“The worst men often give the best advice.” -Francis Bacon

The beginning of a new academic year seems to be the right time to give advice. I will attempt to dispense what little advice I now possess. Giving advice about monumental efforts like the first two years of medical school makes me reflect on memories of other times of strife and supreme effort. I remember holding a fragment of an explosive that killed a friend, extracted from that person in an attempt to save their life. I remember turning a rejection letter over and over again in my hands. I recall falling asleep, lulled by the sound of a pair of friends, soon to be ex-lovers, arguing in the next room, heard as murmurs in my ears. In the back of your mind you know that the experience is going to leave a mark. But you still survive, you are still strong, and you will persevere. You will excel.

To the first year medical students, you are entering into a wonderful opportunity to swim in the wealth of biomedical knowledge circa 2011. A host of dedicated and talented teachers will be focused on imparting to you the best of medical educations. Take advantage of their talents and honor them with your hard work. Some of you will do well on exams; some of you will just scrape by, the honor and dishonor of both paths is illusionary and transitory. However, the energy and strength that you bring to this year will define your life to yourself, your peers, and to your profession. Do not waste it. You will not have this chance again. As Rudyard Kipling said, “Fill the unforgiving minute with sixty seconds worth of distance run.” And for the Love of God, learn the Brachial Plexus.

Next, to the second year medical students, you have filled your toolboxes of medicine and now is the time to learn how to use those tools. More importantly, this is the time to learn how to learn. You will need to learn rapidly, efficiently, and without anyone keeping you accountable. Use this time to refine your work ethic and find the tools to absorb the vast quantities of detail that will enable you to effectively work in medicine. This year you will balance learning the practical aspects of medicine with being able to demonstrate your basic biomedical science knowledge on what will likely be the biggest test of your career, Part 1 of the USMLE. Year 1 was learning the grammar of the language of medicine and now you are learning to use and master that language. Do not fall into the “High Yield” trap, (I know, funny to hear that from me, the Master of High Yield) but use “High Yield” to give your brain and memory handles to grasp detail and put it into context. And for the Love of God, learn the Brachial Plexus.

In the end however, I’m afraid I feel a little bit like a famous author (David Foster Wallace) who wrote back to an aspiring writer: “Thank you for your nice letter. I'm sorry that I have no words of wisdom or inspiration. I get sad and scared too. I think maybe its part of the natural price of wanting to do this kind of work. I wish you well.“ But trust me on the Brachial Plexus. (Forgive the references to the structure of North American medical education.)