[What is used to close a patent ductus arteriosus?] “…Prostaglandins??” *flips card* “Wait, indometacin? I thought–OH, prostaglandins are used to keep a PDA open, not closed. Okay, I’ll get it next time.”
[Procainamide can cause what undesirable side effect? What other two drugs cause this side effect?] “Drug-induced lupus, and… hydralazine and isoniazid??” *flips card* “Yes! Finally remembered it!”
[Heart failure and resulting left ventricular remodeling can lead to what valvular disorder?] “Mitral regurgitation.” *checks card* “Good.”
[Pericarditis after an MI can be treated with…] “Colchicine and aspirin.” *flips card* “Good.”
[Right atrial hypertrophy, tricuspid regurgitation, S3 and S4 lung sounds, and defective conduction in the right ventricle all can appear in…] “… … … … …” *flips card* “Ebstein’s anomaly. Huh. Looks like I need to study congenital heart defects a bit more.”
[What is used to close a patent ductus arteriosus?] “…Prostaglandins??” *flips card* “…Indometacin. Right. *facepalm* Next time.”
Such is life during the first two years of medical school. The first year, as the metaphor goes, is a huge fire hose, and you’re trying to grab hold as much of the water as you can. You only have a cup at first, but as the year goes on, you learn how to make a bowl, then a gallon jug, then a two-liter bottle. The second year is a bit more of the same: You fill the old jugs and bottles to the brim, and you learn to make bigger and sturdier barrels and water coolers. You do this all in the hope that you’ve gathered enough water to drink during your travels in the harsh desert of the Step 1 exam, and to ensure that you continue to make barrels and coolers of knowledge for the rest of your medical career.
…I may have stretched the metaphor too thin. Regardless, the point stands that medical students are expected to grasp a great deal of knowledge in their first two years. Coupled with that is, in some cases, a sense of ethereal theory without a connection to reality. Without a lot of ways to apply that knowledge in the real world, as you will have in the third and fourth year clinical rotations, the whole endeavor can seem futile at times, a mind-numbing churn of flash cards and diagrams and lists of symptoms.
For students currently in their first year of school, and for people now applying to medical school, I’ll remind you of this: It gets better. It is possible to keep all that knowledge in your head, especially if you remember that eventually, you’ll use it to help people. And every once in a while, a professor will say something in lecture, or you’ll read something in a textbook, and things will click. More than once last year, I looked over to a classmate, eyes wide, and mouthed, “Whoa,” blown away by how suddenly something made sense.
Those moments, and many others, will spur you to find more answers, and they will make the hours, days, weeks, and months of studying more meaningful. Those moments don’t come easily, however; it takes a lot of stewing, a lot of swimming through mountains of material, before it all starts to make sense and come together. The more time you spend immersed in the material, the more it will make sense, no matter how disorganized and mysterious it may seem at first.
