Mastering M2: Top questions for your second year of medical school


As a second-year medical student, you have transitioned to the next level of your training and gotten through the ringer of being an M1. Throughout your journey as a medical student, some key questions are likely to arise. The AMA offers answers to questions medical students frequently ask during their undergraduate medical training.

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Many M2s have yet to do dedicated patient rotations—the majority of schools begin clerkship during the third year of training—but that doesn’t mean that students can’t impact patient health. Added-value roles for pre-clinical medical students are plentiful, some exist within the curriculum in arenas such as patient navigation. 

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Medical student sitting on a stack of textbooks

Another appealing option is to get involved in interacting with patients through a medical school’s free clinic—most schools operate one. Pre-clinical medical students at the University of Toledo College of Medicine and Life Science, for example, demonstrate a commitment to patients from their earliest days in physician training by working at student-run community care clinics.

“It's the first patient contact that our students get,” said AMA member Addison Sparks, who worked as the clinic’s executive director as an M2. “We allow first-year students to have supervised interactions with patients.”

“It's really rewarding to learn about something in lecture and you think you know it, and then you actually see it in real life and how it can affect a person's well-being,” Sparks said. “Then you have the opportunity to address that and then improve their condition for them, which is just really valuable.”

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Students generally take the United States Medical Licensing Examination® (USMLE®) Step 1 exam after the completion of pre-clinical training. This can be anywhere from the completion of your first year to the end of your second year.

In recent years, the exam shifted from a numerical score to a pass-fail system. The exam’s content was unaffected by the switch, so diligent prep is often the best measure to ensure one registers a passing score. As far as how to go about studying, the best method can often be to stick with what has worked for you in the past.

“It is easy to get drawn into the hubbub that swirls about from people who have completed [Step 1] and are offering 1,000 strategies,” said Pauline Huynh, MD, an otolaryngology resident at Kaiser Permanente Northern California.

“You need to find something that works for you—and you've done it before, when you studied for the MCAT [Medical College Admission Test], when you studied for the SAT or ACT,” Dr. Huynh said. “So you know that there is something, intrinsically, that works for you. Be confident in it. … For example, I learned early on that I study better in a coffee shop, away from my bed.”

In much the same way the Step 1 moved to a pass-fail setup, the first level of the Comprehensive Osteopathic Medical Licensing Examination of the United States (COMLEX), most commonly taken by osteopathic medical students, went pass-fail in 2022. It shouldn’t change your prep much, experts say.

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Some students do their clerkship rotations as M2s—though the third year of  medical school is the most common time to do them. Regardless of the timing of your clerkship rotations, it might be worth planning ahead.

The move signifies a transition from classroom to clinic, making for a different type of learning environment. Tips from those who have gone through these key rotations include maintaining professionalism, remembering your patient experiences to help your learning and using the experience to hone your specialty choice options.

Having recently completed his family medicine residency at United Health Services in Binghamton, New York, James Docherty, DO, is a few years removed from his own clinical rotations as a medical student at New York Institute of Technology College of Osteopathic Medicine. “If I could do it again, I'd definitely be more forthright with my thoughts,” Dr. Docherty said in an interview for the AMA’s “What I Wish I Knew in Medical School” series. “I'd be more confident with how I spoke and really put my thoughts out there.”

“What you are really learning is how to develop a concrete plan. It’s a different phase of medical school. In your first and second years you learn about individual diseases, and you learn how to treat individual diseases because they give you all the pharmacology knowledge, and now you have to combine all those different diseases in a real person. It's so rare that one person has one chronic disease.”

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Mentors are vital throughout all of medical school. Avani Patel, MD, a psychiatry resident at the University of Mississippi Medical Center, went so far as to say that “mentors should be mandatory” in medical school.

Dr. Patel said that mentor relationships can differ at different stages of medical school.

“M1 and M2 years, I looked for mentors who could really help me in terms of test taking and navigating courses,” Patel said. “So, I spoke to a lot of medical students early on. After that, I looked for mentors in the specialty I was interested in, because I came to medical school with a specific specialty in mind. When I connected with them, I soaked up as much advice as I possibly could while trying to take my own path.”

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Research can be a career-long pursuit for physicians. A physician researcher’s journey often begins in medical school.

Getting started with that pursuit as a medical student doesn’t necessarily require any prior research experience, according to Luke Finck, EdD, the associate director of the office of medical student research at Vanderbilt University School of Medicine.

“When students come to medical school, they want to work with patients,” Finck said. “Previous work that they did in the lab does help them understand the translational aspects of research, but may not be the type of research they want to engage in. So, students who don't have any experience aren't necessarily at a disadvantage to those who have it, because the type of research they're likely going to do in our program may not be the same research that they did before they came to medical school.”

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Medical students have a voice. Honing it can start on your medical school campus.

That’s what Aneri Shah, a second-year medical student at the Midwestern University Chicago College of Osteopathic Medicine has discovered. Shah is the president of the school’s AMA chapter and the outreach coordinator for the AMA Medical Student Outreach Program. The two roles have allowed her to see how the physician landscape shifts beyond the clinical realm.

“I knew that students could possibly try to affect change, but until I joined the AMA, I didn't realize the extent to how far our voices could reach,” she said. “One thing that really pulled me in was that medical students actually put together the resolution for people not being allowed to smoke in airplanes. That turned into a pretty significant piece of legislation.”

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Medical students are more likely to experience burnout and depression than other similarly aged individuals pursuing different careers, and this elevated risk persists into residency training. Systemic solutions are generally considered the more effective method for preventing medical student burnout. 

 At the individual medical student level, however, one piece of advice to combat burnout is to try to get back to parts of your past wellness routine. That, of course, is easier said than done for the stretched-thin medical student.  

“At the end of my third year of medical school, I was a physical mess,” said Sandra A. Fryhofer, MD, immediate past chair of the AMA Board of Trustees and a practicing internal medicine physician in Atlanta. “I had no time to exercise. I was exhausted. I looked in the mirror and I said: What is happening? I'd always gone to dance classes for exercise, but as a third-year medical student there was no time. There was no schedule. But I then joined a health club, and I went to exercise every day. This health club was close to my home, so I had to change what I'd always done—and it helped. 

“Knowing self-care strategies can be helpful. … Organized study groups can really be helpful. They can reduce stress, anxiety and depression.” 

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The AMA’s Facilitating Effective Transitions Along the Medical Education Continuum handbook takes a deep dive into the needs of learners along the continuum of medical education—from the beginning of medical school through the final stage of residency. Download now.