Welcome to Wash U, and to the wonderful city of St. Louis. First and foremost, enjoy every minute of your preclinical years. Don’t get too wound up in classes — they are pass/fail and matter very little in the grand scheme of things. Instead, frequent the numerous establishments around the Central West End, the Loop, on Washington Ave, and in the Grove. Spend time in Forest Park and stock up on sleep.
If you do want things to worry about, here they are in order of importance: building relationships with mentors, Step 1, and research. Many new med students stress about picking a specialty, but it’s not a hard commitment at this stage. Choose one or two things that you think you may want to do, and just go for it. Identify a few faculty members in those specialties, voice your interest to them, and work with them consistently throughout your time here. They will help you get what you need to do well, and will be your strongest advocates when the time comes. If you decide to switch specialties later on, the transition is smoother than you may think, and your mentors will support you regardless. Finally, find mentors who are current residents as well. They were just in your shoes and will be happy to spend time with you to get you into their fields.