Mastering M1: Top questions for your first year of medical school

From an M1’s white-coat ceremony though graduation day four years later, medical school is a marathon. Throughout your journey as a medical student, some key questions are likely to arise. The AMA offers answers to frequently asked questions medical students are likely to ask during their undergraduate medical training.

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The short answer is that it takes four years to graduate medical school. As medical education has evolved, however, the paths available for medical trainees have followed suit.

One option is a dual degree track. Medical students pursuing dual degrees can spend the better part of the decade in medical school. Dual degree tracks include MD/master’s of business administration (MBA); MD/doctor of philosophy (PhD); and MD/master’s in public health (MPH).

According to the Association of American Medical Colleges, roughly 10% of medical school graduates pursued a dual degree in 2023. Master’s degree tracks usually add about one year to a medical students’ time in medical school. An MD/PhD can take upwards of eight years for medical students to advance to residency.

There are also avenues though which medical students can earn a degree in less than four years, though they are relatively uncommon. Programs such as the Accelerated Competency-based Education in Primary Care (ACE-PC)—a partnership between the University of California, Davis School of Medicine and  Kaiser Permanente Northern California—offer a streamlined path to graduation. The program combines medical school and residency. It allows students to earn their MD degree in three years.

 Dive deeper:

• 1 program, 6 years: From med school to primary care practice
• Considering a dual degree? Those who did it share the pros, cons

While acknowledging that each student is going to be different, Lawrence Lash, PhD—a professor of pharmacology at Wayne State University School of Medicine—recommends studying about 24 hours per week. Dividing that time effectively can lead to early medical school success.

“We give students a suggested schedule, and I think trying to stick to that schedule as much as possible helps,” Lash said. “The idea behind that schedule is it gives direction. If one falls behind, there's just too much material to catch up. I recommend they prioritize some resources too, but it's really important to keep up with the recorded lectures, which are sort of their foundation resources.”

Dive deeper:

• Hone these good habits as an M1—it'll pay off
• 5 tips to survive first-year anatomy lessons in medical school

To some extent, new students are going to be caught off guard by those first few exams. 

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“The first exam is usually the train that hits you hardest,” said Mohammed Ibrahim, DO, a family medicine resident at Trinity Health Michigan. “A lot of people fail. After that, you understand what the expectation is and find your way to succeed from there. Once you understand the expectation and understand the style and understand how they really want you to think, exams become easier.

The best method for studying is “about using the resources that you know are going to help you, which might take some time to figure out,” Dr. Ibrahim said. “For example, some people studied through different question banks, different textbooks, different resource materials. It’s best to try and find what helps you and that’s sort of individualized. What I ended up using the most was sticking to our course materials as well as questions related to the course materials.”

Dive deeper:

• As an M1, find a studying style and remember to leave the library

Students generally take the United States Medical Licensing Examination^® (USMLE^®) Step 1 exam after the completion of preclinical training. This can be anywhere from the completion of your first year to the end of your second year.

In recent years, the exam shifted from a numerical score to a pass-fail system. The exam’s content was unaffected by the switch, so diligent prep is often the best measure to ensure one registers a passing score. As far as how to go about studying, the best method can often be to stick with what has worked for you in the past.

“It is easy to get drawn into the hubbub that swirls about from people who have completed [Step 1] and are offering 1,000 strategies,” said Pauline Huynh, MD, an otolaryngology resident at Kaiser Permanente Northern California.

“You need to find something that works for you—and you've done it before, when you studied for the MCAT [Medical College Admission Test], when you studied for the SAT or ACT,” Dr. Huynh said.  “So you know that there is something, intrinsically, that works for you. Be confident in it. … For example, I learned early on that I study better in a coffee shop, away from my bed.”

Dive deeper:

• Cut yourself slack and seek help to get through USMLE Step 1 prep
• 4 tips to maximize the dedicated Step 1 study period

As a medical student pondering your future as a doctor, choosing a specialty is one of the more career-shaping decisions one will confront. The level of patient interaction, work-life balance and the amount of procedural work one aspires to—if any—are all big factors in the decision.

One key to making the decision is to approach it with an open mind.

“Coming into medical school, you might say you want to be a pediatrician, and that's exactly what you do, and that's wonderful,” said Avani Patel, MD, a psychiatry resident at the University of Mississippi Medical Center. “But there's also a possibility that it isn’t what you love at all.

“For example, I came in wanting to do something completely procedural, where I would probably hardly speak to patients, and now I've done something the polar opposite, where it's not procedural and I will be talking to patients all the time. So I think those are important questions to ask yourself as you're going through. It's perfectly OK to have a plan but allow yourself to come out of that box because we change. People change, and there’s power in feeling that acceptance.”

Dive deeper:

• When picking a physician specialty, don’t ignore your instincts
• 5 things students overlook when choosing a specialty
• The AMA's “Shadow Me” Specialty Series
• FREIDA's Specialty Guide

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Almost every medical school will offer some sort of housing resources for incoming students. They also are likely to connect you with your soon-to-be classmates for those who may prefer or need to live with roommates.

Whatever your preferred living arrangement, finding a place to live and getting to town in advance of starting school should be priorities.

“Our orientation starts in mid-August,” said John D. Schriner, PhD, associate dean for admissions and student affairs at Ohio University Heritage College of Osteopathic Medicine. “I always suggest to folks that they plan on being moved in no later than Aug. 1. Usually, you are going to be starting a lease at the beginning of a month. My advice is if you can move in a month in advance, that is going to give you an opportunity to get physically settled into your new housing situation and acclimated to your new surroundings and community.”

Dive deeper:

• So you've been admitted to medical school: Now what?

You are likely to enter into medical school with an existing social network. You don’t need to abandon those friends, but forging relationships with your classmates has value. Afterall, nobody can relate to what a medical student is going through better than another medical student.

“What was nice about my friends in med school was not only could they relate to my life because they were going through it as well, but after tests we would always go out and do something fun,” said Bukky Akingbola, DO, an ob-gyn resident at the University of Minnesota. “One of my good friends and I would always go to like a nice restaurant after a test, no matter how we did. Good or bad, we were getting a nice meal at the end of it.

“At that meal we would give ourselves 40 minutes to talk about school, to talk about the test, to talk about whatever it is related to medical school. And then after that, we're like—OK, we're not going to talk about medical school. We're going to talk about other things. That was really nice because ... it allowed us the opportunity to really vent.”

Dive deeper:

• Your medical school classmates are not your competition

Relationships during medical school are certainly possible. If you are dating a nonmedical student, open communication and expectation-setting can be key. Some students meet their partner during medical training and go through the Couples Match.

All that having been said, with most medical students graduating while still in their 20s, there is more time for relationships after medical school. 

“Different people are looking for certain relationships at different times,” noted Dr. Patel. “The biggest thing that I want students to know is a lot of us are single. When the time is right for a relationship, if you want that to happen, it will happen. I’m not going to force it. There’s so much that we already have in front of us.”

Dive deeper:

• Relationships in med school: Time to seek a mate, or stay single?
• Why doctors marry doctors: Exploring medical marriages
• Perfecting it as a pair: The do’s and don’ts of the Couples Match

If you’re early in your medical school career, you are likely in the process of taking on significant debt to finance your education. The median medical student debt is around $200,000, according to data from the Association of American Medical Colleges.

The list of key measures students can take to protect their financial future—with significant earning potential on the horizon—includes protecting against identity theft, managing one’s credit score and avoiding credit-card debt. Any small savings or minor investments can also pay off long-term. 

“The things that a younger person does with their long-term wealth—while the amounts may be smaller, the end result of their forward thinking and planning could help them earn a lot more money than if they get started later,” said Allan Phillips, a certified financial planner with Taylor Wealth Solutions who has worked extensively with physicians at all levels.

Dive deeper:

• First year in medical school? Here's your financial checklist
• 5 key student-loan terms that medical students should know
• What medical students should do to best prep for loan repayment

For medical students hoping to have children at any point in their training, planning ahead is important. It’s also important to understand that things don’t always go according to plan.

Physicians are in the habit of “constantly trying to find the right time for everything,” said Sarah Marsicek, MD, a pediatrician in Gainesville, Florida. “There is no perfect time to have a baby in medicine, and it's so true. When it took us forever to get pregnant with [her first child], we realized that we really just can't go with what works with my professional schedule. It really just has to go with what works for us personally.”

Dive deeper:

• When planning your family as a medical student, expect the unexpected

Medical students are more likely to experience burnout and depression than other similarly aged individuals pursuing different careers, and this elevated risk persists into residency training. Systemic solutions are generally considered the more effective method for preventing medical student burnout.

At the individual medical student level, however, one piece of advice to combat burnout is to try to get back to parts of your past wellness routine. That, of course, is easier said than done for the stretched-thin medical student.

“At the end of my third year of medical school, I was a physical mess,” said Sandra A. Fryhofer, MD, immediate past chair of the AMA Board of Trustees and a practicing internal medicine physician in Atlanta. “I had no time to exercise. I was exhausted. I looked in the mirror and I said: What is happening? I'd always gone to dance classes for exercise, but as a third-year medical student there was no time. There was no schedule. But I then joined a health club, and I went to exercise every day. This health club was close to my home, so I had to change what I'd always done—and it helped.

“Knowing self-care strategies can be helpful. … Organized study groups can really be helpful. They can reduce stress, anxiety and depression.”

Dive deeper:

• Burnout’s not about you—it’s about the broken health system
• 8 ways to cut medical student burnout
• Medical school burnout: How to take care of yourself
• Take a mindful approach to manage med school stress

The AMA’s Facilitating Effective Transitions Along the Medical Education Continuum handbook takes a deep dive into the needs of learners along the continuum of medical education—from the beginning of medical school through the final stage of residency. Download now.