in medical school. But until you live it, those don't quite give you the full experience.

These are the unwritten and unspoken rules of medical school.

Dr. Jubbal, MedSchoolInsiders.com. This is inspired by a video I did on my personal

channel, Kevin Jubbal, M.D., linked in the description. That video is a bit more raw

and raunchy and is largely a compilation of your responses to my post on Instagram. If

you want something more unfiltered, be sure to check out that video after this one. Here,

we'll discuss more extensively the unwritten rules that no one else will tell you.

The first rule is a broad general rule, as your medical education and training is going

to be lengthy with plenty of reason to complain. You'll have professors whose competence you

question, attendings during your clinical rotations that seem impossible to please,

schedule changes that seem to always work against you, and other forms of bad luck.

But no one likes a Debbie Downer, so although there will always be reasons to get irritated

or whine about how things are inefficient, unfair, or a waste of time and resources,

don't become the person that's seemingly always pessimistic. Doing so just brings other people

down and makes the already irritating situation become worse than it already is.

Rather, if you're able to be the person that always finds the silver lining, that can turn

negative into positive, you'll not only win many friends and favors, but find yourself

much more at peace with the roller coaster ride of medical school.

In line with this, avoid getting defensive or egotistical when your knowledge gaps are

pointed out. If you're wrong or don't know something, don't try to explain why. Just

appreciate the person who is teaching you something and move on.

The second rule is to know clinical rotation etiquette before you get to your clinical

rotations. And this expands beyond simply knowing that a small towel on the handle of

the call room means it's occupied. Actually, that's a good one to know to make sure you

don't barge in and wake someone from their few minutes of precious slumber on a busy

call night. First, understand that a big part of your

overall grade in any rotation comes down to a subjective evaluation from your residents

and attendings. There are pros and cons to this, one of which is that being on your phone

is often interpreted as you being distracted and texting, going on social media, or finding

dank memes. It is for this reason that I bought an iPad Mini. By using my iPad to look up

information, I was more likely to be perceived as being studious and hard working when using

my devices, as opposed to distracted on a phone. The irony here is that just about anything

you can do on your phone you can do on your tablet, and vice versa. You could be studious

on your phone and be distracted on your tablet, but again the optics of your behavior are

important for your clinical evaluation. Second, don't be a gunner. When you rotate

at clinic or in the hospital, you'll usually be rotating with one or more other students.

You should never, under any circumstance, throw them under the bus. Making others look

bad is not only a terrible thing to do that will weigh on your conscience, but your residents

and attendings can usually see right through it, and that's not a good look.

Similarly, consider how your behavior makes others look. If you're in the operating room

or on rounds and the attending asks the resident a question, don't pipe in with the answer.

Sure, it may be impressive that you know something the resident doesn't, but what's more salient

is that you couldn't contain yourself to blurt out the answer, thus making the resident look

bad. No one wants to work with someone like that. If you are directly asked the question

next, it's of course fine to answer. When you put energy into looking good, you

come across as conceited and you paradoxically look bad. If instead you value others and

try to make them look good, you become a likable personality who appreciates others, and that's

the kind of teammate we all want. Another under appreciated skill is knowing

when to ask a question. If it's something that's easy to look up, look it up yourself

and don't waste other peoples' time or energy answering a simple question. If it's not easy

to look up and it's a genuine question, don't be afraid to ask it. However, know when to

ask questions. This comes down to social calibration. If things are hitting the fan in the operating

room, try to be helpful and let the team handle the situation, and refrain from asking unnecessary

questions in moments of acuity or stress. And finally, it's deeply frowned upon by everyone

in the hospital and clinic when you fail to like this video and subscribe to Med School

Insiders. The third rule is to appreciate and value

the little time you have. It's normal to feel like there aren't enough hours in a day, and

it's normal to feel like you're expected to do an impossible amount of work or studying

in too short of a time period. The value of facing this reality will serve

you well for the rest of your life. If you allow it to, it will teach you lifelong lessons

in productivity, efficiency, and effectiveness that will make you better rounded and able

to handle more than you thought possible. I have entire videos and playlists on efficiency

and productivity, so I won't rehash them here, but they are linked below. What I will emphasize

is that while you're in the hospital or clinic, maximize any down time you have. There will

be moments when you are waiting on the patient to be rolled into the OR, or when you're waiting

on seniors to begin rounding. Never let a moment in the hospital or clinic go wasted.

After all, you will not be able to relax and unwind while you're there, so seize the moment

in one of two ways: if you're feeling mentally sharp, power through some flashcards, practice

problems, or quick bursts of studying. If you're feeling mentally fried, then focus

on procedural memory, like practicing your suturing or knot tying.

The fourth rule is actually two rules about finances.

First, be mindful that everyone's financial position is different, and it's best practice

to avoid talking specifics. Some of your medical school classmates will be taking out more

loans, others will be taking out less. A surprising number won't take out any loans at all because

their parents are footing the bill. Those who have parental help may feel guilt or receive

some resentment from those who have to take out loans. It doesn't matter what other medical

students' financial situations are. Simply concern yourself with your own finances. And

if you're footing the bill, trust me when I say it's an incredibly empowering feeling

to know you paid your own way through medical school and the feeling you get when you finally

pay off your loans is priceless. Second, physicians are notorious at being

terrible with money. Don't contribute to the stereotype. Educate yourself on some simple

financial basics. I recommend the White Coat Investor book, linked below, for a quick and

easy read that will teach you 80% of what you need to know. Countless medical students

make poor financial decisions under the premise that since they're already in six figures

of debt, spending another few hundred dollars here or there is just a drop in the bucket.

The truth is that it's not just a drop in the bucket. In fact, it's a snowball that

rolls faster and grows larger the more you contribute to it due to interest and the compounding

effect working against you. It's a common trap medical students fall into

– they want to crush their boards, ace their pre-clinical blocks, dominate their clinical

rotations, and match into the best residency they can. I get it. I've been there.

At one point or another, the students that take this approach become miserable, burn

out, and find medical school far more painful than it needs to be. Tying in rule three,

it's not about brute forcing work at the expense of everything else. Success in medical school

comes down to optimizing your time and energy, and that includes high density fun and relaxation,

like spending time with friends or your partner, and of course the three pillars of exercise,

nutrition, and sleep. Some say not to enter a relationship while

in medical school, but the reality is that some relationships can immensely help with

your resilience and perspective of medical school, and others will be an energy drain

and hold you back. I was fortunate in medical school that I dated a fellow medical student

who definitely made my life better. But I know others who found that their relationships

caused their class performance and mental state to suffer.

Speaking of relationships, there's a common saying to not have a bowel movement where

you eat. This is said to indicate you shouldn't date someone where you work or in a small

class. The counterpoint to this is that you'll meet some amazing people you may want to enter

a relationship with. The key is to act with integrity so that if you part ways, you can

do so on good terms. Medical school classes are also much smaller

than any typical college, and for that reason you'll hear about everyone's business. Gossip

is a plenty, and it feels more like high school in this way. Don't give into the temptation.

Stay out of the gossip and drama and stay in your lane. You'll thank me later when things

implode and become a distraction from the little time you already have.

If you view your fellow classmates through a long term lens, meaning that you want to

be on good terms with everyone, and for a long period of time, you'll find yourself

avoiding many faux pas, like asking others what score they got on a quiz or test. Doing

so has very little upside for you but substantial downside– after all, you already know the

class average and max scores, but there is a high probability to make someone else uncomfortable.

When you view medical school and your classmates through this perspective, it's natural to

look out for one another and want the best for each other. After all, you're all in it

together, and challenging times can be great sources of strength and bringing us closer,

but only if you let it. If you enjoyed this video, check out the other

unspoken rules on my Kevin Jubbal, M.D. channel or this other video. Much love, and I'll see

you guys there.