Summer vacation means graduation for many very recent undergrads starting medical school in the fall, and it seems that many are left somewhat perplexed about what to do with the summer. I’ll try to go through some of the popular options. You might consider a mix of these things.
1) Work to earn money. Medical school is obviously notoriously expensive, so depending on your personal finances, it may make a lot of sense to try to make as much money as possible to help pay for life in med school. Obviously what work you might do varies tremendously, but putting away some savings is a good thing for everyone, particularly if it means you can reduce student loans.
2) Volunteering. Seeing that you’ve gotten accepted into medical school, presumably you have a good academic foundation, so spending some time helping with tutoring or mentoring kids interested in careers in science and medicine is a great way to give something back. It is also easier for you to have an “in” volunteering in health related settings, and frankly a lot of physicians and surgeons will be more willing to show you things and teach you if they know you are starting school in the fall, so you might get a little something out of it as well. It doesn’t hurt to have as much practice as possible just being involved in healthcare delivery and talking to patients.
3) Research. If you’re interested at all in a career in academic medicine, then getting a jump on research can be a huge asset. Once classes start, you’re going to be incredibly busy, so if you can get started working in a research group at your medical school the summer before you start, it already gives you a lot of momentum. It’s a lot easier to keep working on a project than it is to try to start a new one while you’re trying to drink from the firehose of medical knowledge.
4) Travel. If you’ve got the resources, then this can be a nice thing to do. If travel is how you get energized, then it’s a great way to get your batteries full for medicine. Being well travelled also helps you relate to different people from different places, and opens up your mind, which is always a good thing.
5) Exercise. Depending on your medical school and study habits, your first two years of medical school may involve endless hours of sitting in lecture and then many more hours sitting and studying. There are lots of video and audio resources, but there will also be a lot of sitting. It doesn’t hurt to start a good exercise program and get yourself as fit as possible in preparation.
6) Reading & Studying. Pre-studying is a pretty controversial subject with a lot of medical students. Some people will say that it is totally not worth your time, as you’ll be exposed to so much information so fast that it will totally blow away any of your efforts to study in advance. While the amount of required information in medical school may come very quickly, I don’t buy the argument that learning things in advance, even just a few things is a waste of time. However, I would suggest that one of the best things to do is to focus on trying to get a high level of view of medicine. In the first few years of medical school, both the facts and the required skills come very quickly. That means it is very easy to lose perspective and forget the big picture. When you’re memorizing all the steps of citric acid cycle, or all the different types of cephalosporins, it’s easy to forget what it’s actually all about.
So where are you going to get the big picture? Atul Gawande writes some amazing pieces in the New Yorker. These are not only worth reading because they are very good, but they are also influential, so that professors in your medical school are likely reading them too. The past few years of articles in the NY Times Health section are a great place to look for relatively current events. If you have access to the New England Journal of Medicine (student subscriptions are basically a steal), each issue has some short articles in the front which are “Perspectives”, these are just really good pieces of commentary or journalism form important leaders in healthcare, research, and even politics. As you get more knowledgeable medically, many of the other articles may get more understandable. It’s not really that big picture, but the Clinical Case reports in NEJM are a useful way to do some case based learning on your own. This is also a good way to help stockpile some stuff to help fuel your enthusiasm later when you are feeling overwhelmed with memorization. It helps to have some clinical correlations or context to help motivate your learning things like biochemistry or neuroanatomy.
Another good thing to try to learn about it is the history of medicine. It is essentially never taught at all in medical school, and yet it permeates so much of the field. Senior doctors love including historical nuggets in their presentations to colleagues. History helps put things in perspective as well. If you start to think that things like concern for medical curriculum reform, debate over balancing expenditure on expanding healthcare delivery vs research, vaccination controversies, problems with over-specialization, or many other topics are novel, it’s important to remember that these are all old problems. So where to start with history? It all depends on your interests, whether it is Galen or DeBakey, or anything in between. There are some general introductions to medical history, such as the great Cambridge Illustrated History of Medicine, which are readable and cover a lot of ground, but there you only get a superficial view of things. I think an even better approach is to study a few biographies. They give you a good historical perspective and yet also give you a model of a life (usually) well lived in medicine. I will go through a longer discussion of medical biographies in a subsequent post.
If you feel that you absolutely do need to study something academic before medical school, I would mention that the one thing my entering class was encouraged to look at before starting classes was biochemistry. Biochemistry requirements vary quite a bit before starting school, and it is often taught incredibly quickly at the beginning of medical school. I had a year of undergraduate level biochemistry taught by the chemistry department, and it actually had very little overlap with the few weeks of biochemistry we had in medical school. I have several biochemistry textbooks and study guides on my bookshelf, and yet I don’t know of one that I really think is outstanding. If I had to recommend one for medical school, it would probably be the Lippincott’s Illustrated Review, originally by Champe & Harvey, now by Denise Ferrier. It’s in depth enough to cover everything, and yet concise enough to not get bogged down in details you don’t need, like many bigger hardcover books. If you want something really concise, then Vijay’s Underground Guide to Medical Biochemistry and Metabolic Disease is quite compact and covers what you need to know for the Step 1. In the interest of full disclosure, I am friends with the author’s sister.
For general medical reading and entertainment, The House of God is a popular recommendation. I have mixed feelings about it. It’s pretty dated by now, although some parts are timeless I guess. However, it may also turn you cynical and jaded before you even start. Kill as Few Patients as Possible is more concise, and a little bit funnier. Again, it also is a bit out of dates as it is a bit focussed around a career in private practice, which is something few physicians beginning training now will probably have. Something which is quite a bit older but in many ways timeless is the writings of Osler. It’s definitely not for everyone, but not only is it incredibly stirring and motivating stuff, but it also is a gold mine of quotes for talks and presentations. I like this annotated edition, because it helps give some background when Osler makes references to obscure bits in Greek mythology or 17th century literature.
Good luck, and for anyone actually reading this because they are starting medical school: congrats! You’re going to start on a wonderful adventure.