You’re a first year medical student. Eight hours a day you sit in your seat listening to the various doctors trying to teach you about autonomic nervous system ganglia. Sometimes its physicians with receding hairlines and boring stories of rare “zebras,” and sometimes it’s PhD’s with esoteric and insanely specific special interests. You can’t decide which one is worse, so you try to focus on something more interesting. Your thoughts go to the date out at the local bar you have planned with the attractive blonde in the fourth row of the lecture hall on the left (They’re always more attractive in the fourth row on the left, just a rule of medical school). You’re thinking about your chances to turn this low key trip to MacLaren’s pub might turn into something legendary, maybe even the first sparks of a relationship. You’re not thinking about that question on how to treat organophosphate toxicity, the one which will show up on the test for sure. By the way, the answer is atropine sulfate and pralidoxime (2-PAM). You can thank me later.
Now you’re a third year medical student. You finally managed to scrape together enough time to spend some personal time with your significant other this month. Surgery has made you firebomb nearly your entire social life, except for your partner. You are excited to meet them back at MacLaren’s where you had that first low-key hang out that lead to what seemed like a bulletproof relationship. So many people have told you what a gamble relationship in the same school can be. One person even made a joke about it being better to open a restaurant since those only have a 50% failure rate. But what do they know? You think this to yourself the whole time you’re at the bar: while you’re having the unexpected argument with your partner, while they are yelling at you that you no longer give them the time that you used to, while they say that you’ve both changed too much, while they walk out of your life. Of course, they didn’t really walk out of your life. You’ll see them tomorrow at the surgery suite while you finish the second month of your rotation. You’ll also see them for the next two months after that for internal medicine. The school’s policy on changing rotation sites is pretty strict about not being able to rotate at different sites even if you don’t really want to spend every waking hour at the hospital working in the same service as your ex.
There is an underreported epidemic in medical school of students on a highly risky practice called “dating.” And I’m not here to tell you to give up on your dreams of finding Mr. Right in your class, nor Ms. Right Now at a histology microscope. But just like your RA hopefully warned you in undergrad, you don’t necessarily want to have relationships of any kind in situations where you’ll see the person every day if you break up. They called it “floorcest” back then and it was the principle that you remain solely platonic with everyone on the same dorm floor as you, so there is no friction if things go sour. I guess the logical conclusion is to extend the principle to anyone in your lecture hall in the pre-clinical years, and your specific rotations in clinical years. We’ll call it “medcest” so it retains that cringe-inducing ring to it.
There are all sorts of emotional pleas for why people will do this, I’ll let amorous anatomy partners defend themselves; I’m going to focus on why you should perhaps think twice about it. It goes far beyond the simple ‘you’ll see them every day’ argument that was used in undergrad. Most people feel that medical schools would be qualified as “doctorate education”, which is very hard to argue against given the name of the degree you earn. I argue that medical school is instead an ‘occupational school’ of the highest educational caliber. If you view medical school as training you directly for an occupation, which it certainly is, you can begin to realize that any bridge you burn is a potential lost opportunity in the future. The people you learn with now are some of the best resources for helping you accomplish the true team art of medicine. Even if you don’t go on to work with these people at all, study resources, connections in other cities, references, and research assistance are all so vital throughout medical school and practice that it is nothing short of a sin to lose those resources over anything.
Furthermore medical school is insanely insular and there are no secrets among anyone. If you think no one knows, you’re wrong. If you think no one cares, you’re the talk of the class and you’re wrong. The students who choose not to partake in medcest all find your little foray into it much more entertaining than the most common lab finding in Chronic Granulomatous Disease. Even if this person doesn’t know you from a hole in a wall, eventually word will get around just because human nature is to marvel at stuff like this and, in some shameful corner of their being, hope that if it becomes a train wreck breakup they get to see it. Everyone hears the gossip and eventually will choose sides. I once had a doctor make an inside joke to a group of students, none of which talk to her, about the students’ mutual friend not being able to throw a proper punch and earning himself a bar room fracture. When the school doctors know the status of your 5th metacarpal and who the proper people to joke about it with are, you can be sure that everyone knows about, and has an opinion on, your relationship no matter how open or secret you are about it. What happens if you break up with your significant other over a ‘miscommunication’ or other, often inflammatory, situation? Not only will you have angered your previous flame, you will have the story of your actions and/or misdeeds run the rounds through the whole school. Forget losing out on opportunities with one person and burning bridges, you’re potentially napalming the whole countryside now.
There is also a small chance that you may become a bit of a repeat offender. If you somehow escape from one in-school relationship relatively unscathed you may be tempted to simply move onto the next opportunity. This is a poor idea. I know plenty of people, myself included, that liked a particular “type” of person and would keep dating within one large social circle where people had that “type” in common. That didn’t work out well for anyone in undergrad. I feel like this goes without saying that serial dating in medical school is, perhaps, even worse and exponentially raises the odds of a bad outcome. The only thing worse than having the other 100 people in your class know all about your personal life and potentially judge you, is let them keep that judgment ammunition to shoot holes in your next attempt at medcest. There are reputation factors: where dating around your class may earn you titles that are less than complimentary. Simply put, if I have to enumerate out all of the reasons why serially dating people within your own class is a terrible idea, perhaps it would be more entertaining to simply let you try it and find out first hand.
Of course, love is a force you can’t resist; or so I’m told by the RnB music industry. If you truly fall head over heels for the girl who chews her highlighter in that sexy way in row 7 seat 2, or the guy in the library who wrote you a love sonnet about the wheal and flare reaction, who am I to stop you? Your friends, they should be the ones to stop you. If you friends fail in their duties to convince you to avoid this huge gamble, and my warnings on the risks don’t stop you from trying, then I wish you the best of luck. Relationships can be a beautiful thing, and I have seen one or two nice ones come out of the medical school chaos. I have simply seen many more train wrecks and horror stories. I just want to do my part to bring awareness to the under-reported epidemic of medcest.