You're a M2... You know everything (you know this is NOT true, but your non-med school friends don't)

For the non-med school people out there, let me break down the common medical education system for you.

Undergrad: Complete pre-med requisites, which include: two semesters of Bio, Chem, Organic Chem, Physics and the corresponding labs, two semesters of English, math (this varies depending on the school), and that is IT! Anatomy, not required. Pathology, nope. Micro-what!? Definitely not required. Sure, a lot of med students major in Bio, Anatomy and Physiology, or something science-y, but even then, in most cases, they know more about a plant or a frog at this point in their education than the human body. A lot of medical students do not even major in a science, myself included. Therefore, don't let us fool you. If we are undergrads, even if we know we will someday be doctors, we probably don't know anything about that weird spot on your inner thigh or why sometimes when you have a sinus infection it mysteriously switches sides in your nose.

Acceptance/Pre-M1: Yay! We are officially going to med school. This does not make us smarter than when we were in undergrad, in fact, most of us are still in undergrad at this point. We can tell people "I'm in med school," and it's technically not a lie, but we still can't tell you what that weird spot is or why your sinus drainage changes.

M1: The first year of medical school, in a traditional curriculum (this curriculum style is changing at many schools, so I am speaking from my experience alone), teaches the student about the normal function of the human body. Normal anatomy, biochemistry, cell biology, genetics. Normal human organ system function. For the most part, the only class full of pathology is neuroscience, and that feels theoretical anyway (there are how many pathways in brainstem? they cross? what? I thought nuclei were cell control centers?!). Sure, we learned about diabetes and obesity and MIs, and maybe at this point we could at least remember what lecture we could refer back to about that weird spot on your leg, but we had like 60 other derm terms to cram and all those pictures looked relatively the same. Oh! And we did learn about maxillary sinus drainage, so if you wanted, I could explain to you the anatomy about why that switch happens. But, trust me, even though we memorized over 5,000 pages of notes, attended 400+ lectures, contributed to more than 70 small group sessions, spent over 120 hours with cadavers, passed at least 30 exams, and spent countless hours studying, we still are pretty clueless when it comes to correctly diagnosing/treating something. We understand the normal, and therefore how to recognize abnormal, but not necessarily how to classify and treat it.

The one thing my Mom wanted me to learn in medical school was why her stuffy nose would switch sides sometimes. A late night study session led me to this profound answer. I called my mom at 3 am to tell her, and then I drew her a picture similar to this the next time I saw her. Guess the rest of med school isn't important! :-)

M2: This is the year spent on pathology, aka the study and diagnosis of disease. We learn how to identify it, and thanks to pharmacology, we learn thousands of potential drugs to treat it. We are totally getting closer to being a real doctor. Time is spent studying infectious disease, pathology, abnormal histology, pharmacology, and clinical case studies. By now, we should be able to recognize that vesicle on the medial side of your thigh, because we know immediately that a fluid-filled blister less than a centimeter in diameter is classified as a "vesicle." We also might be able to tell you exactly what treatment to use to help that sinus infection, and exactly why it works. Maybe there will be a pathway we can draw for you!

The Dreaded Step 1: In between the M2 and M3 year, we have 3-5 weeks to study everything we've ever learned to take the USMLE Step 1. The first of many board exams we will have to pass to continue our medical education. Are we ready to see real patients? Will we survive the wards? Fingers crossed.

Finally! First Aid in COLOR!!!

M3: This is the year we have all been eagerly awaiting! Boards are over and Hellllll Yeahhhh we get to see REAL PEOPLE! One lady even called us "Doctors" today. We couldn't stop smiling. And then our attending pimped us, crushed our souls, and "forgot" to release us until we'd been there for 13 hours, four of which we had nothing to do, so we tried really hard to look busy and avoid the questioning. Anyway, it is during this year that we do most of our core rotations, which means we spend 2-8 weeks in various specialties, and then have to take shelf exams in each area before moving on.

M4: The year of interviews. As we continue to rotate through various fields, we also have to start thinking about what we want to spend the rest of our lives doing. We apply for residency, and hopefully, we match. Right now, Match Day feels like worlds away for me. I was at the bar when the recent M4s matched, and wow, it was like they were party animals who had been chained down, buried, kicked, and left for dead, and then all of a sudden, they drank the Elixir of Life and were floating on top of the world. There were more shots taken, more attempts at swing dancing, and more yelling than any frat party or celebration I've ever witnessed (not that frat parties were my scene, one of my freshman partners-in-crime thought it was awesome to pull the fire alarm when she was drunk... needless to say, there were quite a few places we didn't feel like frequenting again).

Bring it on, Match Day! http://ezbartending.net/drink_recipes.php

Intern. Resident. Fellow. Attending. Since I'm not there, I really can't claim to know a lot about these stages, except this is the order they go in, and they supposedly get "easier" as you progress through the stages, though the responsibility increases. But, once we are here, we can legitimately be referred to as "Doctors" and we are as close to knowing "everything" as we will ever get, and if we don't know it, we know someone who does, or at least we know how to appropriately research it.

I'm an M2... I know everything (I know this is FAR from the truth, but apparently, my friends don't... and you know what? I don't mind one bit). I guess, like most med students, I have always been the "responsible" one and the "smart" one, in my group of friends, though they, better than anyone else, can definitely name times where this would be called into question. I was the one that my high school friends would name-drop if their parents weren't going to let them go somewhere. Of course, I never minded filling this role, and it still gives my ego a boost :-) Once I got accepted to med school, my friends immediately started calling me "Doc" and giving me a hard time about it - lovingly, of course. But, they also started texting me weird pictures of their body parts and asking "is this normal?" My first reaction is like "WTF, dude! Gross! Holy crap, what happened!?" But, my second reaction quickly kicks in, and I'm like, "Yay! Let me tell you all the possible diseases you could have (because I have no clue what it actually is) and all the ways you could potentially treat it! Oh, and do you want me to draw the pathway out for you (because that's about all I know at this point in my education)?" And if all else fails, I can just say "diabetes" - the M1's answer for everything. (If you are a current med student and have not seen the M1 Patient Diagnosis, worth two minutes of your time.)

Example 1: Best friend texts me a picture of right upper quadrant that looks severely bruised and injured from blunt trauma.

Me: Holy crap! What happened!?

BFF: I don't remember!

Me: WHAT!? How can you not remember that!? It looks like it hurt like hell.

BFF: Well what should I do about it? Can I still run ten miles a day?

Me: Tell me about your pain (haha, thank you clinical education course)

BFF: Well, it hurts really bad. I think I fell down on something (No, really!??!?!)

Me: When did it happen? Did you take anything to alleviate the pain? Have you tried running since your injury?

BFF: I think late Saturday night. I tried Tylenol, still hurts like a b!tch. Yeah, tried running and I cried.

Me: Well, I recommend you stop running (genius, right? Just hand me that MD right now). I know you're in training, so try some static lifting or exercises that don't involve your core. Or, go for a walk. Just take a week off so you stop agitating it.

BFF: Thanks, Doc.

Me: Or, you could go to a real doctor.

BFF: Nope, I trust you (Good choice!?!?!)

Note: BFF is okay, and completed first half marathon with flying colors. Proud.

Example 2: BFF texts me a pic of really bloody big toe with this caption "Ouch. What should I do?"

Me: Try cleaning it. Add some neosporin. BOOM.

Example 3: 

BFF 2: What's the real name for knee cap?

Me: Patella.

BFF 2: YES! Crossword complete.  

Example 4: This morning, hence the inspiration for this blog, BFF 2 texts me.

BFF 2: You can have white stuff on your tonsils and not necessarily have strep throat right?

Me: Yep.

BFF 2: It's gross.

Me: A lot of times it's just calcium build up. Maybe try increasing your water intake. (Will this help? Not sure, but I can reason it out in my head about why it might help, plus, she doesn't drink enough water anyway. Solid advice)

BFF 2: So I should wait it out? Not bother making a doc appt? Even if my throat is sore? (I give her credit for contemplating seeing a real MD)

Me: If you have a fever and your throat hurts like strep, make an appt. If you don't have strep symptoms, wait it out. Pain may be from build up irritating your tonsils.

BFF 2: Okie dokie, thanks Doc.

Moral: Since I just finished my M1 year, I know a lot about nothing and a little bit about everything. 

A few notes from M1 year.

Even though I am years away from being a physician, I still take pride in the fact that my friends contact me about their injuries or questions, no matter how weird or insignificant. Currently, I appreciate this. They have confidence in me and trust my advice, even though, I don't know if I would trust my advice at this point. I have heard a lot of physicians complain about this. They get frustrated when their fourth cousin twice removed phones them in the middle of the night asking what they think their cough means. Hopefully, I don't ever become one of these physicians. Yes, I can understand where it gets annoying. But, as physicians, we are choosing to fulfill a simple role in society: to help people. People put their trust and their confidence in us. They tell us weird things, personal things, scary things, secret things. And they trust in us to help them. To fix them. To heal them. In med school, we are all taught about social responsibility from day one. So, even if I'm an M2, and I don't know everything, it is still my social responsibility to help out my friends, even if it's only on the daily crossword.