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Ten Anchors for Med24

A ship sails on a stormy sea, as seagulls circle above.

Please note: This article reflects solely the views of the author and quoted students. These views do not represent the entire class of 2023.

To the Johns Hopkins University School of Medicine Class of 2024 (Med24), a warm welcome as you join the Johns Hopkins family! I am ecstatic for you as you officially begin this journey toward a career in medicine. You are in for an adventure that will challenge you to become better each day — both for others and for yourself. Some days you will clearly see this happening; other days, you may question everything about yourself. Rest assured that this is all part of the adventure.

When I started medical school last year as a student in Med23, I, like many of my peers, had an endless list of questions for students in Med22. Having just accomplished their first year (M1), they surely had all the answers to M1 success, I thought. I attended all the informational sessions they hosted for our class, where I collected as many pearls of wisdom that I could find. I also regularly picked the brains of my incredible Med22 peer mentors.

My friends in Med22 were, and still are, an amazing source of support for me, and I hope that we in Med23 can encourage you just the same. But what I found after all my conversations with Med22 — and, more importantly, after learning many things as I stumbled through M1 — is that the “answers” to M1 success are principles, not study strategies.

What do I mean? Very soon, you will come to find that one way of studying is “correct,” and another is “incorrect” — and the two will be the same! A study method that is right for someone else may not be right for you. You’ve probably heard this already. But because I think it is so important, I am reiterating it, and even listing it as one of the principles (#3).

So, rather than tell you my version of how to study “correctly,” I think it is far more worthwhile to share what I humbly believe are the essential principles that will help you thrive in M1. This “top 10” list (ranked in no particular order) was created based on both my own experiences and feedback from other students in Med23. These principles, unlike specific study strategies, are like reliable anchors for any medical student. May they steady you through the winds and waves ahead.

1. Remember where you are.

Sooner or later, you will think you are not “good enough.” This feeling came swiftly for me, within the first week of anatomy, and lasted throughout the year. For others, it may not strike until much later. But as a medical student, it is universal to feel, somewhere along the way, that you are deficient. When you feel this way, remember where you are, both with confidence and with humility.

With confidence, remember that you made it to medical school. Ben Koleske (Med23) writes, “Now that you’re here, you’ve successfully made it past one of the most challenging, actively gate-kept hurdles of your life.” You are good enough to be here (reputation and all!).

With humility, remember that you are in your first year of medical school. If you unfairly compare yourself to physicians, residents or even upper year students, of course you don’t know as much as them — yet. That’s exactly what this adventure is all about. If your standard is your fellow classmates, see the next two anchors.

2. Realize this is new for everyone.

When your anatomy lab partner seamlessly dissects your cadaver while simultaneously verbalizing all the nerves and vessels along the way, it is easy to doubt yourself and feel like you should be able to do all those things just as well. Don’t buy into this illusion or assume anything about your classmates other than the fact that the medical school experience is new for everyone. You are all on the same ship, and this ship is in uncharted waters for everyone on board. Some people will have skills and inclinations that allow them to better adapt to one part of these waters. On the other hand, you may be more successful in navigating other parts of the unknown.

Nonetheless, if and when you see your classmates captaining the ship like Jack Sparrow himself, use the next anchor.

3. Don’t play the comparison game.

Believe it or not, there is still time in medical school to play games. I hope the College Advisory Program (CAP) Olympics can take place safely this year; there are lots of amazingly fun games that you really should play, especially if you are in Taussig College. (You may also like to play the incredibly clever digital murder-mystery-themed escape room created by Harshi Gupta from Med22 and Mary Chen, Med22.)

The one game you absolutely should not play as a medical student is the comparison game. Despite this advice — which you’ve heard dozens of times before medical school — you will probably still play it. It’s really hard not to. The comparison game enticed me all year and I wasted a lot of time on it.

But try really, really hard to stop playing if you find yourself caught up in the game. Notice especially when you begin to compare your study strategies and resources to those of your peers. If you don’t believe me, believe my classmates:

“Do not compare yourself to others, but take the time to learn your strengths and build upon who you are, and you will also be successful in your own way (the best way!).” — Khadijah Tiamiyu (Med23)

“Study in a way that works for you, and try not to compare yourself (or your study habits) to others. This can be difficult, but you have to trust yourself and recognize that everyone is going to learn differently.” — Caroline Daly (Med23)

“I would recommend not worrying too much about how your classmates are studying — everyone is going to be using different resources, learning in different ways and focusing on different results. Try out a few things that peers recommend and then stick to what works for you!” — Justine Enns (Med23)

“At the beginning of medical school, we’re told time and time again that digesting this information is like drinking from a water hose. While that is true, I personally found trying to digest all of the advice we were given to be like drinking from a water hose as well. Some students will advise you to always use Anki, some will say to never use Anki and some will suggest yet another study strategy. Some people will tell you that you have to sacrifice a lot in order to study all the time, while others will tell you grades are not as important as extracurriculars. … My biggest piece of advice for incoming M1s is that it is OK to find which of the many pieces of advice thrown at you in the first weeks work for you and ignore the rest.” — Alyssa Kretz (Med23)

Ask us for study advice. Use the MedWiki. Try Anki. You can do all those things. But know that there are many different paths to success, and the one you’re on is perfectly fine. “Hike your own hike,” Lillian Hayes (Med22) writes in a beautiful piece.

Sometimes, when I get anxious that I am not using all of the most “high-yield” study resources, I humorously ask myself: How did medical students before 2013 ever become great doctors without Anki, Pathoma or Boards and Beyond? The reason is that there is no universally best way to study (though I must acknowledge that these resources are extremely effective for many students,  including me). Ultimately, the best way to study is that which works for you — both regarding selection of resources and how you use them — and that will come through trial and error. This brings me to the next anchor.

4. Learn to embrace change.

As you weather the seas of medical school, you will face many storms at a moment’s notice and be required to adapt quickly to them. Beginning the journey expecting and embracing change will make a crucial difference in navigating these storms when they hit.

One of the most salient examples during M1 is the vastly different teaching formats, content or schedules you may encounter as you transition from one course to the next (and sometimes even within the same course). Knowing this will happen and viewing these changes with an attitude of eager curiosity will make them more interesting and exciting.

Additionally, you may find the need to modify or even altogether change your study strategy as the year goes on. This is normal. The way I studied at the beginning of the year looks nothing like how I study now. I made many revisions along the way. One of the best pieces of advice I heard from an upper year student is that M1 should be the year when you try different things and learn what works best for you through the painful but necessary process of trial and error.

If you find yourself continually struggling — with studying or any other issue — steady yourself with the next anchor.

5. Ask for help.

Medical school will push you to your limits. You do not have to — nor should you — carry your burdens alone. An incredible network of support is available to you here in the Johns Hopkins community, begging to be used. It includes (but is not limited to): Johns Hopkins Student Assistance Program, University Health Services (UHS) Mental health program, UHS Wellness and Ellen Kaplan, the learning specialist and disability services coordinator at the school of medicine.

First year students have a variety of built-in support systems in the form of their college, adviser, molecule, anatomy group, and their virtual microscopy group. Pending any COVID-19-related changes, you will spend a significant amount of time with these folks, and they are meant to be there for you. I have found the entire Johns Hopkins community, both my peers and the faculty members, to be warm, collegial and always willing to help.

Here are some insights from my classmates:

“The focus now is preparing you to be excellent doctors, which means that the people around you (including one another) are there because they want to help you rather than swat you down. Ask for help whenever you feel that you could use it, and even more often than that.” — Ben Koleske (Med23)

“1. Talk to Ellen, the learning specialist! I was struggling really hard during the anatomy quizzes, which really stressed me out before our first exam. I made an appointment with her and she eased my stress and helped me focus on some really useful learning strategies that allowed me to start passing the quizzes  —which felt like a miracle at the time, but that’s good study hygiene for you. You can make appointments with her throughout the year, so if you find yourself struggling at the start of a new block, don’t hesitate to make that appointment!

"2. Hang out — even if virtually — with your molecule outside of scheduled CAP (Colleges Advisory Program) advising times and Clinical Foundations of Medicine (CFM)! These four other people will be such a strong support for you throughout M1, and hopefully beyond, so it’s great if you can get to know each other outside of the confines of scheduled CFM sessions. A great way to start a tradition is to learn each other’s birthdays early so you can celebrate each person’s special day with their favorite dessert.” — Justine Enns (Med23)

“Take care and reach out to others when you feel overwhelmed. Everyone struggles at some point and there are so many people who are willing to help you out.” — Seye Raymond (Med23)

There are people here who will care for you through thick and thin. I have discovered, though, that one of the best ways to say “thank you” to these people — besides caring for them in return — is to care for ourselves.

6. Set limits for yourself.

You’ve heard about self-care ad nauseam, and will continue to hear about it throughout medical school and beyond because it is that important. I suspect that many of us may be here at Johns Hopkins because we have neglected self-care in order to achieve our goals. If you are like me, your self-talk in college centered on delayed gratification (“I need to work as hard as possible now and will rest later after I reach my goals”).

It’s a tough mindset to break precisely because it has worked so well for us. But delayed gratification is particularly insidious in medicine, and gratification can become interminably delayed if we do not notice what we are doing to ourselves. This voyage will last forever if you allow it to.

Medical school, unlike college, is not simply a steppingstone to the next chapter. Medical school is where you learn how to be content and enjoy yourself now — absent of where you ultimately want to be — so that you can thoroughly cherish this adventure while you are on it and not only after you’ve completed it. Offering a personal insight, Matthew Rabinowitz (Med23) writes, “I felt much of my undergraduate experience was motivated by pushing myself to the limit, disregarding my own well-being, because I knew medicine was my ultimate goal. I soon realized at Hopkins that this is not undergrad #2, this is when I need to consciously and decisively decide what will give my life wellness and purpose in the years to come.”

My classmates and I have found that the key to self-care is to set daily limits for ourselves. You have likely heard that medical school will consume as much of your time as you allow it to. Despite how you may feel, outside of mandatory classes, you choose where your hours go.

After asking my classmates for advice they’d like to share with Med24, I was not surprised to find that the most common response had to do with self-care, especially setting limits for yourself.

“My advice for both adjusting to anatomy and virtual learning is to schedule in time for yourself/other activities — I blocked out my schedule and tried not to work on things in anatomy after 7 or 8 p.m., so that I would have time to decompress. For virtual learning, I would study during the day and have free time (for exercising, talking with friends, Netflixing, etc.) at night — that helped me balance school and home life.” — Sara Hurley (Med23)

“Make time for exercise. It really helps with your physical and mental health. You have to make a conscious effort to determine your priorities outside of school and carve out dedicated time for them. Otherwise you may find yourself unhappy and studying all day.” — Seye Raymond (Med23)

“Reflect on the things that are most important to you, and make time for them in your schedule. This could include talking with family and friends, cooking, reading, working out, getting involved in a religious community, painting, really anything. Medical school is hard. Medical school online can make it feel even harder at times. Make a schedule so that your day is structured and you don’t spend all day looking at the screen.” –—Caroline Daly (Med23)

More often than not, I have found that setting limits for myself and enjoying my life outside of medical school rejuvenates me and actually makes me more effective when I return to work. It also gives me a clearer vision for the life that I want to live, one that routinely and intimately enables me to practice the next principle.

7. Cherish people and their stories.

“Remember to take time for yourself and for the ones you love. People are why we got into this field in the first place, and people will provide the support we need along this journey.” — Ashley Zhou (Med23)

Many students, including myself, find Clinical Foundations of Medicine (CFM) to be one of the most rewarding aspects of M1. CFM is all about people — interviewing people, examining people and working with other people (namely, your molecule). This is followed up in your second semester by the Longitudinal Ambulatory Clerkship (LAC), in which you apply all the skills you learned in CFM in a real primary care setting.

Though you may experience nervousness and awkward conversations along the way, CFM and LAC are where you can truly soak in the feeling of being a budding clinician. My biggest recommendation is to take an immense interest in what your patients — your real and standardized patients — tell you. It will make your learning all the more fruitful.

When M1 gets hard, remembering why you are here in medical school — people — can be a powerful anchor.

8. Try not to cram.

This is as close to a study strategy that I will recommend without hesitation, because not cramming will really serve you well in M1 no matter how you are studying. Your mental health will thank you, and you will have more to contribute in small group sessions, which will also make you feel better about how you’re doing.

I will admit that this principle is a bit unfair, because the firehose of anatomy will almost certainly make you resort to cramming at some point, even if you felt you did everything perfectly. This is a rite of passage, and we’ve all gone through it. Relax! Do your best not to cram, and when you do, say to yourself, “This is all part of the process.”

“The idea is to constantly quiz yourself. Start early, not just right before the exam. It can be frustrating to constantly get questions wrong, but it makes you aware of gaps in your knowledge and concepts that you don’t fully understand.” — Seye Raymond

“Study every day, and try to be proactive. I realized that when I took it easy in the beginning of a block, I was often more stressed out by the end than when I began a block strong.” — Caroline Daly

9. Trust the process.

Trusting the process worked out (sort of) for the Philadelphia 76ers, but it will work out even better for you. The proof is in the pudding — generations after generations of medical students at Johns Hopkins and elsewhere have been through all the ups and downs you will go through, and they have become fantastic doctors.

Now, as an M2, my most pressing concerns are directed toward “M2 stuff” like Genes to Society II and Step 1. I do feel nervous about the road ahead, and some days the fear of failure really affects me. But it has always grounded me to remind myself that everyone has gotten through this, and so will I.

On those days when you feel afraid, rest assured — we have been there and gotten through it, and you will too.

“It will feel like a lot is expected of you at first in the personal and professional spheres — and sometimes both at once — but you will get there. We all did, and you’re just as capable as us, if not more.” — Ben Koleske (Med23)

“Success in medicine is not based on how ‘smart’ you are but your perseverance. Keep going no matter how hard it might be in the moment. You’ve faced hard times before but conquered them, so know you have it in you.” — Khadijah Tiamiyu (Med23)

10. Remember where you’re going.

The first essential principle on this list is to remember where you are (#1), and now the last is to remember where you’re going.

On this adventure, it can be frightening when you are suddenly lost at sea (#4) and unsure how you will get to your destination. But you know where your destination is, and if you put in the work and trust the process (#9), you will get there.

Remembering where you’re going — to become a healer of people — will help you cherish people now (#7). And the desire to be the best healer you can be for others necessitates that you learn to care for yourself (#6) and to be vulnerable and honest enough to ask for help (#5).

It will comfort you to know that you and your peers are all in this together (#2), and that everyone has unique strengths (#3) to contribute to this team effort.

Finally, if you find yourself cramming for an exam (#8), try Matthew Crane’s golden Anki decks, which many people have endorsed but which I’ve never used. Remember, everyone studies differently. Learn how you learn best. You’ll be just fine.

As the Navy saying goes, “Fair winds and following seas.”

A special thank you to the following members of Med23: Alyssa Kretz, Anya Kim, Ashley Chen, Ben Koleske, Caroline Daly, Justine Enns, Kelsey Melinosky, Khadijah Tiamiyu, Matthew Rabinowitz, Sara Hurley and Seye Raymond.

Bonus Anchor: Adopt a Pet

“Adopting a pet, especially if you have a nonmedical significant other, is definitely feasible during M1! BARCS — the Baltimore Animal Rescue and Care Shelter — has a lot of great pets available to adopt or foster, and having a creature to take care of is a great way to de-stress during medical school. However, I’d definitely recommend that if you do get a pet, try to do it after anatomy. It is not super fun to try to juggle staying on top of all that content with figuring out how to take care of a new pet.” — Anya Kim (Med23)

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