“All I would say on the roommate question is to put yourself in a situation where you are going to be able to sleep or study anytime that you might want,” Chris counsels. “If your potential roommates are likely to be a distraction from studying or are likely to keep you awake when you should be sleeping, get your own place. If you think roommates will serve as a support network, then go that route.”
Other housing considerations
Once you’ve identified a location, settled on a budget, and found a roommate (if you wanted one), you’re off to the marketplace. Most major cities offer apartment locator services that tend to have fairly comprehensive and up-to-date listings of vacancies. These services can be good sources of reliable information about building quality and landlord responsiveness, but they usually charge a fee for their services. They also tend to focus on larger, multiunit buildings as opposed to houses or duplexes. Most of your mentors relied on the good old-fashioned Sunday want ads.
If you’re moving from far away, obtain newspapers for your city either online or via special order at your local bookstores so you can start perusing the market and making initial calls/appointments well before school begins. As you evaluate the ads, consider the features you’re looking for in your new home. The fundamental rules here should be safety, convenience, and simplicity. You’ve already focused on an area near school; now consider how you’ll get around—what’s parking like if you have a car, what’s public transportation like if you’ll go by bus or train, or how easy and safe is it to ride a bike or walk. Graduate student areas don’t tend to be in the high-rent district; remember that you will be going to and from campus at all hours of the day. You should feel safe coming home in the middle of the night.
Once you’ve selected a place, make sure that any summer sublettors will be out early enough to allow you to move in at least several days prior to the start of classes to allow you enough time to get settled. Use this time to accomplish such mundane but vital tasks as finding a local bank, getting your telephone and Internet access established, registering your car, and laying in supplies.
Many schools will provide you with or require you to buy a computer before classes start. Get your system up and running before classes begin so you don’t have to spend precious hours on hold with tech support.
If you’ve got the time and can allow a week before classes, take the opportunity to get to know the area a bit, especially if you’re completely new to the city. Finding a couple of good restaurants, a place to get your morning coffee, a place to get a bite late at night, and a good place to take a run are important things to do before classes begin.
Your school may also assist you with the transition by offering a planned orientation. This is often a week or so of on-campus and offcampus activities like orientation to classes, honor code review, and dinners with upperclassmen. Don’t even think of blowing off this orientation if one is offered, as it will likely provide you with an invaluable bonding experience with your new classmates and a good preview of your experience to come.
STEP FIVE: LEARN TO KEEP STRESS AT BAY
Stress is a reality of our everyday, hectic lives, and nothing breeds stress more effectively than medical school. But that doesn’t mean you must become overwhelmed by it. As you no doubt know already, stress stems from worrying that you’re going to fall short, run out of time, or not be able to complete something. Unfortunately, instead of leading to a solution, stress causes you to dwell on the problem, and in turn, this turmoil causes you to waste way too much time being stressed about being stressed.
The trick is learning to manage the stress of medical school and using a little bit of the pressure you feel as a motivator to keep you moving forward every day.
Keep your perspective
All that takes is perspective and a promise. If you keep perspective on the reality behind the pressure and keep your eye on your fundamental goals, much of the perceived stress will disappear. Remember that you are in med school to become an effective physician, not to ace every test. Nearly every practicing doc has a war story or two about an exam he or she got destroyed on in med school. It’s practically part of the experience. Try to remember that you want to learn so you can apply the knowledge in your practice, not just to regurgitate information for one exam. What you are undertaking is a lifelong pursuit—the same concepts you struggle with today will likely still be challenging you and shaping you in new and different ways many years from now. You will not succeed at every turn, but through dedication and perseverance you will grow and thrive. Always remember that medicine is a vocation, not a life. You will bring more to your profession and your patients by being a whole person with relationships and interests and experiences outside of medicine than by being the world’s most complete walking encyclopedia of medical knowledge. Find a creative outlet, volunteer, and try to set at least one important goal for yourself outside of medicine.
“One of the best things I did with my preclinical years is become extremely involved with community volunteer efforts and community groups,” Pete notes. “It was a good way to stay sane and not spend all of my time in Anatomy Lab or a dingy library somewhere.”
“Okay,” you say. “Got it. I can handle that.”
But guess what?
Unless you constantly remind yourself about this, you’ll be overwhelmed within two weeks of the start of med school. That’s where the promise part comes in.
It’s great to start off feeling balanced and in control, but the real work, the real test, is keeping that perspective once you’re down in the trenches. When you’re feeling overwhelmed, it’s tempting to ignore this perspective and focus on nothing but med school. When you find yourself slipping into this pattern (and trust us, you will!), force yourself to stop.
Just stop everything you’re doing and take a time-out.
Drop back and force yourself to remember why you’re doing all this. Remind yourself of the roots of your passion. This may mean taking time away from the books, instead of strapping yourself permanently into a chair in the library. Figure out what it was that you did that put you into a state of upset, and strive to avoid falling into the same pattern next time. We’re not suggesting that you should blow off your work. All we’re saying is that you should—in fact, you must—strive to find a balance. Be sure to get your exercise, your sleep, and to get off campus on a semiregular basis to recharge.
“I made an effort to go to class every day,” Chris says. “I did this more because I knew if I did not drag my butt out of bed I would sleep until noon every day, not because I got a whole lot out of class. After class I would try to get in a few hours of reading but also make an effort to work in some exercise in the afternoon. I would go home and have dinner with my wife every evening, making sure to spend at least an hour with her, and then take off for the library to study until about midnight.”
Remember, this is a marathon and not a sprint.
Get organized and stay organized
That brings us to the second important stress management tool: getting organized and staying organized. The absolute key to juggling all your academic requirements and still finding time for yourself lies in good organization and planning. This can be a daunting task. That's why it is important to start organized. If you start organized, it'll be easier to stay organized.
The most important organizational tool to acquire is a good calendar reference. It doesn't matter if it's a day planner, a PDA, or a sheet of paper on your wall at home—just make sure you have a good daily and monthly calendar that you constantly keep up to date. Once you get class schedules and outlines with test dates, make sure all of those critical dates go onto the calendar immediately. As you add group meetings, group project assignments, and other obligations, make sure everything gets captured immediately on this calendar so nothing falls through the cracks. Get in the habit early of relying on this calendar, keeping it current, and consulting it when you get up in the morning and right before you go to bed at night.
Doing so will not only remind you of important deadlines and events, it will give you the peace of mind to know that you're not forgetting anything and help you to relax.
Armed with proper perspective and the organizational tools required to maintain your balance, the last piece of the puzzle is to make sure you actually apply these tools. This may mean budgeting in some time for self-evaluation. One of the best resources can be someone close to you—a friend, a family member, a partner—anyone who can watch you day-to-day from an outside perspective and give you feedback on how you're weathering the storm. When they reach out and tell you you're overstressed, working too much, ignoring too many things in your life, your immediate and natural response will be, "Duh, of course I'm overstressed . . . I'm in medical school, I've got three tests next week, and I can't learn anatomy." All that may be true, but listen to them. Sit down with a calendar and carve out time to keep moving forward with your studies, but don't forget to budget in some much-needed personal time. Carefully consider your current work priorities and expectations and ask yourself if they are truly reasonable.
"Time management is the key!" Kate insists. "Everyone has the same amount of information to learn, but those who can budget their time efficiently are successful and have pleasant memories of medical school. Make sure you have time designated to yourself and your family, and stay well-rounded. This will help you focus on your studies and have a successful career."
Be ready to practice damage control
Last, you should develop a mental checklist that you will call upon to help you when things go awry. When a crisis develops, don’t panic. There aren’t many mistakes or problems that can’t be corrected. First, help yourself; see if you can identify the problem and institute a solution. This will be a move in the right direction so that when you enter the next step, enlisting outside help, you’ve already shown you’re committed to making things right. Help can come in many forms, but remember that no one is more aware of how stressful med school can be than the faculty at your school. Most of your professors have spent years watching class after class struggle with the same elusive concepts, and seen people make every kind of mistake and experience every kind of breakdown there is to experience. Keep that humbling thought in mind. If you feel yourself slipping or are worried about how things are going, be sure to reach out to the available resources at school. Your professors can direct you to additional study resources, recommend alternate texts or methods of study, or even help set up tutoring. In addition, your school will almost certainly have a range of professional counseling resources for students experiencing trouble either academically or emotionally. In short, when you feel you’re wandering off course or losing control, swallow your pride and reach out for help. It’s closer than you think, and the sooner you seek help the faster you can get back on track.
But, you say, everyone is stressed to the max and feels like they’re sinking. How do you really know when you’re in trouble? Take a look at the following list of symptoms:
Flunking first-term tests
Uncontrollable urge to cheat or cut corners
Social and emotional isolation or thoughts of suicide
Substance abuse or other abusive behaviors
Unexplained absences from required functions
Reports from peers that something’s amiss with you
Daily visits, for whatever reason, to the Dean of Student’s Office
If you’re displaying or feeling any of these symptoms, or if you can’t shake the nagging sensation that you’re sinking faster than you can bail water, it’s time to reach out for help.
CHAPTER 11
Funding Your Med-School Education
Can anybody remember when the times were not hard and money not scarce?
—RALPH WALDO EMERSON
SHOW ME THE MONEY!
THE ACTUAL COST of your medical education obviously depends on which school you attend. According to the most recent AAMC figures, the average cost of a public medical-school education is about $27,500 per year, while the average cost of private medical school is nearly $44,000 per year.
The AAMC also reports that the average debt load for a graduating medical student is slightly more than $100,000 at a public school and $130,000 at a private school. That’s an overwhelming sum of money to most people. In 2007 those numbers are expected to increase to $120,000 and $160,000, respectively. Still, an investment of time and money in a medical degree remains a sound long-term investment.
Funding your medical education is a complex process that warrants your dedicated attention and study. Once again, the AAMC Web site (www.aamc.org) provides a wealth of resources for explaining and evaluating your options. There are three sources of financial aid for med students—scholarships and grants, loans, and workstudy. Scholarships and grants are blocks of money awarded on the basis of need or merit that do not need to be repaid. Loans fall into one of two subcategories: subsidized or unsubsidized. Subsidized loans do not accrue interest while you’re in school, while unsubsidized loans begin accruing interest immediately. Finally, work-study jobs pay you an hourly wage and may apply some of that wage toward your tuition bill.
“One thing I wish I had done was to apply for more scholarships—or any scholarships, for that matter,” Deb notes. “There were several people in my class who won scholarships during medical school. Scholarships are out there—you just have to look for them.”
Typically, a med student’s financial-aid package is derived from a mix of these sources. When you begin school, you will likely have a meeting with the institution’s financial-aid advisor. He will have you complete the Free Application for Federal Student Aid (FAFSA) form ahead of time to determine your need, your available funds, and your qualifications for different types of aid. This form will look at your prior student loans, your recent tax returns, your parents’ tax returns (depending on your age and independence), and any other financial obligations you have. The financial-aid advisor will help you design an optimal package of funding for your complete education.
Take these meetings seriously, ask lots of questions, and take lots of notes. Managing financial-aid packages can be a complicated task, and staying on top of your aid and the requirements of your various funding sources is imperative. Missing deadlines, missing payments, or failing to meet loan criteria can have dire long-term consequences that could affect your future credit rating and purchasing power.
Scholarships and grants
Your first step should be determining if you can get any money for free—that is, scholarships and grants. Your financial-aid advisor will have a list of scholarship and grant money that he is familiar with, but that should not be the end of your search. Scour the Internet for lesser-known scholarships, and check for available resources in your home and med-school communities. Many civic organizations such as Rotary International offer scholarships for students pursuing a medical degree.
“A five-hundred-dollar Grange or Rotary scholarship may not seem like much, but it is that much less that you have to pay off down the line,” Pete notes. “When you calculate the accrued interest that the five hundred dollars would have tacked on over time, you’ll realize the value of that scholarship. Every little bit helps.”
Consult the appendix (page 271) for more resources to pursue in your search for scholarships.
Subsidized and unsubsidized loans
Everyone is eligible for some degree of federal aid. The primary source for this money is from Stafford and Perkins loans. Stafford loans come in the subsidized or unsubsidized flavors as previously described. The Stafford interest rates are set annually and calculated by the Department of Education based on the 91-day Treasury Bill return. The Perkins loans are similar need-based loans but are shared by the federal government and your school. All the loans go into automatic repayment six months after you graduate from medical school. If you are enrolled in a residency program after graduation, you may have the option to defer your loan payments until after completion of yo
ur residency. The AAMC Web site offers the most complete breakdown of the various repayment and deferral programs currently available, so check it for the very latest information.
Most private financial aid is offered by major lending institutions and is coordinated through the financial-aid office at your school. As a student, you will also have an on-campus mailbox constantly stuffed full of fliers from these companies. Their rates tend to be higher and come with more fees and penalties. However, private loans often play an important role in making up the difference between your maximum federal aid and the actual tuition cost. More information regarding private lending sources is usually available through your financial-aid office.
Impact of personal or family resources
The degree to which family or personal resources will play a role in your financial-aid package varies from school to school. Now that you’re out of college and living on your own, it may seem ridiculous to think med schools would consider your parents as a source of tuition funds (and if you find this notion outrageous, wait until you hear what your parents say on the subject!). Nonetheless, for some of you, family resources may be identified as a source of tuition funds, and if you can’t obtain these funds from family, you’ll have to look to alternative personal loans to meet the funding gap.
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