What do you REALLY want from Med School?

“Education is not preparation for life. Education is life itself.” ~ John Dewey

A few days ago I was talking to a second year med student about tests. She told me about a major test she took as an MS1 where she scored a 95%. A 95%! She was ecstatic, and felt proud of her accomplishment. She had studied hard and felt that the result was a good indication of the effort she had put in.  Then…she looked at the class average…it was 96%. Well… all that good feeling went down the drain. Where she had felt pride and accomplishment, she now felt dejection and insecurity. In undergrad (pre-med), grades can mean a lot, not just because they’re needed for a good application, but they also offer validation for one’s identity as a student. For many medical students, they took pride as pre-meds in being “above average” in terms of grades. However, once you take all the “above average” students, and bring them together in medical school, it’s STILL a matter of necessity that 50% of the students will be below average, but does that make them poor students? OF COURSE NOT. In terms of academic ability, medical students are still an elite class of students, regardless of how their grades compare among peers. I’ve seen a lot of students suffer because of a laser-focus on performance (i.e. grades). They still saw and defined themselves mainly as a function of their grades. They carried with them, the pre-med mentality, not knowing that the rules have changed. Of course, med school is not going to punish you for getting good grades. The real punishment comes later in life, once you’ve taken the pre-med mentality into residency, into fellowship, into practice, and made it a central fixture in your life. You will look back at how you’ve treated med school as a hoop to jump through, and then the next, and then the next, until you realized that you’ve missed out the on the meaning of these (potentially) wonderful experiences in your life. So what do you REALLY want from med school?  I was involved with a project at the University of Utah recently where we explored the question, what does a student really get out of higher education? Of course, you get a diploma, a piece of paper…that’s nice. This piece of paper does allow access to certain opportunities. In the old days, this paper was enough to guarantee at least a comfortable life. Not any more. So if the paper, which is getting more expensive by the year, doesn’t guarantee a comfortable life? What is its VALUE? That is, if you paid money for this schooling, what do you want for the money that you’ve paid? The conclusion was that you really want four things.

• You want RELATIONSHIPS
  • You want to make friends
  • You want to have great mentors
  • You want to belong
• You want to MASTER KNOWLEDGE AND SKILLS
  • You want to acquire knowledge
  • You want to learn about things that you are curious about
  • You want to manage yoruself
• You want ACHIEVEMENT
  • You want to do well academically (you DO want good grades)
  • You want to secure a good future (residency, job, etc.)
  • You want to have impact and make a difference
• You want SELF-DISCOVERY
  • You want to “be yourself”
  • You want to express yourself authentically
  • You want to understand yourself better

(This four quadrant model is adapted from the Competing Values Framework developed by a mentor of mine, Bob Quinn) Here’s the thing, you don’t just want the benefits of one quadrant. You don’t just want grades and burn out because you never talked to anyone. You don’t just want to ‘hang out’ with friends (and then fail to match). You don’t just want to memorize a lot of facts and fail to understand your niche in medicine. You want it ALL. ALL FOUR QUADRANTS.