It’s long been said that learning information in medical school is like trying to drink from a fire hydrant. You simply can’t imbibe everything that is thrown at you, even if it’s thrown at you from the front of a large lecture hall by a lecturing doctor. At the same time, there still is a good deal of information that you do have to learn in medical school; the fire hydrant scenario holds some truth. It, however, is arguably not the only applicable medical school metaphor. When surveying a spectrum of first through fourth year medical students, their perspectives and advice on facing the difficulties of medical school was both terrifying and encouraging at all once.

“I think medical school is kind of similar to playing tetherball back in elementary school,” reflects Nathan (a current second year medical student). “Only, it’s like the ball just keeps swinging your way, and instead of pounding the ball back towards your opponent, you’re basically just ducking and dodging the ball as it swings towards you constantly.” While his words don’t necessarily seem like the most encouraging bit of reflection at first, they do hold some strings of hope to hold onto. For one, Nate’s words show that even though that tetherball keeps swinging towards you, if you have deftness and endurance, you can stay in the game successfully. Medical school does not stop or slow down, except perhaps for your school year breaks (Christmas and spring break, your first two years) and summer break (between your first and second years). Towards the end of the game, things also slow down; fourth year at most schools is considered to be the “promised land” of medical school, with time for interviews and relaxing a little bit before the madness of intern years and residencies starts.

Another somewhat more appalling analysis of medical school life is brought to us from Steve, a third year medical student who compares the endurance and mental toughness of the battle of medical school to training for the Navy Seals. While obviously not anywhere nearly as grueling as Seal training, medical school does require its students to push through and work harder than they’ve probably ever had to work before; medical school is a very different game from undergrad or other careers even. However, as with Nathan’s statement first, this comparison of medical school to a very grueling physical and mental challenge also has its bright side; even though it’s hard, it’s still doable. In fact, it’s so doable that there are many others who have gone before you (and who might possibly be your teachers, residents, and attendings during your four years of medical school) and can show you that there is light at the end of the tunnel. As with any challenge, however, medical school will be hard, but it will also show you that you’re capable of far more than you ever thought you were.

Personally, as a medical student myself, I find that the marathon analogy is really the best way to answer the question, “How hard is medical school?” Running 26.2 miles may sound like an impossible task to many people, but the fact remains that it’s entirely doable—and not only is it doable, but it’s also very possible for people to do it very well. The key to this success, however, lies in their training. A successful marathoner trains his body by adding on mileage to his weekly runs, working up closer and closer to the actual race mileage; this is a physical task as well as a mental one, as running for hours on end can be very boring with plenty of opportunity for your tired mind to convince you of seemingly reasonable reasons to quit. In addition to long runs, a competitive marathon runner also works on improving his short sprinting muscles. Not only does doing so improve overall muscular strength to help prevent from running injuries, but it also gives him the power to be able to dig deep within himself and give himself an extra spurt of energy to push through the finish line on race day.

As with a marathon, “training” for medical school requires mental and physical toughness. How each student builds up this toughness will vary, depending on specific study methods. For most students, however, medical school success requires the ability to study for hours at a time for days in a row.  Training for this might mean forcing yourself to focus and study until a timer goes off, setting goals for covering study materials in a day (and teaching yourself to stick by them), or creating a study schedule for yourself during which you gradually increase your study hour increments. Just like training for a marathon might mean different ways to get to the same goal, so prepping your mind to have the mental endurance and focus for medical school might mean training in different ways for different students.

In addition to training for the long study spells of medical school, just as with marathon training, successful medical students also know how to prepare their minds for short spurts of extra energy demands. Specifically, even though medical school is always a “long run” race, its test weeks and finals periods are more of a time for sprinting. It may just be a sprint to the weekend, but in medical school, even a short two days off can seem like a glorious luxury. How hard is medical school? It’s as hard as a marathon, filled with a requirement for mental endurance but still completely doable if you’ve prepared yourself adequately.

Additionally, it is important to point out exactly what makes medical school so difficult. After all, many premeds are used to a demanding schedule with little time to do much else besides studying. As Brian, a current third year resident explains, “The material you learn in medical school is typically not any harder than what you might have to learn in an organic chemistry class. In fact, a lot of medical school’s concepts are pretty easy to grasp. The difficulty of medical school lies in the amount of material, not in the difficulty level of the concepts presented.”

His statement is something that I really have found true for myself. Medical school’s primary difficulty, at least for myself and for many of my friends, is mostly found in your constant battle against time. Time is needed to cover materials that you need to know. Time is needed to learn everything that you need to understand for your USMLE Step exams; even if material isn’t conceptually difficult, the amount of material still requires you to make good use of your time at all times.

This means that for many students, the major struggle of medical school probably won’t lie in an inability to understand the concepts taught but in a difficulty to manage time wisely in order to allow for adequate time to study all materials. If studying all the time is what you were born to do, then this challenge of medical school probably won’t prove very difficult for you. However, if you’re like the majority of people, you’ll quickly realize that your mind (and body) simply can’t solely study. Your personal health thrives in a lifestyle when you’re active physically and taking times for other activities (like enjoying healthy eating) besides studying. Learning to find a balance between a dedicated study lifestyle and setting aside time for other healthy life choices is arguably one of the hardest challenges faced by medical school students.

While all this discussion of the difficulties of medical school might make it seem overwhelming to think about having to endure it all for a whole four years, medical student hopefuls should take heart. Even though medical school is four years from your white coat ceremony to your graduation day, it isn’t actually four years of focused studying day in and day out. Instead, the most intense years of your medical school studying career are the first two years. Following these first couple of years, most students then take their USMLE Step 1 exam prior to beginning the next half of their medical school experience. This second half of medical school is made up of your “clinical years,” during which the majority of your time is actually spent in a hospital or other clinical settings. These years give students the opportunity to try out most of the major specialties of medicine prior to applying for residencies during their fourth year of school. In fact, for most students, the third year of medical school is the most difficult part of their clinical years—fourth years at most medical schools across the nation allow students more than ample time to travel to interviews and to sometimes take time off prior to graduation and the start of residencies.

What does all of this boil down to? Simply put, medical school is difficult. This difficulty, however, lies primarily in the amount of material—not in the difficulty of said materials. Budgeting your time in medical school, and finding a way to lead a balanced lifestyle is often the hardest part of a medical student’s struggle, but even though medical school lasts for a total of four years, only the first two years of medical school are mostly focused on studying and testing in a traditional classroom environment. As a whole, medical school is challenging, but it’s far from impossible. It’s tough, but it’s doable if you’ve prepared your mind to focus. It’s long, but this focused studying part of it really isn’t as long as it might seem as first. For the dedicated, focused, determined premed student, medical school is just a challenging—but perfectly doable—step on the road to becoming an excellent physician.