Stephen Hawking described intelligence as “the ability to adapt to change,” and this is the intelligence necessary to succeed in medical school. Most students know that medical school is hard, many are unprepared for the immense amount of material and intense pace, like drinking water from a fire hydrant. Even more difficult, for many, is the constant change; class schedule changes, visiting professor changes, and exam policy changes to name a few. Not to mention adapting to living on a small island in a foreign country, while learning the new language that is medicine. Personally, having family with me made the moving easier, but the curriculum and pace were challenging.

AUC provides various resources to aid students, either online or on campus and there are professors who care deeply and will certainly help struggling students. Nevertheless, from my experience, other students and upperclassman were also vital resources for succeeding, as most students will happily share their experiences. The guidance and advice of upperclassman gave me invaluable insight on how to prepare and study for individual classes, COMP, STEP 1, as well as information regarding clinical rotations so I could make the best choice for myself and my family.

Preparing for the USMLE STEP 1 exam is usually accompanied with more changes including moving back to parent’s houses and home countries. Resting is essential, as most students are still recovering from the recent exhausting preparation for the comprehensive NBME exams and shelves. Passing those exams and almost immediately resuming study for another, even longer test is difficult for some students. However, this is a crucial time in our academic life and there is no time to waste. The average study time for STEP 1 is 8 weeks, I personally prepared for 10 weeks. I did not feel ready, but I am unsure if anyone ever feels ready to take this career defining exam.

Waiting for the score was as hard as actually taking the exam. The 3 weeks wait felt more like 3 years. The USMLE exam is not a feel-good test, and like many of my colleagues, I walked out feeling I had failed. Staying busy was essential to calm the growing knot in my stomach, I spent some well-deserved time off, reconnecting visiting with family and friends.

The joy of passing the first board exam is rapidly followed by a cascade of emails; there are physical exams, vaccines, drug testing and background checks, as well as HIPPA and infectious diseases training. The transition into clinical medicine happens at a fast pace, and although we are still students, we are reminded that this is a professional course. We no longer have the scheduling flexibility we had in basic sciences, now our time belongs to the hospital, or clinic we are rotating at. 

I decided to do the majority of my core rotations in the United Kingdom as I enjoyed my time in Preston after Hurricane Irma relocated AUC temporarily to England. Also, students have the option of full or partial rotations and their choice of 7 different hospitals, all unique in their locations in England. Knowing my schedule before heading into STEP 1 prep, was one less thing to have to think about during this crucial time. I spent just over seven months in the UK, and that was certainly the right decision for me. I would certainly recommend that every student takes the time to learn as much as they can about the clinical rotation sites, early on, before they have to make a decision. The AUC team in England is good at returning emails and informing students as questions arrive, however, once again, upperclassmen can be a great resource for information from a student’s perspective.

Change is constant for medical students, I like to think it is preparing us for the ever-changing field of medicine and a career of learning, adapting and growing. Having the ability to adapt to change is not a skill we are all born with, but learning this skill, will allow you to flourish as a medical student and you will continue to reap the benefits as a doctor.

Gilmar Costa, MS3