Fourth Year Best Year? An Exposé

As my time as a medical student winds down, I’m looking back at fourth year and thinking about all the things that I thought it would be and all the things that it ended up being.

Many of you are familiar with the term “fourth year best year” and we’ve all seen medical students living their best lives during their last few months of school…and I can remember how excited I was last year at this time thinking about how good life would be when I finally became a fourth year! I had all these plans and ideas of how amazingly smooth things would go and then…they didn’t. A few months ago a good friend of mine said “I’m starting to think they were saying ‘fourth year stressed year’ and we just miss heard them” and that really hit home for me…and a few other people that I knew too.

I’m not saying that this year wasn’t amazing and didn’t come with its blessings. I’m just saying that my reality was far from the fairytale that is often projected on Instagram and the likes.

Life in the Hospital

One of the greatest things about fourth year was actually KNOWING what I was doing in the hospital. You’ve gotten the hang of writing notes, talking to nurses, and interviewing patients. It’s a great feeling to be (almost) a doctor. In this time, however, it is important to remember what it felt like to be a third year and so when you see an underclassman walking around the hospital, lost as can be, be sure to reach out and help them in any way that you can. Don’t be arrogant though. You’re not their attending. You’re not anyone’s attending. I know that I don’t and will never know everything.

Board Exams

What I thought: Studying for Level 2 would be so much easier than studying for Level 1.

My Reality: Nope! I had to relearn how to learn. I fell into the trap of using videos to regurgitate information and not using enough questions and vignettes to study and test my knowledge. I would advise anyone going into Level/Step 2 to take a step back, even before scheduling the exam, to reevaluate how you learn and how you test. Then…dive head first. I ultimately used Mastering the Boards and UWorld as my study tools and it did pay off.

Another thing…if you don’t meet surpass your Level/Step 1 score by a specific margin…know that it is OKAY! You are more than your scores. Don’t let what you see online get you down. More on that later.


What I Thought: I’m going to get all the auditions and be up to my neck in interviews.

My Reality: Almost all of my audition rotations fell through and I actually only ended up doing two (which is still good) but I definitely didn’t see my fourth year scheduling going the way that it did. In the end, I saved a lot of money and, looking back, I’m okay with not doing more away rotations because everything did work out.

I’d be lying if I said that the feeling of rejection didn’t HURT at the moment, though. One of the hardest things to read is a “we regret to inform you that we will not be offering you an interview” email at 6:25 in the morning as you’re brushing your teeth and getting ready to start your day. It’s a hard hit in the stomach and sometimes it makes you want to cry. But you’re tough…medical school has made you tough…so you brush your shoulders off and keep going. There is a light at the end of the tunnel.

My Relationships

One of the least talked about aspects of fourth year, and medical school, in general, is the strain that it puts on your relationships. Friends. Family. Significant others. Sometimes the stress of school/work/applications gets so heavy that you isolate yourself from the people that love you the most.

For me, there were points in this year when I didn’t answer the phone for my parents, best friends, and even Gage because I felt like a failure and because I felt unworthy of love. It is so easy to place OUR personal value in the process of the Match and I began to lose myself. I’m so grateful for the people in my life that didn’t let me slip too far. They reminded me of all the good things around me and in me.

If you feel that you are slipping, during any year of medical school, please reach out to someone. You are beautiful, intelligent, and worth it.

My relationship with my fiancé was probably the most complex. Anyone with a medical school sweetheart can probably relate. He’s my best friend. He’s my lover. But he’s also my classmate. His triumphs made me happy but then his low points also wore on me…on top of my own lows. The same was true for him. There were times when I was frustrated and crying and I’d look over at him and I’d see how much my hurt was affecting him. It was as if we were trying to carry each other as we were trying to figure it out for ourselves at the same time. This is stressful on any relationship.

We, of course, made it. Gage is my superhero and he’s the strongest man I know and I’m so grateful that he’s a part of my support unit, along with the best parents and the best sister that a medical student could ask for.

Read about medical school blues –> HERE!

Read about maintaining relationships in medical school –> HERE!

Couples Matching

What I Thought: Easy Peasy! Going for the same program. They’ll love us both!

My Reality: Gage was a MUCH better applicant on paper. We were both going for pediatrics and it was at times so hard to see and feel that programs “liked him better” than they did me. I even asked him many times if he wanted to leave me by the wayside (and forget about couples matching) because I really felt like I was holding him back…fast forward to Match Day and I now see that it was all in my head.

Instagram vs Reality

I think this is where the meat of the “fourth year best year” lies. We all share our best moments on Instagram…don’t get me wrong…I do it too. I share when I’m on top and when I’m smiling and when I feel good about myself. But the reality is that that isn’t my daily experience. Whenever I talk to pre-meds or medical students who are coming up behind me, I always make sure to emphasize that life as a medical student is hard. There are lots of bloggers who make it seem like its fun and fantastic without ever showcasing the harsh reality that sometimes what’s going on can and will bring you to tears. I strive to be 100% real with you guys whenever you message me or comment on one of my posts.

I struggled with sadness and let-downs every step of the way in medical school…the reality is most of us deal with imposter syndrome, loneliness, self-doubt, and a desire to just flat out quit at some point(s) during medical school. I had a few moments like that…even during this year. Getting rejected for interviews…comparing myself to other applicants…feeling like I was dragging my fiancé down…it was hard!

My call to other medical bloggers is that we all showcase the good, bad, AND the ugly that comes with the territory. I love sharing the good moments in my life but I know that whenever I share my not-so-good days it speaks to people who may be having down days and it lets them know that they aren’t alone.



I just want to make sure that you all know that I’m good! : ) I love my life and wouldn’t trade it, or this up and down journey, for anything in the world. This year has been every and anything. But I am blessed. I count it a blessing that I will be able to do what I’ve always wanted to do…I get to be an advocate for patients and their families…I get to doctor. And even on my sad days, I thank God that I get to do what I get to do. Fourth year may not have been my “best” year but it was still good.

Before I go I want to leave you with a quote that I kept with me throughout this year to encourage me and uplift me when I had my ups and downs. “When you stumble make it a part of the dance.” And your dance is beautiful.

Feel free to like, comment, share, and follow. I love hearing from you guys…I hope 2019 is going amazing for all of you. And if it’s not, know that I am always here for you. I love you guys! I’ll see you really soon. XX!

P.S. I’ve updated my Personal Statements Page to include my Residency Application PS in case anyone needs an example of what to write in these next few months. XX!

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