Step 1 study update

by Lorien E. Menhennett

FirstAid is the ultimate review book for USMLE Step 1 (USMLE = United States Medical Licensing Examination). I’ve defaced my copy to read “USMILE.” I may not always feel like smiling when I see this book, but this helps with my attitude.

It’s been about three weeks since I’ve written here. During that short time, I feel like I’ve been teetering on the edge of a black hole. I know my fellow classmates are feeling it. Doctors and residents have confirmed it too. Studying for the USMLE Step 1, the first of my board exams, is a soul-crushing process.

There is an inhuman (and therefore impossible) amount of material to memorize. Much of what is to be memorized has little relevance to patient care. And the questions are anything but straightforward. Half the time, the question stem gives you the diagnosis, sometimes the treatment too. That’s not the mystery. The mystery is which interleukin / exotoxin / antibody / enzyme (or other obscure item) is implicated in the disease process at hand.

I’ve been doing this all day, six days a week, for four weeks now. Every day is a struggle. It’s a struggle to maintain focus and motivation, but also to maintain a sense of purpose — why I’m doing this in the first place. Sure, I need to pass this test. But that’s not the end game. The goal here is becoming a physician, and this exam is simply one in a long series of hurdles to get there.

I’ve written positive statements on the dry erase board next to my desk. They’re good reminders when I feel discouraged.

I do what I can to keep myself healthy in mind, body, and spirit. I eat well and exercise regularly. I spend time (on the phone and in person) with people I love. When I’m tired, I take a nap. I take every Sunday off.

In less than two weeks, studying for Step 1 will be a part of my past. I look forward to that day. In the meantime, I know there are things to learn from this excruciating process. Not just about medicine, but about life in general. And those life lessons will last far beyond the memory of anything I’ve memorized for this test.

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