The Medical School Curriculum – Everything You Wanted to Know

The medical school curriculum will vary somewhat from school to school. However, there are some things that are relatively constant in the subjects taught in medical school.

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First Year (Freshman Year)

Many medical students find their first year a

difficult year. It’s definitely a big transition between undergrad and medical school. You will likely be studying more than you ever have before.

Some of the subjects taught in medical school during the first year include anatomy and histology.

For anatomy, you will likely be dissecting a cadaver under supervision of your instructors. There are some schools, like UCLA medical school, where the cadavers are prosected. This means that you do not do the actual dissection, but study certain parts of the body that have been dissected for you. This definitely saves you time and is something that I liked about the medical school curriculum at UCLA.

Histology is the study of human tissues under the microscope. You will learn about the different layers of skin, the cells in the ovary, heart, lungs and all the tissues of the body. This is one of the subjects taught in medical school, along with anatomy, that I would recommend taking before medical school.

Pharmacology is a part of the medical school curriculum that will also be new to you. This is the study of drugs and how they affect the body. You will also learn about the half lives of drugs, how they distribute into the body and other important information.

The other subjects taught in medical school will likely be the types of classes you have already taken. You will learn about physiology, cell biology and genetics. If you studied hard in your classes for your medical school requirements, these courses will likely be review for you.

You will also likely start a few courses designed to help you start thinking like a doctor (or a clinician, as you will often hear). These parts of the medical school curriculum are very important and will help prepare you for your clinical years.

The subjects taught in medical school that will be more clinical might include PBL (problem based learning)
and preceptorship.

PBL is a course where you sit down with a small group and go through a case. You follow the course of a patient a little bit at a time, thinking about what the diagnosis might be as you go through. You have a tutor who is a doctor helping to guide the discussion so that you don’t get too off track! As you go through, you select “learning issues” relating to the case. For example, if the case is about diabetes, you might choose to write a one to two page essay about the complications of diabetes. You usually go through most of the case on Monday, select your learning issues, then finish the case on Friday and present your learning issues. This is part of the medical school curriculum that bothered me at first. However, once I got to third year, I thought it was one of the most important subjects taught in medical school. It helps you learn how to think like a doctor.

Preceptorship is being assigned to a doctor that you follow. That doctor may have any number of specialties, but usually you will be assigned to a family practice doctor. During your first year, you will probably mainly just watch the doctor. If you’re lucky, he or she might let you talk to patients first or do procedures. My advice to you is to be proactive with your preceptor and ask to do things on your own. This is how
you will learn! If you just watch, you’re missing out. You will likely have a preceptor first, second and third years as part of the medical school curriculum.

Second Year (Sophomore Year)

Second year is very similar to first year. Generally first year is dedicated to understanding the “normal” physiology of the human body and the anatomy. The second year is more focused on pathology, or what can go wrong with the body. You will spend more time learning about the diseases of the human body and a little bit about their treatment. Depending on your medical school curriculum, you may focus on organ systems, symptoms, or have a “traditional” curriculum. Organ systems based means that you study for example the heart for several weeks, focusing on the anatomy, physiology, pharmacology and pathology of the heart. Symptom based means that your subjects taught in medical school will focus around a specific symptom, for example headache. You will learn about the anatomy that can contribute to headache, the possible causes due to the physiology and pathology and the pharmacology to treat headache. I like this system the best because it is most like real life. You will be treating symptoms throughout your career. Traditional curriculum means you focus on one subject at a time. You will do anatomy for several weeks of the whole body. Then pharmacology for several weeks. Then physiology of the whole body. Then pathology of the whole body. These systems will happen during your first and second years. So, be aware of them and choose the type that seems best for you. It’s an important part of choosing your best medical school and something to ask during medical school interviews.

You will essentially repeat what you learned during first year, but this time focus on pathology instead of physiology. You’ll also learn about infectious diseases during second year. You’ll also continue PBL and Preceptorship.

At the end of your second year you will take USMLE Step 1. This is a pretty scary test that will go over all the subjects taught in medical school during your first two years. That’s a lot of information. You can see the books I recommend for Step 1 here.

Third Year (Junior Year)

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The third year of the medical school curriculum is when you really start to be a doctor. You will be in the hospital during this year. The subjects taught in medical school during this year consist of “rotations.”

You will have required rotations in the following subjects: surgery, OB/GYN, pediatrics, neurology, psychiatry, internal medicine, family medicine, ambulatory medicine. There may be some variations on required rotations depending on your school, but these are ones you will
definitely have.

During each rotation, medical students will take on the responsibilities of the doctors in their rotations. During the surgery rotation, you will assist with surgeries. During OB/GYN, you will get to deliver babies. It’s a great year when you really get to see what it’s like to be a doctor. It’s a real transition in the medical school curriculum.

Along with your new opportunity to do cool things come much different hours than what you’ve ever been used to as medical students or as any other type of student. You’ll be working like a doctor. This means that you will have times when you are on call, which means that you will stay at the hospital overnight. They are currently making changes so that residents can’t stay in the hospital for more than 16 hours, so some of the scheduling might be a little different in the years to come. This is a controversial change in the medical school curriculum. I’ll keep you posted!

Some rotations in the medical school curriculum have much longer hours than others. Surgery, internal medicine and OB/GYN have the most intense hours. You will likely be on call twice a week, have one day off a week and will work over 12 hours every day. Pretty different from your 8am-12pm classes!

Pediatrics, neurology, psychiatry, family and ambulatory medicine will be more relaxed. Usually. My neurology rotation was pretty tough as well with call once a week and about 12 hour days. They also had us take call on weekends. But, for the other rotations, it was more like a 9 to 5, Monday to Friday type of schedule.

This year is extremely difficult, but the one where you learn the most. Our Dean also told us that this year will have the most bearing on where you get into residency, and therefore the most important year in the medical school curriculum. You are evaluated during each rotation and those evaluations will help form your Dean’s letter, which goes to your residency programs. Your school may also have and Honors/Pass/Fail or other grading system so that you get a grade for each rotation.

Depending on how well you do during your third year and how you do on Step 1, you may become AOA, which is an honors society for the top medical students. Being a member of this will help you get into more competitive residencies, like orthopaedic surgery.

Fourth Year (Senior Year)

Hopefully during your medical school curriculum you’ve found subjects taught in medical school that you like and rotations that you loved.

Fourth year is the time to hone in on your specialty choice, if you’re not sure yet. You should take subinternships in the specialties that you are thinking about going into. During subinternships, you will be functioning more independently. You will be writing orders for your patients and will be reporting directly to the resident instead of to the intern.

These terms were confusing to me for a long time. An intern is a first year resident. A resident is a second or further year resident. An attending is someone who has completed residency in their specialty. This is “the doctor” on your medical team. So, the medical totem pole looks like this: 3rd year medical student, 4th year medical student (subintern), intern, resident, attending.

At any rate, as a subintern, you will be the person primarily responsible for your patients. You will also be evaluated and may be looking for a letter of recommendation from one of the attendings. Work hard on your subinternships. They will either help you or hurt you in getting into the residency of your choice. For more about residency programs, click here.

Other than your subinternships, fourth year should be a fun and relaxing year. At UCLA, you only need to be in rotations for 30 weeks of the year! This means plenty of time to go do residency interviews, relax, travel or pack in some extra rotations. This year is the one that you have the most control of and the one that I’m enjoying right now!

Summary

The medical school curriculum is very rigorous. Medical students are some of the busiest people on earth, especially during third year. But, you are learning to treat disease and save lives, so the training should be difficult. You are taking on a great responsibility. Learn the subjects taught in medical school
well and you will be a great doctor!

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