Life after the Step

July 28, 2012

Hey guys!  Greetings from the other, other side!  I feel like the weight of the world has been lifted from my shoulders!  I went and took my Step I this past Monday and am soooo glad it’s over.  It gets so tiring feeling guilty (for 3 months) when you’re doing anything other than studying–it’s nice to have a normal life (even if it’s only for a few weeks) now.

What can I tell you about the Step?  Well, I think there are a lot of patrol dogs out there looking for people giving out USMLE secrets so they can void their scores, so I’ll avoid talking about the subject matter, but will say that overall I found the test very approachable and wasn’t frightened off by any “out-there” questions where I had no idea what the test was trying to get at.  Actually, I thought the comp shelf was harder–that might have been because I didn’t study as much for it, but then again, I only spent a month doing U-World for the Step after taking 2 months leisurely reading First Aid and a couple of the Kaplan books (Path and Pharm) during my workouts–not exactly strenuous.  It goes to show you, just like back on the island, you SHOULD NOT listen to your peers and feel pressured to study as much or as little as them.  I know it’s a competitive environment, but what works for them might not work for you or might be too much content or too fast for you.  I’m glad I didn’t overstudy and get to the point where I was burnt out the week before my test and couldn’t go near a book.  Pace yourself.  Also, don’t let anyone tell you that last-minute studying is a waste of time and you won’t remember anything from it.  There are many professors I’ve had–and respected–who looked down upon “cramming” before the exam but I’ll be honest and say that there were a couple of questions that wouldn’t have been so easy for me had I not reviewed their subject material mere hours before the exam.  It’s never too late.

Now that the step is over, I am feeling a void where the drive to go study for the step used to be.  I have been watching Fringe and the Olympics,  and playing Tetris Attack and Backgammon online (simultaneously with TV–can’t NOT multitask) just to keep my mind occupied, but meanwhile have ordered a variety of books on clinicals to begin reading if they’ll ever get here!  (I’m still trying to regain my patience…obviously.)  I picked up a course on Medical Spanish from a local bookstore a LONG time ago that I might start, as it seems like something useful to do with down time before I go to the wards.  Meanwhile, I started back on my diet after taking a week’s break for the test.  My temporary reunion with carbs was wonderful–I miss them already.  I also took a week off from the gym, so I’ll start back at that tomorrow.  The local agricultural fair is about 2 weeks away; I’ve been spending some time over at the fairgrounds helping to get everything cleaned up and ready.  I think my Dad was really surprised that I jumped in and volunteered to do manual labor and clean–I, admittedly, can act a bit like an entitled Diva at home–when given the choice between doing a set of practice questions or dishes, which would you pick?  Anyway, that work is exhausting but very fulfilling and hopefully we’ll have a great fair this year.

Will keep in touch when I have more news to share–just waiting right now.  Scores will be back in T-19 days!

Hi Ya’ll

July 13, 2012

Well, it’s been almost a month.  I’ve kicked my butt into shape and have been studying on a much more regular basis.  I think getting to the point where you do only practice questions as your main method of study requires a completely different frame of mind.  I came home with the intention of going through Kaplan (since I’m too cheap to go take a $5000 review course) so I gave myself a month and a half to “get into it” and it never really happened.  You sit there passively watching the videos and reading the text but there isn’t really a challenge to it and it gets boring quickly.  Soon domestic chores like cooking, dishes, and car washing become much more interesting and studying takes the back burner.  I did some Kaplan Qbank questions at the same time, but they were really detailed and were on stuff that I knew I’d learned, but was too tired to review.  So other than reading Kaplan books at the gym while working out (and had no other opportunity for distractions), I stopped studying for a good long while.  It wasn’t until I got my test date that I realized I really needed to start studying unless I wanted to end up fighting for a loser clinicals spot in some big city with gang problems, that I probably couldn’t afford to live in.

Since my awakening, I bought a month’s subscription to UWorld–I’m a glutton for punishment–it’s the Qbank everyone said was the most difficult, and I’ve actually been doing ok so far.  I don’t think the questions arethat difficult–not for the amount of whining people did while we were still on the island, particularly when those questions found their way onto our regular exams in class.  There are a few questions every now and then that are obviously trick questions (55% of people choose the wrong answer and like 13% choose the right answer) that you’d expect to see on one of our nitpicky path exams, but you look at the explanation, realize they’re trick questions and comfort yourself with the knowledge that the USMLE people don’t play that way and if they do, questions like that will likely be thrown out. 

The Dean of clinicals recommended that we get to a point where we’re doing 200 questions daily and where we do like…5 or 6 mock exams before the big day.  That seemed like a reasonable penance to me back when I wasn’t really studying that much, but now that I’ve gotten into the habit of doing daily questions, I realize that’s completely unrealistic and find myself completing between 75 and 125 questions daily.  But then again, questions are more of a process for me–I’ll do a block of questions, then take double the time going back through them and reading the explanations for all of the answer choices (even if I got the question right) to make sure that I know the background information, then I keep a notebook of facts that I’ve either never learned before or things that are really important that I’ve forgotten.*  I think it’s easy to get into a state of panic when doing questions, especially if you have a bad block and get many of them wrong, because you think of all these things you’re supposed to remember that you’ve forgotten and it quickly becomes overwhelming, BUT if you’ve got a notebook, where you write those facts down and you know they’re safely tucked away but easily accessible, then if you can’t remember a particular fact at that very moment, who cares?  You just make a mental note to review it in your fact notebook and you’re fine.  Best idea ever.  Really helps to deal with the anxiety.  The key, of course, to this notebook is that you review it so that these new little bits of information you acquire start to stick in your head.  I take it with me to the gym every day instead of my Kaplan books and reread my notes.  My accuracy percentage is increasing. 

*One thing I have noticed as I’m doing questions–and I’m sure this is common across the board for Caribbean medical students–is that I’m often second-guessing my education–rather I’ll come to a question and if I don’t immediately recognize something in the vignette, I’m quick to assume (FALSELY) it’s because it’s something new or cutting-edge that was not covered in my** education on the island.  **I DO NOT THINK MY MED SCHOOL EXPERIENCE AND EDUCATION WAS SUB-PAR!  It’s just that I think many of us have a chip on our shoulder or some doubt in our gut because we went to such well-known undergrad schools, but then ended up down at the “bottom-of-the-barrel” in terms of medical schools [ACCORDING TO THE REST OF THE US] that we often worry that we’ve missed out on learning something from a US med school.  I know this is just a misconception–most US schools have less lecture hours than we do, and really only differ in that they start clinical experiences earlier and many of them now have a research requirement for graduation.  Maybe I’m alone on this misconception, but my point is that I’ll find myself fatigued and about to make a flippant guess on a question when I see something unfamiliar, but that most of the time, if I’ll reread the vignette or definitely when I get to the explanation after the test was over, I’m like ‘oh…crap, yeah I did learn that.’

In a way, I wish I would have started this system earlier, but then at the same time, I know that back in April and May, when I didn’t have a test date even remotely in sight, I wouldn’t have had the motivation to continue studying like I do now.  I took a mock exam from UWorld before I started doing questions so I’d have a baseline and to see how my knowledge has changed since the leaving the island (and regular scholastic activity).  Not surprisingly, my score had decreased since my last mock exam in January (with Kaplan).  (I never checked to see what my comp score equated to in terms of USMLE scores, so I can’t compare it to that.)  That was sad–it was only a 10-point drop, but it was sorta expected and made me feel a bit guilty.  But on the happier side of things, based on my percentage of correct UWorld questions so far, I’m right back where I need to be.  (