5.1) How long is medical school?

  In the United States, medical school is generally four years in
  length.  You spend the first two years predominantly in the
  classroom and lab, and the last two years predominantly in the
  hospital.

5.2) What classes are there in medical school?

  The classes in medical school vary from place to place.  But there
  are some that everyone takes in their first two years, no matter
  where they are:

   Gross Anatomy
   Biochemistry
   Pathology
   Behavioral Science
   Pharmacology
   Physiology
   Microanatomy/Histology
   Microbiology
   Physical Diagnosis (or some kind of intro to the patient class)
   Medical Ethics

  The amount of lab work varies from class to class and school to
  school, although some classes (like gross anatomy) feature as much
  lab work as you have time for.

5.3) How are students graded/evaluated in medical school?

  Again, depends on the school.  Many schools still have the standard
  A/B/C/D/F scale of grading.  The rest go on the pass/fail scale or
  some variation of it.  Many schools have an "honors" grade which
  reflects performance in an upper percentile of the class for that
  course.

  The grading scale can change as you advance in your studies.  For
  example, some schools have letter grades the first two years and
  then pass/fail grades the last two (or letter grades the first three
  and pass/fail the last year only).

  The grades themselves are objective the first two years - based
  almost entirely on written exams, oral exams, and practical (or lab)
  exams.  In the third and fourth years, grades depend in large part
  on evaluations by other members of your hospital team - the
  attending physician(s), the resident(s) and/or the intern(s).  There
  are also written/oral exams in the last two years, and the relative
  importance of exams vs. evaluations varies greatly from rotation to
  rotation.

5.4) What are "rotations"?

  Rotations are the blocks of time you spend on the different services
  in the hospital.  Most schools have a set of required rotations and
  let you choose from a vast field of elective rotations to fill out
  the rest of your third and/or fourth year.  The required rotations
  everywhere:

   Surgery
   Internal Medicine
   Psychiatry
   Pediatrics
   Obstetrics and Gynecology (Ob/Gyn)

  Generally you will spend a total of about 10 months doing these five
  rotations.  Some schools make you take all required rotations in the
  third year, and some let you spread them out so that you can take
  electives in the third year, thereby allowing you to take some
  electives that may help you narrow down your possible choice of
  specialty for residency.

  There are some rotations that are required at all but a few schools:

   Family medicine
   Neurology
   Orthopedics

  A typical third year might look something like this:

   Surgery - 2 months
   Pediatrics - 2 months
   Neurology - 1 month
   Family Medicine - 1 month
   Ob/Gyn - 6 weeks
   Psychiatry - 6 weeks
   Internal Medicine - 3 months

  As far as electives go, generally there are several ways you can go.
  You can take "away" rotations - rotations arranged to spend at other
  hospitals (ideally the hospitals where you think you might like to
  do your residency).  Generally, schools will let you do a month or
  two away.  When considering away rotations, keep the following
  tidbits in mind:

   1) Most residency applications are due by October or November, and
  most residency committees start making decisions on who to interview
  by the end of November at the very latest.  Therefore, for an away
  rotation to really help you sway the people at the hospital you
  visit, it must be done in the first few months of the fourth year
  (keeping in mind that USMLE Step II is usually at the end of August
  of that year).  September and to a lesser extent October tend to be
  the most popular months to schedule away rotations.

   2) At most schools, there are a lot of hoops to jump through to get
  an away rotation approved.  You have to determine that the hospital
  you want to go to actually has an open slot in the rotation you want
  during the month you want to be there.  Once you've gotten that
  info, there are lots of forms and signatures needed--deans and
  chairmen from both schools, grading papers, course content papers,
  etc.  The point of all this is: once you decide to take an away
  rotation, get started on planning it because it takes a month or two
  to get everything straightened out.

  The electives you do at your home school tend to fall in these
  categories:

   1) Electives in what you think will be your residency specialty
   2) Electives in things you think will help you in residency (a lot of
      people take things like cardiology, radiology or emergency medicine
      because they provide valuable training for the intern year)
   3) Electives in things that interest you
   4) Electives your friends are taking
   5) Electives that are easy (generally includes things like
      ophthalmology, dermatology, and lots of odd little electives that
      will turn up on the list at your school; at my school we could do a
      month sitting in the blood bank drawing blood from people, or do a
      month learning what the different lab tests are and what they mean)

5.5) What are the "must have" textbooks?

  The only absolutely essential, "must have" textbook is the "Atlas of
  Human Anatomy," by Frank H. Netter, M.D. (now in its 2nd edition).
  Beyond that, your textbook purchases should reflect:

   a) the recommended texts of your school - not all texts cover the
  same subjects to the same depth, and you might miss out on a
  professor's pet area that he loves to test heavily because it's so
  insignificant that a different book barely touches on it (thus a
  gentle reminder to try to learn what your professors consider
  themselves to be experts in, because those things will always be on
  the tests).  Also, remember that your required texts will all be on
  reserve in the library (usually in multiple copies) - so if you
  really feel you need to read one chapter, you can always just borrow
  the library copy and read it.

   b) the course materials given out in each class - some classes
  feature thick, comprehensive syllabi that cover each lecture
  specifically and that make the purchase of an outside textbook
  pointless.  And some schools have note-taking services that "can"
  lectures - basically giving you a typed transcription of the entire
  lecture, complete with copies of overhead materials.  As with the
  syllabi, a good set of cans renders a textbook moot.  Not all
  schools allow the canning of lectures, but if they are offered you
  should absolutely sign up and get them.

   c) your personal study preferences - how do you study best?  Some
  people love to read the texts.  Some people like lectures and don't
  read much at all.  Determine where you fall in the scheme of things
  and plan your purchases accordingly.  Even if a text is great
  (example - the Robbins pathology text), generally the book will be
  dry reading and very long, and if you are not the kind of person who
  learns well from books like that, then your money is better spent
  elsewhere.
  
5.6) What is PBL?

  PBL stands for "Problem Based Learning."  Basically, there are two
  basic types of curricula in medical schools today: PBL and so-called
  "traditional" learning.  Traditional learning is the basic stuff you
  had in college--lectures and plenty of 'em, labs, classes taught as
  discrete entities (gross anatomy, pathology, pharmacology, etc.).
  PBL represents a more integrated way of presenting the materials.
  Lectures are kept to a minimum; instead, the emphasis is on small
  group learning, teamwork and problem solving.  Groups meet and are
  given clinical situations in keeping with the current subject
  material.  These situations can involve anatomy, pathology,
  pharmacology, etc. all at the same time.  The group then solves the
  problems using available resources (library, computers, etc.) and
  discusses their solutions.  In this way they learn the body as it
  is--a set of interrelated systems--instead of in discrete chunks.

  That said, PBL is not for everyone.  Some people prefer the
  lectures.  Some schools offer only PBL, some only traditional, and
  some give you an option of which you would prefer.  Contact the
  schools you are interested in and ask them about their curricula.

5.7) Is there any free time in medical school?

  There is as much free time as you want there to be.  In spite of
  what you might hear, medical students don't study ten hours a night
  AND go to every lecture AND go to every lab AND read journals just
  for interest AND work on a cure for cancer.  At the beginning, sure,
  you'll feel this overwhelming fear that everyone is ahead of you and
  you will make the lowest grade and somehow people will find out and
  point and laugh at you.  So you'll study like crazy right up until
  that first gross anatomy test that you'll take on no sleep in some
  caffeine-induced trance.  After that, though, you'll learn what your
  best study methods are and how best for you to use your time.  After
  that, you'll discover that there is plenty of free time to have a
  family life, have friends, go to parties, form a bowling team in
  your second year and win the league championship after defeating the
  five-time defending champions in the playoffs (which a group of
  students from my school - myself included - did).

  In the clinical years, your free time depends on your rotation.
  Surgery tends to lend itself to hospital work and sleep only.
  Psychiatry tends to give you more free time than you could possibly
  fill.  The others fall someplace in the middle.

5.8) What is the USMLE?

  In spite of its resemblance to the words "U SMILE," it's not a happy
  thing.  USMLE stands for United States Medical Licensing
  Examination, and the website may be found at <http://www.usmle.org>.
  There are three parts to it (the first two parts consisting of a
  one-day, eight-hour exam and the third part consisting of a two-day
  exam), and in virtually every state you must pass the parts in order
  to get licensed.  The examination is now offered on computer at
  testing centers, and may be taken whenever the student wishes.  See
  the USMLE web site for more information.

  The parts are:

   Step I, taken after your second year
   Step II, taken in your fourth year
   Step III, taken at the end of your internship year

5.9) What is a good USMLE score?

  A good score is one that is (a) passing and (b) passing, a fact that
  the USMLE apparently realized because rumor has it they are going to
  make the exams pass/fail in the near future.  For now, keep in mind
  that the national average (which has been rising, probably through
  artificial means) has been around 215 in 1997-98.  The cut-off for a
  "good" score once was 200 (when 200 was set as the statistical mean,
  or 50th percentile score).  Now, though, "good" scores start around
  215 and go up from there.  And yes, it is sad but true that some
  residency programs use USMLE Step I scores as a preliminary cut-off
  point for sending out secondary applications and/or interview
  requests.  Generally the programs that do this tend to be the more
  competitive ones - surgery, orthopedics, ENT, neurosurgery, etc.

5.10) What is AOA?

  Alpha Omega Alpha, or "AOA," is a national medical honor society that
  was founded in 1902 to promote and recognize excellence in the medical
  profession.  Most, although not all medical schools have a chapter of
  AOA.  Each school's chapter selects a small group of students to join
  the society, generally in their junior or senior years.  "Junior AOA
  status," or being selected as a junior, is considered superior to
  "senior AOA status."

  In order to meet the minimum requirements of the national society,
  students must be in the top 15% of their class academically, and
  possess leadership and community service attributes.  Academic
  activities such as research, performance in clerkships and electives
  and extracurricular program participation are generally included in
  the selection criteria.
  
  Individual chapters may also elect to induct outstanding alumni,
  faculty and house staff to AOA.  Induction ceremonies are generally
  held just before graduation and are highly specific to the
  individual chapters.

  Having AOA on your curriculum vitae is considered an asset when applying
  in the very competitive post-graduate programs such as dermatology and
  surgical subspecialties. 

  [Maintainer's note: Stanford, the University of Connecticut, and
  Harvard are the schools that do not have AOA.  If you are aware of
  other schools that do not have a chapter, please let me know.]