Top questions to help master life as a second-year medical student

As a second-year medical student, you have transitioned to the next level of your training and gotten through the wringer of being a first-year student. 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.

Many second-year students 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. 

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 second-year student. “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.”

Dive deeper:

• How medical students can help drive changes to community health
• As health navigators, students see value of team approach
• How a medical student-run clinic is navigating the pandemic

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. 

Dive deeper:

• Cut yourself slack and seek help to get through USMLE Step 1 prep
• 4 tips to maximize the dedicated Step 1 study period

According to Joshua D. Brooks, PhD, associate director of medical academics at Kaplan Medical—one of many third-party study resource providers, along with AMBOSS, UWorld and others—it’s better to get started sooner than later.

Brooks said that students should create a study plan and get started at least six months, but preferably 12 months, before the exam. Early on, it’s more important to get into the rhythm of studying than to feel like you’re gaining knowledge. By starting early, you can also incorporate test prep into the studying you do for classes.

Dive deeper:

• 7 timeless tips for not squandering USMLE Step 1 study time
• For your USMLE Step 1 study plan, follow the evidence on what works
• USMLE high-yield topics—in the eye of the beholder?
• 4 keys to maintaining personal wellness during USMLE prep

Some students do their clerkship rotations as second-year students—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.”

Dive deeper: 

• The science of scheduling: When to do key medical school rotations
• 4 tips to enhance patient communication as a medical student
• The AMA’s transition in med ed handbook offers key tips for leaners 

With residency applications for most students going out in the fall of year four, most students pick a specialty at the end of their third year of medical school. As first- or second-year student, you may have a specialty preference, but that often changes. 

A 2023 study of more than 10,000 medical students found that 56% changed their career choice between their second year of medical school and graduation. 

In shifting his preferences from ophthalmology to internal medicine, AMA member Charles Lopresto, DO, found that core clinical clerkship rotations during his third year of medical school were a key data point. 

“When I started clinical rotations, I fell in love with internal medicine on the second or third day that I was on the floors,” he said. “I found that having the clinical experience and being on the floors with the patients in the specific environment was a lot more useful for me to actually see what I was interested in than a preconceived notion that I had limited clinical experience in.”

Dive deeper:

• How physician specialty choices change between second year and graduation
• Future physicians: When's the right time to choose a specialty?
• When picking a physician specialty, don’t ignore your instincts
• 5 things students overlook when choosing a specialty

Historically, the National Resident Matching Program considers the most competitive specialties to be those that match with the highest percentage of U.S. medical school graduates. To land a place in one of those residency programs, an applicant must stand out.

Key tips include a resume of across-the-board academic excellence, speaking with mentors in a given specialty and understanding what it takes to match in a specialty. It’s also very important to put your passions over prestige, according to Kim Templeton, MD, professor and vice-chair of orthopaedic surgery at the University of Kansas School of Medicine and Health System.

“If you have to wake up at two or three o'clock in the morning to go reduce a dislocated hip and you don't like working with the musculoskeletal system, that's going to be really hard,” said Dr. Templeton, referring to typical on-call duty in orthopaedic surgery.

“You'll drag yourself out of bed, but you're going to resent your career—and you don't want to do that. You don’t want to pursue training in a competitive specialty only because of the challenge that that presents or because you are encouraged (or discouraged) from pursuing a particular specialty,” Dr. Templeton said. “You want to do something that you enjoy, something that makes you happy, something that makes it so you look forward to every morning.”

Dive deeper:

• How to prep for a competitive physician specialty
• The AMA's “Shadow Me” Specialty Series
• FREIDA's Specialty Guide

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.”

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.”

Dive deeper:

• Medical student research FAQ: Get started, showcase your work
• How medical students can thrive when making a presentation
• From poster to print: Get published as a medical student, resident
• How medical student research can resonate with residency programs
• Tips to land your first medical student research experience

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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.”

Dive deeper:

• Leadership 101: What medical students need to know
• 4 ways organized medicine helps medical students grow as leaders
• Tips to find enriching medical student leadership opportunities 
• 3 keys to boosting your medical student leadership skill set 

While precise data on the number of medical student parents is unavailable, a figure from the Association of American Medical Colleges’ 2023 Medical School Graduation Questionnaire sheds some light on the prevalence of parenthood among future doctors. When asked “How many dependents do you have (not including a spouse or partner)?” roughly 4% medical students said one, 2% said two and 0.4% said three. The word “dependent,” however, isn’t exclusive to children.

AMA member Rommel Cruz Morales, MD, entered medical school with one child and had another as he progressed in training. He highlighted the importance of flexibility in being an effective medical student parent. 

“Every month tends to be a different balance, as the expectation varies between my clinical schedule and [his wife] Kathryn’s professional projects,” said Dr. Cruz Morales, now an ob-gyn resident at Wright State University. “For example, right now I'm approaching my overnight shifts on my ob-gyn subinternship, and we're planning our week where she'll need to take on more of the evening childcare.

“At our busiest times, we prioritize things as they appear, using whatever free time to handle the most urgent things as quickly as possible. If I know my wife has had a rough day, I'll let her sleep while I handle all the shopping, food prep, housework, etc.—and she does the same for me.”

Dive deeper:

• Starting your family in medical school: 5 things to consider
• How medical student parents factor in family when picking a specialty
• Are you a parent in medical school? Here are tips to navigate Match

Medical students may not have extensive clinical knowledge from the jump—that comes over time. Still, what students may lack in know-how, they tend to make up for in passion.

Channeling that passion can take on many forms. One of them is advocating changes to the U.S. health system so that it can better serve physicians and patients.

For those looking to get started as a student advocate, the AMA Medical Student Section Committee on Legislation & Advocacy strives to be the medical students' leading voice for improving medical education and advocating for the future of medicine. 

“To me the idea of grassroots advocacy is following up your words with action and making an impact on the community around you. Walking the walk,” said Matthew J. Christensen, MD, a former member of the AMA-MSS who is now a resident physician at Naval Medical Center in San Diego.

“Anyone can share an article on social media or be an armchair politician, but grassroots advocacy is about making a deliberate and tangible effort to truly do something,” Dr. Christensen said.

Dive deeper: 

• How to get involved in advocacy work as a medical student
• How medical students help shape AMA policy—and medicine’s future
• 4 reasons medical students should get involved in local advocacy

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.” 

Dive deeper:

• Burnout’s not about you—it’s about the broken health system 
• 8 ways to cut medical student burnout 
• Medical school burnout: How to take care of yourself 
• Take a mindful approach to manage med school stress 

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.