First Years

The first part of a year-long series documenting the experiences of

first-year Duke medical students in their quests to don

the white coat and call themselves "doctor."

Some days, they only see one room and the cafeteria from 9 in the morning until 5 at night. Just like students in first grade, the medical students stay at their desks all day and their teachers come to them.

But unlike elementary school classrooms, the first-year classroom for medical students is a tiered amphitheater complete with multiple slide projectors, chairs that swivel and a multi-media editing room where technicians record every lecture and classroom discussion to post on the Internet.

"During the first week, my first feeling all the time was very intimidated," says first-year student Jen Lin, a 2003 Stanford graduate who had transferred from Berkeley after her freshman year because it was too big and too competitive. "My first thought was, 'I'm too young to be doing this.'" She smiles and shrinks back a little in her chair before she admits that even four months into school, she still feels a little wet behind the ears.

It's hard not to be intimidated by Duke Medical School. The classroom is only a few steps from the Duke Hospital South food court, which smells more like Hardee's bacon double cheeseburgers than the antiseptic of most hospitals. Many of Duke's premier physicians eat there at least occasionally--the famous cancer researchers, the chair of medicine, the transplant surgeons--and unlike the real world, where the CEOs are indistinguishable from other well-dressed business people, the doctors wear white coats and nametags, announcing their positions.

The students are unquestionably aware of their presence, but they don't usually eat there. The cafeteria food is too expensive for the majority of students who are cognizant that they are in debt to be there--most brown bag it.

"We're all living on money we don't even have," says Jennifer Reavis, a first-year student who comes across as more serious than most. Reavis graduated from Vanderbilt University in 2000 with a degree in chemical engineering and worked for three years in pharmaceuticals before she realized she missed dealing with people and decided to learn some biology, take the MCAT and become a doctor.

The transition back to school has been difficult for her, she says. "You have more flexibility on an hourly level, but your days and your weeks are far more controlled," she says. But she's quick to add that she doesn't regret her return to academia.

The students are acutely aware of each other too. Before classes started this summer, they all went on a week-long camping trip that is not-to-be-discussed. When it's mentioned, everyone laughs nervously and someone tentatively volunteers, "We definitely bonded."

The community of students is somewhat cloistered. They see each other all day, many of them live together and they socialize together at night. So they know each other well both in class and out of class.

Other than that, so far, medical school feels pretty much just like college.

"It's just a hell of a lot less fun," says Tony Wang, who came straight from Vanderbilt to Duke. "Everything's not so new."

There are still bars on the weekends--specifically Charlie's on Ninth Street where many of the first-years hang out--and occasional mixers with other groups--the undergraduate Delta Gamma sorority has an event planned and earlier this year some med students organized an evening with the nearly-all-female physician's assistant class. A couple of students even say they go out more now than they did in college or when they were working.

Students also still talk about who's dating whom and who's going to break up next. A group of guys keeps a "sketchy list" of classmates with long-distance relationships who they don't think will stay together through the New Year.

"A lot of people just don't break up when they finish college," says Wang, who has his own long-distance girlfriend. "They're with them because they're too stupid or immature to be without them." He maintains that he and his girlfriend are not like that and his friends verify that at the moment, he is not on the list.

In the beginning, even classes are similar to college courses. Molecules and Cells, the first block that ended a week ago, is essentially intensive, condensed cell biology, genetics and biochemistry. There are some case examples, but it's not really medicine yet, which frustrates some students.

"I don't want to be a scientist," says Eric Dziuban, who graduated from Western Michigan University with a degree in biomedical sciences. "What we're doing right now is scientist training."

Because of the structure of Duke's medical school, the students spend only one year studying these basic sciences whereas at other universities, students spend two. That makes the first unit especially a struggle for those who didn't major in biology-related fields. It's doable, but harder.

David Kang majored in music at Davidson College and spent two years doing urology research and filling in pre-med classes after graduation. "I was definitely playing catch-up," he admits. In some ways, that has helped him learn how to pick out what matters, he says. "There are so many details that are interesting but will probably be useless when trying to make a sick person better."

Kang had always wanted to be a doctor growing up but got swept away with piano and voice during college and spent a year pursuing a music career at a conservatory before he returned to college and eventually decided he really did want to be a doctor.

Indeed, everyone who sits in the amphitheater each day really does want to be a doctor. One of the biggest assets of going to Duke medical school rather than a less well known university is that everyone in the room will have a job when he graduates.

Despite medical school's reputation for being cut-throat and competitive, these students are in it together. Then again, the first part of class was pass-fail grading. As of last week, it became pass-fail-honors. Students know that for some, that makes a difference.

"Until now, the s--t hasn't really hit the fan," says Dziuban.