doc w/ Pen

journalist + medical student + artist

Tag: step 1

Step 1 study update

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.

Recharged and ready to go after winter break

Playing with my dad's cats, Regina and Ismael, was such a treat.

Playing with my dad’s cats, Regina and Ismael, was such a treat.

It’s always hard to get back into the swing of things after vacation. As I got up this morning, inwardly I groaned, thinking about the weeks of intense studying that lie ahead. (I’ve been studying for only five days so far, and already I’m exhausted … only five weeks to go.) But looking back on some of the wonderful memories made over the two weeks I was in Chicago raised my spirits:

  • Spending much-needed time with my parents, sisters, and future brother-in-law. We talked, laughed, ate, drank, played cards, watched movies. I only wish we could do it more often. But since we can’t, our time together is all the more precious.
  • Visiting with some (but not all) of my lovely Chicago-area friends — what a treat!
  • Going to the Garfield Park Conservatory to get a chlorophyll hit as winter raged outside.
  • Watching a Blackhwaks game at the United Center. The Blackhawks lost, but did score so we got to do the goal dance thing. If you’ve been to a Hawks game, you know what I’m talking about.
  • Reading a whole novel — I hadn’t read for fun in months and months.
  • Seeing Rogue One in 3-D IMAX (I hadn’t been in a theater in ages) and then following that up with three more Star Wars movies over the next two weeks in my dad’s man cave.
  • Driving a car.
  • Creating things with my hands.
  • Eating Lou Malnati’s deep dish pizza not once, but twice — giardiniera and sausage, yum.
  • Playing with my dad’s two cats.

These next five weeks, post-vacation, will be intense as I study for my board exam. But this two-week break was exactly what I needed to recharge after such an intense semester. This time off put me in a better frame of mind to start my study period.

I’m ready. Bring it on.

Practice makes better

In about two months, I take the USMLE Step 1, the first of my board examinations. Yesterday, I took an abbreviated practice exam in our main lecture hall with my classmates. This was not by choice — it was a mandated exercise. And I took it begrudgingly.

I plan to study full time for five weeks for the real exam. At this point, I haven’t studied at all. What I have done, though, is plow through three semesters of medical school. While I’m in no way ready to take Step 1 now, the practice exam didn’t have the demoralizing effect I expected. First of all, I remembered more than I thought I would. That suggests that if I do apply myself during my study period, I will be ok. The level of detail required, though, reminded me how much I do have to review. And my difficulty in sitting through even an abbreviated exam reminded me that I need to build test-taking stamina to make it through the real deal.

So as much as I griped about this, I’m glad to have taken it. I know I have my work cut out for me. But I’ll be trying to work through those five weeks of studying with a mindset of calm, not panic.

Repurposing old rules for a new test

Words to live by -- and take a test by.

Words to live by — and take a test by.

Becoming a physician tests you. Your intellect, patience, determination, resolve, and inner strength. Your humanity. This testing happens every day — in the classroom, in the clinic, in the hospital. Part of this process also occurs during actual multiple-choice tests.

More than three years ago, on May 23, 2013, I took the MCAT — the gate-keeper exam for entering medical school. A little over four months from now, on Feb. 10, 2017, I take the next exam in this sequence toward earning my M.D. — the USMLE Step 1 board exam. It’s an 8-hour test, with more than 250 questions probing “whether you understand and can apply important concepts of the sciences basic to the practice of medicine, with special emphasis on principles and mechanisms underlying health, disease, and modes of therapy,” according to the official United States Medical Licensing Examination website.

The stakes are high — I have to pass this exam to move forward. But focusing my thoughts and energy on how high those stakes are is a sure path to test anxiety. After classes end on Dec. 16, I have until my exam date to prepare (minus a trip to Chicago to see my family for Christmas). That’s plenty of time to review and solidify my understanding. It’s a matter of perspective, and directive. Which is why I think it’s time to repurpose the “rules” I developed for the MCAT. They apply here too.

Lorien’s USMLE Step 1 rules:

1. Take a breath.
2. Trust your gut.
3. Take this seriously.
4. Focus.
5. Maintain tempo.
6. Think NOW – not ahead, and not behind.
7. Read every word carefully: passages, questions, and answer choices.
8. Eliminate wrong answers.
9. Estimate.
10. Guess and move on after the allotted time.
11. Keep calm and carry on.
12. Think positive, not negative thoughts.
13. Channel confidence, not fear or doubt.