MS1 stands for “Medical Student Year 1,” the first year of a four-year medical school program. It’s the beginning of the preclinical phase, where the focus is almost entirely on learning how the healthy human body works before later years shift to disease, diagnosis, and hands-on patient care. You’ll sometimes see it written as M1, and both terms mean the same thing.
What You Study During MS1
The MS1 curriculum is built around understanding normal human structure and function. Most schools organize the year into organ system blocks, so rather than taking separate courses in each discipline, you learn all the relevant science for one body system at a time. A cardiovascular block, for example, weaves together the anatomy of the heart, how heart cells look under a microscope, how the circulatory system develops in an embryo, the physics of blood flow, and basic drug principles that affect the heart.
The core disciplines threaded through these blocks include gross anatomy, histology (the study of tissues under a microscope), embryology, physiology, biochemistry, cell biology, genetics, neuroscience, and introductory pharmacology. Gross anatomy is the most iconic piece of the first year. Students work in small groups to dissect a human cadaver over several months, mapping out muscles, nerves, organs, and blood vessels in three dimensions. It’s one of the few parts of MS1 that can’t be replicated by a textbook or video.
What a Typical Week Looks Like
A common MS1 schedule places lectures in the morning, typically four 50-minute sessions running from about 8 a.m. to noon with short breaks in between. Afternoons are generally unscheduled, left open for self-directed study, small group activities, or labs. Anatomy lab sessions run roughly two hours and happen every one to two weeks, depending on the block. That open afternoon might sound relaxed on paper, but most students fill it with hours of independent review. The volume of material is the defining challenge of the year: each lecture can introduce dozens of new concepts, and they accumulate fast.
Many schools have moved toward making lectures optional or recording them for later viewing, which means a significant number of MS1 students study from home on their own schedule rather than sitting in a lecture hall every morning. This flexibility is a double-edged sword. It allows you to learn at your own pace, but it also requires serious self-discipline to stay current.
Study Tools Most Students Use
The sheer volume of information has pushed most medical students toward a shared toolkit of digital resources that supplement (or sometimes replace) school-provided materials. Anki, a spaced-repetition flashcard app, is nearly universal. It works by showing you cards at increasing intervals, so you review material right before you’d otherwise forget it. Pre-made Anki decks aligned with popular video series save students from building thousands of cards from scratch.
Beyond flashcards, the most widely used video resources among first-year students are Boards and Beyond (comprehensive topic reviews), Sketchy (which uses memorable visual stories to teach pharmacology, microbiology, and pathology), and Pathoma (focused on disease processes, which becomes more relevant as MS1 transitions into MS2). For anatomy specifically, students often turn to 3D anatomy apps and university-produced atlases alongside their cadaver work. First Aid, a condensed review book originally designed for board exam preparation, serves as a reference throughout the preclinical years.
How MS1 Is Graded
More than 80% of U.S. MD-granting medical schools now use pass/fail grading for preclinical courses, according to data published in JAMA. This is a deliberate shift away from letter grades and class rankings during the first two years. The intent is to reduce cutthroat competition and protect student well-being during an already demanding period. In practical terms, it means your goal during MS1 is to pass your courses and truly learn the material rather than chase a specific GPA.
That said, pass/fail grading hasn’t eliminated academic pressure. It has redirected it. With USMLE Step 1 (the first major national licensing exam) also shifting to pass/fail scoring, students now feel more pressure to build competitive residency applications through other channels. A survey of medical students found that those taking Step 1 under the pass/fail system believed they needed an average of 4.6 research experiences to match into their preferred specialty, compared to 3.4 among students who received a numerical score. The overall perceived importance of research didn’t differ between groups, but first- and second-year students clearly feel the need to do more of it.
Early Clinical Exposure
MS1 is primarily a classroom and lab year, but most schools build in some patient contact early on. At the University of Washington, for instance, first-year students complete at least one community preceptorship: a half-day experience in a community physician’s office where involvement can range from simply observing to taking a patient history or performing parts of a physical exam under supervision. Many schools also use standardized patients, trained actors who simulate medical scenarios so students can begin practicing communication and exam skills in a controlled setting.
These experiences are limited compared to the clinical immersion of the third and fourth years, but they serve an important purpose. They connect the science you’re memorizing to the patients you’ll eventually treat, and they start building comfort with clinical interactions long before clerkships begin.
The White Coat Ceremony
Most MS1 students begin medical school with a White Coat Ceremony, held before any lectures or lab sessions start. During the ceremony, students receive their first short white coat and hear from faculty about the professional and humanitarian responsibilities of medicine. It functions as a rite of passage, formally welcoming new students into the medical profession as apprentice members. The timing is intentional: it marks the point where professional identity formation begins, not at graduation, but on day one.
The Summer Between MS1 and MS2
The summer after first year is one of the few extended breaks in medical training, and most students use it strategically. Research is the most common choice, especially given the growing pressure to build a strong application for residency. The NIH runs a dedicated program called M-SOAR (Medical Student Summer Opportunities to Advance Research) specifically for first-year medical students interested in translational research. It’s a full-time, 40-hour-per-week position within an NIH research lab, and it includes mentorship and professional development alongside the bench work. Similar research fellowships exist at individual medical schools and academic medical centers across the country.
Other students use the summer for clinical volunteering, global health experiences, or simply recharging before the second year, which typically ramps up in intensity as the curriculum shifts from normal body function to disease processes.
Common Challenges During MS1
The first year of medical school has a relatively low attrition rate. One six-cohort study found that 5.7% of students left their program overall, and broader analyses put the average around 11% across all four years, not just the first. Outright academic failure is uncommon, but the struggles that lead to it are not. In one retrospective study, 55.7% of students who eventually left had documented academic difficulty, 40% had psychological illness (including depression, anxiety, and stress-related conditions), 30% had significant absenteeism, and 20% experienced social isolation. Researchers noted recurring themes of isolation, failure, and despair among students who struggled, and acknowledged that psychological symptoms were likely underreported.
The transition into MS1 is jarring for many students because the strategies that worked in undergraduate courses often don’t scale to the volume of medical school material. Passive reading and re-reading, for example, is far less effective than active recall methods like flashcards and practice questions. Students who recognize this early and adapt their study habits tend to find their footing faster. The pass/fail grading system helps buffer some of the stress, but the internal pressure to master an enormous body of knowledge in a short time is a constant feature of the year.