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<p>Four months ago I became a graduate student. I spent the preceding two years submerged in my medical education. It was a world of clear goals and expectations: memorize the Brachial Plexus, recite the Review of Systems, pass Step1. Everything converged on preparing me for the clinical portion of my training. To be torn off [&hellip;]</p>

My Transition to Graduate School

Four months ago I became a graduate student. I spent the preceding two years submerged in my medical education. It was a world of clear goals and expectations: memorize the Brachial Plexus, recite the Review of Systems, pass Step1. Everything converged on preparing me for the clinical portion of my training. To be torn off that path so abruptly was painful. As an MD/PhD student the change was not unexpected; I simply hadn’t had time to prepare. One week I am frantically preparing for the Boards, the next I am breeding mice and culturing cells.

In graduate school familiar objects acquire new meanings. A white coat becomes a lab coat. In med school it was a status symbol, the armour that gave me the confidence to talk to real patients in the clinic. Now it is part of my PPE—the personal protective equipment that guards me from my own experiments and from scrutinizing lab inspectors. Retroviruses are no longer disease-causing agents. Now they are crucial experimental tools. My patient care is now focused on mice: ensuring that they are healthy, breeding, and fed.

The greatest change is my independence. Graduate school is wonderfully unstructured and self-guided. I choose when to come and leave lab. I choose my research questions and the best experiments to test them. The challenge is, given the lack of explicit goals, how do I assess myself? Am I doing well?  Am I successful? Am I efficient? Medical school provides you with straightforward answers to these non-trivial questions: you spent X hours studying to get Y grade giving you a class rank of Z. There is no equivalent formula in graduate school. My new measures of success are more ambiguous: are my ideas sound? Can I articulate myself clearly? Is my experiment feasible? With less formal feedback in graduate school, I find myself brooding over these questions. And so my independence becomes both my greatest pleasure and greatest concern.

I use the following analogy to help define the problem. Imagine two bridges over a valley. The med school bridge is a narrow, teetering tightrope. It is scary to cross, but you are supported by a harness and safety net. In the back of your mind, you know that if you fall you will be caught. The graduate bridge, on the other hand, is a solid wooden plank. It feeds sturdy, but there are no safety backups: no handrail and no net. The exhilaration you feel is in knowing that you are fully on your own.

I’ve only taken a few gingerly steps along my grad school bridge and I’m excited to be independent and in control. But I know the valley is wide and I have a long way to go. I cannot help but wonder: what will I think when I reach the middle and look down below?

The views expressed in this content represent the perspective and opinions of the author and may or may not represent the position of Indiana University School of Medicine.
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Stefan Tarnawsky

MS4 MD/PhD Student. Going into Internal Medicine; interested in Heme/Onc. Bread baker, bonsai artist, aspiring astronomer.