You CAN Do It: Guide to Navigating Pre-Med in College
If you only read one post on this blog, it should be this. The guide in front of you reflects the central purpose of Cells and Surgery - to empower STEM trainees and aspiring physicians/investigators with free resources that better equip you to pursue your dream. Doing a pre-med or pre-MD/PhD track in college involves a lot of moving parts that can feel very intimidating. I developed this post to highlight broadly applicable points I think could have a critical impact on your pre-med training. What you won’t find in this guide is more technical studying advice specific to your courses or that covers extremely common questions such as those about medical school application or MCAT requirements. This is because there are other sources of information more specific to you that are better for addressing those kinds of questions (i.e. your academic advisors and fellow students for questions about specific courses), and because those questions have been so thoroughly addressed by other pre-med resources and STEM communicators that I have nothing of substance to add that hasn’t already been said.
Instead, I want this post to be impactful far beyond any advice I can give for organic chemistry or timing your MCAT CARS section or how many letters you need for med school applications. The most powerful impact this post could ever have is helping you realize your human potential. If you are able to recognize the power of human potential and understand that you have just as much of it as any other person, you will begin to understand that you are capable of much, much more than perhaps you thought possible, and this will allow you to plunge into rigorous training and embrace the incredibly steep learning curves that accompany your journey. This will also allow you to look some of the misconceptions in pre-med straight in the eye and refuse to be bullied out by them, recognizing that it is not an uninterrupted stream of flawless achievements that will make you a great doctor, but rather a fierce commitment to growth.
You are an unimaginably complex neural network of experiences, curiosity, and potential, capable of ideas and solutions that will not appear a second time in this universe. If your heart is lit on fire for medicine and research, then your future patients - and possibly the entire world - need you more than you know, to believe in yourself.
Let’s dive in.
Growth Mindset + Constructive Internal Monologue
In medicine, there is an immense amount of responsibility over the lives of patients. Committing to accept this level of responsibility over living peoples’ safety, their physiology and anatomy, their wellbeing, under high-stakes, high-complexity circumstances is not a ‘reasonable’ goal. Thus, I believe that to pursue medicine, you must be an unreasonable person. Those are my favorite kind of people. In order to grow into the person that’s going to shoulder this level of responsibility, you will need to continuously reinvent yourself over and over as you move through your training. The ideas about fixed limits and how much effort truly constitutes trying one’s best that are sometimes casually tossed around in other areas of society do not suffice here. This is not to say that you aren’t just as human as anyone else nor that you should ever put so much pressure on yourself that you enter a miserable or unsafe place in your mental health - you are a treasure in this universe and the value of your life is not contingent upon anything. What I’m saying is that the importance of the responsibility that you are signing up for in medicine necessitates that you put aside misguided ideas about fixed limits and you commit to learning, growing, and being teachable on a scale that is going to bring you further than you know. It does not matter where you’re at right now. If your heart is truly called to medicine, you have everything you need. The most powerful tool in the universe is at your disposal - human potential - and with that, you can learn everything else. You must become a person who is ceaselessly committed to growing - who looks for lessons and improvement everywhere - who doesn’t use the phrase, “I’m just not good at ___ so I’ll never be good at it.” I promise you, you can learn it all. It’s not going to come easily. But it is going to be worth it. As you do it, you also owe yourself the same compassion you’ll someday give to your patients. You need to hold yourself to high standards and push your limits, but also derive your fulfillment from the process of doing this rather than from specific results. Mistakes and failures are guaranteed. If you aren’t making mistakes and experiencing failures, you aren’t reaching high enough. Instead of thinking “I’m not good enough” think to yourself, “I know I’m capable of more, yet I also give myself grace and compassion as I commit to the difficult journey that is trying to do great work.”
Approach to Studying/Learning: You Can Learn Anything
Even the most complex concepts in science are large combinations of extremely simple ideas. You need to train your brain to encounter problems, challenges, and questions that throw a bunch of information at you, and first to fight off the panic reflex where you’re overwhelmed and don’t know where to even begin thinking about the information, and instead systematically reduce that hurricane of information into smaller little chunks of simpler concepts that you do understand. You probably need to slow down in order to speed up. Particularly in the age of information overload and scrolling, attention spans are under threat, yet complex scientific concepts don’t care whether you have the attention span to understand them. As you’re reading from your textbook or watching lecture or following a problem, you need to develop a very sharp, focused internal monologue where you ask yourself, ‘Do I actually understand what I just read? Or did I just passively skim what it said?’ You’ll know that you focused and slowed down enough to actually understand what that sentence of your textbook is saying when you are actively visualizing that concept in your head, and paradoxically, when you’re no longer wondering if you understand it or not and you aren’t thinking any other thoughts than about literally what that material in front of you says. You will also be able to apply that information to new situations at increasing levels of complexity and abstraction as you understand it better. A lot of the material in your college courses is dense, however, and it’s going to feel like a very steep learning curve. Give yourself grace and time. You’re not stupid.
Do Not Let Mistaken Ideas in Pre-Med Culture Scare You Away
An extremely misguided and harmful idea that can permeate some aspects of our education systems and pre-med culture is the overemphasis on whether a student is ‘cut out’ for something. This is an insult to human potential, and it is the opposite of a growth mindset; it convinces brilliant, passionate people who would otherwise go on to achieve absolutely incredible things that they aren’t good enough before they’ve even had a chance to realize their potential. How this can show up in education is this implied sense of ‘If you don’t understand this complex concept immediately or aren’t able to keep up in this course, then you’re not cut out for ___ major or ___ profession.” Here we see ‘weeder courses’ and an overall approach to academia that says ‘Here is the standard. If you aren’t immediately at or above it, you’re out.’ You may encounter some peers that have internalized this and derive their sense of self from their ranking in this system, who brag about their accomplishments. This can create a suffocating environment where there is so much pressure to perform, where the highest scorers and the students who seem to instantly understand the material are often showcased and talked about with great pride, further implying that students who aren’t amongst them just aren’t good enough. The underlying assumption here is that these metrics and academic courses are these objective things that immediately indicate someone’s lifelong potential and intelligence. So if you’re not immediately a star, you never will be, and you should pack up and move out. This is completely false, but particularly as a freshman, you may be in an echo chamber environment where it feels real. Please, please, please, if medicine is your passion and it is your dream to help patients, do not allow this to convince you that you aren’t good enough. Do not let a tone-deaf pre-med advisor hooked on grades/test scores convince you you won’t make it. This can be incredibly daunting. But I promise you, there are so many people in medicine, with power, outside of these environments, that WILL see your potential.
I’m not saying that you can bomb your coursework all the way through and come out with the skills and knowledge necessary to be a physician. Aside from the inequities and misguided aspects of academia, yes I think your academic training is incredibly important in order to prepare you to handle the intellectual and scientific aspects of being a physician. What I’m saying is, you don’t have to be a prize stallion right out of the gate. Your academic performance at 18 or 20 years old does not determine your potential for how much you will grow in your later 20s, 30s, and 40s and beyond. If you do have some failures and setbacks, what’s going to make all the difference is what you do in response to those. You are going to eventually need to make major strides and leaps in your academic abilities, because these ARE important for learning the information you need to learn to be a good physician, and a major component of that is the ability to take in diverse and complex information, synthesize it, and apply it in complex ways to solve problems. However this is a learnable skill! So in the next section I’m going to discuss what I think is the single most important skill in all of your STEM courses, MCAT, etc., that can transform anyone into a star student.
Method for Understanding Any Concept in Science and Medicine
There is no such thing as a complex topic in STEM. There are only combinations of extremely simple things. This is how I recommend you approach the material in your science courses. This mindset has the potential to save you from convincing yourself that you’re a stupid person (you’re not!) if some complex thing doesn’t immediately click for you. There is a very damaging misconception in academia that I think fundamentally arises from a miscalculation about how well the root concepts feeding into some more complex one are understood. Let me explain. For a professor lecturing on some complicated topic, they may have been studying that topic their entire career, and so the root concepts - the simple little blocks that add together to make that complicated thing - may be so obvious to them that they forget to incorporate them into what they’re saying. For the writers of a peer-reviewed scientific publication, there are TONS of assumptions made about readers’ background knowledge and understanding of root concepts from which their entire manuscript draws upon (which is actually a major problem right now in scientific literature becoming too specialized/siloed and being written only for audiences of fellow experts). Even for your peers, you don’t know their background understanding of the simple root concepts that go to create the more complicated one. And so in all these situations where your professor understands the root concepts but isn’t emphasizing them, the scientific paper you’re reading assumes an understanding of the root concepts, and many of the high-achieving students have a more solid footing with the root concepts than you’re aware of, the outcome is that you feel stupid when you don’t immediately understand that complicated thing.
Yet you may also notice that the best lectures from the most skilled professors actually feel simple, even if they involve sophisticated topics, and this is because your lecturer is doing a good job communicating a logical progression that allows your brain to routinely pause and think “Yeah that’s simple! That makes sense.” They do this iteratively, feeding you simple little blocks of information and visually and verbally drawing your attention to the most pertinent information at the right time, clearly conveying how everything relates. They continue doing this until you realize you’re actually dealing with something quite complicated - something that perhaps you would have found extremely intimidating if the lecture had immediately begun there. Something that maybe you would have thought yourself lesser or stupid for not immediately understanding if it were presented in a more chaotic format by a poor lecturer or if you were surrounded by students who came in with more understanding of the simple building block components of that complex thing, and thus were still able to excel in something you found confusing. I believe that 99% of the time in situations where you’re getting a fair question and you feel stupid for not understanding something, it is because you aren’t able to connect simple building blocks of root concepts together - it is not because you are stupid or lack the ability.
As I make these points, I also don’t want you yourself to fall into the trap where you just blame all of your professors and courses and external factors for not knowing something and never actually take ownership of your education. What I’m trying to do here is acknowledge some of the raging deficits in our education system and areas where you might trick yourself into thinking you’re not good enough to reassure you that you aren’t stupid. Ultimately, you DO need to accomplish a lot of learning and academic growth in your pre-med journey, and I’m trying to set you up here to realize that though the playing field isn’t always equal, you have enormous potential, and I believe the single most important academic skill in STEM courses, MCAT, and beyond, is the ability to systematically approach complex material by deconstructing it into a bunch of simple things that make intuitive sense to you that you can then think through, apply, and manipulate easily. And fortunately, this is a LEARNABLE skill! You can teach your brain to do this! Below I’m going to outline my method for doing this - whether it’s in a textbook reading, an exam question, an MCAT passage, a medical school lecture, a peer-reviewed scientific publication, etc:
SLOW DOWN and focus
Identify exactly what you’re confused about or where you’re tripping up
Seek out an understanding of what you identified in 2) as the root cause of your confusion, often by going simpler
Recognize when your understanding is ‘good enough’ and then keep moving
Repeat.
The end result of this is that your brain should understand that sentence or passage or figure in front of you as a combination of simple things interacting. Invest the time to actually understand everything in front of you. This will likely mean slowing down WAY more than your preconceived notions might tell you, but this is what it really means to allow concepts to sink in. At the same time that you’re slowing down and correcting your points of root cause confusion, you also don’t want to go TOO deep into that correction where you start to go down rabbit holes, and this is where your ability to recognize when your understanding is ‘good enough’ becomes crucial. This is a difficult skill to master and takes years - I believe it’s one major aspect of the steep learning curves in STEM in college. On the one hand, you’re likely in challenging courses that are hammering into your head the importance of details (think significant figures, lewis electron structures, etc), and to a first approximation I think this is good because details are VERY important in nature, medicine, and research. However, I also believe professors and classes can go a little overboard with this where the curriculum degenerates into such a high density of trick questions that it discourages students. The other thing this can do is create SUCH a strong emphasis on detail that students are unable to stop chasing details and zoom out to see the bigger picture when they need to. This latter skill of consciously deciding to oversimplify something and say ‘good enough for my purposes’ is equally as important as being able to appreciate the nuances and details that you DO need to know.
If you’re doing this right, particularly in your undergraduate education as you’re encountering lots of new topics that can be very dense, you may often need to do these entire process multiple times simply to understand one SENTENCE in your textbooks or lecture.
Routines, Study Environments, Minimizing Distractions, Time Management
You will spend an enormous amount of time studying and working as a pre-med. The environment(s) in which you do this work will have a huge impact on you getting to your dream, so you take it very seriously how you select and design your study environments. Your physical environment when you’re studying can have an enormous role in your focus, as well as the amount of excitement you feel to settle into that environment for a nice long study session. So find those places for you. Make the library your second home. Discover your love for coffee shops. Create your own map of secret study nooks on campus. Make your study space at home into a productive and cozy haven that you LOVE to be in, even when you don’t want to be studying. Home life is crucial. If living with college roommates, their own habits and behaviors can significantly impact your lifestyle. If living with family, same thing. Although different people have different relationships and obligations to who they live at home with, reader know that anyone who is a healthy and supportive presence in your life should understand and give immense respect to the amount of time that you need to spend focused and are thus unavailable or other things. Do not tolerate people who don’t understand nor respect your dream.
There’s another elephant in the room when it comes to a productive study environment: your smartphone and social media. It’s not a conspiracy theory to state that social media is literally designed to hook your attention as much as it possibly can, and so I would argue that you need a solid strategy and habits by which you remove these things from your environment, as the instant gratification of scrolling can rob significant amounts of time that truly you wanted to be studying for. Utilize options like parental controls on iphone to set a time limit for specific apps, and web browser extensions like StayFocusd (https://www.stayfocusd.com/) to block any and all specific sites that will waste your time and you can set specific hours and time limits, etc using these tools. Or, you could not use social media altogether; our brains are designed for living in communities, being outside, and having face-to-face interactions, and you’re going to spend quite enough time looking at screens already through studying, so scrapping the social media accounts altogether can be a great choice! Also if you can, try to put your phone in a different room altogether when you’re working.
Do not promise yourself that you’ll study ‘when you have the motivation’ or get into the habit of saying ‘I would only be ready to study if ___’. You need to learn how to recognize when excuses or procrastination is occurring - and you’re a very bright person so it may be extremely subtle because you are good at tricking yourself. You also need to realize that your habits, your level of performance, and your success, is MUCH more defined by what you do when you DON’T feel like studying/working etc, versus when you have the motivation. Teach your brain to recognize that the more you don’t feel like doing something important that you know you can otherwise do, the more important this moment is right now to do it, because this is building your habits and training your brain to perform when things are difficult. That ability to focus and to perform is going to be crucial in getting you to your dream. But it’s not easy. It is in fact very uncomfortable. It sucks. You’re not going to be perfect at it. But if you simply recognize this challenge and the importance of working on your habits and responses when things are difficult and uncomfortable, you’ve already taken an enormous step. You can grow all of these things. They are not constant. You can train your brain to shoulder increasing responsibilities. Additionally, if you can make these things fun, if you can make them easy for you to do, then performing when you need to perform is going to become more and more natural. The book “Atomic Habits” is worth your time reading, as it elaborates greatly on how to arrange your living circumstances and physical environment and plan your day in a way that programs your brain to default to doing important work that matters to you.
Finally, be very specific and intentional with yourself about which times are study/work times, and which are for doing other things. Try to adhere to a daily schedule of study times that allows you to obtain good sleep and also is a realistic (read: large) amount of time for you to actually accomplish the many things you’ll need to accomplish. You can and should also protect time for fun and socializing with friends, but again be intentional about this. When it is your study block time, study. When it is your fun time, have fun. You won’t be perfect at this, and there are lots of things to do in college and lots of things that can potentially interrupt this balance, and don’t hold it against yourself too hard. These sorts of habits can be cultivated over months and years. You don’t need to have it all together overnight.
Taking Initiative and Departing the Well-Worn Path
There are many aspects of your pre-med journey that must be self-initiated. Yes, internships and structured programs can be great opportunities, but don’t be fooled by the many pre-mandated requirements for pre-med training into thinking that everything you do must be an internship or structured program that already exists with a neat little label and category. There’s no rule saying you can’t try and launch something of your own. Think about your passions - or if you haven’t identified them yet, areas where you’re curious. Think about experiences or parts of your identity from your past or present that you value - they don’t have to be clinical - and you might be surprised at the ideas you start coming up with for new ways to apply your areas of passion. There’s no limit to the medical or research faculty or community organizations you can reach out to with your ideas. Try to regularly block off time simply to search for opportunities of interest to you, send emails expressing your interest, and put yourself on peoples’ radars. Who knows the work you could be doing or new areas you could be exploring if you simply decided to, at times, depart the well-worn path, and venture into settings or experiences where there isn’t this immediate categorization of that activity or payoff, and you’re being purely guided by sheer curiosity or passion. The only way to do truly great work is to love what you do. If you find things you’re truly passionate about that illuminate aspects of medicine and research that light your heart on fire, then your coursework, MCAT, etc., will take care of themselves.
For me it was spending significant time in roles that got me into trauma stabilization rooms, operating rooms, ICUs, and research labs. These places are where I heard my calling into medicine and research, and they motivated me to push very hard in my coursework and training.
Research
Particularly if you want to do an MD/PhD program, or if you know you want to do significant research as a physician, finding an undergraduate research lab is a CRITICALLY important decision for you to make, and one that you should dedicate significant time and strategy to making. I have a guide to help you approach this task and all the factors I believe are important for you to think about here: https://cellsandsurgery.com/blog/finding-the-right-research-lab-as-an-undergraduate
Clinical Experiences
Let me start by saying you are worthy of teaching. Let me say that again. You, as a pre-med student, are worthy of teaching. So much of the time it feels like during pre-med, you feel like a bother, or you feel guilty, about asking things of people. Yet YOU are the one who’s signing up for a career that provides a critical benefit to society, and you’re at a requisite early step in this long journey where you aren’t yet an expert clinician. People should be pouring into you. Seek out clinical experiences where you are genuinely valued, and ideally where skilled healthcare providers can provide you with direct teaching. You’ll know you’re finding the right clinical experiences/areas when you leave them feeling energized and motivated to study, because you’re directly witnessing the ultimate objective that you’re working so hard in the trenches of pre-med for! I’m working on a post about how to approach seeking out clinical experiences as a pre-med, what constitutes quality experiences, what to avoid, and how to find good physician and physician-scientist mentors. Stay tuned.
Building a community and network
One of the beautiful things about medicine is that it is a GLOBAL system that safeguards human rights, and medicine is best when it is carried out by an incredibly diverse breadth of individuals from all backgrounds, with a myriad of life experiences and perspectives. It is an incredibly fulfilling and bonding experience to work with other people aspiring to medicine/research who feel similarly passionate to commit their lives to this field and safeguard the rights/health of all human beings. Find people like this who inspire you, who may have stories or backgrounds different from your own, and establish a team with them. You can support and carry each other further than you can imagine. One of my favorite quotes, from an African proverb, is, “If you want to go fast, go alone. If you want to go far, go together.”
You also just might meet the love of your life!
Protecting Time to Plan Out Academic Course Requirements
Navigating the pre-med path is academically complex. You should be meeting with your academic advisor at least once or twice a year (and your college should also offer drop-in advising so that during those times in your training when unexpected changes occur and you need advising/support urgently, you can get it rapidly). You should also be blocking off times at least once a semester where you can exclusively focus on mapping out when you’re going to take courses, understanding the course requirements for the majors/minors/additional tracks you want to pursue, and creating Plan A, plan B, etc to achieve those. You also don’t know what you don’t know, and I think many opportunities can be missed simply because you never knew they existed, for academic tracks or courses that you otherwise would have loved. Be VIGILANT about knowing the exact dates in which you are allowed to register for courses for the following semester, as the dates/times of specific course offerings may fill up very quickly if it’s a large course required for many people at your college. And this actually happens the other way around as well! If it’s a smaller upper-level course offered to people further along in the major, there may be less spots altogether, so that may fill up quickly as well! If fulfilling your degree requirements depends on you getting that Monday Wednesday Friday 9:05-10:10 section of Biology 1055, try to make sure you get it! If you’re really having trouble and there’s truly a class you NEED to take a given semester but it has already filled or there’s some very small time conflict occasionally with it, communicate. It never hurts to ask! Email the course professor - or better yet, if you have a good academic advisor who’s genuinely invested in your success, they may be willing to make some phone calls or send emails themselves to try and magically find a way to squeeze you in if they understand your need. This will not happen if you don’t ask, however. Finally, embrace the fact that your academic course roadmap is going to change! You’re going to find new courses you’re especially interested in. You’re going to hear from students to avoid taking _ course at all costs because it is a universally horrible experience, and you should indeed avoid that course! Your college may open up new courses as you get further into your education that didn’t even exist when you were a freshman. My own academic course roadmap changed every single semester I was in college.
Finding Mentors
If you’re at a large university I guarantee you there are highly accomplished, successful, and KIND senior pre-meds. Find them. Ask them to get coffee and ask for their advice. Don’t act entitled to their time, but also don’t feel guilty if you feel like you have nothing to give back as a mentee; they were in your shoes, and they should want to pour into you to pay it forward to future generations by simply giving you advice.
There’s no rule saying you can’t ask medical students for some mentorships meetings at a coffee shop either - however, if you don’t take initiative, they aren’t going to reach out to you! With all of these interactions, be respectful and courteous.
MCAT Preparation and Applying to Medical School
There are lots of considerations for these things and you should seek out experiences and information from groups, events, and resources like the one you’re reading so that as you move through college you increasingly understand what you need to be a strong applicant. There is a massive abundance of these resources online. Learn about these things and be aware of them far in advance, but do not fall into the common trap of overly obsessing about them. To avoid this spiral, you need to have trust and confidence in yourself that as long as you’re aware of and meeting the benchmarks you need to be meeting, then you can and should focus on being you rather than being the idea of you that you think med schools most want to see. Trust that if you’re you and you’re meeting the basic requirements for medical school, someone is going to believe in you.
Yes You Can Still Go Out and Have Fun
Being pre-med is one of the most demanding academic tracks you can pursue. Even so, yes, you can still intensely focus on your goals each day or most days, and also go out and have other kinds of fun! The more you can establish routines, study habits, time management, and environments that allow you to be productive in your academic coursework (the most important work priority for you as a pre-med), the more this may actually free up time for you to go out and do other stuff. The one way in which I think you should be strategic about this is to be very deliberate in how you plan your study time and fun time. Be realistic in this plan, but commit to adhering to it, especially when you don’t feel like it. Map out in a weekly calendar when you’ll need to be in class, commuting to class, eating, sleeping, etc., and how much time you realistically need to block off for focused study (likely a large amount of time). Then, protect other times for you to go have fun and interact with friends! You are young and likely living in close proximity to lots of other people and friends your age - there will probably never be a time like this for you again, so go have some adventures!
Failure and Resilience
Give yourself permission to make mistakes at all the above. It is cliche but true that we can often learn the most from our mistakes. Response to failures and setbacks is actually a critical training experience for aspiring physicians, as it is preparing you to handle extremely challenging clinical scenarios where patients’ lives are depending on you and entire teams of providers are looking to you to stabilize situations. Would you want to put your life in the hands of a doctor who had never experienced unexpected setbacks or failures and had to keep pushing through them? These experiences of failure can be very disorienting, they can make you question things, and they just simply suck, but if you can recognize even a little bit as you’re going through them that simply your decision to keep moving forward despite them IS training you and qualifying you to be a physician, then you are reclaiming these experiences as growth, and there are many people in medicine and on admissions committees that will recognize the value of this.
Trigger warning: Suicide
Mental health challenges, burnout, and suicide are far too much of a problem across every stage of medical training for me to not discuss them here, because your life is the most important thing. Being pre-med and moving through academia is one frame of reference by which you could experience the world, and especially if this is 100% of your circle and life and peer group, it can be really difficult to imagine living your life any other way. But you are a human being, and there are a vast number of additional ways in which you could lead a happy and fulfilling life in this universe, and even if that’s hard for you to see in a moment of deep hurt, please believe it. People who treat you terribly can be replaced with people who treat you with love. Experiences and environments that make you feel awful can be changed into those that give you joy and life. Please know that your life is an unconditional treasure, that you are loved by many people who have never met you and probably many that have, and that it would be a tragedy if you lost your life. If this journey is threatening your health or safety, please, seek help. It might be the hardest thing you ever do, but you have to do it. You are NOT weak for leaving this field and it should never take your life, so if it’s threatening your life, you have to escape. There are so many people out there that will understand the courage it requires to seek help, who will pour support and love into you, and you will find a different path in life, where your future self speaking back to you now would say, ‘You can’t imagine how much better it gets once you seek help.’
Call or text 988 right now to speak with a crisis counselor.
Closing
I hope you found this guide useful, and if there’s any way I can further support your journey such as through a mentorship meeting, please reach out! I have never said ‘no’ to helping a pre-med.
