Starting the pre-med track is one of those experiences that looks completely different from the inside than it does from the outside. From the outside, it seems straightforward: take the right classes, get good grades, check the boxes, get into medical school. From the inside, it is a relentless series of decisions, trade-offs, surprises, and moments where nobody tells you what you actually need to know until it is too late. Here are five things I wish someone had told me before I started.
1. AP® credit is more complicated than you think
In high school, I loaded up on AP® courses because I thought earning college credit would give me a head start. And for some courses, it does. AP® English, AP® History, AP® Calculus, and other non-science AP® credits can save you time and tuition in college by fulfilling general education requirements. But AP® credit for pre-med science courses (biology, chemistry, physics) is a different story. Many medical schools do not accept AP® credit as a substitute for the prerequisite courses they require. Even if your college grants you credit and allows you to skip introductory biology or general chemistry, medical schools may still expect you to take those courses at the college level. Some schools explicitly state that AP® credit does not satisfy their prerequisites. Others accept it but recommend that you take additional upper-level courses in the same subject to demonstrate competence.
The practical advice: take the AP® science exams (the knowledge helps regardless), but do not plan to skip the introductory college science courses unless you have confirmed with the specific medical schools you are targeting that they accept AP® credit for those prerequisites. When in doubt, take the college course. The MCAT® tests the material covered in introductory biology, general chemistry, organic chemistry, biochemistry, physics, psychology, and sociology, and you need a strong foundation in each of these subjects regardless of how many AP® exams you passed. See our AP® and IB courses page for detailed guidance.
2. Your major does not matter as much as you think
I spent weeks agonizing over whether to major in biology, biochemistry, chemistry, or something else entirely. Here is what I wish someone had told me: medical schools do not care what your major is. They care that you complete the prerequisite courses (biology, general chemistry, organic chemistry, biochemistry, physics, math, English, psychology, and sociology), earn competitive grades in those courses, score well on the MCAT®, and build a compelling application with clinical experience, research, service, and leadership. You can do all of that as a biology major, an English major, a music major, or an engineering major. The prerequisite courses are the same regardless of your major.
Choosing a major you genuinely enjoy has practical advantages: you are more likely to earn higher grades in courses that interest you, you develop expertise that differentiates you from the thousands of biology majors in the applicant pool, and you have a backup career path if you decide medicine is not the right fit. See our choosing a major page.
3. Clinical experience is not optional, and you need to start early
I knew that medical schools wanted clinical experience, but I underestimated how much and how early you need to start building it. By the time you apply to medical school (typically the summer after your junior year of college), admissions committees want to see sustained, meaningful clinical experience, not a few weeks of hospital volunteering the summer before you apply. The strongest applicants have accumulated hundreds to thousands of hours of direct patient interaction over multiple years. EMT certification is one of the best ways to build clinical experience starting in high school (see our EMT career page). Medical assisting, scribing, CNA work, and clinical research coordinator positions are also valuable. The key is to start early and maintain your clinical involvement consistently throughout your pre-med years, not to cram it in at the last minute.
4. The MCAT® is a bigger deal than you expect
Everyone told me the MCAT® was important. Nobody told me how important, or how different it is from any exam you take in college. The MCAT® is a 7.5-hour standardized exam that tests your knowledge of biology, chemistry, physics, biochemistry, psychology, sociology, and critical reading. It is scored on a scale of 472 to 528, with a median of 500 and a competitive score of approximately 510 or higher for most MD programs. The exam does not just test memorization; it tests your ability to apply scientific concepts to novel scenarios, analyze experimental data, and reason through complex passages under time pressure. Most students need 3 to 6 months of dedicated preparation to score competitively. This is not a test you can study for over a weekend. Plan your preparation timeline carefully, use official AAMC® practice materials (they are the gold standard and many are free), and consider taking the exam after you have completed organic chemistry and biochemistry. See our MCAT® prep guide.
5. Taking care of yourself is not optional
Pre-med culture glorifies overwork. Students brag about sleeping four hours, studying through meals, and sacrificing every hobby, friendship, and moment of rest on the altar of a competitive application. This culture is toxic, and it does not produce better doctors. It produces burned-out students who arrive at medical school already depleted. The research is clear: chronic sleep deprivation impairs memory, cognitive function, and academic performance. Students who maintain regular exercise, adequate sleep, social connections, and stress management practices perform better academically and are more resilient in the face of setbacks.
Taking care of yourself is not a luxury you earn after you get accepted. It is a skill you practice now that will sustain you through the decades of demanding work ahead. Build exercise into your routine. Protect your sleep. Maintain friendships outside of pre-med. Find a hobby that has nothing to do with medicine. And if you are struggling with your mental health, seek support (your college counseling center is a good starting point, and it is usually free). See our wellness and mental health page. The students who last in medicine are the ones who learn to take care of themselves along the way, not the ones who sacrifice everything to get in.
