Dear Third-year Medical Student:

It’s hard to believe that, as I’m writing this, I am in my last rotation of third year. This year has been amazing and has gone by so quickly. There is no way to predict or to prepare for what your third year will have in store, but if it’s anything like mine, then it will be full of ups and downs — moments that you will cherish for the rest of your life and a few that you’ll wish you could forget.

You will laugh with your colleagues, with your residents, with your patients, and with your attending when you accidentally drink his coffee. He won’t even hold it against you; in fact, he may even laugh with you as you spit it out because it has too much Splenda in it.

You will cry. Maybe during your surgery rotation, alone in a hospital bathroom. But it will be OK. You will survive that day and the rest of the rotation, and you’ll eventually appreciate what you learned in that moment when all you wanted to do was go home and crawl into bed. Splash some cold water on your face and scrub back in.

You will lose your patients, and it will be tough, especially in pediatrics where death feels unfair and cruel. You might visit the “butterfly room” afterward and try to imagine what that mother is thinking, say one last goodbye to the three-year-old who never had a fair chance, and then continue your day. You’ll still have other patients who need you, like the six-year-old down the hall whom you’ll teach how to swallow pills using Tic Tacs and Halloween stickers with googly eyes.

You will make mistakes. You will overlook important labs or miss huge and obvious physical exam findings. You will always forget to ask something that in retrospect seems like the most obvious question in the world. But, you will get better. Every single day you will improve, and you’ll realize that having someone point out your mistakes is a necessary step in developing into a competent and qualified physician who is going to change people’s lives.

You’ll talk to patients more than anyone else on the team, inevitably explain something to the patient that they never understood, ask a question that no one had taken the time to ask before and unlock a part of the patient’s history they never felt comfortable sharing. As medical students, we have the opportunity to know our patients on a deeper level than anyone else on our team. We have the time to actually hold a meaningful conversation with them. When we’re residents with twenty patients to see but only ten minutes to spend with each one, we won’t get to hear the stories of pain, of healing, of suffering and of happiness, and we will miss them.

You’ll likely fall asleep on rounds, in the ER, in your car in the parking lot, standing up during a kidney transplant at 2:00 a.m., and even occasionally in your own bed. But you’ll also never feel more awake than in the incredible moment you’re watching surgical clamps being removed and blood flowing through that same transplanted kidney, saving a twenty-three-year-old’s life. You will learn more than you ever imagined possible, even when you don’t realize it. You are surrounded by incredible, caring, and compassionate people every day. Your residents, your attendings, your fellow students, the nurses, techs and secretaries, and most of all your patients will teach you about life, death, hard work, and also a little medicine. You will grow as a person and begin to see your own potential. You will realize that the “C” on your transcript from first year really doesn’t matter (seriously), and that you are meant to be here. Even if you failed a pathology test or two, you are still capable of becoming a great doctor.

You will learn more than you ever imagined possible, even when you don’t realize it. You are surrounded by incredible, caring, and compassionate people every day.

I hope your third year is every bit as happy, sad, energizing, exhausting, confusing, simple, rewarding, and beautiful as mine has been.

Lauren Gambill is now a pediatric chief resident. She can be reached on Twitter @renkate.

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