A Guide to Swallowing the Metaphorical Medical School Elephant

Written by Telyn Peterson, OMS II, RVUCOM-SU

Medical school has been the best, most challenging time of my life; however, you may have some very rational concerns about how you’ll make it through the next four years. This guide’s intent is first to address the topic of survival while trying to swallow the Medical School Elephant (MSE),* and second to approach the same problem from a more positive angle: becoming an MSE connoisseur. The latter objective hopefully makes this quest infinitely more enjoyable for you and those around you.

If you’ve heard the metaphor of how to swallow an elephant, you know how to survive medical school. It’s as easy as breaking down the task at hand into its individual parts, deciding what needs to get done and when, staying on task, and knowing how you like to digest information. In his New York Times Bestseller, “The 4-hour Work Week”, Tim Ferris writes about life hacks and a few hard and fast rules he lives by. One of his top rules is called “Pareto’s Rule”, which is that 80% of your daily accomplishments can be finished by 20% of your daily tasks. Leaving the remaining 20% on the table may mean that you’re not top of the class, but we’re discussing survival here. While in survival mode, it’s imperative to focus on the following:

• Focus on “high yield” topics.  What will mostly likely be on the test?
• Incorporating what you love into your study (e.g. I like to ride a stationary bike and review flashcards).
• Determining how much “people time” you need away from your studies and then sticking to it.
• Sleep! Cutting back is not a sustainable way to do well.

I’ve already recommended chopping our MSE into little pieces (which most schools do for you in terms of systems or courses), but how does one digest all those little pieces when the pace is so quick? Here is an incomplete list of what I do:

• Know if you’re a top-down (big picture) or bottom-up (little details) learner, then study with summaries or flashcards accordingly.
• Discover the art of 2x speed for video lectures. It cuts the watch time in half.
• Know when to call it a day. The law of decreasing returns is real.

The only difference between surviving the MSE and becoming a MSE connoisseur is learning how to enjoy the journey, not just the destination. This is difficult for the average person like myself to do in a destination-driven world; however, I’ve discovered the key to finding more joy in the journey (and not just surviving) is a paradigm shift that I call, “The Art of Abandon”.

You see, tasks that require a controlled outcome often focus more on the results and away from the process. Medical school will challenge you daily to control each graded outcome down to the 0.1% because you want the best for your patients! This is where “giving up” becomes a fine-tuned paradigm shift. You have to abandon some control in the little details and instead, give more attention to the “why” behind those details. Here are ways I have found that work:

• I write down a vision of who I could be, who I can help, and how I could improve life around me three years from now. This is my fuel, but not necessarily my destination.
• I research each stepping stone of that vision. I know them so well that I could teach anyone each step to make the vision happen.
• I make a conscious commitment to find ways to enjoy each stepping stone on that list. This new paradigm helps me feel like I’m simply floating downstream even when life becomes difficult.
• I abandon control to the vision and just constantly shuffle my feet, trusting that I’m heading in a good direction. I find things I love about the process or outsource it to people who I trust. This way, I genuinely like everything I do and can keep going longer than most.

For the skeptics out there, this thought exercise may help. Pick someone you admire and try to decide what it is about them that you appreciate. Is it the way they act around others? Is it their technical skills? Write your thoughts down and look at them every day. Later, reflect how you’ve tried to pursue that admirable trait or become like them. You’ll find your actions will naturally follow the flow of your focus. This is the art of abandon, which is how I’m slowly becoming a MSE connoisseur.

^{*Disclaimer: No elephants were harmed in the writing of this article.}