Medical school prerequisites, such as mandatory premed classes and the Medical College Admission Test or MCAT, are designed to ensure that anyone accepted to medical school is prepared for the academic challenge of becoming a physician. Nevertheless, though most medical students perform exceedingly well in their undergraduate courses and achieve stellar college GPAs, many students discover that medical school courses are much more rigorous than college courses.
Dr. Aron Sousa, the senior associate dean of academic affairs with the Michigan State University College of Human Medicine, says the amount of work medical students are expected to complete during medical school is formidable. "For the most part the intellectual difficulty of the work is about the same as a meaningful upper level college course, but there is so much studying and work that even very good students work long hours," Sousa wrote in an email. "Most medical schools expect their students to work 60-80 hours a week every week."
Success in medical school requires persistence, according to physicians. "Think of it as intellectual and endurance boot camp that lasts four years. Any physician I've ever asked agrees with me: I'm glad I did it, and would never, ever repeat it," Dr. Robert B. Young, an associate professor of psychiatry at the University of Rochester School of Medicine and Dentistry in New York, wrote in an email.
Young says the stakes are higher in medical school than in other types of higher education, because medical students need to absorb their professors' lessons well enough to apply that knowledge during a health crisis. "The point of the whole exercise is to become able to make decisions about people's lives that are in your hands, so that's -- that's kind-of an additional pressure, because you want very, very much to get it right," he says. "It's not just about making the grades; it's about learning to do what you'll have to be able to do in order to deserve that responsibility."
Medical school is similar to premed undergraduate coursework in that it is science-focused, Young says, but the medical school curriculum more heavily emphasizes the science of human health and human disease, as opposed to general science. "The goal in medical school is to learn everything that is known until that year about the human body," he says.
David Delnegro, a fourth-year medical student at the University of South Florida Morsani College of Medicine, says that the intensity of medical school courses often shocks new medical students.
"The speed in which medical school material is delivered is breathtaking and will humble every incoming student, especially since little guidance is given on how to prioritize the mountain of material," Delnegro wrote in an email. "In stark contrast to most undergraduate programs, in-person attendance at most medical schools' basic science lectures are optional. This means it is the sole responsibility of the student to watch the recordings in order to keep up and seek out help when needed."
Paige Johnson, a student and osteopathic manipulative medicine fellow at A.T. Still University of Health Sciences--Kirksville in Missouri, says that medical courses require close attention to detail. "It's much more in-depth than you would ever think," she says. "And it's fascinating, because you learn that all of those little details that you thought weren't important in undergrad turn out to be very important in medical school. Learning every little detail and learning such a large breadth of information is -- in a word -- overwhelming."
Young notes that medical school typically begins with health-related science classes in fields like biochemistry, physiology, pharmacology, anatomy, histology, microbiology and genetics. It also includes lessons on how to interview and interact with patients, he says.
Eventually, as medical students become more advanced in their education, they begin their clinical rotations, where they assist experienced doctors in various medical specialties and hone their ability to diagnose and treat various health ailments. Young says that the clinical rotations are often the most fun and rewarding aspect of medical school. "It's actually very exciting to finally start your third year, because that's when you're located with patients all the time," he says. "You still have lectures ... but that is when you actually begin to contribute to patient care."
He notes that medical students in clinical rotations typically interview patients, write up thorough patient history reports and perform physical exams.
Upper-level medical students have the dual responsibility of performing coursework and simultaneously doing clinical work, Sousa says, and this period of medical school can be especially difficult. "When students are deep into clinical rotations in clinics and hospitals, there are long hours of patient care and yet more studying for examinations and preparation for presentations," he wrote. "And, whenever they are involved in clinical care, students face the emotional challenges of helping sick patients and their families as well as the challenge of performing in a stressful work environment."
Dr. Joseph Kass, a professor of neurology and associate dean of student affairs at Baylor College of Medicine in Texas, says that in order to be successful in medical school, students typically need to spend two hours studying per hour of lecture. He notes that though cramming is sometimes an effective study strategy in college, it is not a viable option during medical school, which requires continuous disciplined study.
Physicians caution that, while it is common for people who excelled in undergraduate science courses to apply to medical school, it's important for these individuals to reflect on whether a career in medicine is the best fit.
"Prospective medical students should feel a calling to medicine beyond it being the next most logical step or pursuing medicine because they have the academic posture and MCAT scores to gain admission," Dr. Anik Cockroft, a Hawaii-based pediatric sports medicine physician, wrote in an email. "The medical school curriculum and courses are more focused for the future physician than the basic sciences which are the cornerstone of premedical education."
Medicine is a profession that requires extensive training, physicians warn, and there are many science jobs for science-focused students to consider that do not involve health care. Nevertheless, Young says prospective medical students should understand that, if they are admitted to medical school, the school believes they are capable of earning a medical degree. "If you're accepted into medical school, have no fear," he says. "You'll get through."
Medical school dropouts are rare, and it is unlikely that medical students will flunk their classes, Young says. Furthermore, because medical schools have caps on the number of students they can enroll and graduate, these schools have an incentive to ensure that every student they admit eventually becomes a physician, Young adds.
"There's an absolute limit on how many physicians-in-training there can be every year, and nobody -- including the school -- wants to waste a position by having somebody find out halfway through the first year or later that they don't like it and they're quitting," he says. Medical schools typically offer significant academic support to struggling students, Young adds.
"You can handle the academics of medical school," he says. "It's harder, but you can handle it, because I did and everybody else who got in did, and they will make sure you get through as long as you keep trying."
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