How Hard Is Medical School? A Complete Guide

“How hard is medical school?” You’re an aspiring doctor, and you’ve been thinking about this question for a long time.

We got you covered.

An undergraduate education is a major step in any young person’s life.

Engaging classes, an active social life, and new levels of independence mean the potential for a great experience and a lot of fun.

In most cases, no one is checking up on your class attendance and sleeping until noon is a rite of passage during college.

So it would make sense that those pursuing a career as a doctor would be able to continue the fun for the following 4 years in medical school, right?

Unfortunately for those looking for another 4 years of parties and skipping class, medical school is a lot more rigorous than most undergraduate programs.

Medical school is meant to prepare future doctors to save lives, after all.

How Hard Is Medical School?

Click above to watch a video on how hard medical school is.

How are classes structured? 

Medical school is unique in that the way material is delivered changes each year.

Medical school itself consists of 4 years of instruction. Classes are structured differently each year.

Years 1 and 2 of Medical School

The first 2 years consist mostly of classroom instruction and labs.

  • Students are meant to learn the basics of medicine and how to treat and care for patients.
  • This is the time when the majority of book learning takes place, with studies of patient cases and other scientific principles.

This makes for an easier transition from undergraduate coursework to medical school, as these first 2 years are the most similar to what you probably experienced in a pre-med program.

  • Students are required to pass Step 1 of the United States Medical Licensing Examination after their first 2 years or sometime during the third year of medical school.
  • This test is designed to make sure that medical students “understand and can apply important concepts of the science basics to the practice of medicine, with special emphasis on principles and mechanisms underlying health, disease, and modes of therapy,” according to the USMLE study guide website.

It is the first of 3 required exams to be licensed as a physician.

Year 3 of Medical School

Classes and labs will continue, but students begin to spend more time in actual hospitals and clinics.

  • This is meant to give them hands-on experience actually practicing medicine under the guidance of a physician.
  • During the third year, most students get a range of clinical rotations in a variety of specialties to gain experience and knowledge that they will use to specialize later in their career.

Year 4 of Medical School 

The fourth-year is similar to the third—classes, labs, and clinical rotations.

But fourth-year medical students are often able to spend more time rotating through areas that they may want to specialize in down the road.

What will I learn during each year of medical school? 

Medical school courses focus on the actual practice of medicine.

A pre-med program covers the basics of anatomy and physiology, while medical school courses go over how doctors use that knowledge to effectively to treat patients.

  • Each institution has a slightly different curriculum but there are a number of subject areas that you should expect to study.

Below is a typical 4-year medical school curriculum from New York University’s School of Medicine.

Year 1: Classroom instruction focuses on studying the human body; it is foundational to successful practice as a doctor.

  • DNA, Organelles, & Cells
  • Infection & Immunity
  • Morphological and Developmental Basis of Medicine I
  • Cardiology
  • Pulmonary
  • Renal
  • Gastro-Intestinal (GI)
  • Endocrine/Reproductive

Year 2: Classroom instruction continues but students often begin their clinical rotations at one of NYU’s teaching hospitals or clinics.

  • Morphological and Developmental Basis of Medicine II
  • Nervous System
  • Musculature/Hematology/Dermatology
  • Begin hands-on clinical work, called ‘Core Clerkships & Interclerkship Intensives”
    • Ambulatory care
    • Medicine
    • Surgery
    • Neurology
    • Pediatrics
    • Psychiatry
    • Obstetrics & Gynecology

Year 3: Core Clerkships and Interclerkship Intensives continue but with an added focus on individual goals and career paths. This is a time to prepare for the USMLE Step 1 and take electives that interest the particular student.

Year 4: The fourth and final year of medical school focuses completely on clinical work and preparing for the USMLE Step 2 and Residency.

  • At the NYU School of Medicine, year 4 is called the Career Preparation stage.
  • Students “complete a critical care clerkship and select an advanced subinternship in surgery, medicine, or pediatrics.”

This helps them “take on additional patient care responsibilities” as well as prepare to be a medical resident.

A medical education is not complete after 4 years of medical school. Students go on to work as residents before taking the final exam to become fully board-certified doctors.

Those pursuing an advanced specialty need to complete additional education and experience requirements as well.

What subjects are taught in medical school? 

Medical school differs from many other advanced degrees because it focuses so heavily on clinical rotations and hands-on patient care experience.

  • Classroom instruction is a big part of the first 2 years but becomes less prevalent as medical students start to work more in hospitals and clinics.
  • When they do meet (which is often), it is to discuss and learn from their clinical experiences.

Each school has its own course offerings but many have similar core subjects.

The Harvard Medical School course catalog includes the following core courses for their Pathways track and Health Sciences and Technology track, which focuses on biomedical research.

  • Practice of Medicine
  • Foundations of Medicine
  • Immunity in Defense and Disease
  • Essentials of the Profession I & II
  • Homeostasis I & II
  • Mind, Brain, & Behavior
  • Human Functional Anatomy
  • Matlab for Medicine
  • Musculoskeletal Pathophysiology
  • Human Pathology
  • Principles and Practice of Human Pathology
  • Mechanisms of Microbial Pathogenesis
  • Endocrinology
  • Human Reproductive Biology
  • Hematology
  • Cardiovascular Pathophysiology
  • Respiratory Pathophysiology
  • Renal Pathophysiology
  • Gastroenterology
  • Neuroscience
  • Molecular Medicine
  • Biochemistry and Metabolism
  • Principles of Pharmacology
  • Genetics in Modern Medicine
  • Molecular Diagnostics and Bioinformatics
  • Principles of Biomedical Imaging
  • Cellular and Molecular Immunology
  • Introduction to Biostatistics
  • Medical Decision Analysis and Diagnostic Test Interpretation
  • Clinical Epidemiology: Methods for Clinical Research
  • Research in Health Sciences and Technology I & II
  • Introduction to the Care of Patients
  • Blood Vessels and Endothelial Phenotypes in Health and Disease
  • Introduction to Global Medicine: Bioscience, Technologies, Disparities, Strategies
  • Introduction to Clinical Medicine
  • Molecular Biology of Human Disease
  • Psychopathology and Intro to Clinical Psychiatry

Even the core courses in a medical school curriculum are extremely rigorous and require mastery of the basics of anatomy, physiology, biology, and other science disciplines.

From the very first day, medical students are expected to build upon their strong foundational knowledge and apply what they know.

Almost all medical schools build in some time for students to take electives and pursue areas that interest them as part of their course of study. Electives include areas such as:

  • Medical Education Longitudinal Elective
  • Health Management for Older Adults
  • Human Health and Global Environmental Change
  • Introduction to Health Care Management
  • The Physician as Leader
  • Understanding the Peer-Reviewed Literature
  • Spirituality and Healing in Medicine
  • Social Change, Injury Prevention, and the Practice of Medicine
  • Mindful Medicine: A Master Class in Medical Thinking
  • Mentored Clinical Casebook Project
  • Training the Eye: Improving the Art of Physical Diagnosis
  • Case Studies in Global Mental Health Delivery
  • Foundations of Mental Health and Sustainable Development

Students may also have the opportunity to study specific vocabulary and usage of a second language, such as Spanish, in the medical field.

This will help them communicate effectively using clinical terminology with patients with a limited knowledge of English. It is important to note that each medical school has its own priorities and focus, even for its medical students.

That is why it is so important to find a medical school that is a good fit for you and your areas of professional interest.

How to succeed in medical school 

It’s no secret that medical school is hard. Just look at the number of advanced courses that you need to take!

But there are a few tips that will help you succeed.

These tricks can be used to make any academic endeavor easier but are especially important when you are in a challenging program like medical school.

  1. Stay on top of your work. The pace of medical school is fast. Students are expected to read, study, and learn at lightning speed. Don’t let yourself get behind on your classroom work or your clinical work. It will be hard to catch up and you may find yourself falling further and further behind.
  2. Ask a lot of questions. The knowledge that you gain in medical school builds on each other. You will be expected to apply what you study in the classroom during your clinical rotations and beyond. Don’t understand a concept? Need another explanation? Ask questions early and often to make sure that when it comes time to demonstrate your knowledge, you are ready to go.
  3. Get your hands dirty. Medical school is practice-based because once you are a doctor, you are expected to practice medicine, not just study it. This means you should get as much hands-on experience as possible during your 4 years as a med student. You will get a good amount during your clinical rotations, everyone does. But you should try to make the most of those opportunities and seek out additional chances for hands-on learning whenever possible.
  4. Make friends. Medical school requires long hours of studying—drawing diagrams, learning systems, memorizing treatments. Joining a study group can do wonders to help you make the most of your time. You will quickly learn the value of dividing and conquering when it comes to reviewing case studies and taking notes.
  5. Seek out mentors. Experienced physicians are everywhere at medical schools. You can find them on the school’s faculty, working in the hospital or clinic, or even among your school’s alumni network. Look for opportunities to get to know them better. It may just help you land a great Residency or give you additional insight into what you may want to specialize in later.
  6. Attend to your mental and physical health. It’s hard to do your best academically if you are not taking care of yourself. Make sure that you make time to breathe, enjoy your hobbies, and just take care of yourself. Eating healthy meals and finding time for exercise will keep your body and brain in top shape for the rigors of medical school.

Advice From an Expert

Mike Davis, assistant professor of biology and pre-med advisor at Sweet Briar College, has this to say about why medical school is difficult:

It is a childhood dream of so many to become a doctor. The profession can be lucrative, fulfilling and prestigious. Because of this, more and more students are applying to medical schools and, therefore, medical schools are increasingly more selective. When you are accepted to any medical school, you are surrounded by the best of the best, and the schools will challenge students in ways they could not a few decades ago.

For example, it is not uncommon for faculty to expect students to work 80-90 hours a week. This makes finishing medical school one of the most difficult experiences for any student. All of that, coupled with how much we don’t know about human health makes finishing this task increasingly difficult. Taking a set of symptoms, charts and lab analyses into consideration to formulate a diagnosis can seem like an impossible task, and you are expected to do that before you finish your residency! These are but a few reasons why completing medical school is so difficult.

Conclusion: How Hard is Medical School?

 The rigorous classroom work and fast pace of clinical rotations can make medical school academically challenging.

  • But what most medical students consider the hardest part is the pressure and resulting stress that constant high expectations put on them.

Knowing the structure and academic load of each year can do a lot to alleviate the worry and anxiety that comes with medical school.

  • Whether it is knowing what core classes you will need to take or making sure to choose electives that spark your interest, getting familiar with the course catalog and how each class fits into the overall picture will make you more successful in medical school.

Understanding the road in front of you will allow you to prepare adequately for the challenges ahead.

This starts in your pre-med program and should continue throughout your entire medical career.

  • If you have questions, don’t hesitate to talk to your school’s faculty, other students in your year or ahead of you, or the academic office to make sure that you are on ready for your upcoming medical school requirements.

It can be easy to succumb to the pressure and feel high levels of anxiety.

That is why having a support system from encouraging mentors, study groups, and making time to take care of yourself is so critical to medical school success.