Second-Year Classes

The intensity definitely picks up second year, and on some days classes run from 9 a.m. until 4 p.m. The classes generally cover much more material than first year, and there are no teaching assistants (TAs). On a brighter note, the first block will be much less stressful for upcoming years, as pharmacology is being moved to pass/fail spring semester of first year. In general, classes are much more relevant to your career in medicine, and students seem more engaged and happier with the content of the lectures. There are six blocks, the second of which is CPR block (supposedly the most difficult) with cardiovascular, pulmonary and renal systems. I was most nervous for pathology, which is a year-long course, but our course master is wonderful, and her slides make everything clear.
– Andrea S., M2

Medical Scientist Training Program (MSTP)
Graduate Years

The transition from the pre-clinical portion of medical school to the graduate phase is an interesting one. Life as a medical student is paced by the steady, inexorable march of classes and exams toward the looming wall of Step 1. It is a period of almost pathological order, yes, but also one of safety; there are, to quote the inimitable Dr. Crouch, “no surprises here,” and with that surety comes a sense of comfort leavened by the satisfaction of constant (if slow) progress toward an end that is always very much in sight. By contrast, if medical school is a pristinely manicured lawn, grad school is the Australian Outback: wild, unquestionably dangerous and suffused throughout with the fierce beauty of the unknown and unexplored. This is not to say you go in unprepared; the MSTP office does a phenomenal job of guiding students through the process, in addition to providing ample opportunities for mentorship from professors and fellow students. Rather, it is an acknowledgment of the radical change in mindset that is required. Your goals in grad school are different from the ones in medical school, demanding different sacrifices and challenging different aspects of your mind. There are fewer signposts. You are just as — if not more — busy, but your time is largely your own, free to shape as you will. It is challenging, frustrating, and at times, seemingly endless. So far, I’ve loved every minute of it.
– Gregg F., G1

Step 1

The USMLE Step 1 is a rite of passage for every M2 at WUSM. As a first year, you may see and overhear the M2s stressing over how to study for what seems like a very daunting exam. However, it’s over a year away and worrying about it as an M1 is both unnecessary and counterproductive. Focus on getting to know your classmates, figuring out your learning style and enjoying anatomy. Seriously, you never get to do this again! Leave the Step 1 stress to the M2s, and know that while it’s intimidating, the curriculum does an excellent job of preparing WUSM students for success. Remember how difficult the MCAT seemed before you took it? And how much simpler it seems now that you’ve conquered it? You’ll feel the same way. Step 1 will be a challenge that you prepared for and overcame. In the meantime, consider leaving a care package for your M2 big sib. He/she will definitely appreciate it.
– Lulu Y., M3

Clinical Years: Core Rotations

Dressing up and playing doctor will become your life in third and fourth year. This is when the real learning begins.
Dressing up and playing doctor will become your life in third and fourth year. This is when the real learning begins.


By the time you start third-year core clerkships, you’re more than ready to get out of the classroom and into the hospital for some hands-on learning. While many will tell you it’s the most rigorous year of medical school, it’s by far the most rewarding, enjoyable and educational experience you will have. The core clerkships at WUSM are Medicine (12 weeks), Surgery (12 weeks), Obstetrics and Gynecology (six weeks), Pediatrics (six weeks), Neurology (four weeks) and Psychiatry (four weeks). You’ll complete all of these during your M3 year, so that you can take any electives or away rotations during your M4 year. Each clerkship has a clerkship director (like a course master) and its own format, expectations, sub-rotations, etc. You’ll learn a lot of clinical information and practical skills, as well as how to adapt quickly to new situations. It can be a challenge some days, but you’ll find yourself satisfied at the end of the day. After all, this experience is why you came to medical school!
– Lulu Y., M3

Clinical Years: Elective Rotations

Your third and fourth years consist of clinical rotations. Third year has four three-month blocks: neuro/psych/wild card, obgyn/peds, internal medicine and surgery. Each block is split into three four-week or two six-week rotations. Fourth year consists entirely of elective rotations that you choose at Pit Night in the spring of third year. If you don’t know exactly what you want, you can always change your schedule during fourth year as well. There are a myriad of electives in all the subspecialties of medicine. You also have the options of doing away rotations, reading blocks and special electives. Your clinical years mold you into a doctor, and Barnes-Jewish Hospital is a great place to complete them.
– Audrey L., M4

Clinical Years: Away Rotations

You can do “away rotations” at different institutions during fourth year. Some schools recommend doing away rotations at hospitals at which you’re applying for residency, which means they are like month-long interviews. If you perform well, it just might guarantee you an interview spot for residency. You can also do away rotations in foreign countries. Previous WUSM students have gone all over the world to Africa, Asia, Europe and South America.
– Audrey L., M4

Clinical Years: Sub-Internships

The electives your first few months of fourth year are subinternships, or “subi’s” for short, because they are like test months of intern year. As a subintern, you are given the responsibilities of an intern (intern year = first year of residency). You choose subi’s in the field of residency you are applying for, as the subi grades will be going out with your application. Subi’s also provide opportunities to connect with faculty in your chosen field and obtain letters of recommendation. Subi’s are a lot of hard work, but they are theoretically what you’ll be doing for the rest of your life, so they are very rewarding as well.
– Audrey L., M4

Fourth-Year Capstone Course

Capstone is a required month-long course during fourth year that occurs in the spring. It is designed to prepare you for situations that you will find yourself in as an intern. It is a good refresher before residency starts and helps decrease the number of freak-outs you have as an intern. Theoretically. 🙂
– Audrey L., M4

Year-Long Master’s Research

The sperm whale, featured in Moby Dick, can hold its breath for 90 minutes. Many medical students attempt a similar feat by going straight through medical school with their eyes set on residency. Taking a year off for a master’s degree is like letting yourself come up for air in the midst of the pressures of medical school. Not only are you rejuvenated with more sleep, more time, and more freedom, but you also can finally see the world around you. Medical school is difficult, demanding and even isolating. Your thoughts, conversations and dreams can become strings of medical jargon. Entering the realm of a master’s degree brings you back to patients in a unique way and will make you a more successful physician and researcher. My MPH year (and now additional year in Africa) was a wonderful decision for me as it allowed me more time to decide which residency field I wanted to pursue, it introduced me to new friends with different personalities and perspectives from medical students, and it allowed me time to seriously pursue research projects, publish papers and discover my passion for research in addition to clinical care. I strongly encourage you to let yourself come up for air and pursue a master’s degree while at WUSM.
– Austin W., M4

Residency

Starting residency is an overwhelming and intimidating transition to make, no matter how ready you think you are. Looking back from the middle of my residency, I am extremely thankful for the amazing preparation that I received at Washington University. Learning in both the classroom and the hospital gave me the knowledge and problem-solving that I relied on in my first days as a new doctor. Our courses taught me facts that I still use in daily patient care, like antibiotic coverage, differential diagnoses and disease pathophysiology. More importantly our clerkships taught me how to gain patient trust and lead a clinical team. They also gave me the confidence to take charge of acute clinical situations. Compared to our peers, I felt efficient, knowledgeable, and above all, completely competent to adapt to life as an intern and now to thrive as a resident. Most importantly, our faculty mentors are second to none — people like Dr. Greg Polites and Dr. Martin Boyer not only help us develop as clinicians, but as people too.
– Eric P., MD

WUSM Class of 2013

Orthopaedic Surgery Resident at the Thomas Jefferson School of Medicine, PGY-3

Working as a WUSM Alum

Before the FLTC, before lecture webcasts, actually before students had cell phones, the Dis-O Guide was instrumental to me as I started my new life in St. Louis. Fifteen years later, I’ve turned out to be one of the many faculty members who will tell you with a certain mix of pride and surprise, “I came as a first year and I never left” — although we did move to Philly for a few years while I served my residency. There are many great medical schools in the United States, but being a WUSM alumnus is a wonderful privilege; you will be well prepared for practice and very likely will have less student debt than your peers. By the way, did you know that the Alumni Association provides funds to support our student groups? So the next time you see a kindly but disoriented physician wandering our halls and asking where the Bronfenbrenner Lab has gone, show them around our new digs and thank them for their support.
– Ian H., MD, PhD

WUSM Class of 2008

Assistant Professor of Pathology and Immunology at WUSM