Year 1 in Review

From reading my blog posts, there are probably moments you can almost forget I am in medical school, going to classes, and attempting to learn all the things one needs to know to be a physician. Aside from a snippet here, a funny story there, or a random photo displaying my computer, I don’t often write about the details of my studies for a variety of reasons. Primarily, I can’t imagine it would be even mildly interesting to read about, let alone write about. Although my first year of medical school isn’t officially completed, having finished the “basic sciences”, we are in a transition period as we make the last push before summer break. Even though it isn’t reflected in my writing, school, class, and studying often consume the majority of my time and energy. So here is a brief reflection on the school portion of medical school.

The first year has been a whirlwind. I was reading a book recently where the author observed the way we often measure our existence is in hours or days, but when we look back over a period of our lives it can be difficult to understand what we accomplished over time and exactly how we arrived at our present state of being. Until I take time to reflect and look back on highlights, lowlights, and everything in between, that is exactly how I feel about this school year.

My experience with the first two periods of courses and exams had endless ups and downs. To summarize, we had three months of classes followed by 2.5 intense weeks of exams. Then after about 10ish days of break, we started it all again. Instead of taking 6 classes, we focused on one body system at a time during the last two months. With 2-3 weeks per system, we finished endocrinology, hematology, oncology, and rheumatology. To translate, the courses were about hormones, anemias/cancers of the blood, all types of cancer, and malfunctions of the immune system like arthritis or scleroderma.

After the first semester, three patterns emerged within the class. There is a group of students who attend the majority of classes, those who attend less than half, and then a few who only attend the lectures which are absolutely mandatory. The chronic nonattenders primarily use outside resources to learn the material. This is understandable given the format of the courses and exams. Our teachers don’t write the exams. They choose a number of questions from a standardized question bank called the NBME (National Board of Medical Examiners). There are endless videos, summaries, and platforms making lots of money by offering excellent explanations AND highlighting the most important information for our exams, for medical school, and for board exams. Sometimes our exams don’t reflect what was taught during lecture. I would know. We are just expected to somehow know what we are supposed to know and teach it to ourselves if it isn’t covered in class. I found this especially overwhelming for courses like Pharmacology, Pathology, Immunology, etc. We obviously can’t learn it all in depth during the short period of time dedicated to these subjects. But how much do we need to know? Which parts are important, and which aren’t? It can be overwhelming.

As most of you would probably guess, I’m part of the crew who regularly attends lecture. Sometimes I question my choices in this regard. However, looking back, I think it was imperative for me to attend lecture, especially during the first semester. I believe this is where I truly began to get to know my classmates and they had the opportunity to get to know me. We feel a sense of comradery and morale, not only knowing we were going through same thing, but we are witnessing it first-hand. Many hangouts and plans for adventures were hatched between classes. I have learned that a person can do all the planning in the world, but some of the best experiences are simply impromptu.

After Christmas, attendance dropped sharply and rapidly. We had all successfully made it through the first round of exams and believed we knew what it took to pass tests and learn the material. There is a portion of my class whom I feel like I never see. I am quite certain that while we are all bound together by our experiences in medical school and Israel, we are also separated by how vastly different each of our experiences have been and will continue to be. I can’t image how my classmates who spend all day watching videos and doing flashcards could be having experiences which parallel going to class and engaging with professors and classmates daily. One isn’t necessarily better or worse than the other, they are just different. I think solely focusing on the test material and not going to class is probably more efficient and leaves more time for other things. But I also think there is value in hearing from clinicians who are in the field and thinking about the aspects of medicine which won’t ever be found on exams.

On a typical day of lecture, odds were high I was the first one to the classroom. I prefer arriving early, but in my most humble opinion, I wasn’t THAT early. Typically, I would walk in 5-10 minutes before class started, and on a good day, the instructor would arrive a few minutes later (on a bad day, they simply wouldn’t arrive at all haha). Then the professor would ask if they were in the right place, looking around the empty room, understandably confused. A few of my classmates would slowly trickle in, and before starting the professor would ask some version of the dreaded question, “how many are supposed to be here?”, “are we waiting on anyone else?”, etc. Some of our teachers were incredible instructors, others quite average. In the end, I think the lectures were beneficial for me and an important part of my learning during this first year.

After receiving the results of my last first year exam, 16 exams under my belt, I think I have successfully mastered how to manage and pass the exams. I am not convinced I have fully grasped how to apply what I am learning to the field of medicine or how to integrate all the intangibles of being a physician who addresses more than the physical aspects of health into patient care. I have been listening to a number of audio books and enjoying our courses on Global Health and On Being a Doctor. In these courses, we have begun to tackle the murky seas ethics, end of life decisions, equity, politics, patient interactions, and so on. This is just the tip of the iceberg of topics I will continue to discuss and wrestle with for the rest of my life as a physician. Facing these hard questions can feel overwhelming, but in a way it’s a blessing to be confronted with them and work through them now. When given the choice, they are questions I would choose to avoid. But the hard questions are often the most important and the ones I can learn the most from.

I’m writing this from my home, in Kansas, one of my favorite places on Earth. It has been a while since I have posted anything on my blog. It was a hard month, and sorting through my feelings and emotions was the last thing I wanted to do at the end of every day. So I avoided it. But I can’t reflect honestly on my first year of medical school without facing my short comings and trying to understand how to improve in the years to come. First of all, I realize now that I didn’t always make the best use of my time. Something I have slowly come to realize is there is plenty of time to study and still have time left over for other things. The key is to really focus and get work done during the time designated to studying and to explore and adventure guilt free in the time away from studying. If convince myself I need to study all the time, at least half of that time will be spent avoiding studying while simultaneously doing nothing useful or enjoyable. So I’m not really doing any more studying than before, but I’m also wasting time I could spend doing other things. By this point I know the depth and general time I need to learn the material for my exams. Now I need to organize my time to reflect what I have found works for me. The upper classman told us over and over that we have more time than we realize. They are absolutely correct, and I want to improve in this area in the years to come. When I’m working, I want to be completely focused on it rather than making a half-hearted stab at the material and taking triple the amount of time necessary to learn the material. When I’m not working, I want to be fully in the present, guilt-free, and not worrying about getting back to my schoolwork. I also realized I need to work on reaching out to people and planning things. The people are there and if I would just take the time to plan ahead or ask people if they want to hang out, I think my social cup would be filled much more often. At the same time, I need to learn to be more spontaneous. I only went to Jerusalem a couple times this entire year. Less than a 2-hour bus or train ride away from Be’er Sheva, this is just sad. There are so many things I want to see and do in Jerusalem, and I need to stop waiting around and just do them. There is never going to be a perfect moment or opportunity. Another one of my greatest disappointments this year is my Hebrew. I started out learning quite a bit and putting some time into it. But as the weeks went by, and I convinced myself I was too busy, too stressed, too tired, I petered out. I have witnessed the importance of language, and I truly want to learn Hebrew while I am there. One of my goals for the rest of the summer and next year is to be intentional about setting time aside to learn more Hebrew.

Now that I have gotten some of my shortcomings out of the way, there were many highlights. My favorite part about living in Israel is all the wonderful people I have met. I have said it over and over, but I’m going to say it again. I am so blessed by the community surrounding me. The Christian community is incredible and encouraging. I love my classmates. My roommates are wonderful. My basketball friends are really fun and always so inclusive. I could go on and on listing people. Even more so, I am constantly reminded by how intentional my community in the states is and has continued to be. They love me so well, and I could not ask for better friends. Also, I think I went on some wonderful adventures this year. Not as many as I may have expected, I saw some amazing things and learned a tremendous amount about the culture in Israel. I learned what it feels like to be in the minority and not fit in, which I think is a very important perspective to have. I made it through one year of medical school!!! As the saying goes, growth is happening (: and it will continue to happen.

During the remainder of my summer, I hope to publish blog posts about the adventures I haven’t written about. I’m excited to see my people during the weeks to come!! I love you all!!