The 3 Biggest Challenges of Medical School… and how to overcome them

In CaRMS Guide, Mentorship by Anton Gervaziev11 Comments

Getting into medical school is hard. According to recent statistics, both applicants and University enrollment have been increasing. medischool hardThe desire to become a doctor is at an all-time high and many claim that the hardest part of medical school is actually getting in. Whether or not that statement is true remains debatable. This article aims to give a short list of the hardest non-clinical struggles medical students have. As a subjective piece, some aspects will be omitted, and you are welcome to further the list in the comments below. So here are the 3 biggest challenges of medical school… and how to overcome them.

1. Medical Terminology

Daunting at first, the textbooks are ridden with words that look like they require a degree in Lexicology just to pronounce. Medical dictionaries the size of a Russian classical novel petrify freshmen in the libraries- and rightfully so, with over 250 roots, dozens of prefixes and suffixes – the combinations are plentiful. Yet everyone
agrees that knowing the vocabulary of medicine is absolutely crucial to effectively practicing the craft. Medical terminology is about as complicated as a language

Fortunately, it has rules that can be utilized to your advantage. Breaking down medical terminology to its building blocks will aid in formulating the definition, rather than just remembering it. A tried and tested method is flash cards – never underestimate their usefulness.

2. Workload

In addition to the highly complex, long and seemingly abstract terms, the volume of information students are required to know is dumbfounding, especially in the first two years. Having to learn most of human anatomy, pathophysiology, pharmacology and microbiology is a daunting task. In the moment, you may feel terror in your heart as you complete peer-medical termsreviewed presentations, clinical exams and worst of all – written exams.

You need to remember that others have gone through what you are experiencing. And they survived. Find out how. Ask third year and fourth year medical students how they prepared for exams. Did they approach the tutor directly? Do any of the lecturers share useful information in office hours? How were the hardest exams passed? You can follow my example and use post-it notes around the apartment. In my first year, I found that study groups were very helpful with the complex concepts. In addition, I would recommend that you take full advantage of different learning methods. Record your own voice, join discussions or watch online videos – whatever you deem best.

3. Motivation and Burnout

Remember the question “Why do you want to be a doctor”? Now if you look at yourself in the mirror – sleep deprived, tired, unmotivated, not having seen your family and friends for what seems to be eons – and you have difficulty answering that question, you may be suffering from burnout. Ishak et al. (2013) have found that more than half of all medical students will suffer from burnout. It is a serious and complex problem. Contributors include lack of appropriate mentorship, poor exercise habits, unhealthy diet, lack of sleep, lack of autonomy, stress in the work place, exposure to trauma etc. Most often it is a combination of issues. According to the AAMC the 4-year graduation rate is at its lowest rate, 81% in 2009, and has seen a continuous decline in the last 30 years.


With all the work you are expected to do, the pressures you feel from everyone around you and especially from yourself, it is easy to go into a state of overdrive. Talk to your friends and family. Often they will be the first to recognize that something is wrong. Listen to them when they are concerned. If you think it is appropriate, contact the student help center in your university. Never forget – you are the future of medicine and people care about your wellbeing. I cannot stress this enough: you need to care about your wellbeing first and foremost.

There are a few things that one can do to prevent burnout:

  • The first is related to motivation. I can suggest that you search for motivation from within. The BoringEM series #DearPreMed highlights the importance of ensuring that your motivations for medical school are intrinsic. As one of many studies suggests, intrinsic motivation is more lasting and brings about better results as compared to extrinsic motivation. The ALiEM bookclub discussion on Drive also focused on intrinsic motivation. Find out what excites you and what makes you happy about getting up in the morning or on the wards. Then find ways to be involved in those things.
  • Seek out mentorship. Find someone who can help you when times are tough or when you need to talk through a case and to keep you on track when things are going well.
  • Sleep well. Eat well. Work out. Laugh. Love. Don’t forget to take care of your body and to fill yourself up with friends and family. Schedule these in. Make them a priority.

Bottom Line

Getting into medical school is hard. Surviving the first 2 years of medical school is hard. Graduating from medical school is hard. But doctors have the privilege of caring for patients. That is not a responsibility that should be taken lightly. So yes, becoming a doctor is hard, but it’s also incredibly rewarding. Remember to find ways to feel those rewards every single day.


Reviewed by Eve Purdy

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Anton Gervaziev

Anton Gervaziev

Anton Gervaziev

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BoringEM has been 'bringing the boring' to emergency medicine since 2012. In 2016 this Canadian blog brought its content to CanadiEM.
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  • Nadim Lalani

    don’t forget that the skills that got you there are transferrable. e.g. in premed i had a weekend study group…we’d get together in a board room and use the white boards to teach each other. I carried this practice through into med school – with success!

    • Eve Purdy

      Very true Nadim! We did lot of group work and learned about team functioning in undergrad, has certainly paid off in medical school!

  • Leaby

    I disagree regarding the perceived difficulty of medical school. Yes, the workload is high, but is comparable to the workload in many other professional programs. The volume of information to be learned is substantial, but most concepts are straightforward, making the challenge of learning more one of determination and persistence rather than abilities in abstract thought or comprehension. I think the biggest challenge in medical school is learning how to become an effective clinician able to negotiate the complexities of an overburdened and inefficient healthcare system, and not become emotionally or professionally depleted in the process (alluding to challenge #3)

    • Hi Leaby:
      For different people there are different levels of difficulty. What is easy for one person, may be very hard for another. Hard to generalize, but I support Anton’s supposition that for some – it can be a huge challenge.

      I’m really glad that you had an easier way through medical school. I, myself, found it actually quite difficult to translate what I learned in books into pragmatic bedside application. In fact, basic science and it’s need for bedside usage still largely evaded me until some time in PGY5 when things suddenly clicked…

      The pieces from pre-clerkship, from deep dives in PGY5 coalesced into a mental map that finally made sense when I was standing next to patients in the department! I must say, however, that mid-way through clerkship or sometime during residency, I would give pause to say that the material was ‘straightforward’.

      • Leaby

        Teresa, I think you hit the proverbial nail on the head. A person’s experience of med school and the associated challenges are subjective and individual. Therefore, I think this article should come with a caveat that the three “hardest non-clinical struggles medical students have” represent the personal opinion of the author of the article and are not necessarily reflective of the sentiments of the majority. I think if one surveyed med students you would find a spectrum of answers of what students would consider to be the primary challenges they face as learners, which may or may not include the relative ease/difficulty or workload of the medical school curriculum.

  • Gerhard Dashi

    Hi Anton,
    Thank you for this piece. I agree with you, especially on number 3.
    As a second year medical student, I have also noticed 3 additional challenges:
    1) Soon after starting medical school, for many, the initial relief and joy is replaced with insecurity and guilt when taking time off, especially when they find out what their peers are doing. I think this relates to a number of things, but especially the competitive, high-achieving personalities of medical students and their fears about CaRMS and residency.
    2) A major source of stress also comes from having to decide what specialty to pursue and trying to determine whether or not they are competitive candidates for that speciality. Many students start worrying about this from day 1.
    3) Finally, for some, frustration comes from not being able to choose where they live (during med school or residency) and from not being able to make major life decisions, like buying a home or starting a family, due to the unpredictability of their location and occupation.
    I think a lot of students come into medical school expecting answers and security and may have trouble (at least initially) accepting more questions and uncertainty.

    Gerhard D.

  • Great post.

    I would also add that many students who struggle with the workload also struggle with how best to study/manage information. A tool that has worked for me, and for many others, involves spaced repetition flashcard software such as Anki or Quizlet.

    You can make your own cards, or pull from decks others have made, to keep track of all the things you need to know in one easy place. As a plus, this system helps you to feel accomplished after studying, as most of these programs set study goals for you each day; when you see you’ve achieved your goals, you can feel satisfied that you are making solid progress in what an sometimes be an intangible and abstract process.

  • I found that the hardest part of medical school for me was keeping things in perspective. Sure, I shadowed a little bit before medical school. But if I could go back in time knowing what I know now, and seeing the things I’ve seen in residency, medical school would have been completely different. Sure, it was tedious, and I knew we were building the foundation for our knowledge, but back then, it was all fluff to me. And I was sort of right. Do I really need or even remember that Biochem I learned first year? No. But looking back everything now, medical school really was about building that subconscious knowledge base, but even mores than that, building that work ethic. I burned out and flamed back on more times than I can count back in medical school. It was the former EMS guys or the people whose parents were doctors that seemed to have that consistent motivation. I think the reason that were able to do this is that they kept things perspective. It wasn’t about the destination and the diploma, but the journey of a thousand textbooks to get there.

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  • sera

    I am not a fan of group discussions and I’ve made it this far ( medical school first year ) largely by self study. Are there chances of me succeeding with the same technique or am i fooling myself

  • Mohammed Sikandar

    Looking back now as a 4th year med student, I totally agree with you.. Managing burnout was the most difficult for me, personally.

    Great article! I’ve mentioned you on my post about medical school interview questions and how to answer them. check it out! 🙂