operate, and will only serve to give you a false sense of confidence in your ability to adapt to the demands of your new environment.

The distribution of lecture packets by your med school may also seem to be a welcome improvement over your college experience. This is because your time in lectures during college was probably spent furiously transcribing your professors' words whilst whispering to your classmates about what had actually been said; now, all of that work has [theoretically] already been done for you. However, the fact of the matter is that now that you have the lecturers' Powerpoint slides, they will no longer feel the need to explain things properly because "it's all in the notes." They will also brush you off whenever you ask them to slow down for the same reason: "it's all in the notes." In fact, only the bare minimum is ever in the notes, but a professor who truly knows how to deal with med students will never let a student's wishes supersede his own right to run the lecture however he wants.

(Thus, there is only one way to get a concrete answer out of a lecturer: hitting that critical mass of student questions that a lecturer cannot ignore. Lecturers will try to give you the impression that they are Almighty God and therefore Can Never Do Wrong, but after careful examination it is safe to conclude that this is in fact false. That being said, if enough students ask them questions over and over, it is possible to temporarily pause their steamroller-like behavior.)

Even the back-to-back scheduling of lectures will quickly become a liability, as your days will go from the manageable number of 4 hours of lecture per day to the egregious quantity of 8 hours worth of lectures and labs (again, looking at you, second year neurology sequence). By the time you get halfway through your first year, you'll come to the end of each day wishing that you'd followed your friends who went into i-banking and are now living "meaningless" lives consisting of making boatloads of cash right out of college and drinking themselves into oblivion every weekend.

In fact, the only redeeming quality to all of this is that most med school lectures are not required; in fact, many med schools actually record their lectures and place them online so that the videos can be viewed from anywhere with a solid internet connection. By this token, we come to the final and most important difference between lectures in college and lectures in medical school: almost no one attends lectures in med school. Out of a class of 170 students, a lecturer would be lucky if 30 students showed up (and unlike most of the "facts" in this blog, this one is actually not an exaggeration).

I would imagine that most of the people reading this blog will fall squarely within the 140 people category.

#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.

#8: Research

Research is a lot like volunteer work because every medical student will have it on their application. Therefore, so should you. However, unlike volunteering, lying about research when you have not done any is more problematic. Since research is more technical than that "touchy-feely volunteer work" stuff, it is harder to pull off having done some when you really haven't. If you want to say you have done some research, it is important for you to be able to back it up with things like talking about how important your research is to all of society and dropping scientific terminology. Otherwise it is best not to mention research at all.

There are two kinds of research: clinical research and basic science research. Clinical research involves a lot of talking to patients and crunching data. It will be pretty easy for you to get a publication out of clinical research because clinical researchers will publish anything.

On the other hand, basic science research involves you spending a lot of time in a dirty old lab, doing a lot of science experiments which fail most of the time. For this reason, it is more difficult to get a publication out of basic science research. Another reason is that most professors in charge of labs are socially inept and have no desire to help you succeed. Even with all these drawbacks, medical schools like seeing basic science on applications more than clinical research because they know that clinical researchers do not actually do any work.

#7: Anatomy lab

Anatomy lab is done differently at different schools, but is always done in the first year of medical school. If you are lucky, your school will do all of anatomy in about two months, and then you will be done with it forever. If you are unlucky, your school will buy into the "systems-based integrative-knowledge" garbage and you will have anatomy labs throughout the year. Fortunately for this second group, having anatomy throughout the year is a good way to There is absolutely no benefit to having anatomy through the whole year, at all, ever. Only bad things will come of having to prolong the end of this experience because no one learns anything from it and it only ends up pissing people off.

Professors like to call anatomy a "rite of passage," which is an accurate description because anatomy lab is basically a legalized form of hazing. The major difference between the two is that there is less free alcohol in anatomy lab. Major things you will notice about the anatomy labs when you first get there are that they are always very cold, and they always smell like death. Ostensibly, the professors need to keep the temperature of the anatomy labs so low for the sake of preserving the cadavers, although they also get the added bonus of doing even one more thing to make medical students as uncomfortable as possible.

Each lab session consists of approximately three hours of pretending that you are finding whatever body parts are on the list. Pretending is important because even though it is a well known fact that nothing in a [dead] body can really be distinguished from anything else, professors like to see that you are hard at work. For this reason, when you are in anatomy lab, it is best to try to leave as early as possible. Set a deadline for giving up, and then try to beat it. Making a game of this helps keep it fun, even after thirty or more lab sessions.

Sometimes, you will find yourself stuck with a lab partner who wants to find every single last thing in the miniscule chance that they will commit something to memory. Partners like these can make sticking to your deadline difficult, but it is best not to lose your cool in this situation. Simply ignore them and make a habit of leaving lab at a specific time every session; they will adapt to your behavior.

Also, do not worry about how these behaviors will affect your score on the final lab practical. Professors love holding review sessions, which are many times more useful than anatomy lab ever is.

#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.