Congratulations! You've made it to medical school. All of your hard work, community service, pretending to be interested in anesthesiology in order to be able to shadow a physician (any physician), over-involvement in extra-curricular activities, long nights spent studying whilst your English major roommate goes out and enjoys the college experience, and never, ever getting to schedule all your classes on only Tuesdays and Thursdays (so the better to enjoy a 4 day weekend) has finally paid off. Well, sort of. We'll get to that "payment" issue in a minute.
Right now you are, no doubt, a very "big fish" in a little pond. You are probably known as the smartest, most ambitious, and most masochistic, ahem, of all your friends. In medical school, you'll be surrounded by 100 + of people just as smart, ambitious, and masochistic (if not more so) than you. You will probably be, maybe for the very first time in your life, average. And as much as that may give you angina right now, you need to know that "average" is actually ok! No, really!
You thought you studied hard in college, but you are in for a surprise. You *did* study harder, relatively, than anyone else you knew. You also routinely got paid off in As. In medical school, you will sit in the same position for 8-9 hours a day, pausing only for bathroom breaks and pasta, reading, re-writing notes, and reading again, only to score an 80% on your exam. You need to go to lecture, but if you don't go to lecture, then you need a good note service, and, unless you are a hell of a good transcriptionist, if your medical school employs a lot of professors with thick accents, then you will probably need to ante up the cash for someone else to transcribe "your share" of note service lectures. Take some time to go "off campus" for lunches with your friends, and allow yourself to skip a lecture for a mental health hour every now and then. It will be worth it.
The first two years of medical school, you will work, and study, and take tests, and drink copious amounts after tests, and wonder why in the world you ever wanted to go to medical school. Keep the faith. The MD/PhD candidate that sits next you in the third row and your gross anatomy lab group will likely form the core of your best friends throughout your four years together, even though at times you want to throttle all of them. Familiarity breeds contempt, but you are all going through the same hellacious experience. You will value these memories, even if you don't believe it now.
You will have a med school fling. It will be fun, but won't last (and you'll be totally ok with that.) You will make mistakes. You will fail (yes, I said FAIL) a test. You will cry, a lot. You will feel like everyone else smarter than you. You will wonder, more than once, if you have chosen the wrong path. You haven't. You will eat too much, drink too much, and exercise too little. Try to take better care of yourself, that extra hour of studying probably won't make a difference, but that hour of exercise could mean a healthier you four years from now. Don't forget about your family and friends. Try to stay in touch with the people that mean the most to you. Their support is important. Life is going on outside your little microcosm, and you'll be sorry that you lost touch with the friends that knew you before you became a med bot.
Once you start clerkships, you will remember why you started doing all of this in the first place. Taking care of patients! You will *like* what you are doing again, and, all of the sudden, some of the lectures that seemed like absolute nonsense will actually begin to become more clear. No matter what you think you may want to do, clerkships will change your perspective on everything.
Be a good student. Know your patients. Have the patient seen and the notes written before your (overworked) intern hits the floor. Keep a running list of scut that needs to be done on *all* patients on your service (not just *your* patients, remember, you are working as a team) and be sure it is done before you leave the hospital. Check in with your resident/intern often, they are too busy to page you, but you may get to see (and do) some cool stuff if you stay visible. Learn how to write orders and practice whenever you can. Do everything you can to make your resident's life easier. Write prescriptions, skeletonize discharge orders ahead of time, and offer to get them food if you notice they haven't eaten. Stick close to your resident on call, but *go to bed* if they tell you to go! Don't try to show off how much you know, it is obnoxious and will likely come back to bite you. One of your patients will likely die, and you will never forget it.
Once you find out what it is that you want to do when you "grow up," be sure to make yourself known to the residents and attendings in that specialty. Ask lots of questions. Find a resident that needs help with research and offer your data gathering skillz. If it is a surgical specialty, make an effort to scrub in on as many cases as you possibly can. Center your fourth year electives around the specialty early in the year, so you can make the proper connections for letters of recommendation. Make yourself invaluable to your team. It will serve you well no matter what specialty you choose.
Even if you have met the love of your life, and think that January is a wonderful time to get married, think twice about planning a wedding in January of your fourth year. That is right in the height of interview season, and you will cause yourself undue stress trying to plan interviews around your wedding! The good news is, it is quite possible to nurture a fledgling relationship through the stresses of medical school (and it will prepare your spouse to be twice as awesome as he supports you through the worse stresses of residency!)
When you finally finish medical school (it is a marathon, not a sprint!), you will not be the same person that you were. You will be in debt up to your eyeballs, literally. It will take you years (some as an indentured servant) to pay off hundreds of thousands of dollars just for the privilege of being tortured, erm, learning for these last four years. You will realize that you will never be "rich," like your classmate that quit second year because he was making more money day trading stocks than the average family medicine attending. However, you will be a physician...fallible, over-educated, and under socialized, and you are going to help patients in ways you never even considered when you first sent in your application.
All the best of luck (you could use a little of that, as well),
Future Dr. Whoo