What Medical School DOESN’T Teach You

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Medical school primarily teaches you about, well, medicine. Big surprise, I know – the science of the human body, anatomy, physiology, patient care, and the other factors related to that. But becoming a happy and thriving medical professional requires much more than just a base of medical knowledge. Here’s what they don’t teach you in medical school.

 

1 | Financial Literacy

Financial literacy is vastly under-appreciated amongst medical students, residents, and even attending physicians. The belief is that since they’ll be making great money when they’re fully trained with their big boy and big girl doctor jobs, everything will work out. It’s this mindset that results in a shocking number of high-income earning physicians living paycheck to paycheck. They can never free up their time and they’re forever a slave to their job, ignorant of the basics of personal finance and investing.

Part of the hesitancy is due to the intimidating amounts of debt that the majority of medical students take on. It’s scary, and you’re already busy with so many other things, can’t you just worry about that later? Look, if you were able to learn how to manage ventilator settings in a critically ill patient or the nuances of ion transporters in the renal tubules, you sure as hell can learn some basic financial literacy. And you’ll probably be surprised how shockingly straightforward and easy it is once you get the basics down.

The reason it’s important to get started on this sooner than later is because of the compounding effect. As Albert Einstein once said, “Compound interest is the eighth wonder of the world. He who understands it, earns it. He who doesn’t, pays it.” The longer you are able to get the compounding effect to work for you, the greater its seemingly magical effect.

I recommend starting with the White Coat Investor book for a quick yet mostly comprehensive breakdown of finances as it relates to future physicians. If you’d like to go a little deeper, you can find some of my favorite financing and investing books on the essential books list on the Med School Insiders website.

The flip side of financial literacy is to understand the value of your time. Some get too obsessed with saving every single penny they can, so much so that they sacrifice the quality of their life in substantial ways.

Remember that as a medical student and residency physician, you’ll be much busier than the average person. It may make sense to skip upgrading your iPhone or splurging on fancy new shoes and instead use those funds to buy your time back through forms of convenience.

For example, when I was in residency, I paid a premium to live in a townhome near my hospital. Even though I was paying a couple of hundred extra dollars per month, this was a worthwhile expense for me, as I was able to cycle to and from the hospital, which not only saved time commuting but also helped me be regular about my cardio. There were other smaller perks too – I had a washer and dryer in unit, a garage to keep my car cleaner longer, and even had one room as an office and another room as my bedroom which improved my sleep quality. You may also find it worthwhile to spend the extra money to get your groceries delivered or even pay for meal prep services.

 

2 | Bottom-Up vs Top-Down Approach to Life

The next point is what I call focusing on a bottom-up rather than a top-down approach to your life. Given the pressure of medical school and residency, it’s natural for us to focus on the top-level items, such as performance on your upcoming exams and boards, or impressing your preceptors in rotations, or grinding on the next research project to improve your application.

The field of medicine, despite its focus on health, does a terrible job in allowing medical students and residents actually focus on bottom-level foundational factors, most importantly one’s own health. We know that to be at your own peak performance, your health is the most important foundational factor. Yet instead of actually instilling meaningful changes systemically to promote this, we get useless lip service and mandatory wellness sessions that just waste time and tell us how important it is to sleep. No ****, Sherlock, and this 1-hour mandatory session is eating into that precious time.

Since the system is broken, you must take matters into your own hands. No matter how busy you get, remember that your health is the most important thing, and should not be compromised.

There are 3 ways that medical students and residents commonly cut corners on their health that result in significant long-term detrimental effects. You may not notice the effects today or next week, but after a few weeks, months, and even years, these harmful effects will compound with time. That’s not a good thing. Sleep and exercise are the two most obvious ones, and you don’t need me to repeat those, but these 3 are also commonly overlooked:

Relationships

First, relationships! When crunched for time, relationships are commonly one of the first things to go. That’s normal, and definitely something I did as well. But remember that we need our social support systems. We need robust relationships with our family and friends to feel happy and content. We need to be connected with people we enjoy to avoid being sucked into a downward negative spiral from isolation and working ourselves to the limit.

There are many ways to make this work with your busy schedule. Have phone calls while you’re driving to and from the hospital. FaceTime a friend who lives in a different city while you’re eating dinner. Get social with your exercise and invite a friend to cycle, hike, or climb with you.

Mental Health

The second commonly overlooked category is mental health. It’s ironic how much we emphasize the importance of mental health for our patients, yet stigmatize it amongst our own.

Medical school and residency are not easy, and it’s not only ok but the right thing to do to seek out therapy when you need it. It’s okay to not be okay. By getting your mental health sorted, you’ll not only be happier, but much more effective in coping with the massive workload and stressors of the hospital and patient care.

Diet

The third and final one is diet. I get it – you’re busy and don’t have time to cook. There are still ways to eat healthy. If you eat crap, it’s natural to feel like crap. Burgers and deep-fried chicken aren’t your only options when you eat out or grab fast food. I’m always surprised how people write off a certain restaurant as healthy or unhealthy without acknowledging that there is a wide range of options. I can eat relatively healthy or unhealthy at Chipotle, based on what I order. Some of you will squirm at the idea of this, but by simply creating rules for myself, such as “I don’t eat cheese” or “I don’t eat deep-fried foods”, I was able to eat quite clean for years without temptation. It’s actually much harder to weigh the options and decide each time whether or not you’ll allow yourself to indulge. Ultimately, you end up indulging and feeling guilty more often than anticipated.

 

3 | Beware of the Societal Mismatch

There’s a wide gap between reality and society’s expectation of what it means to be a doctor. Many will think your life is easy or that you make lots of money. Very few will appreciate the fact that while most people began working and saving at 22, you’ll be graduating with additional debt and only enjoy your high earning potential in your late 20’s to mid 30’s, depending on your specialty. Not only that, but you’re grinding in the truest sense of the word for years, and that takes a toll on you.

Because of the societal mismatch, you’ll be on the receiving end of a great deal of nonsense.

In recent years, that nonsense has been most prominent in the form of creeping scope of practice. You’ll face others who want to belittle and downplay your level of training, only to elevate their own qualifications, despite them spending a small fraction of the hours you spent in learning patient care. It’s on us collectively, as medical students, residents, and physicians to advocate for our patients and their safety. I recommend the Physicians for Patient Protection, or PPP, to learn more about these issues and get involved. The direction things have been heading is insanely dangerous for patients and bad for physicians, and unfortunately, it isn’t something discussed enough in medical school.

Don’t worry, you’ll receive nonsense in many other forms too. Many female medical students and physicians are still called nurse by their patients because of antiquated societal narratives. You’ll hear more than one healthcare co-worker lament to you about their 12-hour shift, which they have 3 of each week, while you question your decision to become a doctor, realizing you average five 15-hour shifts every week on several rotations.

Despite the noise, remind yourself why you became a physician. Remember the passion that brought you into the field, the joy and connection you feel in providing care to your patients, and the vision of what your life will look like when you’re an attending physician. You have two options – become the jaded attending that regrets their decision to enter medicine, or become the attending that is realistic in understanding no field is perfect, and that medicine has lots to love.

 

4 | Don’t Lose Your Sense of Self

Amidst the madness, don’t lose your sense of self. As you progress in training, you’ll notice a greater and greater proportion of your colleagues growing cynical. As a wide-eyed premed, you’re surrounded by other hopeful premeds looking forward to what lays ahead. Over the four years of medical school, you’ll notice a larger and larger proportion of your classmates growing tired or resentful. And by residency, you’ll be the odd one out, as the majority are cynical, particularly those in their final years of training.

It’s natural for your identity to focus more and more on your role as a doctor. After all, the overwhelming majority of your waking hours are spent in the classroom, clinic, hospital, operating room, or studying. Don’t fall for this trap.

Remember you are much more than a medical student or a physician. Don’t lose touch with those elements in your life that make you feel alive and joyful. For me, it’s racing my car, cycling, and my newest obsession with tea, which you can learn all about on my Instagram and TikTok. For others, it’s travel, cooking, rock climbing, comedy, or playing an instrument.

You don’t find time to do these things. You have to make time. Without doing so, you’ll find your identity sucked into the abyss, only to be spat out the other end as a shell of who you once were.

If you enjoyed the content here, you’ll love my weekly newsletter. In it, I share my insights, tips, and strategies that will make the process of becoming a doctor that much more manageable. You can sign up at medschoolinsiders.com/newsletter.

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